bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective evaluation of EUS-guided fine needle biopsy in pancreatic mass lesions
Authors: Larsen M. , Fristrup C. , Detlefsen S. , Mortensen M. 
Published: February 2018

Abstract
Background and study aim Due to the scarcity of specific data on endoscopic ultrasound (EUS)-guided fine-needle biopsies (SharkCore) FNB in the evaluation of pancreatic lesions, we performed a prospective study of the diagnostic performance of EUS SharkCore FNB in patients with pancreatic lesions. The aim of this study was to evaluate the diagnostic accuracy.
Patients and methods Single-center prospective study of 41 consecutive patients referred for EUS-FNB from October 2015 to April 2016 at our center. EUS-FNB was obtained in a predefined setting regarding the procedure and pathological evaluation. Data regarding demographics, lesion, technical parameters, and diagnostic accuracy were obtained.
Results The study included 41 consecutive patients (22 males (54 %); median age 68 years). The average size of the lesions was 28 mm (median: 30 mm). A diagnostic specimen was identified in 40 (98 %) cases during microscopy with an average of 2.4 passes. The route was trans-duodenal in 20 cases (49 %). The histological diagnosis of the specimens was malignant in 29 cases (71 %), benign in 8 (20 %), suspicious in 2 (5 %), atypical in 1 (2 %) and in 1 (2 %) no material for microscopic evaluation was obtained. This led to a diagnostic accuracy of 93 %, sensitivity of 91 % and a specificity of 100 %. 2 cases (5 %) of self-limiting bleeding were observed. The diagnosis at follow up was malignant in 32 (78 %) of the patients.
Conclusions EUS-FNB of pancreatic mass lesions with the SharkCore needle produced specimens with a diagnostic accuracy of 93 %. The procedure was safe and easy to perform, and these data support the use of EUS-FNB in a routine setting.
Usefulness of a multifunctional snare designed for colorectal hybrid endoscopic submucosal dissection (with video)
Authors: Ohata Ken , Muramoto Takashi , Minato Yohei , Chiba Hideyuki , Sakai Eiji , Matsuhashi Nobuyuki 
Published: February 2018

AbstractSince colorectal endoscopic submucosal dissection (ESD) remains technically difficult, hybrid ESD was developed as an alternative therapeutic option to achieve en bloc resection of relatively large lesions. In this feasibility study, we evaluated the safety and efficacy of hybrid colorectal ESD using a newly developed multifunctional snare. From June to August 2016, we prospectively enrolled 10 consecutive patients with non-pedunculated intramucosal colorectal tumors 20 – 30 mm in diameter. All of the hybrid ESD steps were performed using the “SOUTEN” snare. The knob-shaped tip attached to the loop top helps to stabilize the needle-knife, making it less likely to slip during circumferential incision and enables partial submucosal dissection. All of the lesions were curatively resected by hybrid ESD, with a short mean procedure time (16.1 ± 4.8 minutes). The mean diameters of the resected specimens and tumors were 30.5 ± 4.9 and 26.0 ± 3.5 mm, respectively. No perforations occurred, while delayed bleeding occurred in 1 patient. In conclusion, hybrid ESD using a multifunctional snare enables easy, safe, and cost-effective resection of relatively large colorectal tumors to be achieved.Study registration: UMIN000022545
Endobronchial Ultrasound (EBUS) – Update 2017
Authors: Darwiche Kaid , Özkan Filiz , Wolters Celina , Eisenmann Stephan 
Published: February 2018

AbstractEndobronchial ultrasound (EBUS) has revolutionized the diagnosis of lung cancer over the last decade. This minimally invasive diagnostic method has also become increasingly important in the case of other diseases such as sarcoidosis, thereby helping to avoid unnecessary diagnostic interventions. This review article provides an update regarding EBUS and discusses current and future developments of this method.
Gaze patterns hold key to unlocking successful search strategies and increasing polyp detection rate in colonoscopy
Authors: Lami Mariam , Singh Harsimrat , Dilley James , Ashraf Hajra , Edmondon Matthew , Orihuela-Espina Felipe , Hoare Jonathan , Darzi Ara , Sodergren Mikael 
Published: February 2018

Abstract
Background The adenoma detection rate (ADR) is an important quality indicator in colonoscopy. The aim of this study was to evaluate the changes in visual gaze patterns (VGPs) with increasing polyp detection rate (PDR), a surrogate marker of ADR.
Methods 18 endoscopists participated in the study. VGPs were measured using eye-tracking technology during the withdrawal phase of colonoscopy. VGPs were characterized using two analyses – screen and anatomy. Eye-tracking parameters were used to characterize performance, which was further substantiated using hidden Markov model (HMM) analysis.
Results Subjects with higher PDRs spent more time viewing the outer ring of the 3 × 3 grid for both analyses (screen-based: r = 0.56, P = 0.02; anatomy: r = 0.62, P < 0.01). Fixation distribution to the “bottom U” of the screen in screen-based analysis was positively correlated with PDR (r = 0.62, P = 0.01). HMM demarcated the VGPs into three PDR groups.
Conclusion This study defined distinct VGPs that are associated with expert behavior. These data may allow introduction of visual gaze training within structured training programs, and have implications for adoption in higher-level assessment.
In digital we trust: Bitcoin discourse, digital currencies, and decentralized network fetishism
Authors: Baldwin Jon 
Published: February 2018

AbstractThis paper outlines how the digital currency and network technology of bitcoin functions and explores the context from which it emerged. Bitcoin was conceived in 2008 as an attempt to alleviate trust in government and banks which was at a low during this period of financial crisis. However, with bitcoin trust does not dissipate, rather it shifts. Trust moves from trust in banks or states to trust in algorithms and encryption software. There is a move from conventional trust in the gold standard—“In Gold We Trust”—to the trust announced on U.S. currency—“In God We Trust”—to trust in software and networks—“In Digital We Trust”. The hyperbole of bitcoin discourse is deemed to be an expression of the Californian Ideology, which itself often conceals a right-wing agenda. The paper analyses the hype behind the celebration of decentralised digital networks. It proposes that a form of network fetishism operates here. The failure of bitcoin as a currency (rather than as a hoarded commodity in an emergent bubble) and as an idea might be attributed to the failure to see how ultra-modern digital networks conceal very traditional consolidation of power and capital. The rise and fall of bitcoin, in terms of its original ambition, serves as a cautionary tale in the digital age—it reveals how ingenious innovations that might challenge power and the consolidation of capital become co-opted and colonised by capital. Finally, the paper offers a discussion of the possible progressive uses of the digital technology bitcoin has facilitated.
Capability and adversity: reframing the “causes of the causes” for mental health
Authors: Smith Michael 
Published: February 2018

AbstractScotland is well known for having the worst health in Western Europe, with the country’s premature mortality mainly driven by suicide and substance misuse, rather than physical illness. These problems only emerged relatively recently, and a similar profile of premature mortality, sometimes called “diseases of despair”, can be seen in other societies at different times. But what is “despair” in this context, and how might it exert its effects? Studies of the impact of Adverse Childhood Experiences (ACEs) on adult health consistently reveal a similar profile of morbidity, which is thought to relate to the effects of unremitting, unsupported, “toxic” stress. As models of childhood adversity expand to include a wider range of causes and powerful mitigating factors, there is a need to understand why some life events and circumstances are especially harmful. This paper argues that socioeconomic factors, childhood adversity, attachment, resilience and “toxic” stress are all consistent with a broader concept of human potential: Nussbaum’s “capabilities approach” to human development. Incorporating our understanding of health and wellbeing in the broader frame of capabilities strengthens our understanding of adversity-related harm, and might also point towards new ways of repairing the social and individual damage they cause.
Populism between direct democracy and the technological myth
Authors: De Blasio Emiliana , Sorice Michele 
Published: February 2018

Abstract
In recent years, the scientific debate on populism has experienced a new momentum: on the one hand, the emergence of new populisms even in Western democracies and on the other hand, disagreement among scholars on the definition of populism. In this context, new trends have emerged—such as those concerning the link between populism and technology—along with the need to revise the traditional study paradigms, which are often difficult to operationalise. The transformation of the political sphere appears to be strongly interconnected with the digital media landscape. If the new forms of communication are the cause or the effect of processes, such as the personalisation of leadership, the verticalisation of political organisations, the presidentialisation of political parties, or the social de-legitimisation of the old “intermediate bodies”, these forms should be the subject of ongoing research. At the same time, a very simplistic storyline tries to overlap the rise of neo-populist parties with their use of communication technologies. A quality that is common to the many different populisms is an appeal to the use of direct democracy as a tool to empower citizens. Populism itself is sometimes portrayed as almost synonymous with direct democracy. At the same time, direct democracy is used by populists as a critique of the lack of participation in representative democracy and the need to make it more participatory. In this perspective, technology becomes a tool (and a storyline) to facilitate the use of direct democracy and the rise of a new form of “hyper-representation”. At the same time, concepts such as efficiency, privatisation, short-termism, newism, and meritocracy are keywords successfully used by populist leaders, technocracy élites and neo-liberal political leaders. In other words, we can highlight a strange meeting between technological storytelling about direct democracy and technocracy myths. Even among the new populist parties, the technopopulists appear to represent an important category, whose peculiarities can easily be put into evidence using some empirical tools (such as content analysis). The aim of this article is to investigate the relationships between technocracy, direct democracy’s storytelling and hyper-representation as a distinctive characteristic of neo-populisms.
Performance improvement in a tubular heat exchanger by punched delta-winglet vortex generators
Authors: Khanoknaiyakarn C. , Promvonge P. , Thianpong C. , Skullong S. 
Published: February 2018

Abstract
A novel tubular heat exchanger incorporated with punched delta-winglet vortex generators (called perforated delta-winglet vortex generator, P-DWVG) is proposed for improving its thermal performance and energy saving. The P-DWVG elements are punched out from a straight tape having its width nearly equal to the tube diameter before insertion. The main aim at employing the P-DWVG insert is to produce counter-rotating vortices along the tube to promote turbulence intensity inside as well as to transport the cold fluid at the central core to the near-wall regions. The experiment was performed to study thermal behaviors in a uniform heat-fluxed tube inserted with P-DWVGs. The P-DWVGs with the attack angle of 45° were mounted periodically with three different blockage ratios (BR = 0.1, 0.2 and 0.3) and two pitch ratios (PR = 2 and 3). Air as the test fluid was varied to obtain turbulent airflow for Reynolds number (Re) in a range of 4,150-25,500. The experimental results show that the P-DWVG provides a considerable increase in the rate of heat transfer around 3.1-4.01 times whereas friction factor increases around 11.44- 34.23 times higher than the plain tube. To assess the real benefits of P-DWVGs, thermal performance factor (TEF) is examined and in the range of 1.39-1.48 where its maximum is at BR = 0.1 and PR = 2.
Development and evaluation of a novel user interface for reviewing clinical microbiology results
Authors: Wright Adam , Neri Pamela M , Aaron Skye , Hickman Thu-Trang T , Maloney Francine L , Solomon Daniel A , McEvoy Dustin , Ai Angela , Kron Kevin , Zuccotti Gianna 
Published: February 2018

AbstractBackgroundMicrobiology laboratory results are complex and cumbersome to review. We sought to develop a new review tool to improve the ease and accuracy of microbiology results review.MethodsWe observed and informally interviewed clinicians to determine areas in which existing microbiology review tools were lacking. We developed a new tool that reorganizes microbiology results by time and organism. We conducted a scenario-based usability evaluation to compare the new tool to existing legacy tools, using a balanced block design.ResultsThe average time-on-task decreased from 45.3 min for the legacy tools to 27.1 min for the new tool (P &lt; .0001). Total errors decreased from 41 with the legacy tools to 19 with the new tool (P = .0068). The average Single Ease Question score was 5.65 (out of 7) for the new tool, compared to 3.78 for the legacy tools (P &lt; .0001). The new tool scored 88 (“Excellent”) on the System Usability Scale.ConclusionsThe new tool substantially improved efficiency, accuracy, and usability. It was subsequently integrated into the electronic health record and rolled out system-wide. This project provides an example of how clinical and informatics teams can innovative alongside a commercial Electronic Health Record (EHR).
Expansion Thoracoplasty in Rabbit Model
Authors: Olson J. Casey , Glotzbecker Michael P. , Takahashi Ayuko , Mehta Hemal P. , Snyder Brian D. 
Published: February 2018

Study Design.
In a treatment-control animal study expansion thoracoplasty (ET) was performed in a juvenile rabbit model of thoracic insufficiency syndrome (TIS) and benefits to thoracic development and respiratory function quantified. Rabbits treated early versus late were compared to age-matched normal and disease control rabbits through to skeletal maturity.

Objective.
Evaluate (1) how ET changes the natural TIS disease trajectory and (2) how timing of ET affects changes in spine growth, lung growth, and respiratory mechanics.

Summary of Background Data.
Pulmonary growth potential is thought to diminish with age; thus, early therapeutic intervention may increase pulmonary growth in children with TIS. However, no direct empirical evidence exists to support this treatment paradigm.

Methods.
Convex left scoliosis and resultant TIS was induced in 3-week-old rabbits via surgical rib tethering. We compare the efficacy of ET performed at 7 weeks and expanded at 11 weeks (early, n = 7) versus only at 11 weeks of age (late, n = 7) in preserving lung growth and respiratory function relative to normal (n = 8) and disease (n = 10) rabbits. Sequential computed tomography images and pulmonary function testing was performed to quantify spine curvature, lung growth, and respiratory volumes. At 28 weeks of age chest wall elastance was measured in vivo then acinar complexity analyzed histologically via radial alveolar counts.

Results.
ET performed early or late altered the predicted trajectory of spine deformity, pulmonary growth inhibition, and respiratory dysfunction seen in disease rabbits. Growth was not significantly different between early and late rabbits and post-treatment gains remained below those of age-matched normal rabbits. Chest wall elastance was impaired by ET and more so in early rabbits, there were no differences in pulmonary elastance.

Conclusion.
ET interrupted the natural progression of deformity and pulmonary hypoplasia associated with spine curvature in disease rabbits. However, growth benefits are only seen in cases of the most severe initial deformity and must be balanced against the further impairment to chest wall function associated with repetitive surgery.

Level of Evidence: N/A
Postoperative Complications in Dialysis-Dependent Patients Undergoing Elective Decompression Surgery Without Fusion or Instrumentation for Degenerative Cervical or Lumbar Lesions
Authors: Inoue Tetsuji , Mizutamari Masaya , Fukuda Kazuaki , Hatake Kuniaki 
Published: February 2018

Study Design.
This was a single-institute retrospective study.

Objective.
To evaluate postoperative complications in dialysis-dependent patients undergoing elective cervical and lumbar decompression surgery.

Summary of Background Data.
Spinal surgery in dialysis-dependent patients is very challenging due to the high risk of serious postoperative complications and mortality associated with their fragile general condition. However, the outcome of decompression surgery alone has not been evaluated in such patients.

Methods.
An electronic medical record review showed that 338 and 615 patients had undergone cervical and lumbar spine posterior decompression, respectively. Among them, 48 and 42, respectively were dialysis-dependent patients. Postoperative complications were compared between dialysis-dependent and non–dialysis-dependent patients.

Results.
Among patients who underwent cervical decompression, the rate of perioperative blood transfusion in dialysis-dependent patients (14.6%) was significantly higher than that in non–dialysis-dependent patients (0.7%). No severe complications or mortality occurred in association with cervical decompression. The incidence of postoperative complications in dialysis-dependent patients (6.3%) was not significantly different from that in non–dialysis-dependent patients (4.1%). Among patients who underwent lumbar decompression, the rate of perioperative transfusion in dialysis-dependent patients (11.9%) was also significantly higher than that in non–dialysis-dependent patients (0.7%). With respect to severe complications among patients who underwent lumbar decompression, cerebral hemorrhage occurred in one dialysis-dependent patient, and no mortality occurred. The incidence of postoperative complications in dialysis-dependent patients (9.2%) was not significantly different from that in non–dialysis-dependent patients (6.8%).

Conclusion.
Among patients who underwent posterior decompression alone for cervical or lumbar lesions, the rate of perioperative blood transfusion was significantly higher in dialysis-dependent than in non–dialysis-dependent patients. However, the postoperative rates of severe complications and mortality were not significantly different between the two groups. Therefore, decompression surgery alone is considered a rational surgical method with less invasiveness for dialysis-dependent patients with a fragile general condition.

Level of Evidence: 3
Delayed Fatal Lumbar Artery Bleeding Following Less Invasive Posterolateral Decompression and Fusion
Authors: Ntourantonis Dimitrios , Tsekouras Vasileios , Korovessis Panagiotis 
Published: February 2018

Study Design.
A case report.

Objective.
The aim of this study was to outline the potential risks of late bleeding from the segmental vessels following less invasively dorsolateral approaches to the thoracolumbar spine.

Summary of Background Data.
A low risk of major intraoperative bleeding, associated traditional dorsolateral approach to the lumbar spine is reported, but segmental arteries and great vessels may be rarely damaged. Spine surgeons who are involved with these approaches should be aware of this rare but potential dangerous vascular complication because it could be life-threatening, particularly in elderly patients with increased morbidity, and/or metastatic disease to the spine.

Methods.
A 76-year-old white woman with a comminuted osteoporotic fracture of the L1-vertebrae with spinal canal encroachment underwent a corpectomy and a 360° fusion with the use of a titanium mesh cage, through a less invasively dorsolateral approach.

Results.
Despite the lack of visible intraoperative bleeding and uneventful postoperative period, the patient died on the seventh postoperative day as a result of massive bleeding from a segmental artery at the level of L3 vertebrae body, two levels below our intervention area.

Conclusion.
This article describes a rare complication of delayed and fatal bleeding of the segmental L3 left vertebral artery following less invasively L1 corpectomy, mesh cage insertion, and pedicle screw fixation in a elderly female patient with history of two malignancies. Although injury to large vessels must always be prevented during these procedures, an injury to the segmental vessels occurs more frequently. The dorsolateral approach and other retroperitoneal approaches to the thoracolumbar region are established methods for the surgical stabilization of comminuted vertebral body fractures, especially on the hands of experienced spine surgeons. Great care should be given postoperatively for signs of bleeding and hematoma and the surgeon should be aware for these life-threatening complications.

Level of Evidence: 5
Intersurgeon Cost Variability in Anterior Cervical Discectomy and Fusion
Authors: Sielatycki J. Alex , Chotai Silky , Wick Joseph , Sivaganesan Ahilan , Devin Clinton J. 
Published: February 2018

Study Design.
Retrospective review of prospective patient outcomes and cost data.

Objective.
To analyze the contribution of surgeon-specific variability in cost and patient-reported outcomes (PROs) to overall variability in anterior cervical discectomy and fusion (ACDF), whereas adjusting for patient comorbidities.

Summary of Background Data.
Cost reduction in surgical care has received increased attention. Patient factors contributing to cost variability in ACDF have been described; however, intersurgeon cost and outcome variability has received less attention in the literature.

Methods.
Adult patients undergoing elective primary ACDF by five different surgeons were analyzed from a prospective registry database. Direct and indirect 90-day costs were compared across each surgeon, along with PROs. Predicted costs were calculated based on patient co-morbidities, and an “observed versus expected” cost differential was measured for each surgeon; this O/E cost ratio was then compared with PROs.

Results.
A total of 431 patients were included in the analysis. There were no differences in comorbidities, age, smoking status, or narcotic use. There was significant variation between surgeons in total 90-day costs, as well as variation between each surgeon's observed versus expected cost ratio. Despite these surgeon-specific cost variations, there were no differences in PROs across the participating surgeons.

Conclusion.
Intersurgeon cost variation in elective ACDF persists even after adjusting for patient comorbidities. There was no apparent correlation between increased surgeon-specific costs and 90-day PROs. These findings show there is opportunity for improvement in inter-surgeon cost variation without compromise in PROs.

Level of Evidence: 3