bluuebunny/crossref_metadata_2025_split huggingface dataset:
LVAD speed increase during exercise, which patients would benefit the most? A simulation study
Authors: Gross Christoph , Moscato Francesco , Schlöglhofer Thomas , Maw Martin , Meyns Bart , Marko Christiane , Wiedemann Dominik , Zimpfer Daniel , Schima Heinrich , Fresiello Libera 
Published: September 2019

AbstractPatients supported with a left ventricular assist device (LVAD) have impaired cardiovascular adaptations during exercise, resulting in reduced total cardiac output and exercise intolerance. The aim of this study is to report associations among these impaired cardiovascular parameters and exercise hemodynamics, and to identify in which conditions an LVAD speed increase can provide substantial benefits to exercise. A cardiorespiratory simulator was used to reproduce the average hemodynamics of LVAD patients at exercise. Then, a sensitivity study was conducted where cardiovascular parameters were changed individually ±20% of their baseline value at exercise (heart rate, left/right ventricular contractility, total peripheral resistance, and valve pathologies). Simulations were performed at a baseline LVAD speed of 2700 rpm and repeated at 3500 rpm to evaluate the benefits of a higher LVAD support on hemodynamics. Total cardiac output (TCO) was mostly impaired by a poor left ventricular contractility or vasodilation at exercise (−0.6 L/min), followed by a poor chronotropic response (−0.3 L/min) and by a poor right ventricular contractility (−0.2 L/min). LVAD speed increase better unloads the left ventricle and improves total cardiac output in all the simulated conditions. The most substantial benefits from LVAD speed increase were observed in case of poor left ventricular contractility (TCO + 1.6 L/min) and vascular dysfunction (TCO + 1.4 L/min) followed by lower heart rate (TCO + 1.3 L/min) and impaired right ventricular contractility (TCO + 1.1 L/min). Despite the presence of the LVAD, exercise hemodynamic is strongly depending on the ability of the cardiovascular system to adapt to exercise. A poor left ventricular inotropic response and a poor vascular function can strongly impair cardiac output at exercise. In these conditions, LVAD speed increase can be an effective strategy to augment total cardiac output and unload the left ventricle. These results evidence the need to design a physiological LVAD speed controller, tailored on specific patient’s needs.
Bone, subcutaneous tissue and plasma pharmacokinetics of cefuroxime in total knee replacement patients – a randomized controlled trial comparing continuous and short‐term infusion
Authors: Tøttrup Mikkel , Søballe Kjeld , Bibby Bo M. , Hardlei Tore F. , Hansen Peter , Fuursted Kurt , Birke‐Sørensen Hanne , Bue Mats 
Published: September 2019

Cefuroxime is widely used as antibiotic prophylaxis for orthopaedic procedures. We evaluated bone, subcutaneous tissue (SCT) and plasma pharmacokinetics of cefuroxime in male patients undergoing total knee replacement (TKR) after both traditional short‐term infusion (STI) and continuous infusion (CI). Eighteen male patients undergoingTKRwere randomly assigned toSTIorCIof 1.5 g of cefuroxime. Measurements were obtained in plasma,SCT, cancellous and cortical bone every 30 min for 8 h following surgery. For sampling in solid tissues, microdialysis was applied. Population pharmacokinetic modelling was performed in order to estimate pharmacokinetic parameters, and to assess the probability of attaining cefuroxime concentrations above clinically relevant minimal inhibitory concentrations (MICs) for 65% and 90% of the 8 h dosing interval. LowSCTand cortical bone penetration were found in both theSTIand theCIgroup, but the findings were only significant in theSTIgroup. Irrespective ofMIC, tissue and target,CIleads to improved probability of attaining relevant pharmacokinetic targets compared withSTI. For theStaphylococcus aureusMICbreakpoint (4 μg/mL),STIleads to inadequate probability of target attainment.CIof 1.5 g of cefuroxime leads to improved probability of attaining relevant pharmacokinetic targets in maleTKRpatients compared with traditionalSTI. These findings suggest that application ofCImay improve antibiotic prophylaxis for maleTKRpatients.
Thoracoscopic surgery for hepatocellular carcinoma located in the hepatic dome: Technical aspect and oncological results
Authors: Yamao Takanobu , Imai Katsunori , Yamashita Yo‐ichi , Umezaki Naoki , Tsukamoto Masayo , Kitano Yuki , Arima Kota , Miyata Tatsunori , Nakagawa Shigeki , Okabe Hirohisa , Nitta Hidetoshi , Chikamoto Akira , Ishiko Takatoshi , Baba Hideo 
Published: September 2019

AbstractIntroductionThe objective of this study was to describe the surgical techniques for a thoracoscopic approach to treat hepatocellular carcinoma in the hepatic dome. Also, safety, feasibility, and long‐term outcomes were evaluated.MethodsSurgical procedures were selected based on liver function, the extent and location of the tumor, and each patient's general condition. Thoracoscopic hepatic resection was performed under direct vision through a diaphragmatic incision. Thoracoscopic radiofrequency ablation (TRFA) was performed either with a transdiaphragmatic puncture for deeply located tumors or under direct vision through a diaphragmatic incision for subcapsular tumors.ResultsThoracoscopic surgery was indicated for 107 patients with hepatocellular carcinoma in the hepatic dome. Among these patients, 5 underwent hepatectomy and 102 underwent radiofrequency ablation, which was more frequently employed in patients with impaired liver function. Of the patients who underwent radiofrequency ablation, 43 (42.2%) required a diaphragmatic incision. In the thoracoscopic hepatic resection group and TRFA group, the median operating time was 350 and 197 minutes, the median blood loss was 200 and 5 mL, and the complication rate was 12.7% and 20.0%, respectively. The 5‐year overall and disease‐free survival rates were 100% and 50.0% in the thoracoscopic hepatic resection group, respectively, and 60.7% and 18.1% in the TRFA group, respectively. Local recurrence after TRFA was observed in 10 patients (9.8%).ConclusionThe thoracoscopic approach is safe and feasible, with promising short‐ and long‐term outcomes. It could serve as a treatment option for hepatocellular carcinoma in the hepatic dome.
Probable neuromyelitis optica spectrum disorder presenting with recurrent cranial neuropathy
Authors: Tateno Fuyuki , Sakakibara Ryuji , Aiba Yosuke , Oki Takeshi , Kawabe Kiyokazu , Ogata Tsuyoshi 
Published: September 2019

AbstractBackgroundHypertrophic pachymeningitis has been recognized in neuromyelitis optica spectrum disorder (NMOSD). However, cranial nerve involvement as a result of pachymeningitis in NMOSD is not well known.Case presentationA 49‐year‐old woman, during an 8‐year period, suffered from recurrent, multiple cranial nerve palsies; that is, palsy of the right third (4 times) and right sixth (twice) cranial nerves, due most probably to a right cavernous sinus lesion from NMOSD. Sarcoidosis, Sjögren's syndrome or other collagen diseases were negative. Magnetic resonance imaging was negative for the first to fifth episode. Aquaporin‐4 immunoglobulin G was negative at the first episode; and not measured for the subsequent second to fifth episodes. Therefore, first to fifth episodes could be irrelevant to pachymeningitis or NMOSD. In contrast, at the sixth episode, gadolinium‐enhanced T1‐weighted coronal magnetic resonance imaging showed a pachymeningeal lesion adjacent to the right cavernous sinus. Parallel with this, aquaporin‐4 immunoglobulin G became positive. The patient was finally diagnosed with probable NMOSD and started on steroid pulse therapy, and her symptoms soon disappeared completely. After this, 5 mg/day oral prednisolone was started. In the subsequent 2 years, she has had no recurrence of diplopia.ConclusionsThis case report will help physicians suspect probable NMOSD in patients having recurrent, multiple cranial neuropathies, and provide them appropriate management and care.
Cardiac surgery in the heart transplant recipient: Outcome analysis and long‐term results
Authors: Farag Mina , Arif Rawa , Raake Philip , Kreusser Michael , Karck Matthias , Ruhparwar Arjang , Schmack Bastian 
Published: September 2019

AbstractBackgroundSurvival rates following cardiac transplantation continue to improve. Due to the scarcity of available organs, extended donor criteria have become more prevalent in clinical practice. In this context, the risk of developing cardiac pathology requiring surgical correction is increasing.MethodsBetween January 1991 and October 2010, a total of 479 patients received cardiac transplantations at the University Hospital Heidelberg. Of those, 18 (3.8%) patients required subsequent cardiac surgery until 2018. Short‐ and long‐term analyses were performed.ResultsIndications for cardiac surgery included valvular disease (n = 16) with the majority of cases affecting the tricuspid valve (n = 10), while 6 patients received mitral valve surgery, of whom 3 patients underwent concomitant valve surgery. Other indications included CABG (n = 1) and re‐transplantation (n = 1) for allograft dysfunction. Mean follow‐up time was 6.5 years, while mean interval to surgery was 6.0 years. Early mortality was 11.1% (n = 2), while overall survival at 1, 5, and 10 years were, 88.1%, 81.4%, and 52.2%, respectively. Compared to an overall survival of that transplant cohort at 1, 5, and 10 years of 76.7%, 66.7%, and 52.4% percent, respectively (P = .271).ConclusionAccording to our data, redo cardiac surgery can be performed with acceptable mortality and morbidity. Atrioventricular valve pathology plays a chief role in these patients.
Impact of therapeutic hypothermia on infantile spasms: an observational cohort study
Authors: Abu Dhais Farah , McNamara Brian , O'Mahony Olivia , McSweeney Niamh , Livingstone Vicki , Murray Deirdre M , Boylan Geraldine B 
Published: September 2019

AimTo establish the incidence of infantile spasms in children in the southern region of the Republic of Ireland and to compare the incidence of infantile spasms before and after the introduction of therapeutic hypothermia in infants with hypoxic‐ischemic encephalopathy (HIE).MethodChildren born between 2003 and 2015 and diagnosed with infantile spasms (epileptic spasms with or without hypsarrhythmia) in the first 2 years of life were identified through audits of electroencephalography reports and paediatric neurology patient lists. Data on live births were obtained from the regional hospital statistics databases. Medical charts of infantile spasm cases were reviewed for demographic information, diagnostic workup results, treatment response, disease course, and developmental outcome.ResultsForty‐two infants with infantile spasms were identified. The cumulative incidence of infantile spasms up to the age of 2 years was 4.01 per 10 000 live births. Difference due to sex was minimal (22 males, 20 females) and most infants were delivered at or near term with gestational ages ranging between 30.0 and 41.8 weeks (median [interquartile range] 39.6wks [38.1–40.0wks]). The aetiology for infantile spasms was identified in almost two‐thirds of cases, with HIE being the single most common cause (n=7). Other causes included chromosomal and monogenetic abnormalities (n=8). Infantile spasms occurred in moderate and severe grades of HIE, with a significantly higher incidence in those with severe HIE (p=0.029). Infants with severe HIE who did not receive therapeutic hypothermia were six times more likely to develop infantile spasms compared to those who did, but the difference was not statistically significant (4 out of 16 vs 1 out of 24, p=0.138).InterpretationThis study provides detailed information about infantile spasms before and after the introduction of therapeutic hypothermia. HIE severity is a risk factor for the development of infantile spasms. The introduction of therapeutic hypothermia may have had an impact, but the effect was hard to ascertain in this cohort due to the small number of infants.What this paper adds

The incidence of infantile spasms and patient characteristics in the southern region of the Republic of Ireland is similar to internationally published data.

None of the infants with a history of mild hypoxic‐ischemic encephalopathy (HIE) developed infantile spasms.

The risk of infantile spasms was higher in infants with severe HIE.

Infantile spasms were more frequent in infants with severe HIE not treated with therapeutic hypothermia.
Inadequate description of placebo and sham controls in a systematic review of recent trials
Authors: Webster Rebecca K. , Howick Jeremy , Hoffmann Tammy , Macdonald Helen , Collins Gary S. , Rees Jonathan L. , Napadow Vitaly , Madigan Claire , Price Amy , Lamb Sarah E. , Bishop Felicity L. , Bokelmann Klara , Papanikitas Andrew , Roberts Nia , Evers Andrea W.M. 
Published: September 2019

AbstractBackgroundPoorly described placebo/sham controls make it difficult to appraise active intervention benefits and harms. The 12‐item Template for Intervention Description and Replication (TIDieR) checklist was developed to improve the reporting of active interventions. The extent to which TIDieR has been used to improve description of placebo or sham control is not known.Materials and methodsWe systematically identified and examined all placebo/sham‐controlled randomised trials published in 2018 in the top six general medical journals. We reported how many of the TIDieR checklist items were used to describe the placebo/sham control(s). We supplemented this with a sample of 100 placebo/sham‐controlled trials from any journal and searched Google Scholar to identify placebo/sham‐controlled trials citing TIDieR.ResultsWe identified 94 placebo/sham‐controlled trials published in the top journals in 2018. None reported using TIDieR, and none reported placebo or sham components completely. On average eight TIDieR items were addressed, with placebo/sham control name (100%) and when and how much was administered (97.9%) most commonly reported. Some items (rationale, 8.5%, whether there were modifications, 25.5%) were less often reported. In our sample of less well‐cited journals, reporting was poorer (average of six items) and followed a similar pattern. Since TIDieR’s first publication, six placebo‐controlled trials have cited it according to Google Scholar. Two of these used the checklist to describe placebo controls; neither one completely desribed the placebo intervention.ConclusionsPlacebo and sham controls are poorly described within randomised trials, and TIDieR is rarely used to guide these descriptions. We recommend developing guidelines to promote better descriptions of placebo/sham control components within clinical trials.
Contextualising the relevance of specialty‐specific electives in dental education: Perspectives of dental and oral hygiene graduates
Authors: Mothupi Kelebogile Annastacia , Adefuye Anthonio Oladele 
Published: September 2019

AbstractIntroductionElectives have been shown to contribute to both the professional and personal development of students in specific areas of interest outside the standard curriculum. The School of Oral Health Sciences at the University of the Witwatersrand introduced electives as a pedagogy in the Bachelor of Dental Sciences (BDS) and Bachelor of Oral Health Sciences (BOHSc) curricula in 2010 and 2014, respectively. However, since its introduction, the relevance of these electives in the BDS and BOHSc curricula has not been investigated.MethodsThis research was designed as an evaluation study that used a questionnaire survey administered to 76 dental and oral hygiene graduates (BDS and BOHSc).ResultsOf the initial 76 questionnaires that were distributed, 55 (BDS = 38, BOHSc = 17) were returned, giving a response rate of 72.4%. Almost all the participants (92.7%) agreed that the electives enabled them to develop better interpersonal skills; 80.0% and 82.7% agreed that their clinical skills, and knowledge of key concepts in dental practice, respectively, had improved upon completion of the elective. In appraising the elective programme, 87.0% of the graduates agreed that the content and outcome of the elective programme should be reviewed and changed.ConclusionObtaining empirical data on the impact of electives on clinical knowledge, skill and behaviour of dental graduates will enhance the relevance of electives in dental education. Findings by this study reveal that the actual impact of the electives on dental graduates was desirable and corresponded with the intended impact. The problematic areas that were identified will inform future planning.
A study of cortical and brainstem mechanisms of diffuse noxious inhibitory controls in anaesthetised normal and neuropathic rats
Authors: Patel Ryan , Dickenson Anthony H. 
Published: September 2019

AbstractDiffuse noxious inhibitory controls (DNIC) are a mechanism of endogenous descending pain modulation and are deficient in a large proportion of chronic pain patients. However, the pathways involved remain only partially determined with several cortical and brainstem structures implicated. This study examined the role of the dorsal reticular nucleus (DRt) and infralimbic (ILC) region of the medial prefrontal cortex in DNIC. In vivo electrophysiology was performed to record from dorsal horn lamina V/VI wide dynamic range neurones with left hind paw receptive fields in anaesthetised sham‐operated and L5/L6 spinal nerve‐ligated (SNL) rats. Evoked neuronal responses were quantified in the presence and absence of a conditioning stimulus (left ear clamp). In sham rats, DNIC were reproducibly recruited by a heterotopically applied conditioning stimulus, an effect that was absent in neuropathic rats. Intra‐DRt naloxone had no effect on spinal neuronal responses to dynamic brush, punctate mechanical, evaporative cooling and heat stimuli in sham and SNL rats. In addition, intra‐DRt naloxone blocked DNIC in sham rats, but had no effect in SNL rats. Intra‐ILC lidocaine had no effect on spinal neuronal responses to dynamic brush, punctate mechanical, evaporative cooling and heat stimuli in sham and SNL rats. However, differential effects were observed in relation to the expression of DNIC; intra‐ILC lidocaine blocked activation of DNIC in sham rats but restored DNIC in SNL rats. These data suggest that the ILC is not directly involved in mediating DNIC but can modulate its activation and that DRt involvement in DNIC requires opioidergic signalling.
Thickness effect on the mode III fracture resistance and fracture path of rock using ENDB specimens
Authors: Bidadi Jamal , Akbardoost Javad , Aliha Mohammad Reza Mohammad 
Published: September 2019

AbstractStudy of the thickness effect in predicting the crack growth behavior and load bearing capacity of rock‐type structures is an important issue for obtaining a relation between the experimental fracture toughness of laboratory subsized samples and the real rock structures with large thickness. The fracture of rock masses or underground rock structures at deep strata may be dominantly governed by the tensile or tear crack growth mechanism. Therefore, in this research, a number of mode I and mode III fracture toughness experiments are conducted on edge notch disc bend (ENDB) specimen made of a kind of marble rock to investigate the effect of specimen thickness on the corresponding KIc and KIIIc values. It is observed that the fracture toughness of both modes I and III are increased by increasing the height of the ENDB specimen. Also, the ratio of KIIIc/KIc obtained from each thickness of the ENDB specimens is compared with those predicted by some fracture criteria, and it was shown that the minimum plastic radius (MPR) criterion is the main suitable criterion for investigating the fracture toughness ratio KIIIc/KIc. Also, the effect of ENDB height on fracture trajectory of tested samples is assessed. It is shown that the crack grows curvilinearly in thicker ENDB samples and cannot extend along the crack front in small specimens.
Limited attention and portfolio choice: The impact of attention allocation on mutual fund performance
Authors: Gupta‐Mukherjee Swasti , Pareek Ankur 
Published: September 2019

AbstractThis study proposes that the performance of mutual fund managers is linked to how efficiently they allocate attention across assets in their investment set. Motivated by existing models of optimal portfolio choice and rational inattention, we posit that the efficiency of attention allocation increases when a manager chooses larger (smaller) active positions in assets that need more (less) information acquisition effort to resolve uncertainty about future payoffs. We show that the efficiency of attention allocation has a significantly positive impact on future fund performance. Efficient attention allocation has a lesser impact on performance as the total demands on a manager's limited attention increase.
Multiple trade‐offs regulate the effects of woody plant removal on biodiversity and ecosystem functions in global rangelands
Authors: Ding Jingyi , Travers Samantha K. , Delgado‐Baquerizo Manuel , Eldridge David J. 
Published: September 2019

AbstractWoody plant encroachment is a major land management issue. Woody removal often aims to restore the original grassy ecosystem, but few studies have assessed the role of woody removal on ecosystem functions and biodiversity at global scales. We collected data from 140 global studies and evaluated how different woody plant removal methods affected biodiversity (plant and animal diversity) and ecosystem functions (plant production, hydrological function, soil carbon) across global rangelands. Our results indicate that the impact of removal is strongly context dependent, varying with the specific response variable, removal method, and traits of the target species. Over all treatments, woody plant removal increased grass biomass and total groundstorey diversity. Physical and chemical removal methods increased grass biomass and total groundstorey biomass (i.e., non‐woody plants, including grass biomass), but burning reduced animal diversity. The impact of different treatment methods declined with time since removal, particularly for total groundstorey biomass. Removing pyramid‐shaped woody plants increased total groundstorey biomass and hydrological function but reduced total groundstorey diversity. Environmental context (e.g., aridity and soil texture) indirectly controlled the effect of removal on biomass and biodiversity by influencing plant traits such as plant shape, allelopathic, or roots types. Our study demonstrates that a one‐size‐fits‐all approach to woody plant removal is not appropriate, and that consideration of woody plant identity, removal method, and environmental context is critical for optimizing removal outcomes. Applying this knowledge is fundamental for maintaining diverse and functional rangeland ecosystems as we move toward a drier and more variable climate.