bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sodium‐glucose cotransporter 2 inhibitor plus pioglitazone vs pioglitazone alone in patients with diabetes mellitus: A systematic review and meta‐analysis of randomized controlled trials
Authors: Liao Hung‐Wei , Wu Yi‐Ling , Sue Yuh‐Mou , Lee Meng , Ovbiagele Bruce 
Published: November 2018

SummaryAimsTo evaluate the efficacy and safety of combined therapy with sodium‐glucose cotransporter 2 (SGLT‐2) inhibitors plus pioglitazone versus pioglitazone alone in type 2 diabetic patients.Materials and MethodsSystematic literature searches were performed across PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and clinicaltrials.gov from 1966 to September 2018 to identify randomized, controlled trials. Mean difference (MD) or odds ratio (OR) was used to evaluate efficacy and safety end‐points (active group vs control group), wherever appropriate. Heterogeneity was assessed by P value of χ2 statistics and I2.ResultsFour randomized controlled trials with 1411 diabetic patients were included. Pooling data from included trials showed that HbA1c change was significantly larger in both low‐dose SGLT‐2 inhibitors (MD: −0.59%, 95% CI: −0.77 to −0.41%) and high‐dose SGLT‐2 inhibitors (MD: −0.65%, 95% CI: −0.78 to −0.53%) plus pioglitazone than pioglitazone alone in 24‐26 weeks. Favourable outcomes were also found in fasting blood glucose level reduction and more patients achieving HbA1c <7% in SGLT‐2 inhibitor plus pioglitazone (OR: 3.21, 95% CI: 1.99 to 5.16). Also, SGLT‐2 inhibitor plus pioglitazone vs pioglitazone, reduced weight and blood pressure. The risks of death, heart failure, hypoglycaemia and urinary tract infection were not different between active and control groups although genital tract infection was more frequently seen in SGLT‐2 inhibitor group.ConclusionsCompared to pioglitazone alone, SGLT‐2 inhibitor plus pioglitazone improved glycaemic control, reduced body weight and lowered blood pressure, but increased genital tract infection.
Spatial avoidance as a response to contamination by aquatic organisms in nonforced, multicompartmented exposure systems: A complementary approach to the behavioral response
Authors: Araújo Cristiano V.M. , Blasco Julián 
Published: November 2018

Abstract

The idea that the hazard of contaminants is exclusively related to their toxic effects does not consider the fact that some organisms can avoid contamination, preventing toxicity. Although inferences about avoidance are made in most behavioral ecotoxicology studies, assessment of the real spatial displacement (organisms moving toward another habitat to escape contamination) is difficult due to the type of exposure (confined and mandatory) used in the bioassays: a forced exposure approach. A complementary approach using nonforced exposure systems to assess how contaminants affect the spatial distribution of organisms in a bicompartmented (toxic or nontoxic) environment has long been described. Recently, this nonforced approach has been developed to include a multi compartmented system in which different samples can be simultaneously tested. The aim of the present review was to describe the importance of the nonforced, multicompartmented exposure approach to simulate a gradient or patches of contamination, to describe the 2 main exposure systems, and to highlight the ecological relevance of including spatial avoidance and habitat preference in ecotoxicological studies. The multicompartmentalization of the system makes it possible to simulate more complex scenarios and therefore include new ecological concepts in bioassays. We also contrasted spatial avoidance in the nonforced exposure systems with the behavioral endpoints measured under other exposure systems. Finally, we showed that the nonforced, multicompartmented exposure approach makes it possible 1) to improve environmental risk assessments by adding the dispersion pattern of organisms in a multihabitat scenario, and 2) to integrate ecological concepts such as recolonization of recovering habitats, loss of habitat connectivity, habitat fragmentation, and contamination-driven metapopulation, which have received limited attention in ecotoxicological studies. Environ Toxicol Chem 2019;38:312–320. © 2018 SETAC
Dietary source of saturated fat and percentage body fat of patients with type 2 diabetes mellitus: A cross‐sectional study
Authors: Duarte Camila Kümmel , dos Santos Ana Luiza Teixeira , Kirst Claudia , Nunes Graziela da S. , de Franceschi Karine , de Azevedo Mirela Jobim , Zelmanovitz Themis 
Published: November 2018

AbstractBackgroundThe influence of dietary fat on the body fat of patients with diabetes is not well established. This cross‐sectional study aimed to analyze the association between percentage body fat (PBF) and dietary sources of fat from the usual diet of patients with type 2 diabetes.MethodsOutpatients were submitted to PBF evaluation estimated by bioelectrical impedance. The patient's usual diet was assessed by a 3‐day weighed diet record (WDR), and compliance was analyzed by comparing the protein intake estimated from the WDR and that from 24‐hr urinary nitrogen output.ResultsA total of 188 patients with type 2 diabetes (aged 62.5 ± 8.8 years; 57% female, body mass index [BMI] 29.3 ± 3.8 kg/m²) were analyzed and divided into groups with high and low PBF according to mean PBF (men: 26.6 ± 7.1%; women: 39.8 ± 5.9%). Patients with high PBF consumed an increased proportion of red meat (52.0% of total meat), processed meat (5.4%), and saturated fat from red meat (2.1% of energy) compared to low PBF individuals (42.3% [p = 0.036]; 3.0% [p = 0.010]; 1.5% of energy [p = 0.032], respectively). According to Poisson's regression, the consumption of red meat (PR = 1.008 [95% CI = 1.002–1.013]; p = 0.006) and the reuse of frying oil (PR = 1.670 [95% CI = 1.240–2.249]; p = 0.001) were associated with higher PBF. In the adjusted analysis, the upper tertile of processed meat intake was associated with higher PBF (PR = 1.522 [95% CI = 1.226–1.891]; p = 0.001) compared to the lower tertile.ConclusionsThe present study suggested that a higher ingestion of dietary sources of saturated fat was associated with high PBF in patients with type 2 diabetes.
Treatment adherence as a mediator of blood pressure control in Chinese older adults with depression
Authors: Xue Jiang , Conwell Yeates , Tang Wan , Bogner Hillary R. , Li Yue , Jiang Yuxing , Zhu Tingfei , Chen Shulin 
Published: November 2018

ObjectivesBoth depression and hypertension (HTN) are prevalent, costly, and destructive, and frequently coexist among the aging population of China. This study aimed to examine the role that treatment adherence plays in blood pressure control in older adult Chinese with depression.MethodsData for these analyses were taken from a randomized control trial of a collaborative depression care management intervention conducted in rural villages of Zhejiang Province, China with older adults who had comorbid depression and HTN. They included baseline assessments of 2362 subjects ages ≥60 years, whose blood pressure and depression were measured using a calibrated manual sphygmomanometer and the Chinese version of the 17‐item Hamilton Depression Rating Scale (HDRS‐17), respectively. Treatment adherence was identified by a single question asking whether patients on occasion did not take their medicine.ResultsUncontrolled HTN was associated with older age (t = 3.10, P<0.01), higher HDRS‐17 score (t = 5.76, P<0.01), and higher rates of non‐adherence to HTN treatment (χ2 = 21.34, P<0.01). Logistic regression models indicated that adherence accounted for 39.4% of the total effect between depression and HTN. Specifically, those with poor adherence were at 1.417 greater odds of having their HTN uncontrolled compared with those with good adherence.ConclusionsHypertension control in older adults with depression is complicated by nonadherence to treatment. In addition to diagnosing and treating depression in their older adult patients, primary care physicians can optimize blood pressure control by identifying and addressing their patients' adherence to recommendations for HTN management.
The role of the memory service in helping carers to prepare for end of life: A mixed methods study
Authors: Moore Kirsten J. , Goodison Hannah , Sampson Elizabeth L. 
Published: November 2018

ObjectivesThe objective of the study is to explore current practice and the role taken by UK memory services in helping carers of people with dementia prepare for the end of life.MethodsWe used mixed methods including a survey (48 responses/51% response rate) and semistructured interviews (n = 12) with clinicians working in UK memory services accredited by the Memory Services National Accreditation Programme. We used descriptive statistics to report survey findings and thematically analysed interview and survey qualitative data.ResultsSurveys: services routinely discussed with carers the progressive nature of dementia (89%), legal arrangements (health: 72%; finances: 74%), advance care planning (63%), and implications of loss of capacity (61%). Fewer services routinely discussed the terminal nature of dementia (41%) and meaning of death (11%) with carers. Most (89%) agreed that these conversations were in line with their role. Interview findings corresponded with survey findings. Themes included diagnosis considered too early to discuss end of life, discussions being inconsistent with a “living well” approach, people with dementia being resistant to conversations, and discussions of spirituality crossing professional boundaries. Services' capacity for follow‐up with carers impacted on ability to broach these topics.ConclusionsMore in‐depth and distressing topics such as end of life and advance care planning require longer follow‐up to establish relationships to broach difficult topics. Variability in follow‐up practices between services created inequity in the extent to which memory services could address these topics. More research is required to investigate the best method for broaching these topics with carers and the person with mild dementia within different health care contexts.
Scale‐dependent Poiseuille flow alternatively explains enhanced dispersion in geothermal environments
Authors: Zheng Lizhi , Wang Lichun 
Published: November 2018

AbstractFluid flow exerts a critical impact on the convection of thermal energy in geological media, whereas heat transport in turn affects fluid properties, including fluid dynamic viscosity and density. The interplay of flow and heat transport also affects solute transport. To unravel these complex coupled flow, heat, and solute transport processes, here, we present a theory for the idealized scale‐dependent Poiseuille flow model considering a constant temperature gradient (∇T) along a single fracture, where fluid dynamic viscosity connects with temperature via an exponential function. The idealized scale‐dependent model is validated based on the solutions from direct numerical simulations. We find that the hydraulic conductivity (K) of the Poiseuille flow either increases or decreases with scales depending on ∇T > 0°C/m or ∇T < 0°C/m, respectively. Indeed, the degree of changes in K depends on the magnitude of ∇T and fracture length. The scale‐dependent model provides an alternative explanation for the well‐known scale‐dependent transport problem, for example, the dispersion coefficient increases with travel distance when ∇T > 0°C/m according to the Taylor dispersion theory, because K (or equivalently flux through fractures) scales with fracture length. The proposed theory unravels intertwined interactions between flow and transport processes, which might shed light on understanding many practical geophysical problems, for example, geothermal energy exploration.
Cone‐Beam Computed Tomography of Osteogenesis Imperfecta Types III and IV: Three‐Dimensional Evaluation of Craniofacial Features and Upper Airways
Authors: Reznikov Natalie , Dagdeviren Didem , Tamimi Faleh , Glorieux Francis , Rauch Frank , Retrouvey Jean‐Marc 
Published: November 2018

ABSTRACTThis cross‐sectional study investigated the natural history of craniofacial deformities in osteogenesis imperfecta (OI) and determined the impact of three‐dimensional (3D) analysis on diagnosis and treatment planning in orthodontics and orthognathic surgery in comparison to conventional two‐dimensional (2D) cephalometric examination. 3D images of the craniofacial complex were acquired during 1 calendar year using cone‐beam computed tomography (CBCT) from a cohort of 41 individuals (aged 11 to 35 years; 28 females) with OI type III (n = 13) or IV (n = 28). 3D evaluation of the craniocervical junction and upper airways was conducted using InVivoTM. 2D lateral cephalogram was constructed, traced, and examined using the University of Western Ontario analysis (DolphinTM). Quantitative and qualitative parameters were compared between OI type III and type IV groups (unpaired t test) and the unaffected population (Z‐score). 3D evaluation revealed a high prevalence of craniocervical abnormalities, craniofacial asymmetries, and nasal septum deviation in both OI groups. Mean airway dimensions were comparable to the non‐affected population norms, except for 5 individuals who had insufficient airway dimensions. In 2D, the maxilla was retrognathic and hypoplastic, and the mandibular position was convergent with respect to the face, resulting in mandibular prognathism and face height reduction. The 2D trends were more pronounced in OI type III, whereas the 3D craniocervical and airway abnormalities were common in both types. This study illustrates the prevalence of craniofacial and airway anomalies in OI that occur along with facial deformities are not associated with postcranial phenotype and OI type, are apparent only in 3D evaluation, and are likely to influence treatment strategy. For OI patients, a team effort involving a dentist, orthodontist, neurologist, and ear‐nose‐throat (ENT) practitioner is recommended for successful management of craniofacial deformities. © 2018 The Authors JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
Kinematic assessment of an elastic‐core cervical disc prosthesis in one and two‐level constructs
Authors: Guyer Richard D. , Voronov Leonard I. , Havey Robert M. , Khayatzadeh Saeed , Carandang Gerard , Blank Kenneth R. , Werner Stephanie , Rubin Josh , Padovani Nick , Patwardhan Avinash G. 
Published: November 2018

IntroductionAnterior cervical discectomy and fusion has been associated with the development of adjacent segment degeneration (ASD), with clinical incidence of approximately 3% per year. Cervical total disc arthroplasty (TDA) has been proposed as an alternative to prevent ASD.HypothesesTDA in optimal placement using an elastic‐core cervical disc (RHINE, K2M Inc., Leesburg, Virginia) will replicate natural kinematics and will improve with optimal vs anterior placement.MethodsSeven C3‐T1 cervical cadaver spines were tested intact first, then after one‐level TDA at C5‐C6 anterior placement, after TDA at C5‐C6 optimal placement, after two‐level TDA at C5‐C6 and C6‐C7 optimal placement, and finally after two‐level TDA at C5‐C6 lateral placement and C6‐C7 optimal placement. The specimens were subjected to: Flexion‐Extension moments (+1.5 Nm) with compressive preloads of 0 N and 150 N, lateral bending (LB) and axial rotation (AR) (+1.5 Nm) without preload.Results
C5‐C6 TDA in optimal placement resulted in a non‐significant increase in flexion‐extension ROM compared to intact under 0 N and 150 N preload (P > 0.05). Both LB and AR ROM decreased with arthroplasty (P < 0.01). Optimal placement of C6‐C7 TDA resulted in an increase in flexion‐extension ROM with preload compared to intact (P < 0.05) while LB and AR ROM decreased with arthroplasty (P < 0.01).ConclusionThis six degree of freedom elastic‐core disc arthroplasty effectively restored flexion‐extension motion to intact levels. In LB the TDA maintained 42% ROM at C5‐C6 and 60% at C6‐C7. In AR 57% of the ROM was maintained at C5‐C6 and 70% at C6‐C7. These findings are supported by literature which shows cervical TDA results in restoration of approximately 50% ROM in LB and AR, which is a multifactorial phenomenon encompassing TDA design parameters and anatomical constraints. Anterior placement of this viscoelastic TDA device shows motion restoration similar to optimal placement suggesting its design may be less sensitive to suboptimal placement.
Preparation of a monolithic column with a mixed‐mode stationary phase of reversed‐phase/hydrophilic interaction for capillary liquid chromatography
Authors: Zhang Meng , Gong Li , Liu Guizhen , Kang Jingwu 
Published: November 2018

AbstractA monolithic capillary column with a mixed‐mode stationary phase of reversed‐phase/hydrophilic interaction chromatography was prepared for capillary liquid chromatography. The monolith was created by an in‐situ copolymerization of a homemade monomer N,N‐dimethyl‐N‐acryloxyundecyl‐N‐(3‐sulfopropyl) ammonium betaine and a crosslinker pentaerythritol triacrylate in a binary porogen agent consisting of methanol and isopropanol. The functional monomer was designed to have a highly polar zwitterionic sulfobetaine terminal group and a hydrophobic long alkyl chain moiety. The composition of the polymerization solution was systematically optimized to permit the best column performance. The columns were evaluated by using acidic, basic, polar neutral analytes, as well as a set of alkylbenzenes and Triton X100. Very good separations were obtained on the column with the mixed‐mode stationary phase. It was demonstrated that the mixed‐mode stationary phase displayed typic dual retention mechanisms of reversed‐phase/hydrophilic interaction liquid chromatography depending on the content of acetonitrile in the mobile phase. The method for column preparation is reproducible.
Long‐term swallowing performance following transoral robotic surgery for obstructive sleep apnea
Authors: Paker Miki , Duek Irit , Awwad Faten , Benyamini Limor , Meshyeev Tsipi , Gil Ziv , Cohen Jacob T. 
Published: November 2018

Objectives/HypothesisThis study aimed to evaluate the long‐term swallowing performance following transoral robotic surgery (TORS) to the base of tongue (BOT) in the treatment of obstructive sleep apnea (OSA).Study DesignRetrospective and prospective cohort study.MethodsData analysis of 39 patients who underwent BOT reduction via TORS to treat OSA at our center from September 2013 to April 2016. Long‐term swallowing functions were assessed using subjective self‐evaluated swallowing disturbances questionnaire (SDQ) and objective fiberoptic endoscopic evaluation of swallowing (FEES).ResultsSeven patients underwent TORS BOT reduction alone, whereas 32 had also uvulopalatoplasty ± tonsillectomy, with a surgical success rate of 71.4%. Mean time for swallowing evaluation was 27.4 ± 9.43 months. Twenty‐five patients completed the SDQ with an average score of 9.26 ± 10.05. In 32%, the SDQ was positive for dysphagia. In 10 out of 14 patients who underwent FEES, swallowing problems were noticed. The most common pathological findings were food residue in the vallecula followed by early spillage of food into the hypopharynx, penetration of solid food and liquid on the vocal folds surface, and aspiration.ConclusionsBOT reduction via TORS has a negative effect on long‐term swallowing function. A self‐assessment questionnaire can help detect patients who suffer from swallowing impairment. Postoperative objective swallowing tests are essential not only in the immediate postoperative period but also during late routine follow‐up. Proper patient selection and detailed information about surgery and possible late‐swallowing effect are important factors before scheduling BOT reduction via TORS for OSA treatment.Level of Evidence4 Laryngoscope, 129:422–428, 2019
Real‐time robotic airway measurement: An additional benefit of a novel steady‐hand robotic platform
Authors: Razavi Christopher R. , Creighton Francis X. , Wilkening Paul R. , Peine Joseph , Taylor Russell H. , Akst Lee M. 
Published: November 2018

ObjectiveDescribe the secondary capability of a robotic system to provide real‐time measurements of airway dimensions with high fidelity.MethodsSeven unique phantoms of laryngotracheal stenosis (LTS) were modeled using a computer‐aided design tool and were three dimensionally printed. These stenoses were of different dimensions and orientations, and some were purposefully oblique. The dimensions of the stenoses were then measured with the novel Robotic ENT (Ear, Nose, and Throat) Microsurgery System (REMS; Galen Robotics, Inc., Sunnyvale, CA) because it is capable of tool position memory in three dimensional (3D) space. Five participants (two laryngologists, two otolaryngology–head and neck surgery residents, one neurotology fellow) measured each axis of stenosis (anteroposterior, lateral, and craniocaudal) three times for each of the seven stenosis phantoms. These measurements were then compared to the known design dimensions. Mean magnitude of error (MOE) and interrater reliability (IRR) using an intraclass correlation coefficient (ICC) were then calculated.ResultsMean MOE and standard deviation for all measurements was 0.306 ± 0.247 mm. Mean MOE was 0.374 ± 0.292 mm, 0.300 ± 0.237 mm, and 0.244 ± 0.185 mm for the anteroposterior, lateral, and craniocaudal dimensions of stenosis, respectively. Eighty‐two percent of all measurements had MOE < 0.5 mm. ICC was 0.945 (95% confidence interval [CI]: 0.847–0.989), 0.995 (95% CI: 0.984–0.999), and 0.993 (95% CI: 0.987–0.999) for anteroposterior, lateral, and craniocaudal dimensions, respectively, indicating excellent agreement among participants.ConclusionThe REMS can be used to reliably and accurately measure airway dimensions in 3D regardless of the orientation of stenosis. This ability may be easily extrapolated to the measurement of any airway lesion during laryngotracheal surgery.Level of Evidence4 Laryngoscope, 129:324–329, 2019
Dysfunctional hypoglossal nerve stimulator after electrical cardioversion: A case series
Authors: Vasconcellos Adam P. , Huntley Colin T. , Schell Amy E. , Soose Ryan J. , Boon Maurits S. 
Published: November 2018

Objectives/HypothesisUpper airway stimulation has demonstrated marked improvements in apnea‐hypopnea index, oxygen desaturation index, and quality‐of‐life measures in patients with moderate to severe obstructive sleep apnea (OSA) who cannot tolerate continuous positive airway pressure. Cardiac arrhythmias are common in patients with OSA and can require electrical cardioversion. We describe the first four reported cases of hypoglossal nerve stimulator (HGNS) dysfunction after electrical cardioversion and illustrate our operative approach to device troubleshooting and repair.Study DesignRetrospective case series.MethodsA retrospective review of 201 HGNS implantations performed at two academic institutions revealed four cases of HGNS device dysfunction after electrical cardioversion requiring surgical revision. Preoperative and postoperative device performance metrics and electrical cardioversion specifications were retrospectively assessed and compiled for this case series. The senior authors (R.J.S., M.S.B.) detail operative planning and approach for HGNS implantable pulse generator (IPG) replacement.ResultsAt least two patients with HGNS device dysfunction had received cardioversion via anterolateral electrode pad placement. Three patients had received multiple shocks. All four patients experienced a change in device functionality or complete cessation of functionality after electrocardioversion. Operatively, each patient required replacement of the IPG, with subsequent intraoperative interrogation revealing proper device functionality.ConclusionCounseling for patients with HGNS undergoing external electrical cardioversion should include possible device damage and need for operative replacement. Anteroposterior electrode pad placement should be considered for patients with HGNS who require electrocardioversion. Operative replacement of an HGNS system damaged by electrocardioversion begins with IPG replacement and intraoperative device interrogation.Level of Evidence4Laryngoscope, 129:1949–1953, 2019