bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population Pharmacokinetics and Pharmacodynamics of Dexmedetomidine in Children Undergoing Ambulatory Surgery
Authors: Pérez-Guillé María-Gabriela , Toledo-López Alejandra , Rivera-Espinosa Liliana , Alemon-Medina Radames , Murata Chiharu , Lares-Asseff Ismael , Chávez-Pacheco Juan Luis , Gómez-Garduño Josefina , Zamora Gutiérrez Ana-Lilia , Orozco-Galicia Claudia , Ramírez-Morales Karina , Lugo-Goytia Gustavo 
Published: May 2018

BACKGROUND:
Dexmedetomidine (DEX) is an α-2 adrenergic agonist with sedative and analgesic properties. Although not approved for pediatric use by the Food and Drug Administration, DEX is increasingly used in pediatric anesthesia and critical care. However, very limited information is available regarding the pharmacokinetics of DEX in children. The aim of this study was to investigate DEX pharmacokinetics and pharmacodynamics (PK–PD) in Mexican children 2–18 years of age who were undergoing outpatient surgical procedures.

METHODS:
Thirty children 2–18 years of age with American Society of Anesthesiologists physical status score of I/II were enrolled in this study. DEX (0.7 μg/kg) was administered as a single-dose intravenous infusion. Venous blood samples were collected, and plasma DEX concentrations were analyzed with a combination of high-performance liquid chromatography and electrospray ionization-tandem mass spectrometry. Population PK–PD models were constructed using the Monolix program.

RESULTS:
A 2-compartment model adequately described the concentration–time relationship. The parameters were standardized for a body weight of 70 kg by using an allometric model. Population parameters estimates were as follows: mean (between-subject variability): clearance (Cl) (L/h × 70 kg) = 20.8 (27%); central volume of distribution (V1) (L × 70 kg) = 21.9 (20%); peripheral volume of distribution (V2) (L × 70 kg) = 81.2 (21%); and intercompartmental clearance (Q) (L/h × 70 kg) = 75.8 (25%). The PK–PD model predicted a maximum mean arterial blood pressure reduction of 45% with an IC50 of 0.501 ng/ml, and a maximum heart rate reduction of 28.9% with an IC50 of 0.552 ng/ml.

CONCLUSIONS:
Our results suggest that in Mexican children 2–18 years of age with American Society of Anesthesiologists score of I/II, the DEX dose should be adjusted in accordance with lower DEX clearance.
Benefit and Harm of Adding Epinephrine to a Local Anesthetic for Neuraxial and Locoregional Anesthesia: A Meta-analysis of Randomized Controlled Trials With Trial Sequential Analyses
Authors: Tschopp Clément , Tramèr Martin R. , Schneider Alexis , Zaarour Maroun , Elia Nadia 
Published: May 2018

BACKGROUND:
This systematic review examines the benefit and harm of adding epinephrine to local anesthetics for epidural, intrathecal, or locoregional anesthesia.

METHODS:
We searched electronic databases to October 2017 for randomized trials comparing any local anesthetic regimen combined with epinephrine, with the same local anesthetic regimen without epinephrine, reporting on duration of analgesia, time to 2 segments regression, or any adverse effects. Trial quality was assessed using the Cochrane risk of bias tool and a random-effects model was used. Trial sequential analyses (TSA) were applied to identify the information size (IS; number of patients needed to reach a definite conclusion) and were set to detect an increase or decrease of effect of 30%–50%, depending on the end point considered. Alpha levels were adjusted (1%) for multiple outcome testing.

RESULTS:
We identified 70 trials (3644 patients, 17 countries, from 1970 to 2017). Median number of patients per trial was 44 (range, 9–174). Thirty-seven trials (1781 patients) tested epinephrine for epidural, 27 (1660) for intrathecal, and 6 (203) for locoregional anesthesia (sciatic, femoral, popliteal, axillary blocks). TSA enabled us to conclude that adding epinephrine to epidural local anesthetics could not decrease postoperative pain intensity by 30%, and did not impact the risk of intraoperative arterial hypotension. IS was insufficient to conclude on the impact of epinephrine on the risk of motor block (IS, 4%), arterial hypotension (20%), urinary retention (23%), or pain intensity at rest (27%) during labor. TSA confirmed that adding epinephrine to intrathecal local anesthetics increased the duration of motor block (weighted mean difference [WMD] 64 minutes; 99% CI, 37–91), analgesia (WMD 34 minutes; 99% CI, 6–62), and the time to 2 segments regression (WMD 20 minutes; 99% CI, 11–28). IS was insufficient to conclude on its impact on arterial hypotension (IS, 15%), or when administrated in a combined spinal-epidural, on motor block (IS, 11%) or arterial hypotension (IS, 11%). Adding epinephrine to local anesthetics for a locoregional block increased the duration of analgesia (WMD 66 minutes; 98% CI, 32–100]).

CONCLUSIONS:
Adding epinephrine to intrathecal or locoregional local anesthetics prolongs analgesia and motor block by no more than 60 minutes. The impact of adding epinephrine to epidural local anesthetics or to a combined spinal-epidural remains uncertain.
The Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay: Results From an Enhanced Recovery After Surgery for Colorectal Surgery Cohort
Authors: Grant Michael C. , Pio Roda Claro M. , Canner Joseph K. , Sommer Philip , Galante Daniel , Hobson Deborah , Gearhart Susan , Wu Christopher L. , Wick Elizabeth 
Published: May 2018

BACKGROUND:
Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort.

METHODS:
From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS).

RESULTS:
Process measure compliance was associated with a stepwise reduction in LOS. Patients who received >4 process measures (high compliance) had a significantly shorter LOS (incident rate ratio [IRR], 0.77; 95% CI, 0.70–0.85); P < .001) compared to low compliance (0–2 process measures) counterparts. Multivariable regression suggests that utilization of multimodal nausea and vomiting prophylaxis (IRR, 0.78; 95% CI, 0.68–0.89; P < .001), scheduled postoperative nonsteroidal pain medication use (IRR, 0.76; 95% CI, 0.67–0.85; P < .001), and strict adherence to a postoperative opioid administration (IRR, 0.58; 95% CI, 0.51–0.67; P < .001) protocol for breakthrough pain were independently associated with reduced LOS.

CONCLUSIONS:
Our findings suggest that increased compliance with process measures directly influenced by the anesthesiologists and in concert with a formal anesthesia protocol is associated with reduced LOS. Engaging anesthesiology colleagues throughout the surgical encounter increases the overall value of perioperative care.
Current concepts in the primary management of irreparable posterosuperior rotator cuff tears without arthritis
Authors: Lädermann Alexandre , Collin Philippe , Athwal George S. , Scheibel Markus , Zumstein Matthias A. , Nourissat Geoffroy 
Published: May 2018

Various procedures exist for patients with irreparable posterosuperior rotator cuff tears (IRCT). At present, no single surgical option has demonstrated clinical superiority. There is no panacea for treatment and patients must be aware, in cases of palliative or non-prosthetic options, of an alarming rate of structural failure (around 50%) in the short term. The current review does not support the initial use of complex and expensive techniques in the management of posterosuperior IRCT. Further prospective and comparative studies with large cohort populations and long-term follow-up are necessary to establish effectiveness of expensive or complicated procedures such as superior capsular reconstruction (SCR), subacromial spacers or biological augmentation as reliable and useful alternative treatments for IRCT.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.180002
Choice and Control Within Family Relationships: The Lived Experience of Adults With Intellectual Disability
Authors: Curryer Bernadette , Stancliffe Roger J. , Dew Angela , Wiese Michele Y. 
Published: May 2018

AbstractIncreased choice and control is a driving force of current disability policy in Australia for people with disability and their families. Yet little is known of how adults with intellectual disability (ID) actually experience choice and control within their family relationships. We used interpretative phenomenological analysis of individual, semistructured interviews conducted with 8 Australian adults with ID to understand the meaning given to their experience of family support received around choice and decision making. Three themes were identified: (1) centrality of family, (2) experience of self-determination, and (3) limitations to choice and control. The participants identified trusted family members from whom guidance around choice and decision making was both sought and received, often involving mutual decision making and limitations to control.
Mathematical Models for Dynamics of Molecular Processes in Living Biological Cells. A Single Particle Tracking Approach
Authors: Weron Aleksander 
Published: May 2018

Abstract
In this survey paper we present a systematic methodology of how to identify origins of fractional dynamics. We consider three models leading to it, namely fractional Brownian motion (FBM), fractional Lévy stable motion (FLSM) and autoregressive fractionally integrated moving average (ARFIMA) process. The discrete-time ARFIMA process is stationary, and when aggregated, in the limit, it converges to either FBM or FLSM. In this sense it generalizes both models. We discuss three experimental data sets related to some molecular biology problems described by single particle tracking. They are successfully resolved by means of the universal ARFIMA time series model with various noises. Even if the finer details of the estimation procedures are case specific, we hope that the suggested checklist will still have been of great use as a practical guide. In Appendices A-F we describe useful fractional dynamics identification and validation methods.
Optimization of Price, Default Ratio and Capital under Regulatory Criterion of Maximizing Social Benefit
Authors: Mao Hong , Wen Zhongkai 
Published: May 2018

Abstract
In this paper, we explore the optimal price, default ratio, and capital for insurance companies under social welfare maximization from regulators' perspective. From comparisons of cases under symmetric and asymmetric information in the insurance market, we find that an optimal regulatory objective should be set to maximize social benefit and induce fair benefit distribution in a transparent insurance market, and direct regulation on capital constraint can increase insurance demand and shareholders' benefits in a non-transparent market.
Directors’ and Officers’ Liability Insurance and Firm Performance: Evidence from Taiwan
Authors: Yi Bingsheng , Chen Chia-wei , Lin Barry 
Published: May 2018

Abstract
Using a sample of 5,752 Taiwanese firm-year observations over the 2008 to 2012 period, we examine whether and how the existence of D&O insurance may affect firm performance. Our results suggest that whether to purchase D&O insurance is an endogenous corporate behavior, D&O insurance is not significantly related to firm performance. In addition, we find that firms with higher cash ratio, larger and more independent board are more likely to purchase the D&O insurance, while older firms are less likely to buy the D&O insurance. Our study implies that the government should not require firms to buy the D&O insurance. Instead, government should allow firms themselves to decide whether they optimally should purchase D&O insurance or not based on each firm’s particular circumstances. Firms should also not just simply follow their peers to buy the D&O insurance. They should carefully compare the benefits and costs of the D&O insurance based on their own situations, and only buy the insurance when the benefits exceed the costs.
Non-Congruent Views about Signal Precision in Collective Decisions
Authors: Pan Addison , Fabrizi Simona , Lippert Steffen 
Published: May 2018

Abstract
We relax the standard assumptions in collective decision-making models that voters can not only derive a perfect view about the accuracy of the information at their disposal before casting their votes, but can, in addition, also correctly assess other voters’ views about it. We assume that decision-makers hold potentially differing views, while remaining ignorant about such differences, if any. In this setting, we find that information aggregation works well with voting rules other than simple majority: as voters vote less often against their information than in conventional models, they can deliver higher-quality decisions, including in the canonical 12 jurors case. We obtain voting equilibria with many instances, in which other voting rules, including unanimity, clearly outperform simple majority.
Direct Effects on Seed Germination of 17 Tree Species under Elevated Temperature and CO2 Conditions
Authors: Kim Du Hyun , Han Sim Hee 
Published: May 2018

AbstractEffects on seed germination characteristics of 17 tree species were investigated under elevated temperature and CO2. Seeds of 5 needle-leaf and 12 broad-leaf species were germinated under four conditions: 24°C + 400 μmol CO2mol air–1, 24°C + 750 μmol CO2mol air–1, 27°C + 400 μmol CO2mol air–1, and 27°C + 750 μmol CO2mol air–1. The elevated temperature and CO2affected germination percent (GP) of 7 tree species seeds.GPs ofPinus densiflora,P.thunbergii,Betula ermanii, andMaackia amurensisseeds were affected by the elevated temperature, while only that ofP.jezoensisseed was influenced by the elevated CO2. GPs ofMalus baccataandZelkova serrataseeds were influenced by both the elevated temperature and CO2. In addition, the elevated temperature and CO2also affected mean germination time (MGT) of 12 tree species seeds. Particularly, MGTs ofP.thunbergiiandRhododendron tschonoskiiseeds were influenced by both factors. In conclusion, elevated temperature and CO2affected seed germination characteristics, which were reflected by significant differences among tree species. Specifically, these two factors exerted stronger influence on germination pattern such as MGT rather than seed germination percent.
Mechanisms of salt tolerance in halophytes: current understanding and recent advances
Authors: Meng Xiaoqian , Zhou Jun , Sui Na 
Published: May 2018

AbstractHalophytes are plants that exhibit high salt tolerance, allowing them to survive and thrive under extremely saline conditions. The study of halophytes advances our understanding about the important adaptations that are required for survival in high salinity conditions, including secretion of salt through the salt glands, regulation of cellular ion homeostasis and osmotic pressure, detoxification of reactive oxygen species, and alterations in membrane composition. To explore the mechanisms that contribute to tolerance to salt stress, salt-responsive genes have been isolated from halophytes and expressed in non-salt tolerant plants using targeted transgenic technologies. In this review, we discuss the mechanisms that underpin salt tolerance in different halophytes.
Evaluation of the quality of CT images acquired with smart metal artifact reduction software
Authors: Zhou Peng , Zhang Chunling , Gao Zhen , Cai Wangshu , Yan Deyue , Wei Zhaolong 
Published: May 2018

AbstractObjectiveTo evaluate the practical effectiveness of smart metal artifact reduction (SMAR) in reducing artifacts caused by metallic implants.MethodsPatients with metal implants underwent computed tomography (CT) examinations on high definition CT scanner, and the data were reconstructed with adaptive statistical iterative reconstruction (ASiR) with value weighted to 40% and smart metal artifact reduction (SMAR) technology. The comparison was assessed by both subjective and objective assessment between the two groups of images. In terms of subjective assessment, three radiologists evaluated image quality and assigned a score for visualization of anatomic structures in the critical areas of interest. Objectively, the absolute CT value of the difference (ΔCT) and artifacts index (AI) were adopted in this study for the quantitative assessment of metal artifacts.ResultsIn subjective image quality assessment, three radiologists scored SMAR images higher than 40% ASiR images (P<0.01) and the result suggested that visualization of critical anatomic structures around the region of the metal object was significantly improved by using SMAR compared with 40% ASiR. The ΔCT and AI for quantitative assessment of metal artifacts showed that SMAR appeared to be superior for reducing metal artifacts (P<0.05) and indicated that this technical approach was more effective in improving the quality of CT images.ConclusionA variety of hardware (dental filling, embolization coil, instrumented spine, hip implant, knee implant) are processed with the SMAR algorithm to demonstrate good recovery of soft tissue around the metal. This artifact reduction allows for the clearer visualization of structures hidden underneath.
Role of water soluble vitamins in the reduction diet of an amateur sportsman
Authors: Szczuko Małgorza , Migrała Rafał , Drozd Arleta , Banaszczak Marcin , Maciejewska Dominika , Chlubek Dariusz , Stachowska Ewa 
Published: May 2018

AbstractThis study is aimed at determining the content of water soluble vitamins in amateur sportsmen before and after the use of reduction diet. Twenty adult male amateur sportsmen aged between 20 and 43 qualified for this study. The participants adhered to individually adjusted reduction diets for 3 months. Diet supplements were excluded from the diet during that time. Vitamins were analyzed before and after the reduction diet using HPLC. The following vitamins were analyzed: B1, B2, B3, PP, B5, B6, B7, B9, B12 and vitamin C. Statistically significant increase of riboflavin in blood plasma (p=0.0254) and statistically significant (p=0.048) decrease in the concentration of niacin was found when compared to the period before the diet. Appropriate level of riboflavin can be obtained by the consumption of proper amount of diary in the diet. Supplementation with PP is advised and, in case of improper diet, the supplementation of B1, B7 and B12 may also be considered.
Salivary protein roles in oral health and as predictors of caries risk
Authors: Laputková Galina , Schwartzová Vladimíra , Bánovčin Juraj , Alexovič Michal , Sabo Ján 
Published: May 2018

AbstractThis work describes the current state of research on the potential relationship between protein content in human saliva and dental caries, which remains among the most common oral diseases and causes irreversible damage in the oral cavity. An understanding the whole saliva proteome in the oral cavity could serve as a prerequisite to obtaining insight into the etiology of tooth decay at early stages. To date, however, there is no comprehensive evidence showing that salivary proteins could serve as potential indicators for the early diagnosis of the risk factors causing dental caries. Therefore, proteomics indicates the promising direction of future investigations of such factors, including diagnosis and thus prevention in dental therapy.
Optimizing charge state distribution is a prerequisite for accurate protein biomarker quantification with LC-MS/MS, as illustrated by hepcidin measurement
Authors: Schmitz Ellen M.H. , Leijten Niels M. , van Dongen Joost L.J. , Broeren Maarten A.C. , Milroy Lech G. , Brunsveld Luc , Scharnhorst Volkher , van de Kerkhof Daan 
Published: May 2018

Abstract

Background:
Targeted quantification of protein biomarkers with liquid chromatography-tandem mass spectrometry (LC-MS/MS) has great potential, but is still in its infancy. Therefore, we elucidated the influence of charge state distribution and matrix effects on accurate quantification, illustrated by the peptide hormone hepcidin.

Methods:
An LC-MS/MS assay for hepcidin, developed based on existing literature, was improved by using 5 mM ammonium formate buffer as mobile phase A and as an elution solution for solid phase extraction (SPE) to optimize the charge state distribution. After extensive analytical validation, focusing on interference and matrix effects, the clinical consequence of this method adjustment was studied by performing receiving operating characteristic (ROC)-curve analysis in patients with iron deficiency anemia (IDA, n=44), anemia of chronic disease (ACD, n=42) and non-anemic patients (n=93).

Results:
By using a buffered solution during sample preparation and chromatography, the most abundant charge state was shifted from 4+ to 3+ and the charge state distribution was strongly stabilized. The matrix effects which occurred in the 4+ state were therefore avoided, eliminating bias in the low concentration range of hepcidin. Consequently, sensitivity, specificity and positive predictive value (PPV) for detection of IDA patients with the optimized assay (96%, 97%, 91%, respectively) were much better than for the original assay (73%, 70%, 44%, respectively).

Conclusions:
Fundamental improvements in LC-MS/MS assays greatly impact the accuracy of protein quantification. This is urgently required for improved diagnostic accuracy and clinical value, as illustrated by the validation of our hepcidin assay.
Osteocalcin value to identify subclinical atherosclerosis over atherosclerotic cardiovascular disease (ASCVD) risk score in middle-aged and elderly Chinese asymptomatic men
Authors: Xu Yiting , Ma Xiaojing , Xiong Qin , Zhang Xueli , Shen Yun , Bao Yuqian 
Published: May 2018

AbstractBackground:Our study examined whether osteocalcin contributed to identifying carotid intima-media thickness (C-IMT) over the atherosclerotic cardiovascular disease (ASCVD) risk score.Methods:We recruited 618 middle-aged and elderly men from communities in Shanghai. Serum osteocalcin levels were determined using an electrochemiluminescence immunoassay. C-IMT was measured by ultrasonography.Results:The study included 245 men with low ASCVD risk and 373 men with moderate-to-high ASCVD risk. Serum osteocalcin levels were lower in the moderate-to-high risk vs. low risk men (p=0.042). Multivariate stepwise regression analysis showed that body mass index (BMI) and glycated hemoglobin were predictors for reduced osteocalcin levels (both p<0.001). Among all subjects, the proportion with an elevated C-IMT was higher in the low-osteocalcin group than in the high-osteocalcin group (p=0.042), and the significance of this result was greater when considering only subjects with a moderate-to-high ASCVD risk (p=0.011). The recognition rate of elevated C-IMT was superior with both low osteocalcin and moderate-to-high ASCVD risk vs. either parameter alone (p<0.001 and p=0.015, respectively). Osteocalcin was independently and inversely associated with elevated C-IMT after adjusting for the 10-year ASCVD risk score (p=0.004). The negative relationship remained statistically significant in subjects with a moderate-to-high ASCVD risk in particular (standardized β=−0.104, p=0.044).Conclusions:In middle-aged and elderly men, serum osteocalcin levels strengthen identifying subclinical atherosclerosis over ASCVD risk score, especially among subjects with a moderate-to-high ASCVD risk.