bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mixed reality holograms for heart surgery planning: first user experience in congenital heart disease
Authors: Brun H , Bugge R A B , Suther L K R , Birkeland S , Kumar R , Pelanis E , Elle O J 
Published: November 2018

Abstract

Aims
Proof of concept and feasibility study for preoperative diagnostic use of mixed reality (MR) holograms of individual 3D heart models from standard cardiac computed tomography angiograms (CTA) images. Optimal repair for complex congenital heart disease poses high demands on 3D anatomical imagination. Three-dimensional printed heart models are increasingly used for improved morphological understanding during surgical and interventional planning. Holograms are a dynamic and interactive alternative, probably with wider applications.

Methods and results
A 3D heart model was segmented from CTA images in a patient with double outlet right ventricle and transposition of the great arteries (DORV-TGA). The hologram was visualized in the wearable MR platform HoloLens® for 36 paediatric heart team members who filled out a diagnostic and quality rating questionnaire. Morphological and diagnostic output from the hologram was assessed and the 3D experience was evaluated. Locally developed app tools such as hologram rotation, scaling, and cutting were rated. Anatomy identification and diagnostic output was high as well as rating of 3D experience. Younger and female users rated the app tools higher.

Conclusion
This preliminary study demonstrates that MR holograms as surgical planning tool for congenital heart disease may have a high diagnostic value and contribute to understanding complex morphology. The first users experience of the hologram presentation was found to be very positive, with a preference among the female and the younger users. There is potential for improvement of the hologram manipulation tools.
Evaluation of the French reactive mortality surveillance system supporting decision making
Authors: Baghdadi Yasmine , Gallay Anne , Caserio-Schönemann Céline , Fouillet Anne 
Published: October 2018

Abstract

Background
In France, a mortality syndromic surveillance system was set up with objectives of early detection and reactive evaluation of the impact of expected and unexpected events to support decision makers. This study aims to describe the characteristics of the system and its usefulness for decision makers.

Methods
Anonymized data from the administrative part of death certificates were daily collected from 3062 computerized city halls and were transmitted to Santé publique France in routine. Coverage of the system was measured as the proportion of deaths registered by the system among the complete number of deaths and analyzed by age, month and region. Deaths were described by gender, age and geographical level using proportion. The excess periods of deaths were described based on the comparison of the weekly observed and expected numbers of deaths between 2012 and 2016.

Results
The system recorded 77.5% of the national mortality covering the whole territory. About 81% of deaths were aged 65 years old and more. The surveillance system identified mortality variations mainly during winter and summer, for some concomitant with influenza epidemic or heatwave period, and thus provided information for decision makers.

Conclusion
The ability of the system to detect and follow mortality outbreaks in routine in the whole territory has been demonstrated. It is a useful tool to provide early evaluation of the impact of threats on mortality and alert decision makers to adapt control measures. However, the absence of information on medical causes of death may limit the ability to target recommendations.
Household Accessibility and Residential Relocation in Older Adults
Authors: Granbom Marianne , Perrin Nancy , Szanton Sarah , K.M. Cudjoe Thomas , Gitlin Laura N 
Published: October 2018

Abstract

Objectives
It is unclear how home environmental factors influence relocation decisions. We examined whether indoor accessibility, entrance accessibility, bathroom safety features, housing type, and housing condition were associated with relocations either within the community or to residential care facilities.

Methods
We used prospective data over 4 years from the nationally representative National Health and Aging Trends Study in the United States of Medicare beneficiaries 65 years and older living in the community (N = 7,197). We used multinomial regression analysis with survey weights.

Results
Over the 4 years, 8.2% of the population moved within the community, and 3.9% moved to residential care facilities. After adjusting for demographics and health factors, poor indoor accessibility was found to be associated with moves within the community but not to residential care facilities. No additional home environmental factors were associated with relocation.

Discussion
One-floor dwellings, access to a lift, or having a kitchen, bedroom, and bathroom on the same floor may help older adults age in place. Understanding which modifiable home environmental factors trigger late-life relocation, and to where, has practical implications for developing policies and programs to help older adults age in their place of choice.
UV background fluctuations traced by metal ions at z ≈ 3
Authors: Graziani L , Maselli A , Maio U 
Published: October 2018

ABSTRACT
Here we investigate how LyC-opaque systems present in the intergalactic medium at $z$ ≈ 3 can distort the spectral shape of a uniform UV background (UVB) through radiative transfer (RT) effects. With this aim in mind, we perform a multifrequency RT simulation through a cosmic volume of 10 h−1 cMpc scale polluted by metals, and self-consistently derive the ions of all the species. The UVB spatial fluctuations are traced by the ratio of He $\,\small {II}$ and H $\,\small {I}$ column density, η, and the ratio of C $\, \small {IV}$ and Si $\, \small {IV}$ optical depths, ζ. We find that: (i) η spatially fluctuates through overdense systems (Δ) with statistically significant deviations δη &gt; 25 per cent in 18 per cent of the volume; (ii) same fluctuations in ζ are also present in 34 per cent of the enriched domain (only 8 per cent of the total volume) and derive from a combination of RT induced effects and in-homogeneous metal enrichment, both effective in systems with Δ &gt; 1.5.
Time for Precision: A World Without Susceptibility Breakpoints
Authors: Bader Justin C , Lakota Elizabeth A , Andes David R , Rubino Christopher M , Ambrose Paul G , Bhavnani Sujata M 
Published: October 2018

Abstract
Interpretive criteria for in vitro susceptibility testing criteria, “susceptibility breakpoints,” underpin the evaluation and selection of antimicrobial regimens. However, despite their strengths, susceptibility breakpoints are a relatively blunt instrument employed to address an extremely complex question—what is the likelihood of treatment success for individual patients? With regard to evaluating patients on a case-by-case basis, breakpoints merely allow us to account for pathogen susceptibility. This approach precludes consideration of drug exposures achieved in patients, thus overlooking half of the equation for predicting treatment success. Herein, we propose the framework for considering both pathogen- and patient-specific information to provide clinicians a means of evaluating antimicrobial regimens for individual patients through tools automating pharmacokinetic-pharmacodynamic target attainment analyses. Implementing these tools along with their acceptance by professional organizations will allow for a shift in the paradigm for how antimicrobials are selected and dosed—toward patient-centered care through precision medicine.
Growth Through Inter-sectoral Knowledge Linkages
Authors: Cai Jie , Li Nan 
Published: October 2018

Abstract
The majority of innovations are developed by multi-sector firms. The knowledge needed to invent new products is more easily adapted from some sectors than from others. We study this network of knowledge linkages between sectors and its impact on firm innovation and aggregate growth. We first document a set of sectoral-level and firm-level observations on knowledge applicability and firms’ multi-sector patenting behaviour. We then develop a general equilibrium model of firm innovation in which inter-sectoral knowledge linkages determine the set of sectors a firm chooses to innovate in and how much R&D to invest in each sector. It captures how firms evolve in the technology space, accounts for cross-sector differences in R&D intensity, and describes an aggregate model of technological change. The model matches new observations as demonstrated by simulation. It also yields new insights regarding the mechanism through which sectoral fixed costs of R&D affect growth.
Antiphospholipid score is a novel risk factor for idiopathic osteonecrosis of the femoral head in patients with systemic lupus erythematosus
Authors: Hisada Ryo , Kato Masaru , Ohnishi Naoki , Sugawara Eri , Fujieda Yuichiro , Oku Kenji , Bohgaki Toshiyuki , Amengual Olga , Yasuda Shinsuke , Atsumi Tatsuya 
Published: October 2018

Abstract

Objective
Idiopathic osteonecrosis of the femoral head (ION) is a common complication of SLE associated with CS therapy. Although the pathogenesis of ION involves local bone ischaemia favoured by thrombophilia, the involvement of aPL in lupus ION remains to be elucidated. We have previously reported the aPL score (aPL-S) as a quantitative marker of aPL and the development of thrombotic events in autoimmune diseases. The aim of this study was to identify the impact of aPL on the development of ION using aPL-S.

Methods
This was a single-centre retrospective study comprising 88 consecutive SLE patients who underwent MRI of the hip joints from January 2000 to March 2017. Baseline characteristics, pharmacotherapy and total hip arthroplasty performed during follow-up were evaluated.

Results
The presence of ION was confirmed by MRI scan in 38 patients (43.1%). Male gender, positivity of any aPL, aPL-S, high aPL-S (≥30) and high dose of CS were identified as risk factors for ION by univariate analysis. Multivariate analysis revealed high aPL-S (odds ratio 5.12, 95% CI 1.18–29.79) and use of high-dose CS (odds ratio 10.25, 95% CI 3.00–48.38) as independent variables. Kaplan–Meier analysis showed that patients with high aPL-S received total hip arthroplasty more frequently than those without aPL (P = 0.010).

Conclusions
We newly identified high aPL-S as an important risk factor for ION development in SLE, suggesting the involvement of aPL-induced coagulopathy in the pathophysiology of lupus ION.
SURVEILLANCE OF ENVIRONMENTAL DOSE RATE WITH THE COVARIANCE MATRIX
Authors: Benito G , Sáez J C , Blázquez J B , Quiñones J 
Published: October 2018

Abstract
The objective of this study is the operational verification of an environmental dose rate monitoring network composed by several sensors. The verification of the study has been tested on the CIEMAT’s Radiological Network, establishing a records quality assurance of the detectors using the covariance matrix and the eigenvalues. The technique has revealed an underlying records malfunction, which have not been appreciated by applying conventional surveillance. In this sense, the malfunction has economic and security consequences, which can be minimized with an alternative methodology, which guarantees the radiological protection of a local area according to the Regulatory Agency.
OPTIMISATION OF PATIENT DOSE AND IMAGE QUALITY IN FLUOROSCOPICALLY GUIDED CERVICAL SPINE SURGERY: A PHANTOM-BASED STUDY
Authors: Metaxas Vasileios I , Messaris Gerasimos A , Gatzounis George D , Panayiotakis George S 
Published: October 2018

Abstract
The purpose of the current study was to provide useful data, which may help neurosurgeons to manage the patient dose and image quality in spinal surgery procedures, utilising a phantom and a test object. The kerma area product, cumulative dose (CD) and entrance surface dose (ESD) rate on the phantom and image intensifier were measured, for selectable fields of view (FOVs), fluoroscopy modes, two geometric magnifications and various phantom thicknesses. The images were subjectively evaluated regarding low-contrast detectability and high-contrast resolution. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), high-contrast spatial resolution (HCSR) and figure of merit (FOM) values were also estimated. The ESD rates increased with increasing phantom thickness, when using electronic or geometric magnification, continuous or high-definition fluoroscopy (HDF). The observers’ evaluation showed relatively slight changes in image quality when pulsed fluoroscopy was used. SNR, CNR and HCSR values decreased with increasing phantom thicknesses, while remained almost constant when using pulsed fluoroscopy. SNR and HCSR improved in HDF, while the CNR remained almost constant only for the FOVs 23 and 17 cm. By applying electronic magnification, this resulted in improved HCSR. FOM values decreased in HDF, with increasing phantom thickness and using electronic magnification. For the ‘thinnest’ patients, CD may overestimate skin dose by 25% than the actual values. Geometric magnification resulted in improved FOM, especially for low-dose fluoroscopy and FOV 23 cm. The knowledge of the increments in dose values, image quality and FOM indices concerning phantom thickness may help neurosurgeons to optimise spinal surgery procedures by selecting the appropriate operational parameters, which could contribute toward the establishment of a radiation protection culture.
MCNP APPROACHES FOR DOSE RATES MODELING IN LABORATORY FOR NEUTRON ACTIVATION ANALYSIS AND GAMMA SPECTROMETRY AT OSTRAVA
Authors: Uhlář Radim , Alexa Petr 
Published: November 2018

Abstract
The Laboratory for Neutron Activation Analysis and Gamma Spectrometry at the VŠB-Technical University of Ostrava was equipped with the neutron generator MP320 operating on the principle of the deuterium–tritium fusion and producing 108 neutrons/s at maximum. To ensure radiation protection of radiation workers and public outside the laboratory, the concrete shielding was designed and its protection efficiency was validated by MCNP simulations. Three approaches to calculate the dose rates were compared. The dose rates were estimated for the ORNL MIRD phantom located at the relevant positions (Tally F6 and *F8) and using the MCNPX mesh tally feature with the new ICRP Publication 116 flux-to-dose conversion factors. It was proven that the Approach II in which the absorbed dose rates due to neutrons for all organs are computed using the cell tally F6 and the photon dose calculation is performed by the *F8 energy deposition tally is the most valuable one.
Local Excision Versus Radical Resection for 1- to 2-cm Neuroendocrine Tumors of the Rectum: A National Cancer Database Analysis
Authors: Fields Adam C. , Saadat Lily V. , Scully Rebecca E. , Davids Jennifer S. , Goldberg Joel E. , Bleday Ronald , Melnitchouk Nelya 
Published: November 2018

BACKGROUND:
The optimal surgical management for 1- to 2-cm, nonmetastatic rectal neuroendocrine tumors remains unknown.

OBJECTIVE:
We sought to determine overall survival and operative outcomes in patients who underwent local excision versus radical resection of rectal neuroendocrine tumors.

DESIGN:
The National Cancer Database (2004–2013) was queried to identify patients with nonmetastatic rectal neuroendocrine tumors who underwent local excision or radical resection.

SETTING:
The study included national data.

PATIENTS:
There were 274 patients in the local excision group and 47 patients in the radical resection group.

MAIN OUTCOME MEASURES:
The primary outcome was overall survival. Secondary outcomes included 30-day mortality, hospital length of stay, and procedural outcomes.

RESULTS:
There were no differences in demographics between the 2 groups. Patients who underwent radical resection had slightly larger tumors with higher stage and grade. Patients undergoing local excision had higher rates of positive margins (8.23% vs 0%; p = 0.04). There were no deaths within 30 days in either group, but patients who had radical resection had longer median hospital length of stay (0 vs 3 d; p < 0.01). After adjusting with a Cox proportional hazards model, no difference was seen in survival between the 2 patient groups (HR = 2.39 (95% CI, 0.85–6.70); p = 0.10).

LIMITATIONS:
There are several limitations, which include that this work is a retrospective review; the data set does not include variables such as depth of tumor invasion, which may influence surgical treatment or local recurrence rates; and patients were not randomly assigned to treatment groups.

CONCLUSIONS:
There is no survival benefit to radical resection of 1- to 2-cm, nonmetastatic rectal neuroendocrine tumors. This suggests that local excision may be a feasible and less morbid option for intermediate-sized rectal neuroendocrine tumors. See Video Abstract at http://links.lww.com/DCR/A744.
Tactile cues change trunk and scapular muscle activity, scapular winging, and thoracic kyphosis during knee push-up plus in subjects with scapular winging
Authors: Shin A-Reum , Lee Ji-Hyun , Kim Da-Eun , Cynn Heon-Seock 
Published: October 2018

Abstract
Serratus anterior muscle weakness causes scapular winging, characterized by scapular downward rotation and scapular anterior tipping in the resting position. Knee push-up plus (KPP), a modified push-up plus that is generally used in early rehabilitation programs, is performed to elicit SA activation. However, excessive thoracic kyphosis can easily occur as a compensatory movement during KPP. Therefore, the aim of this study was to examine the effect of tactile cues during KPP on activities of the thoracic erector spinae, rectus abdominis, lower trapezius, serratus anterior, and upper trapezius; scapular winging; and thoracic kyphosis in subjects with scapular winging.
Thirteen men with scapular winging performed KPP exercises under 3 different tactile cue conditions (no cue, to the thoracic spinous process [TSP], and to the interscapular region [ISR]). Electromyography was used to collect the muscle activity; in addition, a scapulometer and ImageJ software were used to measure the amount of scapular winging and thoracic kyphosis, respectively. One-way repeated-measures analysis of variance and Bonferroni correction were used to assess for statistical significance.
The activity of the thoracic erector spinae, rectus abdominis, serratus anterior, and upper trapezius had significant difference among three conditions (P < .05). Lower trapezius activity was no significantly different among 3 conditions. Degrees of scapular winging and thoracic kyphosis had also significant difference among 3 conditions (P < .05).
These results suggest that the tactile cue to the TSP and ISR in KPP exercise can be an effective method for decreasing scapular winging as well as correcting compensatory thoracic kyphosis during the KPP in subjects with scapular winging.
Clinical research on a flapless surgical technique application of narrow implants
Authors: Xu Li , Liu Yihan , Wang Yuanyuan , Chen Jiangang 
Published: October 2018

Abstract
The aim of the present study was to investigate the role of Axiom (implant diameter) ø2.8 mm narrow body implant in the clinical effect of minimally invasive implants in edentulous space.
This study included 10 patients with 10 edentulous spaces less than 5 mm and received minimally invasive surgery with 10 Axiom ø2.8 mm narrow implants. Re-stabilization of all implants began 6 months after surgery to fix the partial denture. All cases were followed up for clinical and panoramic X-ray examinations.
Imaging examination on these 10 pieces of narrow implants after 6 months showed that implant alveolar bone crest average absorption amount was 0.20 mm and no implant peripheral inflammation mucositis and denture with adjacent teeth gingival papilla between the fillings. All patients felt strong mastication and the reparation effect was more than up to expectation. No implant loosening and shedding were observed.
Hence, <5 mm edentulous space by Axiom ø2.8 mm implant minimally invasive reparation can be used for aesthetic purposes.
Nuanxin capsule for heart failure
Authors: Wen Junmao , Cai Yinhe , Sun Weipeng , Jiang Chenguang , Lin Tong , Jiang Nan , Luo Chuanjin , Zhou Chi , Wu Wei 
Published: October 2018

Abstract

Objective
To assess the efficacy and safety of Nuanxin capsule for patients with heart failure (HF).

Methods
A systematic literature search was performed in 6 databases: PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan-fang Data Information Site, Chinese BioMedical Database (CBM), VIP Chinese Science and Technique Journals Database from the date of its inception up to November 2016. Review Manager 5.2 software was used for assessment of risk of bias, data synthesis and subgroup analysis. Begg and Egger tests were used for assessing symmetries of funnel plot by software Stata 12.0. We conducted the GRADE system to assess the quality of evidence.

Results
12 trials involving 1418 participants were eligible. Compared with western medicine (WM) alone, Nuanxin capsule plus WM showed statistical significance in total effective rate (RR 1.18, 95% condidence interval [CI] 1.13–1.25). According to subgroup analysis, the 6-months group and the 12-months group have better effect than the 3-month group. As for 6-minute walking distance (6MWT), Nuanxin capsule plus WM compared with WM has significantly increased walking distance (weighted mean difference [WMD] 42.56, 95% CI 34.27–50.85). Nuanxin capsule plus WM has significantly decreased in mortality (RR 0.29, 95% CI 0.18–0.46) and re-admission rate (RR 0.48, 95% CI 0.39–0.60) compared with WM. Nuanxin capsule plus WM was beneficial for B-type natriuretic peptide (−240.47, 95% CI −332.45–148.49). gger's and Begg's test showed that there was no publication bias exist (P = .937). Influence analysis showed that no single study affected the overall result. The GRADE quality of the evidence was very low to Moderate across the different outcomes.

Conclusions
Despite of the apparently positive findings, we cannot draw a sound conclusion that Nuanxin capsule has positive effect in patients with HF, because of the insufficient evidence.
A case report of pregnancy in a patient with common variable immunodeficiency emphasizing the need for personalized immunoglobulin replacement
Authors: Więsik-Szewczyk Ewa , Jahnz-Różyk Karina 
Published: October 2018

Abstract

Rationale:
Subcutaneous immunoglobulin administration facilitated by recombinant human hyaluronidase is a new mode of immunoglobulin replacement. It has been approved for treatment in primary and secondary antibody immunodeficiency. To date, it has not been reported in the literature as therapy of choice during pregnancy.

Patient concerns:
We report a 31-year-old woman with common variable immunodeficiency (CVID) followed during her first pregnancy.

Diagnoses:
The patient had a history of increased susceptibility to infections and autoimmune phenomena. From diagnosis at the age 29, she received IVIg replacement with partial response to treatment. Due to medical indications and lack of venous access, we had to search for another mode of application. The patient refused traditional, weekly conventional subcutaneous immunoglobulin (SCIg) administration.

Interventions:
Immunoglobulin replacement therapy was successfully continued during pregnancy after the IV route was replaced with subcutaneous administration facilitated by recombinant human hyaluronidase. The frequency of infusions was every 3–4 weeks.

Outcomes:
The treatment was effective and well tolerated by the patient who continued it after delivery. Dosage and the schedule of infusions provided sufficient immunoglobulin G (IgG) levels for the newborn baby.

Lessons:
The presented CVID case illustrates that the selection of the mode of immunoglobulin administration has to be a shared decision, which considers both patient preferences and medical needs. This approach is especially important for the pregnancy period. The case shows that the switch from IVIg to fSCIg can be a management option during pregnancy.