bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Mannequin Training Satisfaction with a Conventional Box Trainer and a Low-Fidelity Fetoscopic Surgical Simulator for Selective Fetoscopic Laser Photocoagulation
Authors: Wataganara Tuangsit , Viboonchart Sommai , Chumthup Wangcha , Chuenwattana Prakong , Pooliam Julaporn , Nawapun Katika , Phithakwatchara Nisarat 
Published: September 2019

<b><i>Background:</i></b> A low-fidelity fetoscopic surgical simulator (FSS) for training of selective fetoscopic laser photocoagulation (SFLP) was developed. <b><i>Objective:</i></b> To evaluate and compare training satisfaction with an FSS and with a conventional box trainer (BT). <b><i>Methods:</i></b> The BT consisted of a cleaned human placenta attached to the inside of a plastic storage box with a watertight lock cover and an ultrasound-transparent rubber skin. The FSS consisted of the replica of a monochorionic twin placenta attached to the inside of a spherically shaped, ultrasound-transparent phantom. Tap water was used as an ultrasound conduction agent. Evaluation of the mannequin trainings was conducted on 8 junior maternal-fetal medicine (MFM) attending physicians and 22 MFM fellows. Training satisfaction was scored from 0 to 10 on 8 different domains. <b><i>Results:</i></b> The mean satisfaction score (±SD) with the FSS was higher than with the BT in all domains (<i>p</i> &#x3c; 0.05). The fellows’ training satisfaction with the BT was greater than that of the attending physicians in 4 domains: tactile feedback, demonstration of chorionic vessels, feedback on performance, and overall value as learning aid (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> As evaluated by a small group of trainees, our FSS is superior to the BT in mannequin training of SFLP. However, the BT may be more useful for trainees with limited clinical experience.
An Integrated Kidney Care eConsult Practice Model: Results from the iKinect Project
Authors: Ong Stephanie W. , Kaushal Amit , Pariser Pauline , Chan Christopher T. 
Published: September 2019

Background: Collaborative management of kidney disease relies on coordinated and effective partnerships between multiple provider teams. Siloed care contributes to limited access between physicians, resulting in delays in the diagnosis and treatment of kidney disease and inappropriate use of healthcare resources. These gaps contribute to dissatisfied and disempowered providers and patients. Digital systems such as eConsult can support collaborative management and address these gaps, thereby streamlining the consultation and referral process between primary care physicians (PCPs) and nephrologists. In this study, we evaluated an established eConsult platform integrated with a central triage process for a network of PCPs and nephrologists. The study aimed to assess the acceptability, feasibility, and impact on access to nephrology when using eConsult integrated into the management of kidney disease between PCPs and nephrologists. Methods: We conducted a 1-year pilot study and used mixed methods to measure the acceptability and feasibility of using eConsult for the management of kidney disease. We compared eConsult and traditional referrals with respect to types of consultation, referrals, and times to response to determine impact on access to kidney care. We conducted semi-structured interviews of PCPs and nephrologists to assess physician experience. Results: From January 8, 2018, to January 11, 2019, 52 PCPs and 23 nephrologists participated in the study, with 250 traditional referrals and 106 eConsults submitted during that period. The median response time for eConsult was 15 (3–64) h, with 25% originating outside the central Toronto region. The median time to first clinic appointment from a traditional referral was 4 months (111 [61–163] days). PCP and nephrologist interviews revealed high user satisfaction, citing efficiency and timely response as key facilitators. Conclusion: The eConsult platform was acceptable, feasible, and facilitated access to nephrology care compared to traditional referrals. Physicians report improvements in physician care delivery, nephrology care gaps, patient experience, and healthcare utilization.
Urodynamic Differences between Complete and Incomplete Spinal Cord Injuries with Neurogenic Detrusor Overactivity
Authors: García Fadrique Gonzalo , Gallego Daniel , Ordaz Domingo , Climent Laura 
Published: September 2019

<b><i>Objective:</i></b> To analyze if there are urodynamic differences in patients with neurogenic detrusor overactivity (NDO) secondary to spinal cord injury (SCI) depending on whether the SCI is complete or incomplete according to the American Spinal Injury Association (ASIA) classification. <b><i>Methods:</i></b> A retrospective and comparative study was carried out, including 194 patients with suprasacral SCI and NDO. Maximum cystometric capacity (MCC), volume at first involuntary contraction (VIC), compliance, maximum pressure of the detrusor during filling cystometry (MaxDetP), detrusor leak point pressure (LeakDetP) and postvoid residual urine volume (PVR) were analysed. Means were compared with Student <i>t</i> test for independent samples, with statistical significance <i>p</i> &#x3c; 0.05. <b><i>Results:</i></b> SCI was complete (ASIA A) in 51 patients (26.3%) and incomplete (ASIA B–E) in 143 (73.7%). The comparison of means showed significant differences regarding MCC (278.5 ± 102.6 mL in ASIA A vs. 321.6 ± 127.1 mL in ASIA B–E; <i>p</i> = 0. 018) and VIC (161 ± 85.1 and 210 ± 114.4 mL ­respectively; <i>p</i> = 0.006). There were no differences regarding MaxDetP (58.8 ± 26.9 vs. 49.3 ± 35.6 cm H<sub>2</sub>O), LeakDetP (44.6 ± 25.3 vs. 48.3 ± 26.7 cm H<sub>2</sub>O), PVR (155.3 ± 94.2 vs. 118.5 ± 129.8) or compliance (29.9 ± 25.3 vs. 48.3 ± 26.7 cm H<sub>2</sub>O). <b><i>Conclusions:</i></b> In our serie incomplete SCI (ASIA B–E) showed differences from complete ones (ASIA A) regarding MCC and VIC, but not regarding LeakDetP, MaxDetP, PVR or compliance.
Intravesical Treatment with Electro-Mediated Administration of Mytomicin C as Prophylaxis for Intermediate and High-Risk Nonmuscle-Invasive Bladder Cancer: A Retrospective Multicenter Study
Authors: Carando Roberto , Zazzara Michele , Cotrufo Simone , Ludovico Giuseppe M. 
Published: September 2019

Background: Topical therapy of nonmuscle-invasive bladder cancer (NMIBC) is based on immunotherapy with Bacillus Calmette-Guerin and chemotherapy administered by passive instillation, but an active drug administration achieves a better concentration of the drugs in the bladder. Aim: This study aimed to investigate the effectiveness of electromotive drug administration (EMDA) of mitomycin C (EMDA/MMC) in intermediate- and high-risk NMIBC patients 6 months after the end of induction treatment. Materials and Methods: Sixty-five patients diagnosed with histologically confirmed NMIBC, with a complete transurethral resection of all visible tumors underwent EMDA/MMC. Primary endpoint was the proportion of responders at 3 or 6 months. Results: Data on follow-up were available for 62 subjects at 3 months and 45 at 6 months. EMDA was effective in intermediate- and high-risk patients: because of the small number of cases no conclusions can be drawn on the efficacy in the low-risk group. No difference in the response to treatment between intermediate- (83.3%) and high-risk (84%) patients could be seen. Conclusions: EMDA/MMC is a useful technique for an effective and safe treatment of primary and recurrent NMIBC, and a valuable therapeutic option in intermediate- and high-risk NMIBC patients.
Leptin Induces Hypertension Acting on Transient Receptor Potential Melastatin 7 Channel in the Carotid Body
Authors: Shin Mi-Kyung , Eraso Candela Caballero , Mu Yun-Ping , Gu Chenjuan , Yeung Bonnie H.Y. , Kim Lenise J. , Liu Xiao-Ru , Wu Zhi-Juan , Paudel Omkar , Pichard Luis E. , Shirahata Machiko , Tang Wan-Yee , Sham James S.K. , Polotsky Vsevolod Y. 
Published: September 2019

Rationale:
Obesity leads to resistant hypertension and mechanisms are poorly understood, but high plasma levels of leptin have been implicated. Leptin increases blood pressure acting both centrally in the dorsomedial hypothalamus and peripherally. Sites of the peripheral hypertensive effect of leptin have not been identified. We previously reported that leptin enhanced activity of the carotid sinus nerve, which transmits chemosensory input from the carotid bodies (CBs) to the medullary centers, and this effect was abolished by nonselective blockers of Trp (transient receptor potential) channels. We searched our mouse CB transcriptome database and found that the Trpm7 (transient receptor potential melastatin 7) channel was the most abundant Trp channel.

Objective:
To examine if leptin induces hypertension acting on the CB Trpm7.

Methods and Results:

C57BL/6J (n=79), leptin receptor (
LepR

b

) deficient
db/db
mice (n=22), and LepRb-EGFP (n=4) mice were used. CB
Trpm7
and
LepR

b

gene expression was determined and immunohistochemistry was performed; CB glomus cells were isolated and Trpm7-like current was recorded. Blood pressure was recorded continuously in (1) leptin-treated C57BL/6J mice with intact and denervated CB; (2) leptin-treated C57BL/6J mice, which also received a nonselective Trpm7 blocker FTY720 administered systemically or topically to the CB area; (3) leptin-treated C57BL/6J mice transfected with
Trpm7
small hairpin RNA to the CB, and (4)
Lepr

b

deficient obese
db/db
mice before and after
Lepr

b

expression in CB. Leptin receptor and Trpm7 colocalized in the CB glomus cells. Leptin induced a nonselective cation current in these cells, which was inhibited by Trpm7 blockers. Leptin induced hypertension in C57BL/6J mice, which was abolished by CB denervation, Trpm 7 blockers, and
Trpm7
small hairpin RNA applied to CBs.
Lepr

b

overexpression in CB of
Lepr

b

-deficient
db/db
mice demethylated the
Trpm7
promoter, increased
Trpm7
gene expression, and induced hypertension.

Conclusions:
We conclude that leptin induces hypertension acting on Trmp7 in CB, which opens horizons for new therapy.
Preeclampsia and Cardiovascular Disease in a Large UK Pregnancy Cohort of Linked Electronic Health Records
Authors: Leon Lydia J. , McCarthy Fergus P. , Direk Kenan , Gonzalez-Izquierdo Arturo , Prieto-Merino David , Casas Juan P. , Chappell Lucy 
Published: September 2019

Background:
The associations between pregnancy hypertensive disorders and common cardiovascular disorders have not been investigated at scale in a contemporaneous population. We aimed to investigate the association between preeclampsia, hypertensive disorders of pregnancy, and subsequent diagnosis of 12 different cardiovascular disorders.

Methods:
We used linked electronic health records from 1997 to 2016 to recreate a UK population-based cohort of 1.3 million women, mean age at delivery 28 years, with nearly 1.9 million completed pregnancies. We used multivariable Cox models to determine the associations between hypertensive disorders of pregnancy, and preeclampsia alone (term and preterm), with 12 cardiovascular disorders in addition to chronic hypertension. We estimated the cumulative incidence of a composite end point of any cardiovascular disorder according to preeclampsia exposure.

Results:
During the 20-year study period, 18 624 incident cardiovascular disorders were observed, 65% of which had occurred in women under 40 years. Compared to women without hypertension in pregnancy, women who had 1 or more pregnancies affected by preeclampsia had a hazard ratio of 1.9 (95% confidence interval 1.53–2.35) for any stroke, 1.67 (1.54–1.81) for cardiac atherosclerotic events, 1.82 (1.34–2.46) for peripheral events, 2.13 (1.64–2.76) for heart failure, 1.73 (1.38–2.16) for atrial fibrillation, 2.12 (1.49–2.99) for cardiovascular deaths, and 4.47 (4.32–4.62) for chronic hypertension. Differences in cumulative incidence curves, according to preeclampsia status, were apparent within 1 year of the first index pregnancy. Similar patterns of association were observed for hypertensive disorders of pregnancy, while preterm preeclampsia conferred slightly further elevated risks.

Conclusions:
Hypertensive disorders of pregnancy, including preeclampsia, have a similar pattern of increased risk across all 12 cardiovascular disorders and chronic hypertension, and the impact was evident soon after pregnancy. Hypertensive disorders of pregnancy should be considered as a natural screening tool for cardiovascular events, enabling cardiovascular risk prevention through national initiatives.
Trends in Survival After Pediatric In-Hospital Cardiac Arrest in the United States
Authors: Holmberg Mathias J. , Wiberg Sebastian , Ross Catherine E. , Kleinman Monica , Hoeyer-Nielsen Anne Kirstine , Donnino Michael W. , Andersen Lars W. ,   For the American Heart Association’s Get With The Guidelines-Resuscitation Investigators
Published: September 2019

Background:
Cardiac arrest in hospitalized children is associated with poor outcomes, but no contemporary study has reported whether the trends in survival have changed over time. In this study, we examined temporal trends in survival for pediatric patients with an in-hospital pulseless cardiac arrest and pediatric patients with a nonpulseless cardiopulmonary resuscitation event from 2000 to 2018.

Methods:
This was an observational study of hospitalized pediatric patients (≤18 years of age) who received cardiopulmonary resuscitation from January 2000 to December 2018 and were included in the Get With The Guidelines-Resuscitation registry, a United States–based in-hospital cardiac arrest registry. The primary outcome was survival to hospital discharge, and the secondary outcome was return of spontaneous circulation (binary outcomes). Generalized estimation equations were used to obtain unadjusted trends in outcomes over time. Separate analyses were performed for patients with a pulseless cardiac arrest and patients with a nonpulseless event (bradycardia with poor perfusion) requiring cardiopulmonary resuscitation. A subgroup analysis was conducted for shockable versus nonshockable initial rhythms in pulseless events.

Results:

A total of 7433 patients with a pulseless cardiac arrest and 5751 patients with a nonpulseless event were included for the analyses. For pulseless cardiac arrests, survival was 19% (95% CI, 11%–29%) in 2000 and 38% (95% CI, 34%–43%) in 2018, with an absolute change of 0.67% (95% CI, 0.40%–0.95%;
P
<0.001) per year, although the increase in survival appeared to stagnate following 2010. Return of spontaneous circulation also increased over time, with an absolute change of 0.83% (95% CI, 0.53%–1.14%;
P
<0.001) per year. We found no interaction between survival to hospital discharge and the initial rhythm. For nonpulseless events, survival was 57% (95% CI, 39%–75%) in 2000 and 66% (95% CI, 61%–72%) in 2018, with an absolute change of 0.80% (95% CI, 0.32%–1.27%;
P
=0.001) per year.

Conclusions:
Survival has improved for pediatric events requiring cardiopulmonary resuscitation in the United States, with a 19% absolute increase in survival for in-hospital pulseless cardiac arrests and a 9% absolute increase in survival for nonpulseless events between 2000 and 2018. However, survival from pulseless cardiac arrests appeared to have reached a plateau following 2010.
Evaluation of Modeled Precipitation in Oceanic Extratropical Cyclones Using IMERG
Authors: Naud Catherine M. , Jeyaratnam Jeyavinoth , Booth James F. , Zhao Ming , Gettelman Andrew 
Published: September 2019

ABSTRACTUsing a high-spatial- and high-temporal-resolution precipitation dataset, Integrated Multi-satellite Retrievals for GPM (IMERG), extratropical cyclone precipitation is evaluated in two reanalyses and two climate models. Based on cyclone-centered composites, all four models overestimate precipitation in the western subsiding and dry side of the cyclones, and underestimate the precipitation in the eastern ascending and moist side. By decomposing the composites into frequency of occurrence and intensity (mean precipitation rate when precipitating), the analysis reveals a tendency for all four models to overestimate frequency and underestimate intensity, with the former issue dominating in the western half and the latter in the eastern half of the cyclones. Differences in frequency are strongly dependent on cyclone environmental moisture, while the differences in intensity are strongly impacted by the strength of ascent within the cyclone. There are some uncertainties associated with the observations: IMERG might underreport frozen precipitation and possibly exaggerate rates in vigorously ascending regions. Nevertheless, the analysis suggests that all models produce extratropical cyclone precipitation too often and too lightly. These biases have consequences when evaluating the changes in precipitation characteristics with changes in cyclone properties: the models disagree on the magnitude of the change in precipitation intensity with a change in environmental moisture and in precipitation frequency with a change in cyclone strength. This complicates accurate predictions of precipitation changes in a changing climate.
Constructing the Three-Dimensional Structure of an Anticyclonic Eddy in the South China Sea Using Multiple Underwater Gliders
Authors: Li Shufeng , Wang Shuxin , Zhang Fumin , Wang Yanhui 
Published: September 2019

AbstractMesoscale eddies have great influence on heat and material transport in the ocean and thus play an important role in modulating the global climate variability. However, our understanding of their fine three-dimensional (3D) thermohaline and biogeochemical structure remains incomplete because of the scarcity of high-resolution measurements. This research aims to construct the fine 3D structure of an anticyclonic eddy in the northern South China Sea (NSCS) to validate the effectiveness of a glider network for observing mesoscale eddies. Twelve Petrel gliders were deployed in NSCS during August 2017 to gather fine information of an anticyclonic eddy. By combining the high-resolution in situ glider data and the sea level anomaly data, we have constructed a detailed 3D structure of the eddy. The analysis results of the absolute dynamic topography map and the water mass comparison imply that the anticyclonic eddy may generate from eddy shedding of the Kuroshio loop current. The maximum potential temperature anomaly (over 3°C) appears at the thermocline, and the maximum salinity anomaly (~0.8 psu) exists at ~50 m. The maximum value of the dissolved oxygen concentration (~7.5 mg L−1) appears at 50–80 m. The maximum chlorophyll concentration (~1.2 μg L−1) lies at 80–120 m, just below that of the dissolved oxygen concentration. The colored dissolved organic matter concentration increases with depth, with the mean value being less than 1.23 ppb above 50 m and beyond 2.2 ppb at 500–800 m. The results verify the capability of the glider network to observe a fine-scaled 3D structure of mesoscale eddies and will provide a useful guide for future eddy observations.
Rene Policistico e trapianto di rene: accesso alla lista d’attesa e post trapianto: risultati della ricerca
Authors: Caldara Rossana 
Published: September 2019

Polycystic kidney disease and kidney transplantation: access to waiting list and post-transplant Autosomal-dominant polycystic kidney disease (ADPKD) is the leading genetic cause of end-stage renal disease (ESRD) worldwide. The number of ADPKD patients who are listed for transplantation or receive a kidney transplant is continuously increasing over time. AIRP conducted a survey to investigate the ADPKD patient journey, meaning the personal experience and expectations of people regarding kidney transplantation as therapeutic option of end-stage renal failure. The survey was conducted on 381 people with ADPKD, using computer-assisted web interviewing (CAWI). The results confirm that there are problems that need to be addressed before listing an ADPKD patient for a kidney transplantation, namely the patient’s comorbidities, the complexity of pre-transplant assessments and the shortage of organs. Pre-emptive transplantation from cadaver donor is a rare event in our country but it is a valid option, especially in case of living donation. Immunosuppression is well tolerated in a high percentage of subjects, but a follow-up is necessary to monitor negative side effects. Despite these problems, the outcome of kidney transplantation is optimal in these patients. Also, the relationship between patients and Nephrologists and/or Transplant Centers is important to ensure a positive outcome.
Neoadjuvant radio-chemotherapy prolongs healing of anastomotic leakage after rectal resection treated with endoscopic vacuum therapy
Authors: Schiffmann Leif , Wedermann Nicole , Schwandner Frank , Gock Michael , Klar Ernst , Kühn Florian 
Published: September 2019

Background: Neoadjuvant radiochemotherapy (nRCT) is an important component in the treatment of advanced rectal cancer. Endoscopic vacuum therapy (EVT) has become the treatment of choice for anastomotic leakage after rectal resection in many institutions in Germany. Published case series report on average success and stoma reversal rates of more than 80%. However, so far, there is no distinct report on the potential influence of nRCT on EVT. Methods: A total of 11 patients treated with EVT for anastomotic leakage after nRCT and rectal resection were retrospectively compared with a cohort of eight patients with rectal anastomotic leakage without neoadjuvant treatment. Primary endpoints were death, treatment success, and long-term preservation of intestinal continuity. Secondary endpoint was the duration of treatment. Statistical analysis was performed using Statistical Package for Social Science (SPSS) version 23.0. Results: There was no difference in mortality (0%), success rate (90.9% versus 100%, p = 0.381), or long-term preservation of continuity (63.6% versus 62.5%, p = 0.960). After nRCT, patients showed a significant longer duration of EVT (31.1 days versus 15.9 days, p = 0.040) which was associated with a significantly higher number of sponge applications (9.6 versus 5.0, p = 0.042). Conclusions: In our analysis, EVT showed success in over 90% of patients with anastomotic leakage after rectal resection for colorectal cancer, regardless of neoadjuvant treatment. However, in case of anastomotic leakage, nRCT seems to be associated with the need for a significant longer duration of EVT.
A Novel Pneumatic Soft Gripper with a Jointed Endoskeleton Structure
Authors: Wu Zhaoping , Li Xiaoning , Guo Zhonghua 
Published: September 2019

Abstract
In current research on soft grippers, pneumatically actuated soft grippers are generally fabricated using fully soft materials, which have the advantage of flexibility as well as the disadvantages of a small gripping force and slow response speed. To improve these characteristics, a novel pneumatic soft gripper with a jointed endoskeleton structure (E-Gripper) is developed, in which the muscle actuating function has been separated from the force bearing function. The soft action of an E-Gripper finger is performed by some air chambers surrounded by multilayer rubber embedded in the restraining fiber. The gripping force is borne and transferred by the rigid endoskeleton within the E-Gripper finger. Thus, the gripping force and action response speed can be increased while the flexibility is maintained. Through experiments, the bending angle of each finger segment, response time, and gripping force of the E-Gripper have been measured, which provides a basis for designing and controlling the soft gripper. The test results have shown that the maximum gripping force of the E-Gripper can be 35 N, which is three times greater than that of a fully soft gripper (FS-Gripper) of the same size. At the maximum charging pressure of 150 kPa, the response time is 1.123 s faster than that of the FS-Gripper. The research results indicate that the flexibility of a pneumatic soft gripper is not only maintained in the case of the E-Gripper, but its gripping force is also obviously increased, and the response time is reduced. The E-Gripper thus shows great potential for future development and applications.