bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a Preoperative Transdermal Fentanyl Patch on Proinflammatory Cytokine and Pain Levels During the Postoperative Period: A Randomized Controlled Trial
Authors: Kwon Youngsuk , Hwang Sung Mi , Jang Ji Su , Ryu Byoung Yoon , Kang Byung Yong , Kang Sang Soo , Lee Jae Jun 
Published: February 2019

Objective:
The main objectives of this article were to assess the effect of preoperative transdermal fentanyl patch (TFP) on interleukin (IL)-6 and IL-8 levels and pain after laparoscopic cholecystectomy.

Materials and Methods:
Patients received a TFP (25 μg/h) (patch group, n=30) or a placebo patch (control group, n=30) applied 14 hours before operation. After surgery, control group received intravenous continuous fentanyl (25 μg/h) with loading dose (25 μg). IL-6 and IL-8 levels were measured at admission and 1, 6, 12, 24, and 48 hours postoperatively. Pain score and consumption of rescue analgesic were evaluated too.

Results:
At 24 hours postoperatively, IL-6 and IL-8 reached a peak and then decreased. The peak IL-6 levels were 21.92(±6.22) and 24.91(±6.81) pg/mL in the patch and control group. The significant differences of IL-6 between groups were shown at 6 and 12 hours postoperatively (P=0.032, 0.0001). There were no significant differences in IL-8 levels and pain score.

Conclusions:
Preoperative TFP attenuated the increase in IL-6 levels after surgery and provided similar analgesia to continuous fentanyl infusion. Preemptive TFP may have influence on proinflammatory reactions and pain control after surgery.
Laparoscopic Distal Pancreatectomy: Our Experience in a Tertiary Referral Center
Authors: Bademci Refik , Nunez Pedro S. , Temidayo Talabi Micheal O. , Blanco Manuel R. , Riart Gemma C. , Raventós Vicente A. 
Published: February 2019

Background:
Despite an increase in the number of laparoscopic distal pancreatectomy (LDP) procedures being performed, the long-term oncology and operative results are still unclear. The aim of this study was to present the surgical and long-term results of patients undergoing LDP for the treatment of distal pancreatic tumors.

Materials and Methods:
A retrospective review was made of patients who underwent LDP in our clinic, between 2006 and 2018, and who were diagnosed with pancreas tail, neck, and corpus tumors. For the purposes of this study, the data related to the preoperative, operative, and postoperative characteristics of the patients were determined.

Results:
A total of 46 patients were identified as suitable for inclusion in the study. Of these, 52.1% were female individuals, and the average age of the whole group was 63 years. Previous surgery for malignant diseases was recorded for 54.3% of the patients, due to premalignant diseases in 13% and benign diseases in 32.7%. On average, 10 lymph nodes were removed from patients diagnosed with malignant tumors. The conversion rate was found to be 2.1%. The postoperative pancreatic fistula rate was 26%, and there was 1 complication each of grades III and IV according to the Clavien-Dindo classification. The mortality rate was 0%.

Conclusions:
It was concluded that LDP of distal pancreas tumors seems to be both safe and effective in respect of the long-term results in addition to the early results of the operation.
Predictors of Urinary Retention After Vesicovaginal Fistula Surgery: A Retrospective Case-Control Study
Authors: Chang Olivia H. , Pope Rachel J. , Sangi-Haghpeykar Haleh , Ganesh Prakash , Wilkinson Jeffrey P. 
Published: February 2019

Objective
The objective of this study is to determine the predictors for urinary retention after vesicovaginal fistula surgery.

Methods
This was a retrospective case-control study of women who underwent vesicovaginal fistula repair between January 2014 and December 2017 at the Fistula Care Centre in Lilongwe, Malawi. Cases were defined as patients with documented urinary retention, defined as a postvoid residual that is 50% greater than the total void of at least 100 mL. The cases and controls were matched by the 3 components of the Goh classification system in a ratio of 1:5. Univariate analysis was used to detect differences between demographic, clinical characteristics, and operative techniques between cases and control. Logistic regression analysis was performed for estimation of odds ratios (ORs).

Results
There were no statistically significant differences between the 40 cases and 187 controls, when comparing age, gravidity, parity, body mass index, and length of postoperative catheterization. The median amount of postvoid residual noted at the time of diagnosis was 240 mL (range, 55–927 mL). Odds for urinary retention was 3 times higher among those with vertical closure than patients with horizontal closure of the bladder (OR, 2.91; 95% confidence interval, 1.35–6.20). Patients with prior fistula repairs were significantly less likely to develop urinary retention compared to those receiving surgery for the first time (OR, 0.27; 95% confidence interval, 0.10–0.67).

Conclusions
Vertical closure of the bladder and patients without a history of prior fistula repairs are predictors for developing urinary retention after fistula repair surgery.
Learning Styles and Motivations of Individuals Without Prior Exposure to Augmentative and Alternative Communication
Authors: Thiessen Amber , Beukelman David 
Published: February 2019

Purpose:
Study purposes were to (a) examine achievement goal tendencies and learning mode preferences of adults who were unfamiliar with augmentative and alternative communication (AAC) facilitation, and (b) determine whether age and gender have an effect on these variables. Recruitment of untrained individuals allowed the researchers to simulate the experiences of individuals in the early stages of AAC facilitation.

Method:
Forty-one adults who were untrained in AAC facilitation completed surveys examining (a) achievement goal tendencies across 3 domains: mastery, performance, and social, and (b) learning mode preference across 4 domains: independent, small group, case study, and step-by-step. Participants were divided into groups on the basis of age (i.e., 26–40 years and 45–65 years) and gender (i.e., 16 males, 25 females).

Results:
Results indicate that participants were motivated to learn for mastery rather than social and performance purposes. In addition, they indicated a preference for learning through case studies. Younger adults rated performance and social learning higher than older adults. Also, women preferred small group instruction.

Discussion/Conclusions:
Facilitators play a vital role in successful AAC intervention, yet they often lack instruction to effectively fulfill this role. Clinicians should consider age and gender when designing instruction programs for these individuals.
Biliary Complications Following Pediatric Living Donor Liver Transplantation: Risk Factors, Treatments, and Prognosis
Authors: Sanada Yukihiro , Katano Takumi , Hirata Yuta , Yamada Naoya , Okada Noriki , Ihara Yoshiyuki , Mizuta Koichi 
Published: February 2019

Background.
We present retrospective analysis of our 15-year experience with pediatric living donor liver transplantation, focusing on the risk factors, treatments, and long-term prognosis for posttransplant biliary complications (BCs).

Methods.
Between May 2001 and December 2017, 290 living donor liver transplantations were performed. The median age was 1.4 years old. The median observation period was 8.4 years. Biliary strictures were classified as anastomotic stricture (AS) or non-AS (NAS).

Results.
Overall incidence of biliary complications was 18.6%, including AS in 46 cases, NAS in 6, and other classifications in 2. The mean period to diagnosis of the AS was 641 ± 810 postoperative days. The multivariate analysis showed that hepaticojejunostomy without external stent was an independent risk factor for AS (P = 0.011). The first treatments for AS were percutaneous transhepatic biliary drainage (PTBD) in 25 cases, double-balloon enteroscopy (DBE) in 19, and surgical reanastomosis in 2. The success and recurrence rates of PTBD treatments were 90.9% and 22.7%, respectively. The success and recurrence rates of endoscopic interventions under DBE were 93.6% and 75.3%, respectively. The 15-year graft survival rates in patients with and without AS were 95.7% and 89.1%, respectively (P = 0.255), but 2 patients with cholangitis due to multiple NAS underwent retransplantation.

Conclusions.
Posttransplant AS can be prevented by hepaticojejunostomy using external stent, and the long-term prognosis is good with early treatments using DBE or PTBD. However, the prognosis of multiple NAS is poor.
Racial/Ethnic Disparities in Access and Outcomes of Simultaneous Liver-Kidney Transplant Among Liver Transplant Candidates With Renal Dysfunction in the United States
Authors: Chang Su-Hsin , Wang Mei , Liu Xiaoyan , Alhamad Tarek , Lentine Krista L. , Schnitzler Mark A. , Colditz Graham A. , Park Yikyung , Chapman William C. 
Published: February 2019

Background.
Since the Model for End-stage Liver Disease (MELD) allocation system was implemented, the proportion of simultaneous liver-kidney transplantation (SLKT) has increased significantly. However, whether racial/ethnic disparities exist in access to SLKT and post-SLKT survival remains understudied.

Methods.
A retrospective cohort of patients aged ≥18 years with renal dysfunction on the liver transplant (LT) waiting list was obtained from Organ Procurement and Transplantation Network. Renal dysfunction was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2 at listing for LT. Multilevel time-to-competing-events regression adjusting for center effect was used to examine the likelihood of receiving SLKT. Inverse probability of treatment weighted survival analyses were used to analyze posttransplant mortality outcomes.

Results.
For patients with renal dysfunction at listing for LT, not listed for simultaneous kidney transplant, non-Hispanic black (NHB) and Hispanic patients were more likely to receive SLKT than non-Hispanic white (NHW) patients (NHB: multivariable-adjusted hazard ratio [aHR] 2.57; 95% confidence interval [CI], 1.42-4.65; Hispanic: aHR, 2.03; 95% CI, 1.14-3.60). For post-SLKT outcomes, compared to NHW patients, NHB patients had a lower mortality risk before 24 months (aHR, 0.80; 95% CI, 0.65-0.97) but had a higher mortality risk (aHR, 2.00; 95% CI, 1.59-2.55) afterward; in contrast, Hispanic patients had a lower overall mortality risk than NHW patients (aHR, 0.61; 95% CI, 0.51-0.74).

Conclusions.
In the MELD era, racial/ethnic differences exist in access and survival of SLKT for patients with renal dysfunction at listing for LT. Future studies are warranted to examine whether these differences remain in the post-SLK allocation policy era.
Donor Characteristics, Recipient Outcomes, and Histologic Findings of Kidney Allografts With Diffuse Donor-derived Glomerular Fibrin Thrombi
Authors: Gao Guofeng , Chen Ling-Xin , Brown Ian E. , De Mattos Angelo , Perez Richard V. , Jen Kuang-Yu 
Published: February 2019

Background.
Limited data are available on whether donor kidneys with diffuse glomerular fibrin thrombi (GFT) are safe to use. In this study, the clinicopathologic characteristics of allografts with diffuse donor-derived GFT were examined.

Methods.
All deceased donor kidney transplant implantation biopsies from our institution between July 2011 and February 2018 with diffuse GFT were included. A control group for comparison consisted of all cases with implantation biopsies obtained during the study period without diffuse GFT. Clinical data were extracted from electronic medical records for all study patients, including donor information.

Results.
Twenty-four recipients received kidneys with diffuse GFT from 16 deceased donors. All donors died from severe head trauma. On average, 79% of glomeruli contained fibrin thrombi. Nineteen cases had subsequent biopsy; all revealed resolution of GFT. Compared with the control group, kidneys with diffuse GFT had longer cold ischemia time (34 versus 27 h), were more frequently pumped using machine perfusion (100% versus 81%), and recipients experienced a higher frequency of delayed graft function (58% versus 27%). Only 2 grafts with diffuse GFT failed within the first year. Overall graft survival was similar between the diffuse GFT group and control group.

Conclusions.
Deceased donor kidneys with diffuse GFT appear to be safe to use given that nearly 92% of recipients in this cohort who received such allografts experienced good clinical outcomes. Histologically, GFT demonstrated rapid resolution following transplantation. Interestingly, diffuse GFT only occurred in donors who suffered severe head trauma in this cohort, which may be a predisposing factor.
Evaluation of Accepting Kidneys of Varying Quality for Transplantation or Expedited Placement With Decision Trees
Authors: Kilambi Vikram , Bui Kevin , Hazen Gordon B. , Friedewald John J. , Ladner Daniela P. , Kaplan Bruce , Mehrotra Sanjay 
Published: February 2019

Background.
Underutilization of marginal-quality kidneys for transplantation produced ideas of expediting kidney placement for populations with decreased opportunities of receiving transplants. Such policies can be less efficacious for specific individuals and should be scrutinized until the decision-making for accepting marginal-quality organs, which has relied on experiential judgment, is better understood at the individual level. There exist rigorous tools promoting personalized decisions with useful and objective information.

Methods.
This article introduces a decision-tree methodology that analyzes a patient’s dilemma: to accept a kidney offer now or reject it. The methodology calculates the survival benefit of accepting a kidney given a certain quality now and the survival benefit of rejecting it. Survival benefit calculation accounts for patients’ and donors’ characteristics and transplant centers’ and organ procurement organizations’ performances and incorporates patients’ perceived transplant and dialysis utilities. Valuations of rejecting an offer are contingent on future opportunities and subject to uncertainty in the timing of successive kidney offers and their quality and donor characteristics.

Results.
The decision tree was applied to a realistic patient profile as a demonstration. The tool was tested on 1000 deceased-donor kidney offers in 2016. Evaluating up to 1 year of future offers, the tool attains 61% accuracy, with transplant utility of 1.0 and dialysis utility of 0.5. The accuracy reveals potential bias in kidney offer acceptance/rejection at transplant centers.

Conclusions.
The decision-tree tool presented could aid personalized transplant decision-making in the future by providing patients with calculated, individualized survival benefits between accepting and rejecting a kidney offer.
Tolerance Biomarkers in Liver Transplantation: Independent External Validation of the Predictive Strength of SENP6 and FEM1C Gene Expression
Authors: Pérez-Sanz Fernando , Revilla-Nuin Beatriz , Martínez-Alarcón Laura , Herrero José I. , Ramírez Pablo , Pons José A. , Baroja-Mazo Alberto 
Published: February 2019

Background.
Numerous studies have emphasized the genetic and phenotypic profiles of tolerant transplant patients. Moreover, different groups have defined several biomarkers, trying to distinguish patients who are going to be tolerant from those who are going to reject. However, most of these biomarkers have not been validated by other groups or even established for clinical practice.

Methods.
We reanalyzed and stratified the predictive capacity of 20 previously described biomarkers for liver transplantation tolerance in a cohort of 17 liver transplant patients subjected to an independent, nonrandomized, prospective study of immunosuppression drug withdrawal.

Results.
Only 4 of the 20 studied biomarkers (expression of SENP6, FEM1C, miR31, and miR95) showed a strong predictive capacity in the present study. miR31 and FEM1C presented an area under the ROC curve of 96.7%, followed by SENP1 with 93.3%. Finally, miR95 had an area under the ROC curve value <86.7%.

Conclusions.
Even though this independent analysis seems to confirm the predictive strength of SENP6 and FEM1C in liver transplantation tolerance, there are also risks in establishing biomarkers for clinical phenotypes without an understanding of how they are biologically relevant. Future collaborations between groups should be promoted so that the most promising biomarkers can be validated and implemented in daily clinical practice.
Continuous Monitoring of Transplant Center Performance: Different Options for Different Goals
Authors: Alexandrine Brian , Savoye Emilie , Pessione Fabienne , Cantrelle Christelle , Jasseron Carine , Santin Gaëlle , Bastien Olivier , Legeai Camille 
Published: February 2019

Background.
In France, the need for continuous monitoring of transplant center performance has recently become apparent. Cumulative sum (CUSUM) monitoring of transplantation is already been used to monitor transplant outcomes in the United Kingdom and in the United States. Because CUSUM monitoring can be applied by different methods, the objective was to assess and compare the performance of different CUSUM methods for detecting higher than expected (ie, excessive) graft failure rates.

Methods.
Data come from the French transplant registry. Lung and kidney transplants in 2011-2013 constituted the control cohort, and those in 2014-2016 the observed cohort. The performance of CUSUM monitoring, according to center type and predefined control limits, was measured by simulation. The outcome monitored was 3-month graft failure.

Results.
In a low-volume center with a low failure rate, 3 different types of control limits produced successful detection rates of excessive graft failures of 15%, 62%, and 73% and false alarm rates of 5%, 40%, and 52%, with 3, 1, and 1 excess failures necessary before a signal occurred. In a high-volume center with a high failure rate, successful detection rates were 83%, 93%, and 100% and false alarm rates were 5%, 16%, and 69%, with 6, 13, and 17 excess failures necessary before a signal occurred.

Conclusions.
CUSUM performances vary greatly depending on the type of control limit used. A new control limit set to maximize specificity and sensitivity of detection is an appropriate alternative to those commonly used. Continued attention is necessary for centers with characteristics making it difficult to obtain adequate sensitivity or sufficiently prompt response.
Development of Triazoles based on AZT and their Anti-Viral Activity Against HIV-1
Authors: Alencar Daniel , Gonçalves Juliana , Cerqueira Sofia A. , Soares Helena , Petronilho Ana 
Published: February 2019

ABSTRACTWe report herein a set of 3’-azido-3’-deoxythymidine (AZT) derivatives based on triazoles and triazolium salts for HIV1 infection. Compounds were tested with □using HIV1 pre-exposure prophylaxis experimental model. All compounds were able to decrease infection and two of them were able to clear almost all the infection, suggesting that these drugs could play an important role in pre-exposure prophylaxis therapies.
Feedback training can increase detection of happiness in ambiguous facial expressions in children and adults with autism spectrum disorders
Authors: Griffiths Sarah , Attwood Angela Suzanne , Penton-Voak Ian Scott , Jarrold Christopher , Munafo Marcus R 
Published: February 2019

AbstractRecognition of subtle emotional facial expressions is challenging for some individuals with autism spectrum disorders (ASD). Training that targets recognition of low intensity emotional expressions may therefore be effective as an intervention to improve social-emotional skills. This paper reports the results of two randomised controlled experiments looking at the effect of a training methodology designed to increase the recognition of happy emotion in low intensity happy facial expressions. The first study implements this training with children with autism spectrum disorder (ASD, N = 14) and the second study implements this training with adults with ASD (N = 27). The training paradigm used images from a morph sequence that mixed a happy expression with a mixed-emotion ‘norm’ expression to create a sequence of varying intensity happy expressions. Participants were asked to say whether or not individual faces from the sequence were happy, to measure their happiness detection threshold. Participants that received active training were given biased feedback to shift their detection threshold, while participants that received control training were given feedback consistent with their baseline threshold. There was some statistical evidence that thresholds in the active training group shifted more than in the control group. This suggests training was successful in increasing the number of expressions that individuals identified as happy. However, there was no evidence that training increased facial expression recognition accuracy, as measured by the Reading the Mind in the Eyes task completed after training (Study 2).
Evolutionary successful strategies in a transparent iterated Prisoner’s Dilemma
Authors: Unakafov Anton M. , Schultze Thomas , Kagan Igor , Moeller Sebastian , Gail Alexander , Treue Stefan , Eule Stephan , Wolf Fred 
Published: February 2019

AbstractA Transparent game is a game-theoretic setting that takes action visibility into account. In each round, depending on the relative timing of their actions, players have a certain probability to see their partner’s choice before making their own decision. This probability is determined by the level of transparency. At the two extremes, a game with zero transparency is equivalent to the classical simultaneous game, and a game with maximal transparency corresponds to a sequential game. Despite the prevalence of intermediate transparency in many everyday interactions such scenarios have not been sufficiently studied. Here we consider a transparent iterated Prisoner’s dilemma (iPD) and use evolutionary simulations to investigate how and why the success of various strategies changes with the level of transparency. We demonstrate that non-zero transparency greatly reduces the set of successful memory-one strategies compared to the simultaneous iPD. For low and moderate transparency the classical “Win – Stay, Lose – Shift” (WSLS) strategy is the only evolutionary successful strategy. For high transparency all strategies are evolutionary unstable in the sense that they can be easily counteracted, and, finally, for maximal transparency a novel “Leader-Follower” strategy outperforms WSLS. Our results provide a partial explanation for the fact that the strategies proposed for the simultaneous iPD are rarely observed in nature, where high levels of transparency are common.