bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patent foramen ovale closure, antiplatelet therapy or anticoagulation in patients with patent foramen ovale and cryptogenic stroke: a systematic review and network meta-analysis incorporating complementary external evidence
Authors: Mir Hassan , Siemieniuk Reed Alexander C , Ge Long Cruz , Foroutan Farid , Fralick Michael , Syed Talha , Lopes Luciane Cruz , Kuijpers Ton , Mas Jean-Louis , Vandvik Per O , Agoritsas Thomas , Guyatt Gordon H 
Published: July 2018

ObjectiveTo examine the relative impact of three management options in patients aged <60 years with cryptogenic stroke and a patent foramen ovale (PFO): PFO closure plus antiplatelet therapy, antiplatelet therapy alone and anticoagulation alone.DesignSystematic review and network meta-analysis (NMA) supported by complementary external evidence.Data sourcesMedline, EMBASE and Cochrane CENTRAL.Study selectionRandomised controlled trials (RCTs) addressing PFO closure and/or medical therapies in patients with PFO and cryptogenic stroke.Review methodsWe conducted an NMA complemented with external evidence and rated certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.ResultsTen RCTs in eight studies proved eligible (n=4416). Seven RCTs (n=3913) addressed PFO closure versus medical therapy. Of these, three (n=1257) addressed PFO closure versus antiplatelet therapy, three (n=2303) addressed PFO closure versus mixed antiplatelet and anticoagulation therapies and one (n=353) addressed PFO closure versus anticoagulation. The remaining three RCTs (n=503) addressed anticoagulant versus antiplatelet therapy. PFO closure versus antiplatelet therapy probably results in substantial reduction in ischaemic stroke recurrence (risk difference per 1000 patients over 5 years (RD): −87, 95% credible interval (CrI) −100 to −33; moderate certainty). Compared with anticoagulation, PFO closure may confer little or no difference in ischaemic stroke recurrence (low certainty) but probably has a lower risk of major bleeding (RD −20, 95% CrI −27 to −2, moderate certainty). Relative to either medical therapy, PFO closure probably increases the risk of persistent atrial fibrillation (RD 18, 95% CI +5 to +56, moderate certainty) and device-related adverse events (RD +36, 95% CI +23 to +50, high certainty). Anticoagulation, compared with antiplatelet therapy, may reduce the risk of ischaemic stroke recurrence (RD −71, 95% CrI −100 to +17, low certainty), but probably increases the risk of major bleeding (RD +12, 95% CrI −5 to +65, moderate certainty).ConclusionsIn patients aged <60 years, PFO closure probably confers an important reduction in ischaemic stroke recurrence compared with antiplatelet therapy alone but may make no difference compared with anticoagulation. PFO closure incurs a risk of persistent atrial fibrillation and device-related adverse events. Compared with alternatives, anticoagulation probably increases major bleeding.PROSPERO registration numberCRD42017081567.
Measuring lupus arthritis activity using contrasted high-field MRI. Associations with clinical measures of disease activity and novel patterns of disease
Authors: Zollars Eric S , Hyer Madison , Wolf Bethany , Chapin Russell 
Published: July 2018

ObjectiveArthritis in SLE is poorly described, and there is no objective measure for quantification of arthritis. In this pilot study, we aim to assess the utility of the Rheumatoid Arthritis MRI Scoring System (RAMRIS) for the quantification of lupus arthritis.MethodsPatients were eligible for entry into the study if they were evaluated at the Medical University of South Carolina Lupus Center and determined by their treating rheumatologist to have active hand arthritis due to SLE. Standard of care lupus activity measures were collected, along with a detailed physical exam. MRIs were obtained using standard musculoskeletal sequences with gadolinium contrast. Semiquantitative scoring of the images used the Outcome Measures in Rheumatology Clinical Trials RAMRIS system.ResultsRAMRIS demonstrates large amounts of synovitis, tenosynovitis, bone marrow oedema and erosive disease in only a minority of patients. Some patients were not scored as having any synovitis or tenosynovitis. We describe potential features of lupus arthritis that are not captured in the RAMRIS scores and may be contributing to symptoms.ConclusionLupus arthritis is an entity separate from rheumatoid arthritis and requires the development of new quantitative methods to describe and quantitate it. MRI findings suggest the inadequacy of a typical lupus musculoskeletal measure including swollen/tender joint counts to assess the level of disease activity.
Effect of altering the ratio of exogenous gonadotropins on reproductive performance of primiparous sows during the seasonal infertility period
Authors: Am-in Nutthee , Techakumphu Mongkol , Kirkwood R.N. 
Published: July 2018

At weaning, 150 primiparous sows were assigned sequentially to receive 400 IU equine chorionic gonadotropin (eCG) with 200 IU human chorionic gonadotropin (hCG) (Gn600), or 400 IU eCG with 400 IU hCG (Gn800), or served as untreated controls. Compared with control and Gn600, the Gn800 had increased estrus response by day 7 and reduced wean-to-estrus intervals (P < 0.05). Compared with controls, both Gn600 and Gn800 increased numbers of large follicles (≥6 mm) at estrus detection (P < 0.05) and the subsequent farrowing rates (P < 0.05). Litter size was unaffected. These data demonstrate the efficacy of supplemental hCG for alleviating effects of seasonal infertility in primiparous sows.
Medullary bone attributes in aged Lohmann LSL-lite layers fed different levels of calcium and top-dressed 25-hydroxy vitamin D3
Authors: Akbari Moghaddam Kakhki R. , Heuthorst T. , Wornath-Vanhumbeck A. , Neijat M. , Kiarie E. 
Published: July 2018

Structural bone depletion over the course of lay cycle predisposes hens to skeletal problems. We investigated the effects of dietary calcium (Ca) and top-dressed 25-hydroxy vitamin D3 (25OHD3) on attributes [relative weight, ash content (AC), and ash concentration (ACN)] in whole ulna, femur, tibia, and subparts of femur and tibia (epiphysis, medullary, and cortical) in 74-wk-old Lohmann LSL-lite layers. Four levels of Ca (3.0%, 3.5%, 4.0%, and 4.5%) and three levels of 25OHD3 (0, 69, and 138 μg kg−1) were tested. All diets had basal level of 3300 IU of vitamin D3 kg−1. Eighty-four, 74-wk-old hens were placed in individual cages, and 13 spare hens were sacrificed for baseline samples. Diets (n = 7) were fed to 81 wks of age, and hens were sacrificed for bone samples. There were no (P > 0.05) diet effects on whole bone attributes. Interaction (P < 0.05) between Ca and 25OHD3 on femur subparts was such that 25OHD3 linearly increased medullary ACN and concomitantly decreased cortical ACN at all Ca levels. In tibia, 25OHD3 (P < 0.05) increased AC and ACN in medullary and reduced these parameters in cortical. The results suggested that subparts and not whole medullary bone attributes are more amenable to dietary interventions in aged hens.
Graph-Based Bilingual Word Embedding for Statistical Machine Translation
Authors: Wang Rui , Zhao Hai , Ploux Sabine , Lu Bao-Liang , Utiyama Masao , Sumita Eiichiro 
Published: July 2018

Bilingual word embedding has been shown to be helpful for Statistical Machine Translation (SMT). However, most existing methods suffer from two obvious drawbacks. First, they only focus on simple contexts such as an entire document or a fixed-sized sliding window to build word embedding and ignore latent useful information from the selected context. Second, the word sense but not the word should be the minimal semantic unit; however, most existing methods still use word representation.
To overcome these drawbacks, this article presents a novel Graph-Based Bilingual Word Embedding (GBWE) method that projects bilingual word senses into a multidimensional semantic space. First, a bilingual word co-occurrence graph is constructed using the co-occurrence and pointwise mutual information between the words. Then, maximum complete subgraphs (cliques), which play the role of a minimal unit for bilingual sense representation, are dynamically extracted according to the contextual information. Consequently, correspondence analysis, principal component analyses, and neural networks are used to summarize the clique-word matrix into lower dimensions to build the embedding model.
Without contextual information, the proposed GBWE can be applied to lexical translation. In addition, given contextual information, GBWE is able to give a dynamic solution for bilingual word representations, which can be applied to phrase translation and generation. Empirical results show that GBWE can enhance the performance of lexical translation, as well as Chinese/French-to-English and Chinese-to-Japanese phrase-based SMT tasks (IWSLT, NTCIR, NIST, and WAT).
HCSG
Authors: Zanni Cédric , Claux Frédéric , Lefebvre Sylvain 
Published: July 2018

Constructive Solid Geometry models solids as boolean combinations of base primitives. It is one of the classical modeling approaches in Computer Graphics. With the advent of 3D printing, it has received a renewed interest: CSG affords for the robust definition of solids, and fits well with parametric modeling, affording for easy customization of existing designs.
However, the interactive display and manipulation of CSG models is challenging: Ideally, CSG has to be performed between a variety of solid representations (meshes, implicit solids, voxels) and the renderer has to provide immediate feedback during parameter exploration. The end result has to be prepared for fabrication, which involves robustly extracting cross-sections of the model.
In this work we propose a novel screen space technique for the rendering, interactive modeling and direct fabrication of parametric CSG models. It builds upon spatial hashing techniques to efficiently evaluate CSG expressions, checking whether each interval along a view ray is solid in constant time, using constant local shader memory. In addition, the scene is rendered progressively, from front to back, bounding memory usage. We describe how the hash encoding the CSG is constructed on the fly during visualization, and analyze performance on a variety of 3d models.
Monitoring gastric myoelectric activity after pancreaticoduodenectomy for diet “readiness”
Authors: Dua Monica M. , Navalgund Anand , Axelrod Steve , Axelrod Lindsay , Worth Patrick J. , Norton Jeffrey A. , Poultsides George A. , Triadafilopoulos George , Visser Brendan C. 
Published: July 2018

Postoperative delayed gastric emptying (DGE) is a frustrating complication of pancreaticoduodenectomy (PD). We studied whether monitoring of postoperative gastric motor activity using a novel wireless patch system can identify patients at risk for DGE. Patients ( n = 81) were prospectively studied since 2016; 75 patients total were analyzed for this study. After PD, battery-operated wireless patches (G-Tech Medical) that acquire gastrointestinal myoelectrical signals are placed on the abdomen and transmit data by Bluetooth. Patients were divided into early and late groups by diet tolerance of 7 days [enhanced recovery after surgery (ERAS) goal]. Subgroup analysis was done of patients included after ERAS initiation. The early and late groups had 50 and 25 patients, respectively, with a length of stay (LOS) of 7 and 11 days ( P < 0.05). Nasogastric insertion was required in 44% of the late group. Tolerance of food was noted by 6 versus 9 days in the early versus late group ( P < 0.05) with higher cumulative gastric myoelectrical activity. Diminished gastric myoelectrical activity accurately identified delayed tolerance to regular diet in a logistical regression analysis [area under the curve (AUC): 0.81; 95% confidence interval (CI), 0.74–0.92]. The gastric myoelectrical activity also identified a delayed LOS status with an AUC of 0.75 (95% CI, 0.67–0.88). This stomach signal continued to be predictive in 90% of the ERAS cohort, despite earlier oral intake. Measurement of gastric activity after PD can distinguish patients with shorter or longer times to diet. This noninvasive technology provides data to identify patients at risk for DGE and may guide the timing of oral intake by gastric “readiness.” NEW & NOTEWORTHY Limited clinical indicators exist after pancreaticoduodenectomy to allow prediction of delayed gastric emptying (DGE). This study introduces a novel, noninvasive, wireless patch system capable of accurately monitoring gastric myoelectric activity after surgery. This system can differentiate patients with longer or shorter times to a regular diet as well as provide objective data to identify patients at risk for DGE. This technology has the potential to individualize feeding regimens based on gastric activity patterns to improve outcomes.
Prematurity reduces citrulline-arginine-nitric oxide production and precedes the onset of necrotizing enterocolitis in piglets
Authors: Robinson Jason L. , Smith Victoria A. , Stoll Barbara , Agarwal Umang , Premkumar Muralidhar H. , Lau Patricio , Cruz Stephanie M. , Manjarin Rodrigo , Olutoye Oluyinka , Burrin Douglas G. , Marini Juan C. 
Published: July 2018

Necrotizing enterocolitis (NEC) is associated with low plasma arginine and vascular dysfunction. It is not clear whether low intestinal citrulline production, the precursor for arginine synthesis, occurs before and thus predisposes to NEC or if it results from tissue damage. This study was designed to test the hypothesis that whole body rates of citrulline, arginine, and nitric oxide synthesis are low in premature pigs and that they precede NEC. Piglets delivered by cesarean section at 103 days [preterm (PT)], 110 days [near-term (NT)], or 114 days [full-term (FT)] of gestation were given total parenteral nutrition and after 2 days orogastrically fed infant formula for 42 h to induce NEC. Citrulline and arginine fluxes were determined before and during the feeding protocol. Gross macroscopic and histological NEC scores and plasma fatty acid binding protein (iFABP) concentration were determined as indicators of NEC. Intestinal gene expression for enzymes of the arginine pathway were quantitated. A lower ( P < 0.05) survival rate was observed for PT (8/27) than for NT (9/9) and FT pigs (11/11). PT pigs had higher macroscopic gross ( P < 0.05) and histological NEC ( P < 0.05) scores and iFABP concentration ( P < 0.05) than pigs of more advanced gestational age. PT pigs had lower citrulline production and arginine fluxes ( P < 0.05) throughout and a reduced gene expression in genes of the citrulline-arginine pathway. In summary, intestinal enzyme expression and whole body citrulline and arginine fluxes were reduced in PT pigs compared with animals of more advance gestational age and preceded the development of NEC. NEW & NOTEWORTHY Arginine supplementation prevents necrotizing enterocolitis (NEC), the most common gastrointestinal emergency of prematurity. Citrulline (precursor for arginine) production is reduced during NEC, and this is believed to be a consequence of intestinal damage. In a swine model of NEC, we show that intestinal gene expression of the enzymes for citrulline production and whole body citrulline and arginine fluxes are reduced and precede the onset of NEC in premature pigs. Reduced citrulline production during prematurity may be a predisposition to NEC.
Impact of endotracheal tube biofilm and respiratory secretions on airway resistance and mechanics of breathing in a neonatal lung model
Authors: Kenaley Kaitlin M. , Blackson Tom , Boylan Lori , Ciarlo Joseph , Antunes Michael , Shaffer Thomas H. , Locke Robert 
Published: July 2018

Endotracheal tube (ETT) obstruction from biofilm formation is a theoretical risk for intubated preterm neonates. The objective of this study is to determine the impact of ETT biofilm on ETT resistance and minute ventilation in a neonatal respiratory model. Postextubation 2.5- and 3.0-mm ETTs from ventilated preterm infants were matched with unused control ETTs. The pressure gradient across the ETT was measured at set flow rates and converted to airway resistance. Spontaneous breathing tests (SBTs) were performed using a virtual patient model and were considered “passed” if minute ventilation of patient ETTs was greater than 60% of control ETTs. Twenty-four 2.5-mm ETTs and sixteen 3.0-mm ETTs were analyzed. In both patient and control ETTs, as flow rate increases, the pressure gradient across the ETT also increases in a linear fashion. Resistance to flow in patient ETTs was statistically different from matched control ETTs ( P < 0.001), and patient ETTs had 19.9 cmH2O·l−1·sec−1 greater resistance than control ETTs. SBTs were performed in 27 of 40 ETTs. Twenty-six ETTs “passed” an SBT. In one obstructed 3.0-mm ETT, SBT measurements were unobtainable. The clinical impact of ETT biofilm as measured by a SBT appears to be minimal for the majority of patients in our study group. In 1 out of 27 ETTs, the presence of a biofilm significantly altered resistance to airflow and resulted in a failed SBT. Gas flow rate and ETT size had a greater impact on resistance to airflow and minute ventilation than ETT biofilm in this study sample. NEW & NOTEWORTHY This is the first study to our knowledge to characterize the impact of endotracheal tube (ETT) biofilm and respiratory secretions on resistance to airflow in a neonatal ETT using a simulation neonatal lung model. Results show that the clinical impact of ETT biofilm is minimal for the majority of patients in our study group, and ETT obstruction from biofilm is an uncommon cause of respiratory decompensation in a preterm neonate.
Neurovascular coupling during cognitive activity in adults with controlled hypertension
Authors: Lefferts Wesley K. , DeBlois Jacob P. , Barreira Tiago V. , Heffernan Kevin S. 
Published: July 2018

Hypertension, even when controlled, may accelerate arterial stiffening and impair the ability of the cerebrovasculature to increase blood flow to support neural activity, i.e., neurovascular coupling (NVC). Optimal NVC depends on continuous, nonpulsatile flow, which is partially determined by extra- and intracranial vessel function. We sought to compare extra- and intracranial hemodynamics during cognitive activity (Stroop task) in 30 middle-aged, well-controlled medicated hypertensive and 30 age-, sex-, and body mass index (BMI)-matched nonhypertensive adults (56 ± 6 years, 28.2 ± 2.9 kg/m2 BMI; 32 men). Aortic and carotid (single point) pulse wave velocity (PWV) were assessed via tonometry and ultrasound, respectively. Carotid and middle cerebral artery (MCA) blood velocity pulsatility were measured via ultrasound and Doppler. Prefrontal cortex (PFC) oxygenation was measured via tissue saturation index (TSI) using near-infrared spectroscopy. Accuracy and reaction times were computed to assess cognitive performance. Stroop performance was similar between groups ( P > 0.01). Aortic and carotid PWV increased, carotid flow pulsatility decreased ( P < 0.01), and MCA flow pulsatility and PFC TSI were maintained during Stroop ( P > 0.01). Our findings indicate that middle-age adults with medically controlled hypertension and adults without hypertension demonstrate similar intra- and extracranial cerebrovascular reactivity during cognitive engagement. Despite increases in large artery stiffness, middle-aged adults with controlled hypertension and without hypertension exhibit reductions in extracranial flow pulsatility during cognitive engagement that may be part of a concerted cerebrovascular response to support downstream cerebral oxygenation and overall NVC. NEW & NOTEWORTHY Hypertension is associated with accelerated arterial stiffening, which may alter extra- and intracranial vascular reactivity during cognitive activity and impair neurovascular coupling. Middle-aged adults with medicated hypertension exhibit similar neurovascular coupling and extra-/intracranial vascular reactivity during sustained cognitive activity. Extracranial modulation of central hemodynamics may be an important component of optimal neurovascular coupling.
Effect of intercostal muscle contraction on rib motion in humans studied by finite element analysis
Authors: Zhang Guangzhi , Chen Xian , Ohgi Junji , Jiang Fei , Sugiura Seiryo , Hisada Toshiaki 
Published: July 2018

The effect of intercostal muscle contraction on generating rib motion has been investigated for a long time and is still controversial in physiology. This may be because of the complicated structure of the rib cage, making direct prediction of the relationship between intercostal muscle force and rib movement impossible. Finite element analysis is a useful tool that is good at solving complex structural mechanic problems. In this study, we individually activated the intercostal muscle groups from the dorsal to ventral portions and obtained five different rib motions classified based on rib moving directions. We found that the ribs cannot only rigidly rotate around the spinal joint but also be deformed, particularly around the relatively soft costal cartilages, where the moment of muscle force for the rigid rotation is small. Although the intercostal muscles near the costal cartilages cannot generate a large moment to rotate the ribs, the muscles may still have a potential to deform the costal cartilages and contribute to the expansion and contraction of the rib cage based on the force-length relationship. Our results also indicated that this potential is matched well with the special shape of the costal cartilages, which become progressively oblique in the caudal direction. Compared with the traditional explanation of rib motion, by additionally considering the effect from the tissue deformation, we found that the special structure of the ventral portion of the human rib cage could be of mechanical benefit to the intercostal muscles, generating inspiratory and expiratory rib motions. NEW & NOTEWORTHY Compared with the traditional explanation of rib motion, additionally considering the effect from tissue deformation helps us understand the special structure of the ventral portion of the human rib cage, such that the costal cartilages progressively become oblique and the costochondral junction angles gradually change into nearly right angles from the upper to lower ribs, which could be of mechanical benefit to the intercostal muscles in the ventral portion, generating inspiratory and expiratory rib motions.