bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computer-based Image Analysis of Natural Approximal Caries on Radiographic Films
Authors: Heaven T.J. , Firestone A.R. , Feagin F.F. 
Published: July 2018

This paper reports on the development of computer software for automatic detection and measurement of approximal caries lesions on digital images obtained from radiographic films. If the program detects a lesion, it defines the lesion's border and measures and reports these lesion parameters: percent mineralization, area, maximum enamel penetration, and mean enamel penetration. Two experiments are reported; both were conducted with the use of extracted human premolar teeth. In the first experiment, thin sections were obtained from 13 approximal surfaces with caries lesions. Microradiographs were made of the sections, and software measurements of the lesions were obtained from the microradiographs. The software was able to separate the lesions into two groups: those that had penetrated less than 100% of the enamel and those that had penetrated 100% of the enamel. The software measurements agreed with evaluation of lesion penetration by polarized light microscopy of the thin sections. In the second experiment, simulated clinical radiographs were made of 16 approximal surfaces, 12 with lesions and four without. Thin sections were obtained for microradiography. Software was used for automatic detection and measurement of the lesions on both types of film. The ability of the software to detect the lesions on the clinical films was compared with that of 10 experienced clinicians. Correlations of the same parameter from the two types of radiographic films were statistically significant, 0.86 ≤ r ≤ 0.95 and p < 0.05. The coefficients of variation were low for both microradiographs, 0.4–2.3%, and for clinical films, 0.7–8.5%. A receiver-operating characteristic (ROC) curve was constructed for the clinicians and the software. The software was more accurate than the clinicians in deciding whether or not a lesion was present. In conclusion, under the conditions of this experiment, the software was able accurately to decide whether caries was present and, when present, to provide information about the extent of the lesion which was in good agreement with that from microradiographs.
Validation and reproducibility of cardiovascular 4D-flow MRI from two vendors using 2 × 2 parallel imaging acceleration in pulsatile flow phantom and in vivo with and without respiratory gating
Authors: Bock Jelena , Töger Johannes , Bidhult Sebastian , Markenroth Bloch Karin , Arvidsson Per , Kanski Mikael , Arheden Håkan , Testud Frederik , Greiser Andreas , Heiberg Einar , Carlsson Marcus 
Published: July 2018

Background 4D-flow magnetic resonance imaging (MRI) is increasingly used. Purpose To validate 4D-flow sequences in phantom and in vivo, comparing volume flow and kinetic energy (KE) head-to-head, with and without respiratory gating. Material and Methods Achieva dStream (Philips Healthcare) and MAGNETOM Aera (Siemens Healthcare) 1.5-T scanners were used. Phantom validation measured pulsatile, three-dimensional flow with 4D-flow MRI and laser particle imaging velocimetry (PIV) as reference standard. Ten healthy participants underwent three cardiac MRI examinations each, consisting of cine-imaging, 2D-flow (aorta, pulmonary artery), and 2 × 2 accelerated 4D-flow with (Resp+) and without (Resp−) respiratory gating. Examinations were acquired consecutively on both scanners and one examination repeated within two weeks. Volume flow in the great vessels was compared between 2D- and 4D-flow. KE were calculated for all time phases and voxels in the left ventricle. Results Phantom results showed high accuracy and precision for both scanners. In vivo, higher accuracy and precision ( P < 0.001) was found for volume flow for the Aera prototype with Resp+ (–3.7 ± 10.4 mL, r = 0.89) compared to the Achieva product sequence (–17.8 ± 18.6 mL, r = 0.56). 4D-flow Resp− on Aera had somewhat larger bias (–9.3 ± 9.6 mL, r = 0.90) compared to Resp+ ( P = 0.005). KE measurements showed larger differences between scanners on the same day compared to the same scanner at different days. Conclusion Sequence-specific in vivo validation of 4D-flow is needed before clinical use. 4D-flow with the Aera prototype sequence with a clinically acceptable acquisition time (<10 min) showed acceptable bias in healthy controls to be considered for clinical use. Intra-individual KE comparisons should use the same sequence.
Effects of right ventricular septum or His-bundle pacing versus right ventricular apical pacing on cardiac function: A systematic review and meta-analysis of randomized controlled trials
Authors: Zhuang Lingfang , Mao Ye , Wu Liqun , Niu Wenquan , Chen Kang 
Published: July 2018

Objective Recent studies have demonstrated that right ventricular apical (RVA) pacing has a deleterious impact on left ventricular function, while right ventricular septum (RVS) or His-bundle pacing (HBP) contribute to improvements in cardiac function. A meta-analysis of randomized controlled trials (RCTs) was conducted to compare the mid- and long-term effects of RVS and HB pacing versus RVA pacing on cardiac function. Methods Eligible RCTs were identified by systematically searching the electronic literature databases PubMed®, Cochrane Library, Embase® and Ovid®. Results Seventeen articles ( n = 1290 patients) were included in this meta-analysis, including 14 studies comparing the effects of RVA and RVS pacing on cardiac function and three studies comparing HBP with pacing at other sites. Compared with RVA pacing, RVS or HBP exhibited a higher left ventricular ejection fraction (LVEF) (weighted mean difference 3.28; 95% confidence interval 1.45, 5.12) at the end of follow-up. Conclusions RVS pacing exhibited a higher LVEF after long-term follow-up than RVA pacing. RVS pacing could replace the previously used RVA pacing as a better alternative with improved clinical outcomes. However, there remains a need for larger RCTs to compare the safety and efficacy of RVS with RVA pacing.
Sugammadex affects emergence agitation in children undergoing strabismus surgery
Authors: Kim Young Sung , Cha Jae Ryung , Lee Yoon Sook , Kim Woon Young , Kim Jae Hwan , Kim Yun Hee 
Published: July 2018

Objective Emergence agitation (EA) has a multifactorial origin, and the effect of sugammadex on EA has not been established. We investigated the effect of sugammadex on EA incidence and severity. Methods We performed a retrospective study of children aged 1 to 13 years who underwent strabismus surgery. Patients received sugammadex or conventional neuromuscular reversal agents. The primary outcome variables were EA incidence and severity. Secondary outcome variables were postoperative fentanyl use, postoperative nausea and vomiting, time from reversal agent administration to extubation, time from the end of surgery to arrival in the post-anesthesia care unit (PACU) and time spent in the PACU. We used propensity score matching to eliminate baseline imbalances. Results Age, sex, use of desflurane, and intraoperative fentanyl were significant predictors of agitation severity using a multivariable analysis. Sugammadex did not significantly affect EA in logistic regression and multiple regression analyses. In the propensity-matched analysis, patients in the sugammadex group showed rapid recovery, but there was no difference in the EA incidence or severity. Conclusion Sugammadex did not affect EA incidence or severity compared with conventional cholinesterase inhibitors, although it showed a favorable recovery profile in children undergoing strabismus surgery.
Safety and efficacy of total parenteral nutrition versus total enteral nutrition for patients with severe acute pancreatitis: a meta-analysis
Authors: Li Wen , Liu Jixi , Zhao Shuqiao , Li Jingtao 
Published: July 2018

Objective This study was performed to systematically compare the safety and efficacy of total enteral nutrition (TEN) and total parenteral nutrition (TPN) for patients with severe acute pancreatitis (SAP). Methods The PubMed database was searched up to January 2017, and nine studies were retrieved. These studies were selected according to specific eligibility criteria. The methodological quality of each trial was assessed, and the study design, interventions, participant characteristics, and final results were then analyzed by Review Manager 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Results Nine relevant randomized controlled trials involving 500 patients (244 patients in the TEN group and 256 patients in the TPN group) were included in the meta-analysis. Pooled analysis showed a significantly lower mortality rate in the TEN than TPN group [odds ratio (OR), 0.31; 95% confidence interval (CI), 0.18–0.54]. The duration of hospitalization was significantly shorter in the TEN than TPN group (mean difference, −0.59; 95% CI, −2.56–1.38). Compared with TPN, TEN had a lower risk of pancreatic infection and related complications (OR, 0.41; 95% CI, 0.22–0.77), organ failure (OR, 0.17; 95% CI, 0.06–0.52), and surgical intervention (OR, 0.17; 95% CI, 0.05–0.62). Conclusions This meta-analysis indicates that TEN is safer and more effective than TPN for patients with SAP. When both TEN and TPN have a role in the management of SAP, TEN is the preferred option.
Iron parameters in patients with end-stage renal disease receiving lanthanum carbonate or other non-iron-based phosphate binders: Results from a phase 3, randomized open-label study
Authors: Wilson Rosamund J , Jones Beverly , Marelli Claudio 
Published: July 2018

Objectives: The recent availability of iron-based phosphate binders has raised some concerns about iron overload in patients with end-stage renal disease. This study evaluated iron parameters in patients with end-stage renal disease receiving lanthanum carbonate or other non-iron-based phosphate binders. Methods: This analysis used 2-year follow-up data from an open-label, multicentre, randomized, active-controlled, parallel-group, phase 3 trial of lanthanum carbonate (SPD405-307). After a washout period, if patients’ serum phosphate levels exceeded 5.9 mg/dL, they were randomized 1:1 to receive lanthanum carbonate (375–3000 mg/day) or non-iron-based standard therapy during a 6-week dose titration period. Patients achieving control of serum phosphate levels (⩽5.9 mg/dL) received maintenance therapy with lanthanum carbonate or standard therapy for up to 24 months. Results: No clinically relevant changes in mean (standard deviation) iron parameters between the treatment groups (lanthanum carbonate, n = 682; standard therapy, n = 677) from baseline to month 24/final visit were observed: iron (µg/dL), −1.1 (41.8) versus 1.0 (38.7); ferritin (ng/mL), 208.4 (445.1) versus 262.4 (505.5); transferrin saturation (%), 2.8 (18.0) versus 2.8 (17.3); and haemoglobin (g/dL), 0.4 (1.9) versus 0.3 (1.7), respectively (all, p > 0.1). There were no clinically relevant changes in the percentage of patients receiving any anti-anaemic preparation in either treatment group (pre- vs post-randomization: lanthanum carbonate, 94.9% vs 97.8%; standard therapy, 95.1% vs 98.8%, respectively). This is in contrast to the study by Lewis and colleagues, which found significant increases in ferritin and transferrin saturation levels in patients receiving ferric citrate versus active control (calcium acetate and/or sevelamer carbonate) after 52 weeks of therapy. Although serum ferritin and transferrin saturation are the recommended iron indices by the Kidney Disease Outcome Quality Initiative, they are indirect indicators of iron status. Longer-term studies are required to understand fully the potential risks associated with iron overload. Conclusion: No evidence of iron accumulation was found in patients with end-stage renal disease receiving lanthanum carbonate or other non-iron-based binders.
Use of a Modified All-Epiphyseal Technique for Anterior Cruciate Ligament Reconstruction in the Skeletally Immature Patient
Authors: Pennock Andrew T. , Chambers Henry G. , Turk Robby D. , Parvanta Kristina M. , Dennis M. Morgan , Edmonds Eric W. 
Published: July 2018

Background: Multiple surgical approaches have been described for the management of anterior cruciate ligament (ACL) tears in skeletally immature patients. Purpose: To provide a detailed description of a modified all-epiphyseal ACL reconstruction and report early outcomes and complications with this new technique. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of all skeletally immature patients undergoing ACL reconstruction via a modified all-epiphyseal technique prior to July 2015 was performed. Skeletally immature male patients with a bone age of 8 to 15 years and female patients with a bone age of 8 to 12 years were selectively indicated for this procedure. The surgical technique involved an all-epiphyseal femoral tunnel drilled parallel and distal to the physis as well as an all-epiphyseal tibial tunnel. Both tunnels were placed in the anatomic footprint of the ACL. Tibial fixation was achieved first with a suspensory cortical fixation device followed by fixation on the femur with an interference screw. Results: During the study period, 30 patients with a mean bone age of 11.8 years underwent ACL reconstruction with this physeal-sparing technique; 26 patients (87%) achieved a minimum follow-up of 2 years. At final follow-up, the mean Lysholm score, Single Assessment Numeric Evaluation score, patient satisfaction, return-to-sport rate, and Tegner activity score were 93, 89, 9.2, 94%, and 7.6, respectively. Four graft failures (15%) and 3 (12%) contralateral ACL tears were identified. One patient was noted to have a 12-mm leg-length discrepancy at final follow-up, which required no additional treatment. No other leg-length discrepancies or angular deformities were identified. Conclusion: The modified all-epiphyseal ACL reconstruction technique achieved good functional outcomes, a high rate of return to sport, low failure rates, and low physeal injury rates at a mean follow-up of 3.2 years. Skeletally immature patients with an ACL tear requiring reconstruction pose a unique challenge for sports medicine clinicians. While several previous approaches have been described for this patient population, the proposed benefits of this new technique are that it is anatomic, it is physeal sparing, it uses osseous tunnels, and it provides good initial graft fixation strength.
The Application of Project Scheduling Techniques in a Real-Life Environment
Authors: Vanhoucke Mario , Demeulemeester Erik 
Published: July 2018

The scheduling of activities over time has gained increasing attention with the development of the critical path method (CPM) and the program evaluation and review technique (PERT). Since then, a large amount of solution procedures for a wide range of problem types have been proposed in the literature. Many of these procedures, however, are not able to solve real-life problems. In this paper we describe a capacity expansion project at a water production center (WPC) of the Vlaamse Maatschappij voor Watervoorziening (VMW) in Belgium. This project aims at expanding the production capacity of pure water. We show that scheduling the project with certain techniques will improve the financial status of the project. We illustrate this statement with different schedules.
Identifying the Contextual Elements of Project Management within Organizations and their Impact on Project Success
Authors: Ives Mark 
Published: July 2018

Change within organizations is becoming the rule rather than the exception as businesses seek to respond to an increasingly fluid, complex, and global business environment. This drive demands that organizations embrace a more strategic response to avoid being leap-frogged by more nimble competitors. As Cicmil points out (1997, 1999), strategic organizational change is most likely facilitated and managed through an organization's use of the project management disciplines. This study attempts to develop a greater understanding of the contextual aspects of project management in an organizational change setting. In reviewing the current literature, I have found an increasing use of project management within organizations and an attendant poor rate of success among these projects; interestingly, I also found only limited research on the context and fit of projects within organizations. I have addressed this void with an essentially exploratory research project that utilizes inductive strategy. The process I have used is qualitative and based on in-depth interviews with four people.
The Amoebic Growth of Project Costs
Authors: Eden Colin , Ackermann Fran , Williams Terry 
Published: July 2018

In the public arena, we often hear about projects that have suffered massive cost overruns. Often they are related to large public construction projects such as airports, bridges, or public buildings. Large overruns also exist in private industry. However, often these do not appear in the newspapers, so the public is not as aware of them. Of course, not all projects go badly wrong, but quite a few do, and frequently we find ourselves uncertain of the causes for such overruns. In this paper, industrial projects that overrun and overrun in a surprising manner are considered. In other words, the paper considers those many projects where the extent of the overrun is well beyond what might ever have been anticipated, even though what was going wrong within the projects was, for the most part, understood. The basis for the content of the paper (that is, the structure and lessons), are drawn from a postmortem analysis of many large projects as part of claims analysis, particularly “delay and disruption” claims for projects whose total expenditure appeared, at first look, inexplicable or surprising. The aim of the paper is to contribute to an understanding of how projects go badly wrong, when they do, and in particular to draw some lessons from this exploration that are likely to help all managers. The reasons for cost escalation are not just the responsibility of project managers.
Managing Project Risks as Knowledge Gaps
Authors: Regev Sary , Shtub Avraham , Ben-Haim Yakov 
Published: July 2018

The development of new technologies and the implementation of such technologies in new applications is a continuous effort to close technological and logistical knowledge gaps. Although knowledge gapscan be closed by accident—like the case of Archimedes who closed an important knowledge gap about the laws of nature while bathing—in most cases, knowledge gaps are closed by a consistent, organized effort, namely by projects. Project management methodologies attempt to manage the risk generated by the one-time nature of projects. This risk is generated by the lack of knowledge and its resulting uncertainty. Tools for managing project risks and their consequences, including risk identification, risk quantification, risk elimination, risk reduction, risk sharing, and risk control, were developed and are implemented to some degree in many technological projects. However, most of these tools are based on statistical theory (e.g., the central limit theorem). Unfortunately, statistical theory may not be applicable to technological projects where there is very little or no relevant previous experience at all. The question is: what can we do when past data is not an appropriate basis for future decisions? In this paper we describe a new approach for dealing with technological projects—an approach based on the analysis of knowledge gaps (i.e., the gap between what we should know in order to succeed in the project and what we really know).
Natural clay from Cuba for environmental remediation
Authors: Martín S. A. , Valdés L. , Mérida F. , de Ménorval L. C. , Velázquez M. , Rivera A. 
Published: July 2018

ABSTRACTThe use of natural clays for the removal of dyes from wastewater, an important part of environmental remediation, is desirable due, not least, to their low cost. Palygorskite (PAL), a rigid-structure clay, is a good candidate for use in the elimination of industrial effluents, based on its exceptional adsorptive properties. Recently, a new palygorskite deposit has been discovered in Cuba and its use in the adsorption of dyes has not yet been explored in detail. In the present study, the use of unmodified natural Cuban palygorskite as a host for dyes was evaluated. Congo red (CR) and methylene blue (MB) were the anionic and cationic dyes tested, respectively, because of their wide use and toxicity to the environment. Several physical-chemical parameters were studied in order to establish the best experimental conditions under which to achieve the greatest dye load per gram of clay. Natural mixtures with different percentages of montmorillonite were also tested to evaluate their effect on the adsorption of the dyes. The results indicated that at pH values of ~7–9 and an initial dye concentration of 0.1 mg mL–1, the process was efficient. X-ray diffraction (XRD) analysis proved the surface adsorption of both dyes on the clays. The main interactions involved in the clay-dye system were electrostatic forces and H-bonds. Adsorption of CR seemed to be controlled fundamentally by the palygorskite phase. Such results support the use of this natural clay as an efficient host for the removal of MB and CR from wastewater.
Integrative genomic analysis reveals cancer-associated mutations at diagnosis of CML in patients with high-risk disease
Authors: Branford Susan , Wang Paul , Yeung David T. , Thomson Daniel , Purins Adrian , Wadham Carol , Shahrin Nur Hezrin , Marum Justine E. , Nataren Nathalie , Parker Wendy T. , Geoghegan Joel , Feng Jinghua , Shanmuganathan Naranie , Mueller Martin C. , Dietz Christian , Stangl Doris , Donaldson Zoe , Altamura Haley , Georgievski Jasmina , Braley Jodi , Brown Anna , Hahn Christopher , Walker Ieuan , Kim Soo-Hyun , Choi Soo-Young , Park Sa-Hee , Kim Dong-Wook , White Deborah L. , Yong Agnes S. M. , Ross David M. , Scott Hamish S. , Schreiber Andreas W. , Hughes Timothy P. 
Published: July 2018

Key Points
Next-generation sequencing revealed variants in cancer-associated genes at diagnosis of CML more frequently in patients with poor outcomes. All patients at BC had mutated cancer genes, including fusions, that predated BCR-ABL1 kinase domain mutations in a majority.
Modelling out-of-area admissions
Authors: Paton Lewis W. , Tiffin Paul A. 
Published: July 2018

SummaryOut-of-area (OOA) placements occur when patients cannot be admitted to local facilities, which can be extremely stressful for patients and families. Thus, the Department of Health aims to eliminate the need for OOA admissions. Using data from a UK mental health trust we developed a ‘virtual mental health ward’ to evaluate the potential impact of referral rates and length of stay (LOS) on OOA rates. The results indicated OOA rates were equally sensitive to LOS and referral rate. This suggests that investment in community services that reduce both LOS and referral rates are required to meaningfully reduce OOA admission rates.Declaration of interestP.A.T. holds an honorary consultant contract with the Tees, Esk and Wear Valleys NHS Foundation Trust.