bluuebunny/crossref_metadata_2025_split huggingface dataset:
Major complications of high‐energy microwave ablation for percutaneous CT‐guided treatment of lung malignancies: Single‐centre experience after 4 years
Authors: Splatt Alexander M , Steinke Karin 
Published: August 2015

AbstractPurposeTo evaluate the rate of major complications related to percutaneous computed tomography (CT)‐guided microwave ablation (MWA) of primary and secondary lung malignancies performed at our institution over a 4‐year period.MethodsFrom May 2010 to September 2014, 70 MWAs were performed on 51 patients. All major intra‐ and post‐procedural complications (as defined by the classification proposed by the Society of Interventional Radiology) were retrospectively analysed. The results were correlated with a systematic review of the available literature on MWA in the lung.ResultsMajor complications were encountered in 14 out of 70 ablations (20%). Twenty‐one separate major complications were encountered (some ablations lead to more than one major complication). One death occurred within 30 days of ablation, though the relationship to the procedure remains uncertain. Other major complications included: nine pneumothoraces requiring drain insertion (12.9%), four cases of large effusion requiring drainage (5.7%), two cases of significant pulmonary haemorrhage altering clinical management (2.9%), two infections (2.9%), one case of mechanical failure (1.4%), one chest wall burn (1.4%) and one case of pleural seeding (1.4%). Major complications were much more likely to occur if the nodule was located within 7 mm from the pleura.ConclusionMWA of pulmonary tumours carries moderate risk; nevertheless, the usually manageable complications should not deter from undertaking a potentially curative therapy for poor surgical candidates.
Scientific basis of personalised tomographic radiation planning for radioembolisation: A form of brachytherapy planning
Authors: Kao Yung Hsiang , Goodwin Mark , Lee Sze Ting , Lichtenstein Meir , Scott Andrew Mark 
Published: August 2015

SummaryToday's tomographic imaging techniques such as catheter‐directed CT and single photon emission computed tomography with integrated computed tomography may be used for pre‐therapy radiation planning for radioembolisation based on prospective calculation of tissue radiation absorbed doses. We outline the scientific concepts that underlie modern personalised tomographic radiation planning for radioembolisation and highlight its similarities to brachytherapy planning.
China national lung cancer screening guideline with low‐dose computed tomography (2015 version)
Authors: Zhou Qing‐hua , Fan Ya‐guang , Bu Hong , Wang Ying , Wu Ning , Huang Yun‐chao , Wang Guiqi , Wang Xin‐yun , Qiao You‐lin 
Published: August 2015

AbstractBackgroundLung cancer is the leading cause of cancer‐related death in China. Results from a randomized controlled trial using annual low‐dose computed tomography (LDCT) in specific high‐risk groups demonstrated a 20% reduction in lung cancer mortality.MethodsA China national lung cancer screening guideline was developed by lung cancer early detection and treatment expert group appointed by the National Health and Family Planning Commission, based on results of the National Lung Screening Trial, systematic review of evidence related to LDCT screening, and protocol of lung cancer screening program conducted in rural China.ResultsAnnual lung cancer screening with LDCT is recommended for high risk individuals aged 50–74 years who have at least a 20 pack‐year smoking history and who currently smoke or have quit within the past five years. Individualized decision making should be conducted before LDCT screening. LDCT screening also represents an opportunity to educate patients as to the health risks of smoking; thus, education should be integrated into the screening process in order to assist smoking cessation.ConclusionsA lung cancer screening guideline is provided for the high‐risk population in China.
Alcohol and Drug Use Among Postoperative Bariatric Patients: A Systematic Review of the Emerging Research and Its Implications
Authors: Spadola Christine E. , Wagner Eric F. , Dillon Frank R. , Trepka Mary Jo , De La Cruz‐Munoz Nestor , Messiah Sarah E. 
Published: August 2015

BackgroundEmerging research suggests that some bariatric surgery patients are at a heightened risk for developing substance use problems, especially alcohol use problems.MethodsAn exhaustive literature review was conducted in January 2015 to investigate all articles published that included data on postoperative alcohol use, alcohol use disorders, and illicit drug use among bariatric surgery patients.ResultsTwenty‐three studies reported on alcohol and/or substance use among bariatric patients. Six studies longitudinally assessed alcohol use behaviors; 3 of these studies found an increase in alcohol use following surgery. Six studies were cross‐sectional, and 2 studies assessed medical records. Five studies investigated the prevalence of admissions to substance abuse treatment, and 3 studies combined alcohol and drug use data in a single index. Six studies reported on illicit drug use and reported low‐postoperative use. The studies' samples were primarily non‐Hispanic white females in their upper 40s, and only 11 of the 23 studies utilized validated assessment instruments.ConclusionsStudies employing longitudinal designs and large sample sizes indicate that bariatric patients who had the gastric bypass procedure are at an elevated risk for alcohol use problems postoperatively. Research also indicates that bariatric surgery patients might be overrepresented in substance abuse treatment facilities. Risk factors for problematic postoperative alcohol use include regular or problematic alcohol use presurgery, male gender, younger age, tobacco use, and symptoms of attention deficient and hyperactivity disorder. As a whole, however, studies indicate bariatric surgery patients demonstrate a low prevalence of problematic alcohol use, and studies about gastric bypass patients are not entirely conclusive. Prospective, longitudinal studies are needed, utilizing standardized and validated alcohol assessment instruments that follow postoperative bariatric patients well beyond 2 years, and account for types of bariatric procedure. Finally, study samples with greater racial/ethnic diversity and wider age ranges are needed.
Innovative community‐based educational face‐to‐face intervention to reduce HIV, hepatitis C virus and other blood‐borne infectious risks in difficult‐to‐reach people who inject drugs: results from the ANRS–AERLI intervention study
Authors: Roux Perrine , Le Gall Jean‐Marie , Debrus Marie , Protopopescu Camélia , Ndiaye Khadim , Demoulin Baptiste , Lions Caroline , Haas Aurelie , Mora Marion , Spire Bruno , Suzan‐Monti Marie , Carrieri Maria Patrizia 
Published: August 2015

AbstractAimsTo study the effectiveness of an educational intervention on risks associated with drug injection, comparing primary [unsafe HIV–hepatitis C virus (HCV) practices] and secondary (local complications at injecting site) end‐points in harm reduction (HR) programmes offering this intervention versus HR programmes not offering it.DesignThis non‐random clustered intervention study was conducted in nine intervention groups (programmes offering the intervention) and eight control groups (programmes not offering it). Each participant was followed‐up through a telephone interview at enrolment and at 6 and 12 months.SettingThe study took place in 17 cities throughout France.ParticipantsOf the 271 participants, 144 were enrolled into the intervention group and 127 in the control group. Of the latter, 113 received at least one educational session.InterventionA series of participant‐centred face‐to‐face educational sessions. Each session included direct observation by trained non‐governmental organization (NGO) staff or volunteers of participants’ self‐injecting the psychoactive product they used habitually; analysis by the trained NGO staff or volunteers of the participant's injecting practices, identification of injection‐related risks and explanation of safer injecting practices; and an educational exchange on the individual participant's injection practices and the questions he or she asked.MeasurementsPrimary and secondary outcomes were ‘at least one unsafe HIV–HCV practice’ and at least one injection‐related complication (derived from a checklist).FindingsThe proportion of participants with at least one unsafe HIV–HCV practice in the intervention group decreased significantly, from 44% at M0 to 25% at M6, as well as complications at the injection site (from 66 to 39% at M12), while in the control group it remained mainly stable. Multivariate probit analyses showed that the intervention group experienced a significant reduction in unsafe HIV–HCV practices at M6 [coefficient, 95% confidence interval (CI) = −0.73 (−1.47 to 0.01)] and in injection‐related complications at M12 [coefficient, 95% CI = −1.01 (−1.77 to −0.24)], compared with the control group.ConclusionsAn inexpensive and easily implemented educational intervention on risks associated with drug injection reduces significantly unsafe HIV–HCV transmission practices and injection‐related complications.
Hemocompatibility of Axial Versus Centrifugal Pump Technology in Mechanical Circulatory Support Devices
Authors: Schibilsky David , Lenglinger Matthias , Avci‐Adali Meltem , Haller Christoph , Walker Tobias , Wendel Hans Peter , Schlensak Christian 
Published: August 2015

AbstractThe hemocompatible properties of rotary blood pumps commonly used in mechanical circulatory support (MCS) are widely unknown regarding specific biocompatibility profiles of different pump technologies. Therefore, we analyzed the hemocompatibility indicating markers of an axial flow and a magnetically levitated centrifugal device within an in vitro mock loop. The HeartMate II (HM II; n = 3) device and a CentriMag (CM; n = 3) adult pump were investigated in a human whole blood mock loop for 360 min using the MCS devices as a driving component. Blood samples were analyzed by enzyme‐linked immunosorbent assay for markers of coagulation, complement system, and inflammatory response. There was a time‐dependent activation of the coagulation (thrombin–antithrombin complexes [TAT]), complement (SC5b‐9), and inflammation system (polymorphonuclear [PMN] elastase) in both groups. The mean value of TAT (CM: 4.0 μg/L vs. 29.4 μg/L, P < 0.001; HM II: 4.5 μg/L vs. 232.2 μg/L, P < 0.05) and PMN elastase (CM: 53.4 ng/mL vs. 253.8 ng/mL, P < 0.05; HM II: 28.0 ng/mL vs. 738.8 ng/mL, P < 0.001) significantly increased from baseline until the end of the experiments (360 min). After 360 min, TAT and PMN values were significantly higher in the HM II group compared with the values in the CM adult group. The values of SC5b‐9 increased from baseline to 360 min in the CM group (CM: 141.8 ng/mL vs. 967.9 ng/mL, P < 0.05) and the HM II group. However, the increase within the HM II group (97.3 vs. 2462.0, P = 0.06) and the comparison of the 360‐min values between CM group and HM II group did not reach significance (P = 0.18). The activation of complement, coagulation, and inflammation system showed a time‐dependent manner in both devices. The centrifugal CM device showed significantly lower activation of coagulation and inflammation than that of the HM II axial flow pump. Both HM II and CM have demonstrated an acceptable hemocompatibility profile in patients. However, there is a great opportunity to gain a clinical benefit by developing techniques to lower the blood surface interaction within both pump technologies and a magnetically levitated centrifugal pump design might be superior.
Pump Speed Waveform Analysis to Detect Aortic Valve Opening in Patients on Ventricular Assist Device Support
Authors: Hayward Christopher , Lim Choon Pin , Schima Heinrich , Macdonald Peter , Moscato Francesco , Muthiah Kavitha , Granegger Marcus 
Published: August 2015

AbstractAs the aortic valve (AV) opens, the pump pressure head remains constant, which is reflected as a “notch/plateau” in pump pressure and flow signals. However, instantaneous flow estimation may be influenced by friction and is particularly difficult in axial pumps. Therefore, a new method to determine the duration of AV opening based on the area under the curve (AUC) of the power spectral density analysis of pump speed signal was developed. Data from patients implanted with HeartWare HVAD left ventricular assist device were studied at different pump speeds, with simultaneous transthoracic echocardiography in two cohorts. In the first group, pump data of 15 patients were used to investigate the ability to discriminate between an open and closed AV. In the second cohort of a further 13 patients, the duration of AV opening was measured from digitized M‐mode images, and the relationship between the AV opening time and the new method assessed. In 14 of the initial 15 patients, AV status could be discriminated using only one threshold for all patients. In the second cohort, gradual speed reduction resulted in aortic valve opening in 12 of the 13 patients. The correlation between AV opening duration and AUC was 0.96 ± 0.03. Regression analysis indicated a linear relationship in each of the patients with a small error between the fit and the measured opening time (root mean square error = 11.0 ± 7.6 ms). However, the slopes (69.0 ± 52.8) and intercepts (−31.4 ± 78.0) varied widely between patients. The sensitivity and specificity for the new method using AUC threshold of 0.95 for aortic valve closure was 95% and 91%, respectively. The newly developed method to detect AV opening not only provides information on the AV status during LVAD support (open/closed) but also gives insight into the duration of AV opening. Because the slope of the relationship varies from patient to patient, initial training and adaptation of the method to each patient seems to be required.
Colloidal bismuth subcitrate impedes proton entry into Helicobacter pylori and increases the efficacy of growth‐dependent antibiotics
Authors: Marcus E. A. , Sachs G. , Scott D. R. 
Published: August 2015

SummaryBackgroundSuccessful eradication of Helicobacter pylori is becoming more difficult, mainly due to emerging antibiotic resistance. Treatment regimens containing bismuth have increased efficacy, but the mechanism is unknown. Helicobacter pylori is a neutralophile adapted to survive the acidic gastric environment via acid acclimation, but demonstrates more robust growth at neutral pH. Many antibiotics used to treat H. pylori rely on bacterial growth.AimTo investigate the mechanism of increased efficacy of bismuth‐containing H. pylori treatment regimens.MethodsRNAseq and qPCR, urease activity in permeabilised and intact bacteria, internal pH and membrane potential were measured with and without colloidal bismuth subcitrate (CBS). Bacterial survival was assessed with CBS and/or ampicillin.ResultsGenes involved with metabolism and growth were upregulated in the presence of CBS at acidic pH. Urease activity of permeabilised H. pylori at pH 7.4 and 4.5 decreased in the presence of CBS, but intact urease activity decreased only at acidic pH. The fall in cytoplasmic pH with external acidification was diminished by CBS. The increase in membrane potential in response to urea addition at acidic medium pH was unaffected by CBS. The impact of CBS and ampicillin on H. pylori survival was greater than either agent alone.ConclusionsBismuth is not acting directly on urease or the urea channel. Colloidal bismuth subcitrate impedes proton entry into the bacteria, leading to a decrease in the expected fall in cytoplasmic pH. With cytoplasmic pH remaining within range for increased metabolic activity of a neutralophile, the efficacy of growth‐dependent antibiotics is augmented.
A combined analysis of worldwide studies demonstrates an association between bipolar disorder and tobacco smoking behaviors in adults
Authors: Jackson James G , Diaz Francisco J , Lopez Lucelly , de Leon Jose 
Published: August 2015

ObjectivesWorldwide studies were combined to examine two hypotheses: (i) bipolar disorder is associated with smoking behaviors, compared with the general population; and (ii) smoking behavior prevalences in bipolar disorder are intermediate between those in major depressive disorder and those in schizophrenia.MethodsCombined analyses used 56 articles on adults obtained from a PubMed search or the senior author's article collection. Odds ratios (ORs) and their 95% confidence intervals (CIs) compared current smoking, heavy smoking among current smokers, smoking cessation in ever smokers, and ever smoking in bipolar disorder versus control groups.ResultsThe combined OR was 3.5 (CI: 3.39–3.54) in 51 current smoking studies of bipolar disorder versus the general population from 16 countries. More limited data provided an OR = 0.34 (CI: 0.31–0.37) for smoking cessation and an OR = 3.6 (CI: 3.30–3.80) for ever smoking. The combined OR was 0.76 (CI: 0.74–0.79) for current smoking in bipolar disorder versus schizophrenia in 20 studies from ten countries. Ever smoking may be lower in bipolar disorder than in schizophrenia (OR = 0.83, CI: 0.75–0.91). The OR was 2.05 (CI: 2.00–2.10) for current smoking in bipolar disorder versus major depression in 18 studies from seven countries. Ever smoking may be higher (OR = 1.5, CI: 1.40–1.70) and smoking cessation lower (OR = 0.51, CI: 0.45–0.59) in bipolar disorder than in major depression.ConclusionsIncreased current smoking in bipolar disorder versus the general population reflected increased ever smoking (initiation) and decreased smoking cessation. Smoking behavior frequencies in bipolar disorder may be between those in depressive disorder and schizophrenia, with schizophrenia showing the highest severity level.
Identification of educational needs in the management of overweight and obesity: results of an international survey of attitudes and practice
Authors: Leiter L. A. , Astrup A. , Andrews R. C. , Cuevas A. , Horn D. B. , Kunešová M. , Wittert G. , Finer N. 
Published: August 2015

SummaryDespite the availability of a growing range of interventions to assist control of body weight for people with excess weight or obesity, only a small proportion of people achieve their weight loss goals and are able to maintain body weight reductions in the long term. Negative attitudes and beliefs are often found among physicians and others involved in treating obesity and may adversely impact the effectiveness of management. In this international study, healthcare professionals were invited to complete an online survey of their attitudes and practice in the management of excess body weight. A total of 335 clinicians completed the survey of whom approximately half were based in Europe. A key finding from the survey is that, while participants are generally confident in their ability to manage overweight and obesity effectively, they also report that most of their patients are not successful in achieving their weight loss goals. At the same time, participants tended to overestimate the effectiveness of current medical management in maintaining reductions in body weight. Educational initiatives addressing the real‐life effectiveness of different weight control interventions may help to close the gap between clinicians' perceptions and reality in the management of excess body weight.
Profiling unauthorized natural resource users for better targeting of conservation interventions
Authors: Harrison Mariel , Baker Julia , Twinamatsiko Medard , Milner‐Gulland E.J. 
Published: August 2015

AbstractUnauthorized use of natural resources is a key threat to many protected areas. Approaches to reducing this threat include law enforcement and integrated conservation and development (ICD) projects, but for such ICDs to be targeted effectively, it is important to understand who is illegally using which natural resources and why. The nature of unauthorized behavior makes it difficult to ascertain this information through direct questioning. Bwindi Impenetrable National Park, Uganda, has many ICD projects, including authorizing some local people to use certain nontimber forest resources from the park. However, despite over 25 years of ICD, unauthorized resource use continues. We used household surveys, indirect questioning (unmatched count technique), and focus group discussions to generate profiles of authorized and unauthorized resource users and to explore motivations for unauthorized activity. Overall, unauthorized resource use was most common among people from poor households who lived closest to the park boundary and farthest from roads and trading centers. Other motivations for unauthorized resource use included crop raiding by wild animals, inequity of revenue sharing, and lack of employment, factors that created resentment among the poorest communities. In some communities, benefits obtained from ICD were reported to be the greatest deterrents against unauthorized activity, although law enforcement ranked highest overall. Despite the sensitive nature of exploring unauthorized resource use, management‐relevant insights into the profiles and motivations of unauthorized resource users can be gained from a combination of survey techniques, as adopted here. To reduce unauthorized activity at Bwindi, we suggest ICD benefit the poorest people living in remote areas and near the park boundary by providing affordable alternative sources of forest products and addressing crop raiding. To prevent resentment from driving further unauthorized activity, ICDs should be managed transparently and equitably.
Regulatory Considerations in the Design and Manufacturing of Implantable 3D‐Printed Medical Devices
Authors: Morrison Robert J. , Kashlan Khaled N. , Flanangan Colleen L. , Wright Jeanne K. , Green Glenn E. , Hollister Scott J. , Weatherwax Kevin J. 
Published: August 2015

AbstractThree‐dimensional (3D) printing, or additive manufacturing, technology has rapidly penetrated the medical device industry over the past several years, and innovative groups have harnessed it to create devices with unique composition, structure, and customizability. These distinctive capabilities afforded by 3D printing have introduced new regulatory challenges. The customizability of 3D‐printed devices introduces new complexities when drafting a design control model for FDA consideration of market approval. The customizability and unique build processes of 3D‐printed medical devices pose unique challenges in meeting regulatory standards related to the manufacturing quality assurance. Consistent material powder properties and optimal printing parameters such as build orientation and laser power must be addressed and communicated to the FDA to ensure a quality build. Postprinting considerations unique to 3D‐printed devices, such as cleaning, finishing and sterilization are also discussed. In this manuscript we illustrate how such regulatory hurdles can be navigated by discussing our experience with our group's 3D‐printed bioresorbable implantable device.
Eye examination as part of the equine prepurchase examination
Authors: Matthews A. G. 
Published: August 2015

SummaryPrepurchase examination (PPE) is the most common reason for eye examination in first opinion equine practice. This paper describes a standard protocol for competent eye examination in the PPE, and reviews the interpretation of the more common clinical findings, particularly in relation to their expected influence on functional vision and their progression. The content is based on the limited existing literature, the personal opinions and experience of the author, and from discussions held with colleagues over the past 30 years.