bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Resynchronization Therapy in Patients with Challenging Anatomy Due to Venous Anomalies or Adult Congenital Heart Disease
Authors: NIAZI IMRAN , DHALA ANWER , CHOUDHURI INDRAJIT , SRA JASBIR , AKHTAR MASOOD , TAJIK ABDUL JAMIL 
Published: March 2014

BackgroundCardiac resynchronization therapy (CRT) has proven salutary effects in patients with congestive heart failure, systolic dysfunction, and electromechanical dyssynchrony in the setting of ischemic, nonischemic, and congenital cardiomyopathy. While CRT device implants have become routine in the adult ischemic or nonischemic cardiomyopathy populations, patients with congenital heart disease offer special challenges due to unusual anatomic variations.MethodsA comprehensive assessment of anatomic abnormalities is essential prior to implant. In addition, implant techniques and equipment must be tailored to the expected anatomy. A flexible approach is necessary—implant may require equipment and techniques adapted from vascular intervention.ConclusionThis article describes our approach to CRT implant in patients with congenital heart disease, and is illustrated by reports of several cases.
A multicenter, randomized, double‐blind placebo‐controlled, single dose trial of the safety and efficacy of intravenous ibuprofen for treatment of pain in pediatric patients undergoing tonsillectomy
Authors: Moss Jonathan R. , Watcha Mehernoor F. , Bendel Laima P. , McCarthy Denise L. , Witham Stacy L. , Glover Chris D. 
Published: March 2014

SummaryBackgroundTonsillectomy is one of the most common pediatric procedures in the United States. An optimal perioperative pain control regimen remains a challenge. Intravenous ibuprofen administered at induction of anesthesia may be a safe and efficacious option for postoperative tonsillectomy pain.ObjectivesTo determine whether preoperative administration of intravenous ibuprofen (IV‐ibuprofen) can significantly decrease the number of doses of postoperative fentanyl when compared with placebo in pediatric tonsillectomy surgical patients.MethodsThis was a multicenter, randomized, double‐blind placebo‐controlled trial conducted at six hospitals in the United States. A total of 161 pediatric patients aged 6–17 years undergoing tonsillectomy were randomized to receive either a single preoperative dose of 10 mg·kg−1 IV‐ibuprofen or placebo (normal saline). Postoperative pain was managed with intravenous fentanyl (0.5 μg·kg−1) on an as needed basis when the visual analog scale (VAS) was >30 mm and deemed appropriate by recovery room nurse/physician. The primary endpoint was the number of doses and amount of postoperative fentanyl administered postoperatively for rescue analgesia.ResultsThere was a significant reduction in the number of postoperative doses and the amount of fentanyl administered after surgery in the IV‐ibuprofen group compared with the placebo group (P = 0.021). There were no differences in the time to first analgesia request or the number of patients who required postoperative analgesia. There were no significant differences in the incidence of serious adverse events, surgical blood loss (P = 0.662), incidence of postoperative bleeding, or a need for surgical re‐exploration between the treatment groups.ConclusionAdministration of IV‐ibuprofen, 10 mg·kg−1, significantly reduced fentanyl use in pediatric tonsillectomy patients.
Postoperative pain during the first week after adenoidectomy and guillotine adenotonsillectomy in children
Authors: Vons Kristy M.J. , Bijker Jilles B. , Verwijs Edwin W. , Majoor Maarten H.J.M. , de Graaff Jurgen C. 
Published: March 2014

SummaryBackgroundAdenoidectomy (AD) and adenotonsillectomy (ATE) are frequently occurring and often painful interventions in children. In literature, it is very prevalent that postoperative pain in children following ATE is hard to control. The purpose of this study was to evaluate the prevalence and severity of postoperative pain in children undergoing AD and ATE in the ambulatory setting.MethodsA prospective cohort study was performed including 167 children aged 0–12 years, undergoing AD using an adenotome and ATE using the guillotine technique in day care. Children undergoing AD received acetaminophen pre‐ and postoperatively. Children undergoing ATE received acetaminophen and diclofenac preoperatively, sufentanyl postoperative and a prescription of around‐the‐clock treatment with acetaminophen and diclofenac at home. Pain intensity and analgesic consumption were recorded in hospital using the Faces, Legs, Activity, Cry and Consolability‐scale (FLACC), as well as during a 1‐week follow‐up period at home using the Parents' Postoperative Pain Measure (PPPM) and Visual Analogue Scale (VAS) scores.ResultsAll children left the recovery room with adequate pain scores and were discharged with a median VAS of two after ATE and one after AD. The PPPM and VAS scores were highest at the first measurement at home for AD patients (VAS = 2.0 and PPPM = 1.5) and ATE patients (VAS = 4.5 and PPPM = 9). On the second postoperative day, AD patients scored 0.0 points on both VAS and PPPM. ATE patients scored at that time 3.0 point on the VAS and 6.0 points using the PPPM. Despite high adherence to pain treatment, daytime activities normalized after an average of 2 and 7 days after AD and ATE, respectively.ConclusionExamination of the PPPM and VAS scores illustrated that children undergoing AD were comfortable with acetaminophen as a single analgesic, whereas children undergoing ATE experience significant pain for up to two postoperative days when treated with acetaminophen and diclofenac.
Dexmedetomidine and ketamine sedation for muscle biopsies in patients with Duchenne muscular dystrophy
Authors: Kako Hiromi , Corridore Marco , Kean John , Mendell Jerry R. , Flanigan Kevin M. , Tobias Joseph D. 
Published: March 2014

SummaryBackgroundDuchenne muscular dystrophy (DMD) possesses many potential challenges for anesthetic care. Invasive and noninvasive procedures with corresponding sedation or general anesthesia are frequent and necessary for affected patients. There remains a need for a better agent or agents for procedural sedation in patients with comorbid diseases. This study prospectively evaluated a combination of ketamine with two different doses of dexmedetomidine for sedation during muscle biopsy in patients with DMD.MethodsDexmedetomidine 1.0 or 0.5 μg·kg−1 was administered as a loading dose over 3 min followed by a continuous infusion of 1.0 or 0.5 μg·kg·h−1. Ketamine (1 mg·kg−1) was administered along with the dexmedetomidine loading dose. As the procedure commenced, additional doses of ketamine (0.5 mg·kg−1) were administered as needed. Sedation scores, hemodynamic data, operative times, and recovery times were recorded.ResultsThe study cohort included a total of 53 bicep, deltoid, or anterior tibialis muscle biopsies in 19 boys including 24 in the dexmedetomidine 1.0 μg·kg−1 group and 29 in the dexmedetomidine 0.5 μg·kg−1 group. Mean age and weight were 9.7 ± 1.4 years and 33.3 ± 7.7 kg in the dexmedetomidine 1.0 μg·kg−1 group and 8.8 ± 1.8 years and 30.2 ± 10.8 kg in the dexmedetomidine 0.5 μg·kg−1 group. No significant changes in blood pressure were noted. A decrease in heart rate (HR) occurred after the loading dose of dexmedetomidine in both groups. The HR was significantly lower in the dexmedetomidine 1.0 μg·kg−1 group compared with the dexmedetomidine 0.5 μg·kg−1 group. Total recovery time to discharge was significantly shorter in the dexmedetomidine 0.5 μg·kg−1 group than the dexmedetomidine 1.0 μg·kg−1 group (146 ± 65 vs 174 ± 58 min; P = 0.03), although the total ketamine dose was significantly greater in the dexmedetomidine 0.5 μg·kg−1 group (3.7 ± 1.0 vs 2.0 ± 0.5 mg·kg−1; P < 0.01). There were no episodes of apnea or hypoventilation; however, a jaw thrust was needed in one patient in the dexmedetomidine 1.0 μg·kg−1group.ConclusionThe combination of dexmedetomidine and ketamine is safe and effective for moderately painful procedures with limited respiratory and cardiovascular effects in a high‐risk patient population. Dexmedetomidine 0.5 μg·kg−1 as a loading dose with ketamine followed by a continuous infusion of dexmedetomidine at 0.5 μg·kg−1·h−1 achieved an adequate sedation level with shorter total recovery times in the perioperative unit compared with a higher dose regimen of dexmedetomidine (1.0 μg·kg−1 loading dose followed by an infusion at 1.0 μg·kg−1·h−1).
Chest Pain in an Out‐of‐Hospital Emergency Setting: No Relationship Between Pain Severity and Diagnosis of Acute Myocardial Infarction
Authors: Galinski Michel , Saget Diane , Ruscev Mirko , Gonzalez Geraldine , Ameur Lydia , Lapostolle Frédéric , Adnet Frédéric 
Published: March 2014

AbstractBackgroundChest pain frequently prompts emergency medical services (EMS) call‐outs. Early management of acute coronary syndrome (ACS) cases is crucial, but there is still controversy over the relevance of pain severity as a diagnostic criterion.Study objectiveThe aim of this study was to determine whether there is a relationship between the severity of chest pain at the time of out‐of‐hospital emergency care and diagnosis of acute myocardial infarction (AMI).MethodsThis was a subsidiary analysis of prehospital data collated prospectively by EMS in a large suburb. It concerned patients with chest pain taken to hospital by a mobile intensive care unit. Pain was rated on EMS arrival using a visual analog, numeric or verbal rating scale and classified on severe or not severe according to the pain score. A diagnosis of AMI was confirmed or ruled out on the basis of 2 plasma troponin measurements and/or coronary angiography results.ResultsAmong the cohort of 2,279 patients included, 234 were suitable for analysis, of which 109 (47%) were diagnosed with AMI. The rate of severe pain on EMS arrival was not significantly different between AMI patients and no myocardial infarction patients (49% [95% CI 40 to 58] and 43% [34 to 52], respectively; P = 0.3; odds ratio 1.3 [0.8 – 2.3] after adjustment for age and gender).ConclusionIn our out‐of‐hospital emergency setting, the severity of chest pain was not a useful diagnostic criterion for AMI.
Medical outcomes of adolescent live kidney donors
Authors: MacDonald David , Kukla Aleksandra K. , Ake Sarah , Berglund Danielle , Jackson Scott , Issa Naim , Spong Richard , Matas Arthur J. , Ibrahim Hassan N. 
Published: March 2014

AbstractLiving kidney donation from donors <18 yr of age is uncommon. The majority of donations from adolescents took place several decades ago providing a unique opportunity to study true long‐term consequences of donation. We compared survival, renal outcomes, and rates of hypertension and diabetes among 42 adolescent donors and matched older controls. Adolescent donors were matched with donors 18–30 yr on the following: gender, relation to the recipient, BMI at donation, eGFR at donation, and year of donation. After a mean follow‐up of 31.8 ± 8.0 yr, 94.9% of adolescent donors were alive vs. 93.8% of controls. There was no significant difference in having eGFR (MDRD) <60 mL/min/1.73 m2 (26.1% vs. 40.9%), hypertension (35.9% vs. 39.4%), diabetes (5.1% vs. 12.5%), or proteinuria (15.4% vs. 14.1%): adolescent donors vs. controls for all comparisons. These data suggest that adolescent donors are not at a higher risk of shortened survival, hypertension, diabetes, or proteinuria. Nevertheless, they probably should donate only when other options are exhausted as they have to live with a single kidney for decades and longer follow‐up is needed.
Using individual DSA titers to assess for accommodation after late humoral rejection
Authors: Filler Guido , Grimmer Joanne , Ball Edward , Sharma Ajay P. , Huang Shih‐Han Susan 
Published: March 2014

AbstractManagement of late humoral rejection remains challenging, and DSA may persist. A case report illustrates how individual DSA titers using solid‐phase‐based assays may help to assess for accommodation. A male cystinosis patient received a cadaveric renal transplant at the age of 12 yr with a daclizumab, tacrolimus, MMF, and steroids‐based immunosuppression. After three acute rejection episodes over the first eight months, interstitial fibrosis/tubular atrophy (IF/TA) was diagnosed on biopsy, while the immunosuppression was left unchanged with a high target exposure for both tacrolimus and MPA. One yr later, AMR type III (C4d and DSA positive) was treated with daily plasmapheresis, IVIG 100 mg/kg and pulse steroids 5 mg/kg. DSA (DR 53, DQ4, and DQ 2) were not responding until the plasma volume was increased to 2.5 plasma volumes. A second rise of creatinine confirmed worse humoral rejection; daily plasma exchange was resumed, and two doses of rituximab (375 mg/m2) were given. Subsequently, all DSA dropped, but only DR53 DSA remained unchanged, whereas the DQ antibodies rebounded to very strong titers. With a follow‐up of over 120 days after recovery of the CD19 count, off all additional treatment and on identical immunosuppression with tacrolimus and MMF and prednisone, the patient's creatinine remained stable between 45 and 50 um while DQ DSA remain strong to very strong. We conclude that the patient is in a state of accommodation. DSA titers should be monitored when managing late humoral rejection.
Pore volume is most highly correlated with the visual assessment of skin pores
Authors: Kim S. J. , Shin M. K. , Back J. H. , Koh J. S. 
Published: March 2014

Background/PurposeMany studies have been focused on evaluating assessment techniques for facial pores amid growing attention on skin care. Ubiquitous techniques used to assess the size of facial pores include visual assessment, cross‐section images of the skin surface, and profilometric analysis of silicone replica of the facial skin. In addition, there are indirect assessment methods, including observation of pores based on confocal laser scanning microscopy and the analysis of sebum secretion and skin elasticity. The aim of this study was to identify parameters useful in estimating pore of surface in normal skin.MethodsThe severity of pores on the cheek area by frontal optical images was divided on a 0–6 scale with ‘0’ being faint and small pore and ‘6’ being obvious and large pore.After the photos of the frontal cheek of 32 women aged between 35 and 49 were taken, the size of their pores was measured on a 0–6 scale; and the correlation between visual grading of pore and various evaluations (pore volume by 3‐D image, pore area and number by Optical Image Analyzer) contributing to pore severity investigated using direct, objective, and noninvasive evaluations.ResultsThe visual score revealed that the size of pores was graded on a 1–6 scale. Visual grading of pore was highly correlated with pore volume measured from 3‐D images and pore area measured from 2‐D optical images in the order (P < 0.01). Visual grading of pore was also slightly correlated with the number of pores in size of over 0.04 mm2 (P < 0.05).ConclusionHigh correlation between pore score and pore volume can be explained by 3‐D structural characteristics of pores. It is concluded that pore volume and area serve as useful parameters in estimating pore of skin surface.
Verb particles and OV/VO in the history of English
Authors: Elenbaas Marion , van Kemenade Ans 
Published: March 2014

AbstractVerb particles (e.g.up,out,off,down,away) are a well‐known and well studied feature of English and of Germanic languages in general. Nevertheless, the functional and categorial status of English verb particles remains debated, and, especially in the diachronic literature onOV/VOword‐order change, this question is typically avoided entirely. This lack of precision about the nature of verb particles is surprising, given the central role attributed to verb particles as diagnostic elements for basic word order. We motivate an analysis of English verb particles as (optionally) projecting intransitive prepositions which function as secondary predicates. In relation to theOV/VOissue, we claim that, although there is a statistically strong cross‐Germanic correlation between the position of verb particles and verb complements, the position of verb particles is not a diagnostic forOV/VOorder. To support this claim, we will show that there is no one‐to‐one correspondence a) between Prt–V surface word order and an underlyingOVgrammar, or b) between V–Prt surface word order and an underlyingVOgrammar. Moreover, it will be shown thatOVorder withDP‐objects in early Middle English is highly discourse‐sensitive, suggesting thatOVorder withDP‐objects is not determined by phrase structure, but by discourse‐sensitive scrambling from aVObase.
West flemish verb‐based discourse markers and the articulation of the speech act layer
Authors: Haegeman Liliane 
Published: March 2014

AbstractThis paper focuses on the West Flemish discourse markers located at the edge of the clause. After a brief survey of the distribution of discourse markers in WF, the paper proposes a syntactic analysis of the discourse markers né and wè. Based on the distribution of these discourse markers, of vocatives and of dislocated DPs, an articulated speech act layer is elaborated which corroborates the proposals in Hill (). It is postulated that there is a syntactic relation between particles used as discourse markers and vocatives. The paper offers further support for the grammaticalization of pragmatic features at the interface between syntax and discourse and for the hypothesis that the relevant computation at the interface is of the same nature as that in Narrow Syntax.
Thoracic cavity segmentation algorithm using multiorgan extraction and surface fitting in volumetric CT
Authors: Bae JangPyo , Kim Namkug , Lee Sang Min , Seo Joon Beom , Kim Hee Chan 
Published: March 2014

Purpose:To develop and validate a semiautomatic segmentation method for thoracic cavity volumetry and mediastinum fat quantification of patients with chronic obstructive pulmonary disease.Methods:The thoracic cavity region was separated by segmenting multiorgans, namely, the rib, lung, heart, and diaphragm. To encompass various lung disease‐induced variations, the inner thoracic wall and diaphragm were modeled by using a three‐dimensional surface‐fitting method. To improve the accuracy of the diaphragm surface model, the heart and its surrounding tissue were segmented by a two‐stage level set method using a shape prior. To assess the accuracy of the proposed algorithm, the algorithm results of 50 patients were compared to the manual segmentation results of two experts with more than 5 years of experience (these manual results were confirmed by an expert thoracic radiologist). The proposed method was also compared to three state‐of‐the‐art segmentation methods. The metrics used to evaluate segmentation accuracy were volumetric overlap ratio (VOR), false positive ratio on VOR (FPRV), false negative ratio on VOR (FNRV), average symmetric absolute surface distance (ASASD), average symmetric squared surface distance (ASSSD), and maximum symmetric surface distance (MSSD).Results:In terms of thoracic cavity volumetry, the mean ± SD VOR, FPRV, and FNRV of the proposed method were (98.17 ± 0.84)%, (0.49 ± 0.23)%, and (1.34 ± 0.83)%, respectively. The ASASD, ASSSD, and MSSD for the thoracic wall were 0.28 ± 0.12, 1.28 ± 0.53, and 23.91 ± 7.64 mm, respectively. The ASASD, ASSSD, and MSSD for the diaphragm surface were 1.73 ± 0.91, 3.92 ± 1.68, and 27.80 ± 10.63 mm, respectively. The proposed method performed significantly better than the other three methods in terms of VOR, ASASD, and ASSSD.Conclusions:The proposed semiautomatic thoracic cavity segmentation method, which extracts multiple organs (namely, the rib, thoracic wall, diaphragm, and heart), performed with high accuracy and may be useful for clinical purposes.
Low‐complexity atlas‐based prostate segmentation by combining global, regional, and local metrics
Authors: Xie Qiuliang , Ruan Dan 
Published: March 2014

Purpose:To improve the efficiency of atlas‐based segmentation without compromising accuracy, and to demonstrate the validity of the proposed method on MRI‐based prostate segmentation application.Methods:Accurate and efficient automatic structure segmentation is an important task in medical image processing. Atlas‐based methods, as the state‐of‐the‐art, provide good segmentation at the cost of a large number of computationally intensive nonrigid registrations, for anatomical sites/structures that are subject to deformation. In this study, the authors propose to utilize a combination of global, regional, and local metrics to improve the accuracy yet significantly reduce the number of required nonrigid registrations. The authors first perform an affine registration to minimize the global mean squared error (gMSE) to coarsely align each atlas image to the target. Subsequently, atarget‐specific regional MSE (rMSE), demonstrated to be a good surrogate for dice similarity coefficient (DSC), is used to select a relevant subset from the training atlas. Only within this subset are nonrigid registrations performed between the training images and the target image, to minimize a weighted combination of gMSE and rMSE. Finally, structure labels are propagated from the selected training samples to the target via the estimated deformation fields, and label fusion is performed based on a weighted combination of rMSE and local MSE (lMSE) discrepancy, with proper total‐variation‐based spatial regularization.Results:The proposed method was applied to a public database of 30 prostate MR images with expert‐segmented structures. The authors’ method, utilizing only eight nonrigid registrations, achieved a performance with a median/mean DSC of over 0.87/0.86, outperforming the state‐of‐the‐art full‐fledged atlas‐based segmentation approach of which the median/mean DSC was 0.84/0.82 when applying to their data set.Conclusions:The proposed method requires a fixed number of nonrigid registrations, independent of atlas size, providing desirable scalability especially important for a large or growing atlas. When applied to prostate segmentation, the method achieved better performance to the state‐of‐the‐art atlas‐based approaches, with significant improvement in computation efficiency. The proposed rationale of utilizing jointly global, regional, and local metrics, based on the information characteristic and surrogate behavior for registration and fusion subtasks, can be extended naturally to similarity metrics beyond MSE, such as correlation or mutual information types.
Deriving Group A Streptococcus Typing Information from Short-Read Whole-Genome Sequencing Data
Authors: Athey Taryn B. T. , Teatero Sarah , Li Aimin , Marchand-Austin Alex , Beall Bernard W. , Fittipaldi Nahuel 
Published: March 2014

ABSTRACTTyping of group AStreptococcus (GAS) is crucial for infection control and epidemiology. While whole-genome sequencing (WGS) is revolutionizing the way that bacterial organisms are typed, it is necessary to provide backward compatibility with currently used typing schemas to facilitate comparisons and understanding of epidemiological trends. Here, we sequenced the genomes of 191 GAS isolates representing 42 differentemmtypes and used bioinformatics tools to derive commonly used GAS typing information directly from the short-read WGS data. We show thatemmtyping and multilocus sequence typing can be achieved rapidly and efficiently using this approach, which also permits the determination of the presence or absence of genes associated with GAS tissue tropism. We also report on how the WGS data analysis was instrumental in identifying ambiguities present in the commonly usedemmtype database hosted by the U.S. Centers for Disease Control and Prevention.