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2. Redundancy System Fault Sampling Under Imperfect Maintenance

Author

C. Zhang, L. Guo, B. Xiao, and R. Kang

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

When conducting simulation for evaluating complex system reliability or availability, method of random sampling is applied to simulate fault occasion of complex system. Current research of fault sampling generally assumes maintenance activity restores systems to “good-as-new” and “bad-as-old” without considering “partly good” situation. However, system usually keeps its function through imperfect maintenance that restores system to “partly good”: the system after maintenance will not as good as new, but younger. A system fault random sampling method under condition of imperfect maintenance must be presented in order to enhance simulation model credibility and correctness. When reliability structure of system is in the form of redundancy, the fault sampling method under condition of imperfect maintenance is difficult because not only redundancy system fault time isn’t exponential distribution but also that the state transition process of redundancy system is hard to model and steady state probability of each component in the redundancy system is hard to determine. So in this paper, a generally repairable parallel system with non-identical components: which is a common form of redundancy is considered, then a fault random sampling method for this kind of redundancy system under condition of imperfect maintenance according to monte carlo simulation principle is presented. The characteristics of this method mentioned above is that Markov chain embedded within this method is employed to model the state transition process of redundancy system and to determine steady state probability of each component in the system. Fault occasions of redundancy system under imperfect maintenance can be simulated and fault components in the system can be determined via the fault sampling method. These are novel contributions made in this paper. Finally, a numerical case using fault sampling method for a redundancy system under imperfect maintenance is given and the validity and feasibility of fault sampling method is verified.

Published
2013
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3. A Design and Implementation of Power Transfer Equipment Based on Fault Diagnostics in System Level

Author

M. Luo and R. Kang

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

This paper presents a design and implementation of a certain automatic power transfer equipment adopted by a power supply system serving for nuclear industry. An integrated approach that employs techniques from engineering disciplines including failure analysis based on usage history, advanced fault detection, sensor-based condition monitoring, and power electronic control was used. The function of fast switching-over between the master and standby power supply units as faults occur in power supply system level was implemented. After the probation period of the equipment, it showed that the uninterrupted power supply function and operational reliability of the whole power supply system were well enhanced.

Published
2013
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4. EBO Optimization Considering the Joint of LORA and Spare Stocks

Author

J. Fan, L. Guo, Y. Yang, and R. Kang

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

Level of repair analysis (LORA) is an important method of maintenance decision for establishing system of operation and maintenance in the equipment development period. Currently, the researches of equipment of level of repair focus on economic analysis models which used to optimize costs, rarely consider the maintenance time required by the implementation of maintenance program. In fact, maintenance time is an important factor influencing the availability of equipment system. Considering the relationship between maintenance time and spares stocks level, it is obvious that there are contradictions between maintenance time and cost. In order to balance these two influencing factors, it is necessary to build an optimization LORA model. To this end, maintenance time representing performance characteristic is introduced in this article, and on the basis of spares stocks which is traditionally regarded as decision variable, we add a decision variable of repair level, and build a single-echelon, multi-indenture optimization LORA model which takes the best cost-effectiveness ratio as criterion, expected number of backorder (EBO) as objective function and is subject to a constraint on cost. Besides, the paper designs a convex programming algorithm of multi-variable for the optimization model, provides solution of the non-convex objective function and method of improving the efficiency of the algorithm. It is worth mentioning that the optimization model of level of repair designed in the paper is applicable to the engineering.

Published
2013
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5. Failure Behavior Modeling : Towards a Better Characterization of Product Failures

Author

Z. Zeng, Y. Chen, and R. Kang

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

The characterization of failures is a crucial part of a prognostics and health management (PHM) program. Field failures of products often result from multiple failure mechanisms acting simultaneously. To better characterize them, it is necessary to understand both the failure mechanisms and the interactions among them. To achieve this aim, a framework for failure behavior modeling is presented in this paper. The framework builds the model from two aspects: modeling of individual failure mechanisms and of the interactions among them. For ease of the framework’s application, the approaches for mechanism modeling and interaction modeling are discussed in details. Some commonly encountered failure mechanism models and frequently used interactive relationships are also presented with illustrative examples.

Published
2013
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6. Quartz Flexible Accelerometer Stability Duration Prediction on Storage Condition Based on Accelerated Degradation Test

Author

D. Xu, Y. Chen, and R. Kang

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

The zero bias and the scale factor which are the important parameters of the accelerometer change with temperature and time due to the influence of material degradation and residual stress changing in the process of storage and use. For studying the stability duration of the parameters of the accelerometer on the storage condition, the accelerated degradation test is designed and applied. First, through analyzing the storage section and the mechanism of parameters changing on account of the environmental stress, the type of the stress in the accelerated degradation test is determined. Moreover, the working range of the stress of the accelerometer is obtained by implementing the enhancement test. Based on the type and the range of the stress, the constant temperature accelerated degradation tests are conducted under different levels of the thermal stress. The changing tendencies of the zero bias and the scale factor of the accelerometer subjected to the thermal stress are performed, and the models of key parameters of the accelerometer changing with time are separately built under different levels of ADT. Then the pseudo life of every level of the temperature test is extrapolated by regression models according to the failure threshold. Finally, the stability duration on the normal temperature is predicted by an accelerated function and the pseudo life on the high stress.

Published
2013
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7. Reliability Estimate of Probabilistic-Physics-of-Failure Degradation Models

Author

Z. Yang, R. Kang, and E.A. Elsayed

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

It is universally accepted that physics-based models provide more accurate estimates of reliability than statistics-based model especially when the physics of failure of the units are well-understood. However, the underlying assumptions of such models regarding the deterministic nature of its parameters limit their applications, implementations and generalization. In this paper, we propose a physic-based accelerated degradation model that considers probability distributions of its parameters. The degradation path is then determined, and the first passage distribution, failure time function and its parameters’ estimation are obtained accordingly. The model is then used to estimate competing risks at normal operating conditions. A numerical example is provided to demonstrate the use of the model and validate its estimates.

Published
2013
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8. Reliability Modelling and Simulation of Complex Systems

Author

Y. Lin, D. Li, and R. Kang

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

The efficiency of complex technological systems requires the guarantee on their reliability against underlying catastrophes. The complexity encoded in their structure and functions makes cascading failures the main failure mode in complex systems. The development of complex systems’ reliability technology relies on the modelling and simulation of the cascading failure. For the complex system, it is difficult to perform macroscopic analysis with tools based on probability theory because of their numerous system states. Meanwhile, it is also difficult to analyse it completely by microscopic system details due to their nonlinear coupling characteristics. The properties of complex systems require systematic analysis in multi-level. As the network science becomes available to model and study the complex system, its underlying concept of statistical physics is suitable to understand the complex system from the relationship between macroscopic properties and microscopic activities. We will review the progress made by network science recently including latest formalism of interdependent network theory, which can be used to understand and study the reliability problem of complex system.

Published
2013
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9. Human Reliability Test and Identification of HCR Model Basic Parameters for Single Factor 'Meta-operation'

Author

Y. Yang, S. Chen, W. Zheng, and R. Kang

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

The lack of basic data and the poor availability are a longstanding puzzle in human reliability analysis (HRA) of the manned space. In order to resolve this puzzle, we begin with analyzing task process operation to define “meta-operation”, and then classify the process of tasks related to the single factor into seven kinds of “meta-operations” which cover both the rule type and skilled cognitive type. According to these seven kinds of “meta-operations”, we design the test environments and the groups of experimental persons. Through five different groups of experimental persons, we obtain nearly 8000 valid experimental data. The analysis of these experimental data reveals that there is no significant difference among the different groups at the “meta-operational” level. From the analysis we also get seven kinds of human cognition reliability (HCR) model basic parameters. This work lays down a solid foundation for the next step research of the reliability of complex task personnel.

Published
2013
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10. Research on Heading Sensitive Drift Behavior of Inertial Platform System under the Influence of Magnetic Field

Author

X. Huang, Y. Chen, and R. Kang

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

The heading sensitive drift of inertial platform system changes along with the degradation of components’ performance and the coupling characteristics under long-term storage conditions. Such heading sensitive drift is different from the drift during operation. It is also difficult to analyze its drift behavior for the model-based PHM system designing of inertial platform systems in engineering application. While the heading sensitive drift is influenced by various factors, this paper aims at dealing with part of this problem from one of the factors, i.e. magnetic field influence. This paper at the beginning derived the principle and the expression of the heading sensitive drift caused by magnetic field. And then, various drift parameters in such expressions were discussed, and the behavioral model of the heading sensitive drift influenced by the magnetic feature of components (such as the sensor, the torquer and the gyrorotor) was obtained. Finally, the long-term drift feature, the acceleration feature and the storage stability of the heading sensitive drift behavior were analyzed with the actual storage profile. The results of this paper indicate that although the heading sensitive drift caused by magnetic field has acceleration feature, the stability is able to meet the accuracy requirement of the inertial platform system under the current storage conditions. The drift value is so small that it can be ignored under the storage conditions. This study has great significance to the model-based PHM system design of inertial platform systems, which aims at improving the inertial platform systems parameters stability.

Published
2013
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11. Study on Parameter Drift Mechanism of a Quartz Accelerometer with a System Analysis Method

Author

Y. Chen, B. Liu, R. Kang, and Z. Hou

Subjects
Chemical engineering, TP155-156, Computer engineering. Computer hardware, TK7885-7895
Abstract

A quartz accelerometer is a chief sensitive device of the inertial navigation system. However, there exists parameter drift during the process of transportation, storage or in work condition, which has a bad influence on the navigation accuracy. In this article, a system analysis method, the combination of FTA (Fault Tree Analysis) and FMEA (Failure Mode and Effects Analysis), is conducted to study the parameter drift mechanism of a quartz accelerometer and the conclusion is drawn that the mechanism mainly lies in the homogenization effect of vibration on welding residual stress. Finally, FEA (Finite Element Analysis) simulation is perceived to confirm the homogenization effect and demonstrates the correctness of the analysis results.

Published
2013
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15. Dietary flavonoid myricetin inhibits invasion and migration of radioresistant lung cancer cells (A549‐IR) by suppressing MMP‐2 and MMP‐9 expressions through inhibition of the FAK‐ERK signaling pathway

Author

Hye R. Kang, Jeong Y. Moon, Meran K. Ediriweera, Yeon W. Song, Moonjae Cho, Dharanibalan Kasiviswanathan, and Somi K. Cho

Subjects
FAK signaling pathway, MMP‐2 and 9, myricetin, transcriptome analysis, Nutrition. Foods and food supply, TX341-641
Abstract

Abstract Myricetin is a commonly found dietary flavonoid. In the present study, we investigated the effects of myricetin on migration and invasion of radioresistant lung cancer cells (A549‐IR). Transcriptome analysis of A549‐IR cells identified several differentially expressed genes (DEGs) in A549‐IR cells compared to parental A549 cells. Functional enrichment analysis revealed that most of the DEGs were linked with PI3K‐AKT signaling, proteoglycans, focal adhesion, and ECM–receptor interactions. A549‐IR cells demonstrated enhanced migratory potential with increased expression of vimentin, snail and slug, and reduced expression of E‐cadherin. A549‐IR cells exposed to myricetin displayed reduced migration and suppressed MMP‐2 and MMP‐9 expression. Notably, myricetin inhibited the phosphorylation of focal adhesion kinase (FAK) and altered the F‐actin/G‐actin ratio in A549‐IR cells, without modulation of EMT markers. These findings suggest that myricetin can inhibit migration of A549‐IR cells by suppressing MMP‐2 and MMP‐9 expressions through inhibition of the FAK‐ERK signaling pathway.

Published
2020
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19. Evaluation of the MolecuTech® REBA MTB-XMDR kit for detection of pre-extensively drug-resistant TB

Author

E. J. Cho, M. R. Kang, J. H. Kim, J. I. Lee, E. S. Son, C. H. Park, W. W. Aung, and J. S. Lee

Subjects
Pulmonary and Respiratory Medicine, Infectious Diseases
Abstract

BACKGROUND: Rapid diagnosis of drug-resistant TB is critical for early initiation of effective therapy. YD Diagnostics in South Korea recently developed the MolecuTech® REBA MTB-XMDR test to rapidly detect multidrug-resistant TB (MDR-TB), pre-extensively drug-resistant TB (pre-XDR-TB) and resistance to second-line injectable drugs (SLIDs) simultaneously using a fully automated test platform. This study aimed to evaluate the MolecuTech® test for the detection of MDR- and pre-XDR-TB, as well as SLID resistance.METHODS: A total of 151 clinical Mycobacterium tuberculosis isolates from South Korea were tested using the MolecuTech test, and the results were analysed by comparing these with phenotypic drug susceptibility testing (pDST) and sequencing.RESULTS: Compared to pDST, the MolecuTech test showed a sensitivity and specificity of respectively 97.7% and 100.0% for rifampicin (RIF), 82.4% and 100.0% for isoniazid (INH), 97.5% and 97.2% for fluoroquinolones (FQs), and 94.0% and 98.8% for SLIDs. Concordances with the sequencing results of each resistance determinant were 99.3% for RIF, 96.7% for INH, 98.7% for FQs and 99.3% for SLIDs.CONCLUSION: The MolecuTech test is an efficient and reliable rapid molecular diagnostic tool for the simultaneous screening of MDR- and pre-XDR-TB.

Published
2022

21. ESICM LIVES 2016: part one

Author

L. Bos, L. Schouten, L. van Vught, M. Wiewel, D. Ong, O. Cremer, A. Artigas, I. Martin-Loeches, A. Hoogendijk, T. van der Poll, J. Horn, N. Juffermans, M. Schultz, N. de Prost, T. Pham, G. Carteaux, A. Mekontso Dessap, C. Brun-Buisson, E. Fan, G. Bellani, J. Laffey, A. Mercat, L. Brochard, B. Maitre, LUNG SAFE investigators and the ESICM study group, P. A. Howells, D. R. Thickett, C. Knox, D. P. Park, F. Gao, O. Tucker, T. Whitehouse, D. F. McAuley, G. D. Perkins, LUNG SAFE Investigators and the ESICM Trials Group, L. Pisani, J. P. Roozeman, F. D. Simonis, A. Giangregorio, L. R. Schouten, S. M. Van der Hoeven, A. Serpa Neto, E. Festic, A. M. Dondorp, S. Grasso, L. D. Bos, M. J. Schultz, M. Koster-Brouwer, D. Verboom, B. Scicluna, K. van de Groep, J. Frencken, M. Bonten, J. I. Ko, K. S. Kim, G. J. Suh, W. Y. Kwon, K. Kim, J. H. Shin, O. T. Ranzani, E. Prina, R. Menendez, A. Ceccato, R. Mendez, C. Cilloniz, A. Gabarrus, M. Ferrer, A. Torres, A. Urbano, L. A. Zhang, D. Swigon, F. Pike, R. S. Parker, G. Clermont, C. Scheer, S. O. Kuhn, A. Modler, M. Vollmer, C. Fuchs, K. Hahnenkamp, S. Rehberg, M. Gründling, A. Taggu, N. Darang, N. Öveges, I. László, K. Tánczos, M. Németh, G. Lebák, B. Tudor, D. Érces, J. Kaszaki, W. Huber, D. Trásy, Z. Molnár, G. Ferrara, V. S. Kanoore Edul, H. S. Canales, E. Martins, C. Canullán, G. Murias, M. O. Pozo, J. F. Caminos Eguillor, M. G. Buscetti, C. Ince, A. Dubin, H. D. Aya, A. Rhodes, N. Fletcher, R. M. Grounds, M. Cecconi, M. Jacquet-Lagrèze, M. Riche, R. Schweizer, P. Portran, W. Fornier, M. Lilot, J. Neidecker, J. L. Fellahi, A. Escoresca-Ortega, A. Gutiérrez-Pizarraya, L. Charris-Castro, Y. Corcia-Palomo, E. Fernandez-Delgado, J. Garnacho-Montero, C. Roger, L. Muller, L. Elotmani, J. Lipman, J. Y. Lefrant, J. A. Roberts, R. Muñoz-Bermúdez, M. Samper, C. Climent, F. Vasco, V. Sara, S. Luque, N. Campillo, S. Grau Cerrato, J. R. Masclans, F. Alvarez-Lerma, S. Carvalho Brugger, G. Jimenez Jimenez, M. Miralbés Torner, J. Trujillano Cabello, B. Balsera Garrido, X. Nuvials Casals, F. Barcenilla Gaite, M. Vallverdú Vidal, M. Palomar Martínez, V. Gusarov, D. Shilkin, M. Dementienko, E. Nesterova, N. Lashenkova, A. Kuzovlev, M. Zamyatin, A. Demoule, S. Carreira, S. Lavault, O. Palancca, E. Morawiec, J. Mayaux, I. Arnulf, T. Similowski, B. S. Rasmussen, R. G. Maltesen, M. Hanifa, S. Pedersen, S. R. Kristensen, R. Wimmer, M. Panigada, G. Li Bassi, T. Kolobow, A. Zanella, M. Cressoni, L. Berra, V. Parrini, H. Kandil, G. Salati, S. Livigni, A. Amatu, A. Andreotti, F. Tagliaferri, G. Moise, G. Mercurio, A. Costa, A. Vezzani, S. Lindau, J. Babel, M. Cavana, D. Consonni, A. Pesenti, L. Gattinoni, for the GRAVITY-VAP TRIAL NETWORK, P. Mansouri, F. Zand, L. Zahed, F. Dehghanrad, M. Bahrani, M. Ghorbani, B. Cambiaghi, O. Moerer, T. Mauri, N. Kunze-Szikszay, C. Ritter, M. Quintel, L. M. Vilander, M. A. Kaunisto, S. T. Vaara, V. Pettilä, FINNAKI Study Group, J. L. G. Haitsma Mulier, S. Rozemeijer, A. M. E. Spoelstra-de Man, P. E. Elbers, P. R. Tuinman, M. C. de Waard, H. M. Oudemans-van Straaten, A. M. A. Liberatore, R. B. Souza, A. M. C. R. P. F. Martins, J. C. F. Vieira, I. H. J. Koh, M. Galindo Martínez, R. Jiménez Sánchez, L. Martínez Gascón, M. D. Rodríguez Mulero, A. Ortín Freire, A. Ojados Muñoz, S. Rebollo Acebes, Á. Fernández Martínez, S. Moreno Aliaga, L. Herrera Para, J. Murcia Payá, F. Rodríguez Mulero, P. Guerci, Y. Ince, P. Heeman, B. Ergin, Z. Uz, M. Massey, R. Papatella, E. Bulent, F. Toraman, E. R. Longbottom, H. D. Torrance, H. C. Owen, C. J. Hinds, R. M. Pearse, M. J. O’Dywer, Z. Trogrlic, M. van der Jagt, H. Lingsma, H. H. Ponssen, J. F. Schoonderbeek, F. Schreiner, S. J. Verbrugge, S. Duran, T. van Achterberg, J. Bakker, D. A. M. P. J. Gommers, E. Ista, A. Krajčová, P. Waldauf, F. Duška, A. Shah, N. Roy, S. McKechnie, C. Doree, S. Fisher, S. J. Stanworth, J. F. Jensen, D. Overgaard, M. H. Bestle, D. F. Christensen, I. Egerod, The RAPIT Group, A. Pivkina, I. Zhivotneva, N. Pasko, A. Alklit, R. L. Hansen, H. Knudsen, L. B. Grode, The RAPIT group, M. Hravnak, L. Chen, A. Dubrawski, M. R. Pinsky, S. M. Parry, L. D. Knight, B. C. Connolly, C. E. Baldwin, Z. A. Puthucheary, L. Denehy, N. Hart, P. E. Morris, J. Mortimore, C. L. Granger, H. I. Jensen, R. Piers, B. Van den Bulcke, J. Malmgren, V. Metaxa, A. K. Reyners, M. Darmon, K. Rusinova, D. Talmor, A. P. Meert, L. Cancelliere, L. Zubek, P. Maia, A. Michalsen, J. Decruyenaere, E. Kompanje, S. Vanheule, E. Azoulay, S. Vansteelandt, D. Benoit, C. Ryan, D. Dawson, J. Ball, K. Noone, B. Aisling, S. Prudden, A. Ntantana, D. Matamis, S. Savvidou, M. Giannakou, M. Gouva, G. Nakos, V. Koulouras, J. Aron, G. Lumley, D. Milliken, K. Dhadwal, B. A. McGrath, S. J. Lynch, B. Bovento, G. Sharpe, E. Grainger, S. Pieri-Davies, S. Wallace, B. McGrath, M. Jung, J. Cho, H. Park, G. Suh, O. Kousha, J. Paddle, L. Gamrin Gripenberg, M. Sundström Rehal, J. Wernerman, O. Rooyackers, H. J. de Grooth, W. P. Choo, A. M. Spoelstra-de Man, E. L. Swart, L. Talan, G. Güven, N. D. Altıntas, M. Padar, G. Uusvel, L. Starkopf, J. Starkopf, A. Reintam Blaser, M. S. Kalaiselvan, A. S. Arunkumar, M. K. Renuka, R. L. Shivkumar, M. Volbeda, D. ten Kate, M. Hoekstra, J. M. van der Maaten, M. W. Nijsten, A. Komaromi, Å. Norberg, M. Smedberg, M. Mori, L. Pettersson, M. Theodorakopoulou, T. Christodoulopoulou, A. Diamantakis, F. Frantzeskaki, M. Kontogiorgi, E. Chrysanthopoulou, M. Lygnos, C. Diakaki, A. Armaganidis, K. Gundogan, E. Dogan, R. Coskun, S. Muhtaroglu, M. Sungur, T. Ziegler, M. Guven, A. Kleyman, W. Khaliq, D. Andreas, M. Singer, R. Meierhans, R. Schuepbach, I. De Brito-Ashurst, G. Sabetian, R. Nikandish, F. Hagar, M. Masjedi, B. Maghsudi, A. Vazin, E. Asadpour, K. C. Kao, L. C. Chiu, C. Y. Hung, C. H. Chang, S. H. Li, H. C. Hu, S. El Maraghi, M. Ali, D. Rageb, M. Helmy, J. Marin-Corral, C. Vilà, A. Vàzquez, I. Martín-Loeches, E. Díaz, J. C. Yébenes, A. Rodriguez, F. Álvarez-Lerma, H1N1 SEMICYUC/GETGAG Working Group, N. Varga, A. Cortina-Gutiérrez, L. Dono, M. Martínez-Martínez, C. Maldonado, E. Papiol, M. Pérez-Carrasco, R. Ferrer, K. Nweze, B. Morton, I. Welters, M. Houard, B. Voisin, G. Ledoux, S. Six, E. Jaillette, S. Nseir, S. Romdhani, R. Bouneb, D. Loghmari, N. Ben Aicha, J. Ayachi, K. Meddeb, I. Chouchène, A. Khedher, M. Boussarsar, K. S. Chan, W. L. Yu, J. Nolla, L. Vidaur, J. Bonastre, B. Suberbiola, J. E. Guerrero, H1N1 SEMICYUC/GETGAG working group, N. Ramon Coll, G. Jiménez Jiménez, J. Codina Calero, M. García, M. C. de la Torre, E. Vendrell, E. Palomera, E. Güell, M. Serra-Prat, J. F. Bermejo-Martín, J. Almirall, E. Tomas, A. Escoval, F. Froe, M. H. Vitoria Pereira, N. Velez, E. Viegas, E. Filipe, C. Groves, M. Reay, A. Ballin, F. Facchin, G. Sartori, F. Zarantonello, E. Campello, C. M. Radu, S. Rossi, C. Ori, P. Simioni, N. Umei, I. Shingo, A. C. Santos, C. Candeias, I. Moniz, R. Marçal, Z. Costa e Silva, J. M. Ribeiro, J. F. Georger, J. P. Ponthus, M. Tchir, V. Amilien, M. Ayoub, E. Barsam, G. Martucci, G. Panarello, F. Tuzzolino, G. Capitanio, V. Ferrazza, T. Carollo, L. Giovanni, A. Arcadipane, M. López Sánchez, M. A. González-Gay, F. J. Llorca Díaz, M. I. Rubio López, E. Zogheib, L. Villeret, J. Nader, M. Bernasinski, P. Besserve, T. Caus, H. Dupont, P. Morimont, S. Habran, R. Hubert, T. Desaive, F. Blaffart, N. Janssen, J. Guiot, A. Pironet, P. Dauby, B. Lambermont, T. Pettenuzzo, G. Citton, C. Kirakli, O. Ediboglu, S. Ataman, M. Yarici, F. Tuksavul, S. Keating, A. Gibson, M. Gilles, M. Dunn, G. Price, N. Young, P. Remeta, P. Bishop, M. D. Fernández Zamora, J. Muñoz-Bono, E. Curiel-Balsera, E. Aguilar-Alonso, R. Hinojosa, A. Gordillo-Brenes, J. A. Arboleda-Sánchez, ARIAM-CARDIAC SURGERY PROJECT AUTHORS, I. Skorniakov, D. Vikulova, C. Whiteley, O. Shaikh, A. Jones, M. Ostermann, L. Forni, M. Scott, J. Sahatjian, W. Linde-Zwirble, D. Hansell, P. Laoveeravat, N. Srisawat, M. Kongwibulwut, S. Peerapornrattana, N. Suwachittanont, T. O. Wirotwan, P. Chatkaew, P. Saeyub, K. Latthaprecha, K. Tiranathanagul, S. Eiam-ong, J. A. Kellum, R. E. Berthelsen, A. Perner, A. E. K. Jensen, J. U. Jensen, D. J. Gebhard, J. Price, C. E. Kennedy, A. Akcan-Arikan, Y. R. Kang, M. N. Nakamae, K. Hamed, M. M. Khaled, R. Aly Soliman, M. Sherif Mokhtar, G. Seller-Pérez, D. Arias-Verdú, E. Llopar-Valdor, I. De-Diós-Chacón, G. Quesada-García, M. E. Herrera-Gutierrez, R. Hafes, G. Carroll, P. Doherty, C. Wright, I. G. Guerra Vera, M. Ralston, M. L. Gemmell, A. MacKay, E. Black, R. I. Docking, R. Appleton, M. R. Ralston, L. Gemmell, A. Mackay, J. G. Röttgering, P. W. G. Elbers, N. Mejeni, J. Nsiala, A. Kilembe, P. Akilimali, G. Thomas, A. E. Andersson, A. M. Fagerdahl, V. Knudsen, P-INFECT, A. Ben Cheikh, Y. Hamdaoui, A. Guiga, N. Fraj, N. Sma, I. Chouchene, N. Bouafia, A. Amirian, B. Ziaian, C. Fleischmann, D. O. Thomas-Rueddel, A. Schettler, D. Schwarzkopf, A. Stacke, K. Reinhart, A. Martins, P. Sousa, G. Snell, R. Matsa, T. T. S. Paary, A. M. Cavalheiro, L. L. Rocha, C. S. Vallone, A. Tonilo, M. D. S. Lobato, D. T. Malheiro, G. Sussumo, N. M. Lucino, V. D. Rosenthal, A. Sanaei Dashti, A. Yousefipour, J. R. Goodall, M. Williamson, E. Tant, N. Thomas, C. Balci, C. Gonen, E. Haftacı, H. Gurarda, E. Karaca, B. Paldusová, I. Zýková, D. Šímová, S. Houston, L. D’Antona, J. Lloyd, V. Garnelo-Rey, M. Sosic, V. Sotosek-Tokmazic, J. Kuharic, I. Antoncic, S. Dunatov, A. Sustic, C. T. Chong, M. Sim, T. Lyovarin, F. M. Acosta Díaz, S. Narbona Galdó, M. Muñoz Garach, O. Moreno Romero, A. M. Pérez Bailón, A. Carranza Pinel, M. Colmenero, A. Gritsan, A. Gazenkampf, E. Korchagin, N. Dovbish, R. M. Lee, M. P. P. Lim, B. C. L. Lim, J. J. See, R. Assis, F. Filipe, N. Lopes, L. Pessoa, T. Pereira, N. Catorze, M. S. Aydogan, C. Aldasoro, P. Marchio, A. Jorda, M. D. Mauricio, S. Guerra-Ojeda, M. Gimeno-Raga, M. Colque-Cano, A. Bertomeu-Artecero, M. Aldasoro, S. L. Valles, D. Tonon, T. Triglia, J. 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Torrents, M. L. Martinez, M. Camprubí-Rimblas, L. Blanch, S. Y. Park, Y. B. Park, D. K. Song, S. Shrestha, S. H. Park, Y. Koh, M. J. Park, C. W. Hong, O. Lesur, D. Coquerel, X. Sainsily, J. Cote, T. Söllradl, A. Murza, L. Dumont, R. Dumaine, M. Grandbois, P. Sarret, E. Marsault, D. Salvail, M. Auger-Messier, F. Chagnon, Apelin Group, M. P. Lauretta, E. Greco, A. Dyson, S. Preau, M. Ambler, A. Sigurta, S. Saeed, L. Topcu Sarıca, N. Zibandeh, D. Genc, F. Gul, T. Akkoc, E. Kombak, L. Cinel, I. Cinel, S. J. Pollen, N. Arulkumaran, G. Warnes, D. J. Pennington, K. Brohi, M. J. O’Dwyer, H. Y. Kim, S. Na, J. Kim, Y. F. Chang, A. Chao, P. Y. Shih, C. T. Lee, Y. C. Yeh, L. W. Chen, M. Adriaanse, W. Rietdijk, S. Funcke, S. Sauerlaender, B. Saugel, H. Pinnschmidt, D. A. Reuter, R. Nitzschke, S. Perbet, C. Biboulet, A. Lenoire, D. Bourdeaux, B. Pereira, B. Plaud, J. E. Bazin, V. Sautou, A. Mebazaa, J. M. Constantin, M. Legrand, Y. Boyko, P. Jennum, M. Nikolic, H. Oerding, R. Holst, P. Toft, H. K. 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Hernández-Flores, K. Pilarczyk, J. Lubarksi, D. Wendt, F. Dusse, J. Günter, B. Huschens, E. Demircioglu, H. Jakob, A. Palmaccio, A. M. Dell’Anna, D. L. Grieco, F. Torrini, C. Iaquaniello, F. Bongiovanni, M. Antonelli, L. Toscani, D. Antonakaki, D. Bastoni, M. Jozwiak, F. Depret, J. L. Teboul, J. Alphonsine, C. Lai, C. Richard, X. Monnet, G. Demeter, I. Kertmegi, A. Hasanin, A. Lotfy, A. El-adawy, H. Nassar, S. Mahmoud, A. Abougabal, A. Mukhtar, F. Quinty, S. Habchi, A. Luzi, E. Antok, G. Hernandez, B. Lara, L. Enberg, M. Ortega, P. Leon, C. Kripper, P. Aguilera, E. Kattan, M. Lehmann, S. Sakka, B. Bein, R. M. Schmid, J. Preti, J. Creteur, A. Herpain, J. Marc, F. Trojette, S. Bar, L. Kontar, D. Titeca, J. Richecoeur, B. Gelee, N. Verrier, R. Mercier, E. Lorne, J. Maizel, M. Slama, M. E. Abdelfattah, A. Eladawy, M. A. Ali Elsayed, A. Pedraza Montenegro, E. Monares Zepeda, J. Franco Granillo, J. S. Aguirre Sánchez, G. Camarena Alejo, A. Rugerio Cabrera, A. A. Tanaka Montoya, C. Lee, F. Hatib, M. Cannesson, P. Theerawit, T. Morasert, Y. Sutherasan, G. Zani, S. Mescolini, M. Diamanti, R. Righetti, A. Scaramuzza, M. Papetti, M. Terenzoni, C. Gecele, M. Fusari, K. A. Hakim, A. Chaari, M. Ismail, A. H. Elsaka, T. M. Mahmoud, K. Bousselmi, V. Kauts, W. F. Casey, S. D. Hutchings, D. Naumann, J. Wendon, S. Watts, E. Kirkman, Z. Jian, S. Buddi, J. Settels, P. Bertini, F. Guarracino, C. Trepte, P. Richter, S. A. Haas, V. Eichhorn, J. C. Kubitz, M. S. Soliman, W. I. Hamimy, A. Z. Fouad, A. M. Mukhtar, M. Charlton, L. Tonks, L. Mclelland, T. J. Coats, J. P. Thompson, M. R. Sims, D. Williams, D. Z. Roushdy, R. A. Soliman, R. A. Nahas, M. Y. Arafa, W. T. Hung, C. C. Chiang, W. C. Huang, K. C. Lin, S. C. Lin, C. C. Cheng, P. L. Kang, S. R. Wann, G. Y. Mar, C. P. Liu, M. Lopez Carranza, H. Sancho Fernandez, J. A. Sanchez Roman, F. Lucena, A. Campanario Garcia, A. Loza Vazquez, A. Lesmes Serrano, ARIAM-SEMICYUC Registry Investigators, L. Sayagues Moreira, R. Vidal-Perez, U. Anido Herranz, J. M. Garcia Acuna, C. Pena Gil, J. L. Garcia Allut, P. Rascado Sedes, C. Martin Lopez, E. Saborido Paz, C. Galban Rodriguez, J. R. Gonzalez-Juanatey, A. Vallejo-Baez, M. V. de la Torre-Prados, ARIAM Group, R. Marharaj, K. Gervasio, M. Bottiroli, M. Mondino, D. De Caria, A. Calini, E. Montrasio, F. Milazzo, M. P. Gagliardone, A. Vallejo-Báez, ARIAM group, U. Anido, M. Cheikh-Bouhlel, M. P. R. D. L. Dela Cruz, J. M. Bernardo, F. Galfo, A. Marino, C. C. Chao, P. Hou, C. C. Hung, C. H. Chiang, Y. J. Liou, S. M. Hung, Y. S. Lin, F. Y. Kuo, K. R. Chiou, C. J. Chen, L. S. Yan, C. Y. Liu, H. H. Wang, H. L. Chen, C. K. Ho, S. Grewal, S. Gopal, C. Corbett, A. Wilson, J. Capps, W. Ayoub, A. Lomas, S. Ghani, J. Moore, D. Atkinson, M. Sharman, W. Swinnen, J. Pauwels, K. Mignolet, E. Pannier, A. Koch, T. Sarens, W. Temmerman, A. M. Elmenshawy, A. M. Fayed, M. Elboriuny, E. Hamdy, E. Zakaria, A. C. Falk, A. Petosic, K. Olafsen, H. Wøien, H. Flaatten, K. Sunde, J. J. Cáceres Agra, J. L. Santana Cabrera, J. D. Martín Santana, L. Melián Alzola, H. Rodríguez Pérez, T. Castro Pires, H. Calderón, A. Pereira, S. Castro, C. Granja, I. Norkiene, I. Urbanaviciute, G. Kezyte, D. Ringaitiene, T. Jovaisa, G. Vogel, U. B. Johansson, A. Sandgren, C. Svensen, E. Joelsson-Alm, M. A. Leite, L. D. Murbach, E. F. Osaku, C. R. L. M. Costa, M. Pelenz, N. M. Neitzke, M. M. Moraes, J. L. Jaskowiak, M. M. M. Silva, R. S. Zaponi, L. R. L. Abentroth, S. M. Ogasawara, A. C. Jorge, P. A. D. Duarte, J. Barreto, S. T. Duarte, S. Taba, D. Miglioranza, D. P. Gund, C. F. Lordani, H. Vollmer, M. Gager, C. Waldmann, A. T. Mazzeo, R. Tesio, C. Filippini, M. E. Vallero, C. Giolitti, S. Caccia, M. Medugno, T. Tenaglia, R. Rosato, I. Mastromauro, L. Brazzi, P. P. Terragni, R. Urbino, V. Fanelli, V. M. Ranieri, L. Mascia, J. Ballantyne, L. Paton, P. Perez-Teran, O. Roca, J. C. Ruiz-Rodriguez, A. Zapatero, J. Serra, S. Bianzina, P. Cornara, G. Rodi, G. Tavazzi, M. Pozzi, G. A. Iotti, F. Mojoli, A. 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Levitt, United States Critical Illness and Injury Trials Group/LIPS-B investigators, S. Siddiqui, SICM NICER Group, J. P. Gilbert, K. Sim, C. H. Wang, I. J. Li, W. R. Tang, P. Persona, A. De Cassai, M. Franco, A. Goffi, B. Llorente Ruiz, J. Lujan Varas, R. Molina Montero, C. Pintado Delgado, O. Navarrete, M. Vazquez Mezquita, E. Alonso Peces, M. A. M. Nakamura, L. A. Hajjar, F. R. B. G. Galas, T. A. Ortiz, M. B. P. Amato, L. Bitker, N. Costes, D. Le Bars, F. Lavenne, D. Mojgan, J. C. Richard, D. Massari, M. Gotti, P. Cadringher, A. Zerman, M. Türkoğlu, G. Arık, F. Yıldırım, Z. Güllü, I. Kara, N. Boyacı, B. Basarık Aydoğan, Ü. Gaygısız, K. Gönderen, G. Aygencel, M. Aydoğdu, Z. Ülger, G. Gürsel, J. Riera, C. Maldonado Toral, C. Mazo, M. Martínez, J. Baldirà, L. Lagunes, A. Roman, M. Deu, J. Rello, D. J. Levine, R. M. Mohus, Å. Askim, J. Paulsen, A. Mehl, A. T. Dewan, J. K. Damås, E. Solligård, B. O. Åsvold, Mid-Norway Sepsis Research Center, A. DeWan, O. Aktepe, A. Kara, H. Yeter, A. Topeli, M. Norrenberg, M. Devroey, H. Khader, J. C. Preiser, Z. Tang, C. Qiu, L. Tong, C. Cai, O. Apostolopoulou, J. Y. Moon, M. R. Park, I. S. Kwon, G. R. Chon, J. Y. Ahn, S. J. Kwon, Y. J. Chang, J. Y. Lee, S. Y. Yoon, J. W. Lee, The Korean Chungcheong Critical Care Research Group, M. Kostalas, J. Mckinlay, G. Kooner, G. Dudas, A. Horton, C. Kerr, N. Karanjia, B. Creagh-Brown, N. D. Altintas, S. Izdes, O. Keremoglu, A. Alkan, S. Neselioglu, O. Erel, N. Tardif, T. Gustafsson, K. N. MacEachern, M. Traille, I. Bromberg, S. E. Lapinsky, M. J. Moore, J. L. García-Garmendia, F. Villarrasa-Clemente, F. Maroto-Monserrat, O. Rufo-Tejeiro, V. Jorge-Amigo, M. Sánchez-Santamaría, C. Colón-Pallarés, A. Barrero-Almodóvar, S. Gallego-Lara, C. T. Anthon, R. B. Müller, N. Haase, K. Møller, J. Wetterslev, M. Nakanishi, A. Kuriyama, T. Fukuoka, M. A. Abd el Halim, M. H. Elsaid hafez, A. M. Moktar, H. M. Elazizy, K. Abdel Hakim, M. Elbahr, T. Mahmoud, E. Khalil, W. Casey, S. H. Zaky, A. Rizk, R. Ahmed, G. A. Ospina-Tascón, A. F. Garcia Marin, G. J. Echeverry, W. F. Bermudez, H. J. Madriñan-Navia, J. D. Valencia, E. Quiñonez, A. Marulanda, C. A. Arango-Dávila, A. Bruhn, D. De Backer, D. Orbegozo Cortes, F. Su, J. L. Vincent, L. Tullo, L. Mirabella, P. Di Molfetta, M. Dambrosio, C. Villavicencio Lujan, J. Leache irigoyen, M. Cartanya ferré, R. Carbonell García, M. Ahmed, M. El Ayashi, E. Ayman, M. Salem, S. Fathy, A. Zaghlol, M. F. Aguilar Arzapalo, Å. Valsø, T. Rustøen, I. Schou-Bredal, L. Skogstad, K. Tøien, C. Padilla, Y. Palmeiro, W. Egbaria, R. Kigli, B. Maertens, K. Blot, S. Blot, E. Santana-Santos, E. R. dos Santos, R. E. D. L. Ferretti-Rebustini, R. D. C. C. D. O. dos Santos, R. G. S. Verardino, L. A. Bortolotto, A. M. Doyle, I. Naldrett, J. Tillman, S. Price, P. Pearson, J. Greaves, D. Goodall, A. Berry, A. Richardson, G. O. Odundo, P. Omengo, P. Obonyo, N. M. Chanzu, R. Kleinpell, S. J. Sarris, P. Nedved, M. Heitschmidt, H. Ben-Ghezala, S. Snouda, S. Djobbi, N. K. J. Adhikari, D. Leasa, D. Fergusson, D. A. Mckim, J. Weblin, D. McWilliams, F. Doesburg, F. Cnossen, W. Dieperink, W. Bult, M. W. N. Nijsten, G. A. Galvez-Blanco, C. I. Olvera Guzman, J. Santos Stroud, R. Thomson, M. Llaurado-Serra, A. Lobo-Civico, M. Pi-Guerrero, I. Blanco-Sanchez, A. Piñol-Tena, C. Paños-Espinosa, Y. Alabart-Segura, B. Coloma-Gomez, A. Fernandez-Blanco, F. Braga-Dias, M. Treso-Geira, A. Valeiras-Valero, L. Martinez-Reyes, A. Sandiumenge, M. F. Jimenez-Herrera, CAPCRI Study, R. Prada, P. Juárez, R. Argandoña, J. J. Díaz, C. Sánchez Ramirez, P. Saavedra, S. Ruiz Santana, O. Obukhova, S. Kashiya, I. A. Kurmukov, A. M. Pronina, P. Simeone, L. Puybasset, G. Auzias, O. Coulon, B. Lesimple, G. Torkomian, A. Bartkowska-Sniatkowska, O. Szerkus, D. Siluk, J. Bartkowiak-Wieczorek, J. Rosada-Kurasinska, J. Warzybok, R. Kaliszan, C. Hernandez Caballero, S. Roberts, G. Isgro, D. Hall, G. Guillaume, O. Passouant, F. Dumas, W. Bougouin, B. Champigneulle, M. Arnaout, J. Chelly, J. D. Chiche, O. Varenne, J. P. Mira, E. Marijon, A. Cariou, M. Beerepoot, H. R. Touw, K. Parlevliet, C. Boer, P. W. Elbers, Á. J. Roldán Reina, Y. Corcia Palomo, R. Martín Bermúdez, L. Martín Villén, I. Palacios García, J. R. Naranjo Izurieta, J. B. Pérez Bernal, F. J. Jiménez Jiménez, Cardiac Arrest Group HUVR, F. Cota-Delgado, T. Kaneko, H. Tanaka, M. Kamikawa, R. Karashima, S. Iwashita, H. Irie, S. Kasaoka, O. Arola, R. Laitio, A. Saraste, J. Airaksinen, M. Pietilä, M. Hynninen, J. Wennervirta, M. Bäcklund, E. Ylikoski, P. Silvasti, E. Nukarinen, J. Grönlund, V. P. Harjola, J. Niiranen, K. Korpi, M. Varpula, R. O. Roine, T. Laitio, for the Xe-HYPOTHECA study group, S. Salah, B. G. Hassen, A. Mohamed Fehmi, Y. C. Hsu, J. Barea-Mendoza, C. García-Fuentes, M. Castillo-Jaramillo, H. Dominguez-Aguado, R. Viejo-Moreno, L. Terceros-Almanza, S. Bermejo Aznárez, C. Mudarra-Reche, W. Xu, M. Chico-Fernández, J. C. Montejo-González, K. Crewdson, M. Thomas, M. Merghani, L. Fenner, P. Morgan, D. Lockey, E. J. van Lieshout, B. Oomen, J. M. Binnekade, R. J. de Haan, N. P. Juffermans, M. B. Vroom, R. Algarte, L. Martínez, B. Sánchez, I. Romero, F. Martínez, S. Quintana, J. Trenado, O. Sheikh, D. Pogson, R. Clinton, F. Riccio, A. Arthur, L. Young, A. Sinclair, D. Markopoulou, K. Venetsanou, L. Filippou, E. Salla, S. Stratouli, I. Alamanos, A. H. Guirgis, R. Gutiérrez Rodriguez, M. J. Furones Lorente, I. Macias Guarasa, A. Ukere, S. Meisner, G. Greiwe, B. Opitz, D. Benten, B. Nashan, L. Fischer, C. J. C. Trepte, C. R. Behem, B. Ana, A. Vazir, D. Gibson, M. R. Hadavi, M. Riahi alam, M. R. Sasani, N. Parenti, F. Agrusta, C. Palazzi, B. Pifferi, R. Sganzerla, F. Tagliazucchi, A. Luciani, M. Möller, J. Müller-Engelmann, G. Montag, P. Adams, C. Lange, J. Neuzner, R. Gradaus, K. H. Wodack, F. Thürk, A. D. Waldmann, M. F. Grässler, S. Nishimoto, S. H. Böhm, E. Kaniusas, C. J. Trepte, M. Wallin, F. Suarez Sipman, A. Oldner, L. Colinas, R. Vicho, M. Serna, R. Cuena, A. Canabal, ECOCRITIC group, M. Etman, M. El Bahr, A. El Sakka, A. Arali, O. Bond, P. De Santis, E. Iesu, F. Franchi, S. Scolletta, F. S. Taccone, Z. Marutyan, L. Hamidova, A. Shakotko, V. Movsisyan, I. Uysupova, A. Evdokimov, S. Petrikov, F. J. Redondo Calvo, N. Bejarano, V. Baladron, R. Villazala, J. Redondo, D. Padilla, P. Villarejo, C. Gomez-Gonzalez, S. Mas-Font, A. Puppo-Moreno, M. Herrera-Gutierrez, M. Garcia-Garcia, S. Aldunate-Calvo, NEFROCON Investigators, E. P. Plata-Menchaca, X. L. Pérez-Fernández, M. Estruch, A. Betbese-Roig, P. Cárdenas Campos, M. Rojas Lora, N. D. Toapanta Gaibor, R. S. Contreras Medina, V. D. Gumucio Sanguino, E. J. Casanova, J. Sabater Riera, SIRAKI group, K. Kritmetapak, S. Peerapornratana, P. Kittiskulnam, T. Dissayabutra, P. Susantithapong, K. Praditpornsilpa, K. Tungsanga, S. Eiam-Ong, T. Winkelmann, T. Busch, J. Meixensberger, S. Bercker, E. M. Flores Cabeza, M. Sánchez Sánchez, N. Cáceres Giménez, C. Gutierrez Melón, E. Herrero de Lucas, P. Millán Estañ, M. Hernández Bernal, A. Garcia de Lorenzo y Mateos, P. A. C. Specht, M. Balik, M. Zakharchenko, F. Los, H. Brodska, C. de Tymowski, P. Augustin, M. Desmard, P. Montravers, S. N. Stapel, R. de Boer, H. M. Oudemans, A. Hollinger, T. Schweingruber, F. Jockers, M. Dickenmann, M. Siegemund, Clinical Intensive Care Research Basel, N. Runciman, L. Alban, C. Turrini, T. Sasso, T. Langer, P. Taccone, C. Marenghi, G. Grasselli, P. Wibart, T. Reginault, M. Garcia, B. Barbrel, A. Benard, C. Bader, F. Vargas, H. N. Bui, G. Hilbert, J. M. Serrano Simón, P. Carmona Sánchez, F. Ruiz Ferrón, M. García de Acilu, J. Marin, V. Antonia, L. Ruano, M. Monica, G. Hong, D. H. Kim, Y. S. Kim, J. S. Park, Y. K. Jee, Z. Yu xiang, W. Jia-xing, W. Xiao dan, N. Wen long, W. Yu, Z. Yan, X. Cheng, T. Kobayashi, Y. Onodera, R. Akimoto, A. Sugiura, H. Suzuki, M. Iwabuchi, M. Nakane, K. Kawamae, P. Carmona Sanchez, M. D. Bautista Rodriguez, M. Rodriguez Delgado, V. Martínez de Pinillos Sánchez, A. Mula Gómez, P. Beuret, C. Fortes, M. Lauer, M. Reboul, J. C. Chakarian, X. Fabre, B. Philippon-Jouve, S. Devillez, M. Clerc, N. Rittayamai, M. Sklar, M. Dres, M. Rauseo, C. Campbell, B. West, D. E. Tullis, M. Okada, N. Ahmad, M. Wood, A. Glossop, J. Higuera Lucas, A. Blandino Ortiz, D. Cabestrero Alonso, R. De Pablo Sánchez, L. Rey González, R. Costa, G. Spinazzola, A. Pizza, G. Ferrone, M. Rossi, G. Conti, H. Ribeiro, J. Alves, M. Sousa, P. Reis, C. S. Socolovsky, R. P. Cauley, J. E. Frankel, A. L. Beam, K. O. Olaniran, F. K. Gibbons, K. B. Christopher, J. Pennington, P. Zolfaghari, H. S. King, H. H. Y. Kong, H. P. Shum, W. W. Yan, C. Kaymak, N. Okumus, A. Sari, B. Erdogdu, S. Aksun, H. Basar, A. Ozcan, N. Ozcan, D. Oztuna, J. A. Malmgren, S. Lundin, K. Torén, M. Eckerström, A. Wallin, A. C. Waldenström, for the Section on Ethics of the ESICM, F. C. Riccio, A. C. P. Antonio, A. F. Leivas, F. Kenji, E. James, S. Jonnada, C. S. Gerrard, N. Jones, J. D. Salciccioli, D. C. Marshall, M. Komorowski, A. Hartley, M. C. Sykes, R. Goodson, J. Shalhoub, J. R. Fernández Villanueva, R. Fernández Garda, A. M. López Lago, E. Rodríguez Ruiz, R. Hernández Vaquero, C. Galbán Rodríguez, E. Varo Pérez, C. Hilasque, I. Oliva, G. Sirgo, M. C. Martin, M. Olona, M. C. Gilavert, M. Bodí, C. Ebm, G. Aggarwal, S. Huddart, N. Quiney, S. M. Fernandes, J. Santos Silva, J. Gouveia, D. Silva, R. Marques, H. Bento, A. Alvarez, Z. Costa Silva, D. Díaz Diaz, M. Villanova Martínez, E. Palencia Herrejon, A. Martinez de la Gandara, G. Gonzalo, M. A. Lopez, P. Ruíz de Gopegui Miguelena, C. I. Bernal Matilla, P. Sánchez Chueca, M. D. C. Rodríguez Longares, R. Ramos Abril, A. L. Ruíz Aguilar, R. Garrido López de Murillas, R. Fernández Fernández, P. Morales Laborías, M. A. Díaz Castellanos, M. E. Morales Laborías, J. Park, S. Woo, T. West, E. Powell, A. Rimmer, C. Orford, J. Williams, P. Ruiz de Gopegui Miguelena, R. S. Bourne, R. Shulman, M. Tomlin, G. H. Mills, M. Borthwick, W. Berry, D. García Huertas, F. Manzano, F. Villagrán-Ramírez, A. Ruiz-Perea, C. Rodríguez-Mejías, F. Santiago-Ruiz, M. Colmenero-Ruiz, C. König, B. Matt, A. Kortgen, C. S. Hartog, A. Wong, C. Balan, G. Barker, S. Tachaboon, J. Paratz, G. Kayambu, R. Boots, R. Vlasenko, E. Gromova, S. Loginov, M. Kiselevskiy, Y. Dolgikova, K. B. Tang, C. M. Chau, K. N. Lam, E. Gil, G. Y. Suh, C. M. Park, C. R. Chung, C. H. Lai, Y. J. Cheng, V. Colella, N. Zarrillo, M. D’Amico, F. Forfori, B. Pezza, T. Laddomada, V. Beltramelli, M. L. Pizzaballa, A. Doronzio, B. Balicco, D. Kiers, W. van der Heijden, J. Gerretsen, Q. de Mast, S. el Messaoudi, G. Rongen, M. Gomes, N. P. Riksen, Y. Kashiwagi, K. Hayashi, Y. Inagaki, S. Fujita, A. Blet, M. Sadoune, J. Lemarié, N. Bihry, R. Bern, E. Polidano, R. Merval, J. M. Launay, B. Lévy, J. L. Samuel, J. Hartmann, S. Harm, and V. Weber

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published
2016
Full Text
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22. The observed pattern and hidden process of female reproductive trajectories across the life span in a non‐human primate

Author

Angelina V. Ruiz-Lambides, Yul H R Kang, James P. Higham, and D. Susie Lee

Subjects
Senescence, Aging, Life span, Process (engineering), Reproduction, media_common.quotation_subject, Longevity, Fertility, Biology, Macaca mulatta, Generative model, Cross-Sectional Studies, Ageing, Hidden markov chain model, Evolutionary biology, Animals, Female, Animal Science and Zoology, Evolutionary ecology, Ecology, Evolution, Behavior and Systematics, media_common
Abstract

Age-specific fertility trajectories are fundamental to understanding population structure and the evolutionary ecology of diverse life histories. However, characterizing reproductive ageing has been difficult with cross-sectional data, where senescence especially late in life can be confounded by selective disappearance. Addressing such challenge requires longitudinal data tracking the reproductive life span of known individuals, but such data are rare, especially for very long-lived species such as primates. We analyse the entire life span trajectory of annual fertility, from reproductive maturity to death, for 673 free-ranging female rhesus macaques, Macaca mulatta, on Cayo Santiago, Puerto Rico. Using generalized linear mixed-effects models (GLMMs), we first tested if time to death explains the ageing pattern independently of and additionally to chronological age, and if so, whether there is interaction between them. While GLMM captures the patterns in the data well, it is not a generative model. For example, given the GLMM and an individual's reproductive trajectory up to a given age, we cannot directly predict the probability of reproduction or death in the next year. For this reason, we further fitted a hidden Markov chain model (HMM) which allows just such a prediction, and additionally helps infer the process underlying the observed trajectory. We show that, after accounting for individual differences in fertility, reproductive ageing exhibits both age-dependent decline and also an abrupt terminal decline independently of age at death. We infer from the HMM that the underlying process of reproductive trajectory is where individuals cycle between reproductive bouts until they enter an irreversible frail condition that constrains fertility. The findings provide valuable insights into the longitudinal progression of reproductive trajectories in primates, by revealing both age-dependent and age-independent patterns and processes of ageing, and contribute to a growing body of literature on reproductive ageing and senescence across animal taxa.Las trayectorias de fertilidad específicas de la edad son pieza clave en los estudios que pretenden entender la estructura de la población y la ecología evolutiva de las diversas historias de vida. Sin embargo, la caracterización del envejecimiento reproductivo ha sido difícil con datos transversales, en los que los patrones asociados a la edad avanzada, como la senescencia, pueden verse confundidos por la desaparición selectiva. Los datos longitudinales que rastrean la vida reproductiva de individuos específicos son fundamentales, pero tales datos son escasos, especialmente para especies muy longevas como los primates. En este estudio analizamos la trayectoria completa de la fertilidad anual, desde la madurez reproductiva hasta la muerte, de 673 macaco rhesus (Macaca mulatta) hembras que habitan libremente la isla de Cayo Santiago, Puerto Rico. Mostramos que, después de tener en cuenta las diferencias individuales en la fertilidad, el envejecimiento reproductivo exhibe tanto un declive dependiente de la edad, como un declive terminal abrupto independiente de la edad al morir. Aplicando un modelo de cadena de Markov oculta, caracterizamos además el proceso reproductivo subyacente, en el que los individuos pasan por ciclos reproductivos hasta que entran en una condición de fragilidad irreversible que limita la fertilidad. Los resultados proporcionan una valiosa visión de la progresión longitudinal de las trayectorias reproductivas en los primates, al revelar patrones y procesos de senescencia dependientes e independientes de la edad, y contribuyen a un creciente cuerpo de literatura sobre el envejecimiento reproductivo en todos los taxones animales.

Published
2021

27. Biomechanically superior treatments do not translate into improved outcomes in randomized controlled trials

Author

Jigyasa Sharma, Julius A. Bishop, Andrea K. Finlay, Jason R. Kang, Grace Xiong, and Michael J. Gardner

Subjects
030222 orthopedics, medicine.medical_specialty, business.industry, Translational research, Logistic regression, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Physical therapy, Medicine, Orthopedics and Sports Medicine, Surgery, 030212 general & internal medicine, business
Abstract

Significant time and resources are devoted to conducting orthopaedic biomechanics research; however, it is not known how these studies relate to their subsequent clinical studies. The purpose of the present study was to determine whether biomechanically superior treatments were associated with improved clinical outcomes as determined by analogous randomized controlled trials (RCTs). A systematic review was conducted to find RCTs that tested a research question based on a prior biomechanical study. PubMed and SCOPUS databases were queried for orthopaedic randomized controlled trials, and full text articles were reviewed to find RCTs which cited biomechanical studies with analogous comparison groups. A random-effects multi-level logistic regression model was conducted examining the association between RCT outcome and biomechanics outcome, adjusting for multiple outcomes nested within study. In total, 20,261 articles were reviewed yielding 21 RCTs citing a total of 43 analogous biomechanical studies. In 7 instances (16.2%), the RCT and a cited biomechanical study showed concordant results (i.e. the superior treatment in the RCT was also the superior construct in the biomechanical study). RCT outcome was not associated with biomechanical outcome (β = −1.50, standard error = 0.78, p = .05). This study assessed 21 orthopaedic RCTs with 43 corresponding biomechanical studies and found no association between superior biomechanical properties of a given orthopaedic treatment and improved clinical outcomes. Favourable biomechanical properties alone should not be the primary reason for selecting one treatment over another. Furthermore, RCTs based on biomechanical studies should be carefully designed to maximize the chance of providing clinically relevant insights.

Published
2021

29. Applications of deep learning methods in digital biomarker research using noninvasive sensing data

Author

Hoyeon Jeong, Yong W Jeong, Yeonjae Park, Kise Kim, Junghwan Park, and Dae R Kang

Subjects
Health Information Management, Health Policy, Health Informatics, Computer Science Applications
Abstract

Introduction: Noninvasive digital biomarkers are critical elements in digital healthcare in terms of not only the ease of measurement but also their use of raw data. In recent years, deep learning methods have been put to use to analyze these diverse heterogeneous data; these methods include representation learning for feature extraction and supervised learning for the prediction of these biomarkers. Methods: We introduce clinical cases of digital biomarkers and various deep-learning methods applied according to each data type. In addition, deep learning methods for the integrated analysis of multidimensional heterogeneous data are introduced, and the utility of these data as an integrated digital biomarker is presented. The current status of digital biomarker research is examined by surveying research cases applied to various types of data as well as modeling methods. Results: We present a future research direction for using data from heterogeneous sources together by introducing deep learning methods for dimensionality reduction and mode integration from multimodal digital biomarker studies covering related domains. The integration of multimodality has led to advances in research through the improvement of performance and complementarity between modes. Discussion: The integrative digital biomarker will be more useful for research on diseases that require data from multiple sources to be treated together. Since delicate signals from patients are not missed and the interaction effects between signals are also considered, it will be helpful for immediate detection and more accurate prediction of symptoms.

Published
2022

36. The effects of varenicline on lumbar spinal fusion in a rat model

Author

Jayme C.B. Koltsov, Linda E.A. Kanim, Khosrowdad Salehi, Hyun W. Bae, Brian A. Karamian, Zachary NaPier, Ivan Cheng, Timothy Thio, Juliane D. Glaeser, and Jason R. Kang

Subjects
Male, Bone Regeneration, medicine.medical_treatment, Radiography, Context (language use), Bone healing, Palpation, Random Allocation, 03 medical and health sciences, chemistry.chemical_compound, Postoperative Complications, 0302 clinical medicine, medicine, Animals, Orthopedics and Sports Medicine, Varenicline, Bone mineral, Smoking Cessation Agents, 030222 orthopedics, Lumbar Vertebrae, medicine.diagnostic_test, business.industry, Rats, Spinal Fusion, chemistry, Rats, Inbred Lew, Spinal fusion, Smoking cessation, Surgery, Neurology (clinical), business, Nuclear medicine, 030217 neurology & neurosurgery
Abstract

BACKGROUND CONTEXT Smoking is detrimental to obtaining a solid spinal fusion mass with previous studies demonstrating its association with pseudoarthrosis in patients undergoing spinal fusion. Varenicline is a pharmacologic adjunct used in smoking cessation which acts as a partial agonist of the same nicotinic receptors activated during tobacco use. However, no clinical or basic science studies to date have characterized if varenicline has negative effects on spinal fusion and bone healing by itself. PURPOSE Our study’s aim was to elucidate whether varenicline affects the frequency or quality of posterolateral spinal fusion in a rodent model at an endpoint of 12 weeks. STUDY DESIGN Randomized control trial. PATIENT SAMPLE Fourteen male Lewis rats randomly separated into two experimental groups. OUTCOME MEASURES Manual palpation of fusion segment, radiography, μCT imaging, and four-point bend. METHODS Fourteen male Lewis rats were randomly separated into two experimental groups undergoing L4–L5 posterior spinal fusion procedure followed by daily subcutaneous injections of human dose varenicline or saline (control) for 12 weeks postsurgery. Spine samples were explanted, and fusion was determined via manual palpation of segments by two independent observers. High-resolution radiographs were obtained to evaluate bridging fusion mass. μCT imaging was performed to characterize fusion mass and consolidation. Lumbar spinal fusion units were tested in four-point bending to evaluate stiffness and peak load. Study funding sources include $5000 OREF Grant. There were no applicable financial relationships or conflicts of interest. RESULTS At 3 months postsurgery, 12 out of 14 rats demonstrated lumbar spine fusion (86% fused) with no difference in fusion frequency between the varenicline and control groups as detected by manual palpation. High-resolution radiography revealed six out of seven rats (86%) having complete fusion in both groups. μCT showed no significant difference in bone mineral density or bone fraction volume between groups in the region of interest. Biomechanical testing demonstrated no significant different in the average stiffness or peak loads at the fusion site of the varenicline and control groups. CONCLUSION Based on the results of our rat study, there is no indication that varenicline itself has a detrimental effect on the frequency and quality of spinal fusion.

Published
2020

38. The router bit extraction technique for removing a well-fixed humeral stem in revision shoulder arthroplasty

Author

Jason R. Kang, Adam J. Tagliero, Anthony L. Logli, and John W. Sperling

Subjects
Male, Router, Time Factors, medicine.medical_treatment, Risk Assessment, Cohort Studies, Tertiary Care Centers, medicine, Humans, Orthopedics and Sports Medicine, Registries, Device Removal, Aged, Retrospective Studies, Orthodontics, business.industry, Shoulder Prosthesis, Recovery of Function, Middle Aged, Arthroplasty, Prosthesis Failure, Bit (horse), Treatment Outcome, Arthroplasty, Replacement, Shoulder, Female, Surgery, Hemiarthroplasty, business, Follow-Up Studies
Abstract

Aims A number of methods have been described to remove a well-fixed humeral implant as part of revision shoulder arthroplasty. These include the use of cortical windows and humeral osteotomies. The router bit extraction technique uses a high-speed router bit to disrupt the bone-implant interface. The implant is then struck in a retrograde fashion with a square-tip impactor and mallet. The purpose of this study was to determine the characteristics and frequency of the different techniques needed for the removal of a well-fixed humeral stem in revision shoulder arthroplasty. Patients and Methods Between 2010 and 2018, 288 revision shoulder arthroplasty procedures requiring removal of a well-fixed humeral component were carried out at a tertiary referral centre by a single surgeon. The patient demographics, indications for surgery, and method of extraction were collected. Results Of the 288 revisions, 284 humeral stems (98.6%) were removed using the router bit extraction technique alone. Four humeral stems (1.39%) required an additional cortical window. Humeral osteotomy was not necessary in any procedure. Most of the humeral stems removed (78.8%) were cementless. Of the four humeral stems that required a cortical window, three involved removal of a hemiarthroplasty. Two were cemented and two were cementless. Conclusion The router bit extraction technique removed a well-fixed humeral component in a very high proportion of patients (98.6%). This method allows surgeons to avoid more invasive approaches involving a cortical window or humeral osteotomy, and their associated complications. Cite this article: Bone Joint J 2019;101-B:1280–1284

Published
2019

39. [The reference intervals of thyroid functional indicators in pregnant population in Xi'an]

Author

G L, Meng, Q, Wang, R, Kang, D, Niu, N, Xing, and Y, Xie

Subjects
Thyroxine, Cross-Sectional Studies, Pregnancy, Reference Values, Thyroid Gland, Humans, Thyrotropin, Triiodothyronine, Female, Thyroid Function Tests
Abstract

To establish reference intervals for thyroid functional indicators in early (T1), mid-term (T2), and late stage (T3) pregnancy in a population of women in Northwestern China. A cross-sectional study was conducted on 620 pregnant women. Subjects were recruited through a questionnaire where apparently healthy women were selected. Serum thyroid stimulating hormone (TSH3), total triiodothyronine (TT3), total thyroid hormone (TT4), free triiodothyronine (FT3), and free thyroid hormone (FT4) were detected using the Beckman Unicel DXI 800 automatic chemiluminescence analyzer (the third-generation TSH detection reagent for TSH3),and the reference intervals of different gestation periods were established. The results showed that the reference intervals of TSH3 in T1, T2, and T3 were 0.05-4.59, 0.61-6.01, and 0.63-4.78 mIU/L, respectively; TT3 were 1.62-2.97 nmol/L, 1.59-2.95 nmol/L, and 1.45-2.70 nmol/L, respectively; TT4 were 95.49-185.00 nmol/L, 92.70-181.54 nmol/L, and 77.93-155.09 nmol/L, respectively; FT3 were 3.18-5.22 pmol/L, 2.78-4.67 pmol/L, and 2.51-4.18 pmol/L, respectively; and FT4 were 7.72-12.97 pmol/L, 6.90-1.09 pmol/L, and 5.63-9.85 pmol/L, respectively. All thyroid function indexes had statistically significant differences between the three stages of pregnancy (TSH:为建立西安地区孕妇妊娠早期（T1期）、中期（T2期）、晚期（T3期）甲状腺功能指标的参考区间。本研究采用横断面研究的方法，通过调查问卷共招募表观健康的620名孕妇，采用全自动化学发光分析仪检测血清促甲状腺激素（TSH）、总三碘甲状腺原氨酸（TT3）、总甲状腺激素（TT4）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺激素（FT4）水平，并且使用新一代TSH检测试剂（3rd IS），以探讨妊娠期特异性甲状腺功能指标的参考区间。结果显示，T1期、T2期和T3期TSH的参考区间分别是0.05~4.59 mIU/L、0.61~6.01 mIU/L、0.63~4.78 mIU/L；TT3是1.62~2.97 nmol/L、1.59~2.95 nmol/L、1.45~2.70 nmol/L；TT4是95.49~185.00 nmol/L、92.70~181.54 nmol/L、77.93~155.09 nmol/L；FT3是3.18~5.22 pmol/L、2.78~4.67 pmol/L、2.51~4.18 pmol/L；FT4是7.72~12.97 pmol/L、6.90~11.09 pmol/L、5.63~9.85 pmol/L。所有甲状腺功能指标在不同孕期之间差异均有统计学意义（TSH：

Published
2021

43. P109 Risk of cervical cancer in incident Ulcerative Colitis during the first 10 years after diagnosis: A nationwide population-based study

Author

J Kim, H Kim, S C Park, J K Lee, D R Kang, S Y Kim, H S Kim, and H M Kim

Subjects
Gastroenterology, General Medicine
Abstract

Background Several studies suggested association between inflammatory bowel disease (IBD) and risk of cervical cancer in women. We investigated the risk of cervical cancer in patients with ulcerative colitis (UC) using the nationwide population-based claims data in South Korea. Methods We analysed the claims data of the Korean National Health Insurance (2006–2015). UC and cervical cancer were defined using International Classification of Diseases-10 codes and UC-specific prescription. Age- and sex-matched individuals without UC (control group) were randomly selected from the general population. Hazard ratios (HRs), adjusted for different covariates, were calculated using multivariate Cox proportional hazard regression. Results In total, 30,546 and 88,829 individuals with UC and without UC, respectively, were enrolled. Cervical cancer developed in 26 (0.21%) among UC patients, and 51 (0.14%) among control group, respectively. The standardized incidence ratio (SIR) of cervical cancer in the UC and non-UC groups were 2.04(95% confidence interval [CI], 1.33–2.98), and 1.35(95% CI, 1.00–1.77). The HR of cervical cancer in UC group, with reference to the non-UC group, was 1.56 (95% CI, 0.97–2.50). Further, UC groups were stratified according to age (HR=9.89, 1.62, 0.79 and 3.65 for 0–19, 20–39, 40–59, and ≥60 years, respectively). HR was significantly higher for early-onset UC (0–19 years) and late-onset UC (≥60 years). Among UC, age≥40, low socioeconomic status, rural residence, cerebral vascular disease are risk factors for cervical cancer. Conclusion UC patients had an increased risk of cervical cancer, especially with early-onset (0–19 years) and late-onset (>59 years). Since cervical cancer incidence is higher in UC patients than in the general population, UC patients should receive the human papillomavirus vaccine prophylactically.

Published
2022

46. Author Correction: Waist circumference and the risk of lumbar and femur fractures: a nationwide population-based cohort study

Author

G R, Park, H S, Kim, Y T, Kim, H J, Chung, S J, Ha, D W, Kim, D R, Kang, J Y, Kim, M Y, Lee, and J Y, Lee

Abstract

Correction to: European Review for Medical and Pharmacological Sciences 2021; 25 (3): 1198-1205-DOI: 10.26355/eurrev_202102_24822-PMID: 33629289, published online 15 February, 2021. After publication, the authors requested to correct Table I and some minor errors in the text. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/24822.

Published
2021

47. Biomechanically superior treatments do not translate into improved outcomes in randomized controlled trials

Author

Grace X, Xiong, Jason R, Kang, Jigyasa, Sharma, Andrea, Finlay, Michael J, Gardner, and Julius A, Bishop

Subjects
Orthopedics, Humans, Randomized Controlled Trials as Topic
Abstract

Significant time and resources are devoted to conducting orthopaedic biomechanics research; however, it is not known how these studies relate to their subsequent clinical studies. The purpose of the present study was to determine whether biomechanically superior treatments were associated with improved clinical outcomes as determined by analogous randomized controlled trials (RCTs).A systematic review was conducted to find RCTs that tested a research question based on a prior biomechanical study. PubMed and SCOPUS databases were queried for orthopaedic randomized controlled trials, and full text articles were reviewed to find RCTs which cited biomechanical studies with analogous comparison groups. A random-effects multi-level logistic regression model was conducted examining the association between RCT outcome and biomechanics outcome, adjusting for multiple outcomes nested within study.In total, 20,261 articles were reviewed yielding 21 RCTs citing a total of 43 analogous biomechanical studies. In 7 instances (16.2%), the RCT and a cited biomechanical study showed concordant results (i.e. the superior treatment in the RCT was also the superior construct in the biomechanical study). RCT outcome was not associated with biomechanical outcome (β = -1.50, standard error = 0.78, p = .05).This study assessed 21 orthopaedic RCTs with 43 corresponding biomechanical studies and found no association between superior biomechanical properties of a given orthopaedic treatment and improved clinical outcomes. Favourable biomechanical properties alone should not be the primary reason for selecting one treatment over another. Furthermore, RCTs based on biomechanical studies should be carefully designed to maximize the chance of providing clinically relevant insights.

Published
2021

48. Comparison of micro<scp>RNA</scp>s in adipose and muscle tissue from seven indigenous Chinese breeds and Yorkshire pigs

Author

J Pang, Y Yang, X.‐B. Lv, R Kang, Y Wang, X Chen, Z Zhong, J Gong, X Yang, Z He, Y Gu, Y Liang, Y Lei, L Ma, S Ying, X Tao, and K Zeng

Subjects
0301 basic medicine, Muscle tissue, Sus scrofa, Adipose tissue, Biology, Genome, 03 medical and health sciences, microRNA, Genetics, medicine, Animals, RNA, Messenger, Gene, Muscles, 0402 animal and dairy science, Skeletal muscle, 04 agricultural and veterinary sciences, General Medicine, Phenotypic trait, 040201 dairy & animal science, MicroRNAs, Phenotype, 030104 developmental biology, medicine.anatomical_structure, Adipose Tissue, Animal Science and Zoology, Intramuscular fat, Transcriptome
Abstract

Elucidation of the pig microRNAome is essential for interpreting functional elements of the genome and understanding the genetic architecture of complex traits. Here, we extracted small RNAs from skeletal muscle and adipose tissue, and we compared their expression levels between one Western breed (Yorkshire) and seven indigenous Chinese breeds. We detected the expression of 172 known porcine microRNAs (miRNAs) and 181 novel miRNAs. Differential expression analysis found 92 and 12 differentially expressed miRNAs in adipose and muscle tissue respectively. We found that different Chinese breeds shared common directional miRNA expression changes compared to Yorkshire pigs. Some miRNAs differentially expressed across multiple Chinese breeds, including ssc-miR-129-5p, ssc-miR-30 and ssc-miR-150, are involved in adipose tissue function. Functional enrichment analysis revealed that the target genes of the differentially expressed miRNAs are associated mainly with signaling pathways rather than metabolic and biosynthetic processes. The miRNA-target gene and miRNA-phenotypic traits networks identified many hub miRNAs that regulate a large number of target genes or phenotypic traits. Specifically, we found that intramuscular fat content is regulated by the greatest number of miRNAs in muscle tissue. This study provides valuable new candidate miRNAs that will aid in the improvement of meat quality and production.

Published
2019

49. Primary reverse shoulder arthroplasty using contemporary implants is associated with very low reoperation rates

Author

Bassem T. Elhassan, Matthew J. Dubiel, John W. Sperling, Joaquin Sanchez-Sotelo, Robert H. Cofield, Mark E. Morrey, Jason R. Kang, and Scott P. Steinmann

Subjects
Adult, Joint Instability, Male, Reoperation, medicine.medical_specialty, Prosthesis-Related Infections, medicine.medical_treatment, Reverse shoulder, Prosthesis Design, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Orthopedics and Sports Medicine, Single institution, Aged, Retrospective Studies, Aged, 80 and over, 030222 orthopedics, Shoulder Joint, business.industry, Shoulder Prosthesis, Sequela, 030229 sport sciences, General Medicine, Middle Aged, medicine.disease, Arthroplasty, Prosthesis Failure, Surgery, Humeral fracture, Early results, Arthroplasty, Replacement, Shoulder, Shoulder Fractures, Referral center, Female, Implant, business
Abstract

Background The early results of reverse shoulder arthroplasty (RSA) were influenced to some extent by the use of first-generation implants and surgeons’ learning curves, resulting in relatively high reoperation rates. The purpose of this study was to quantify the burden of and identify the indications for reoperation after primary RSA using contemporary implants and techniques. Methods A retrospective review of 1649 primary RSAs implanted consecutively between 2009 and 2015 at a single institution was conducted. All arthroplasties were performed by 5 fellowship-trained shoulder surgeons at a tertiary referral center. Demographic characteristics, indications for primary RSA, and reoperations were analyzed and categorized for trends associated with each type of reoperation performed. Results A total of 39 reoperations (2.37%) were performed for a variety of indications. Overall, only a few patients with infection or instability required reoperation (0.55%). The most common indications for reoperation were related to the humeral component (1.03%); the majority of humeral component complications were related to a specific design flaw of 1 implant system. RSAs performed for proximal humeral fracture sequelae more commonly underwent reoperation owing to instability or humeral component–related issues; all 4 cases of aseptic humeral stem loosening occurred in the setting of proximal humeral fracture sequela treatment. Only 0.36% of all primary RSAs required reoperation because of glenoid complications. Conclusions Primary RSA performed with contemporary implants and surgical techniques seems to be associated with a very low rate of reoperation. The most common reasons for reoperation were humeral component fracture for 1 particular implant, humeral loosening, dislocation, infection, and glenoid failure, each occurring at a rate under 1%.

Published
2019

50. Meta-analysis of completion lymph node dissection in sentinel lymph node-positive melanoma

Author

C V Angeles, R Kang, K Shirai, and Sandra L. Wong

Subjects
medicine.medical_specialty, Skin Neoplasms, medicine.medical_treatment, Sentinel lymph node, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Watchful Waiting, Melanoma, Lymph node, business.industry, Hazard ratio, medicine.disease, Treatment Outcome, medicine.anatomical_structure, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Meta-analysis, Relative risk, Lymph Node Excision, Surgery, Neoplasm Recurrence, Local, Sentinel Lymph Node, business, Watchful waiting, Cohort study
Abstract

BackgroundThe role of completion lymph node dissection (CLND) in patients with sentinel lymph node (SLN)-positive melanoma continues to be debated. This systematic review and meta-analysis evaluated survival and recurrence rate in these patients who underwent CLND, compared with observation.MethodsA comprehensive MEDLINE and Embase database search was performed for cohort studies and RCTs published between January 2000 and June 2017 that assessed the outcomes of CLND compared with observation in patients with SLN-positive melanoma. The primary outcome was survival and the secondary outcome was recurrence rate. Studies were assessed for quality using the Cochrane risk-of-bias tool for RCTs and Newcastle–Ottawa Scale for cohort studies. Pooled relative risk or hazard ratio with 95 per cent confidence intervals were calculated for each outcome. The extent of heterogeneity between studies was assessed with the I2 test. The protocol was registered in PROSPERO (CRD42017070152).ResultsFifteen studies (13 cohort studies with 7868 patients and 2 RCTs with 2228 patients) were identified for qualitative synthesis. Thirteen studies remained for quantitative meta-analysis. Survival was similar in patients who underwent CLND and those who were observed (risk ratio (RR) for death 0·85, 95 per cent c.i. 0·71 to 1·02). The recurrence rate was also similar (RR 0·91, 0·79 to 1·05).ConclusionPatients with SLN-positive melanoma do not have a significant benefit in survival or recurrence rate if they undergo CLND rather than observation.

Published
2019

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