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Introduction: Due to the increasing number of cochlear implant (CI) recipients, growing indications, and the aging population, the reimplantation of CI recipients has become a focus of attention. The aim of this study is to examine the causes, timing, and postoperative speech understanding in a large cohort over the past 30 years. Methods: A retrospective data analysis was conducted on over 4000 CI recipients and 214 reimplanted children and adults from 1993 to 2020. This involved collecting and comparing data on causes, manufacturer information, and demographic data. In addition, a comparison of speech understanding in Freiburg monosyllables and numbers before and after reimplantation was carried out. Results: Children did not exhibit elevated rates of reimplantation. The overall reimplantation rate in the entire cohort was 5%. The CI overall survival rate after 10 years in the entire cohort was 95.2%. Device failure was the most common reason for reimplantation, with 48% occurring within the first 5 years after implantation. The second most common reason was medical complications, with the risk of reimplantation decreasing as more time passed since the initial implantation. There were no significant differences in Freiburg numbers and monosyllable comprehension before and after reimplantation, both in the overall cohort and in the subcohorts based on indications. Even a technical upgrade did not result in a significant improvement in speech understanding. Discussion: There was no significant difference in the frequency of reimplantation based on patient age, especially when comparing children and adults. Device failure is by far the most common indication for reimplantation, with no significant difference in implant survival between manufacturers. Patients most often choose the same manufacturer for reimplantation. The likelihood of reimplantation decreases with increasing time since the initial implantation. The indication for reimplantation should be carefully considered, as on average, no improved speech understanding is achieved, regardless of the cause, even with a technical upgrade. [ABSTRACT FROM AUTHOR]

This research focuses on the current legislative provisions of the Russian Federation governing the organization and execution of electronic auctions. It also examines law enforcement case studies that highlight challenges in proving technical malfunctions during such proceedings. The aim of this scientific research is to pinpoint the challenges in demonstrating technical malfunctions during electronic bidding for the disposal of state and municipal property rights, alongside identifying potential solutions to address these issues. This research employed various methods of scientific inquiry, including general theoretical approaches such as synthesis, analysis, generalization, deduction, etc., as well as general scientific methods such as system-structural analysis and specific scientific methods such as comparative legal and formal legal analysis. Consequently, employing these methodologies, the research delves into the intricacies of electronic trading, examines the responsibilities of electronic platform operators, and scrutinizes the challenges associated with proving a technical failure during electronic bidding. It was found that the key distinguishing feature of electronic trading is the presence of an additional participant – the operator of the electronic platform – and the presence of the electronic platform itself as a venue for electronic bidding. Responsibility for various technical failures on the electronic platform lies with the platform operator. Conclusions drawn from the scientific research indicate that the primary evidence of a technical failure during electronic trading comprises screenshots and video recordings, both of which must adhere to specific criteria. Specifically, these records must distinctly demonstrate the occurrence of a technical failure, directly attributed to the electronic platform hosting the electronic auctions, such as a software glitch or technical error visibly captured on the screen. They should also showcase the functionality of the plaintiff's own software and hardware, including a stable Internet connection. Typically, the applicant/plaintiff must provide evidence that an Internet connection with the electronic platform cannot be established while other Internet pages are functional simultaneously. Moreover, these records should possess adequate quality, enabling the determination of the date and time when the respective screenshots were captured or the corresponding videos were recorded.

Simultaneous pancreas‐kidney transplantation (SPKT) is the best treatment for selected individuals with type 1 diabetes mellitus and end‐stage renal disease. Despite advances in surgical techniques, donor and recipient selection, and immunosuppressive therapies, SPKT remains a complex procedure with associated surgical complications and adverse consequences. We conducted a retrospective study that included 263 SPKT procedures performed between May 2000, and December 2022. A total of 65 patients (25%) required at least one relaparotomy, resulting in an all‐cause relaparotomy rate of 2.04 events per 100 in‐hospital days. Lower donor body mass index was identified as an independent factor associated with reoperation (OR.815; 95% CI:.725–.917, p =.001). Technical failure (TF) occurred in 9.9% of cases, primarily attributed to pancreas graft thrombosis, intra‐abdominal infections, bleeding, and anastomotic leaks. Independent predictors of TF at 90 days included donor age above 36 years (HR 2.513; 95% CI 1.162–5.434), previous peritoneal dialysis (HR 2.503; 95% CI 1.149–5.451), and specific pancreas graft reinterventions. The findings highlight the importance of carefully considering donor and recipient factors in SPKT. The incidence of TF in our study population aligns with the recent series. Continuous efforts should focus on identifying and mitigating potential risk factors to enhance SPKT outcomes, thereby reducing post‐transplant complications. [ABSTRACT FROM AUTHOR]

Background Increased intraperitoneal pressure (IPP) is associated with abdominal wall complications and technical failure in peritoneal dialysis (PD). Since the standard measurement of IPP is limited due to its cumbersome procedures, we aimed to develop and validate equations for estimating IPP. Methods We performed a cross-sectional study with a total of 200 prevalent PD patients who were divided into development and validation datasets after random sampling matched by body mass index. The IPPs were measured using the Durand method, with whole-body and abdominal anthropometry indices collected. Equations with 2.0-L and 1.5-L fill volumes were generated by stepwise linear regression modelling. The bias, accuracy and precision of the estimated IPP (eIPP) with 2-L and 1.5-L fill volumes were compared with actual IPPs by the Durand method. The eIPP for the 2-L fill volume was also compared with other existing equations. Results Two new equations incorporating waist circumference and height from the decubitus plane to mid-axillary line were generated. The eIPPs exhibited small biases in relation to the Durand method , with median differences of −0.24 cmH2O and −0.10 cmH2O for 2 L and 1.5 L, respectively. The precisions evaluated by the standard deviation of the absolute value of the differences were 2.59 cmH2O and 2.50 cmH2O, respectively. The accuracies evaluated by the value of the percentage of estimates that differed by >20% for the eIPP were 26% for 2.0 L and 27% for 1.5 L. Better bias, precision and accuracy were observed for the eIPP equation compared with other existing equations for the 2.0-L fill volume. Conclusions We provided two new equations developed from abdominal anthropometry indices to accurately estimate the IPP in the PD population. [ABSTRACT FROM AUTHOR]

The treatment for chronic limb-threatening ischemia (CLTI) has changed dramatically in the last few decades with a shift toward an endovascular-first approach and aggressive revascularization to achieve limb salvage. As the size of the CLTI population and intervention rates increase, patients will continue to experience technical failure (TF). Here, we describe the natural history of patients after TF of endovascular intervention for CLTI. We conducted a retrospective cohort study of patients with CLTI who attempted endovascular intervention or bypass at our multidisciplinary limb salvage center from 2013 to 2019. Patient characteristics were collected according to the Society for Vascular Surgery's reporting standards. Primary outcomes included survival, limb salvage, wound healing, and revascularization patency. Product-limit Kaplan-Meier estimated survival functions for these outcomes, and between-group comparisons were made using Mantel-Cox log-rank nonparametric tests. We identified 242 limbs from 220 unique patients who underwent primary bypass (n = 30) or attempted endovascular intervention (n = 212) at our limb salvage center. Endovascular intervention was a TF in 31 (14.6%) limbs. After TF, 13 limbs underwent secondary bypass and 18 limbs were managed medically. Patients who experienced TF tended to be older (P <.001), male (P =.003), current tobacco users (P =.014), have longer lesions (P =.001), and have chronic total occlusions of target arteries (P <.001) as compared with those who experienced technical success. Furthermore, the TF group had worse limb salvage (P =.047) and slower wound healing (P =.028), but their survival was not different. Survival, limb salvage, and wound healing were not different in patients who received secondary bypass or medical management after TF. The secondary bypass group was older (P =.012) and had a lower prevalence of tibial disease (P =.049) than the primary bypass group and trended toward decreased survival, limb salvage, and wound healing (P =.059, P =.083, and P =.051, respectively). Increased age, male sex, current tobacco use, longer arterial lesions, and occluded target arteries are associated with TF of endovascular intervention. Limb salvage and wound healing are relatively poor after TF of endovascular intervention, but survival appears comparable with patients who experience technical success. Secondary bypass may not always rescue patients after TF, though our sample size limits statistical power. Interestingly, patients who received a secondary bypass after TF trended toward decreased survival, limb salvage, and wound healing compared with primary bypass. [ABSTRACT FROM AUTHOR]

Since the first pancreas transplant in 1966, over 67,000 pancreas transplants have been performed worldwide and the number is growing. While the number of transplants in the US has changed only slightly over the past decade, many countries outside the US have shown strong growth in transplant numbers. The worldwide growth in numbers is due to the increasing number of patients with type 2 diabetes mellitus receiving a pancreas transplant. Only during the COVID-19 pandemic in 2020 and 2021 did transplant numbers decline, but they started to recover in 2022. The decline was especially noted for solitary transplants. This development over time was due to excellent patient and graft survival after simultaneous pancreas and kidney transplant (SPK). Patient survival at three years was >90% in SPK as well as in solitary transplants. At 3 years post-transplant, SPK pancreas graft survival was over 86% and SPK kidney graft survival over 90%. In pancreas transplants alone (PTA) and in pancreas after kidney transplants, the 3-year graft function reached 75%. The main reasons for advancement in outcome were reductions in technical failures and immunological graft losses. These improvements were due to better patient and donor selection, standardization of surgical techniques, and superior immunosuppressive protocols. [ABSTRACT FROM AUTHOR]

BACKGROUND:The prevalence of severe obesity, often considered a contraindication to peritoneal dialysis (PD), has increased over time. However, mortality has decreased more rapidly in the PD population than the hemodialysis (HD) population in the United States. The association between obesity and clinical outcomes among patients with end-stage kidney disease remains unclear in the current era. STUDY DESIGN:Historical cohort study. SETTING & PARTICIPANTS:15,573 incident PD patients from a large US dialysis organization (2007-2011). PREDICTOR:Body mass index (BMI). OUTCOMES:Modality longevity, residual renal creatinine clearance, peritonitis, and survival. RESULTS:Higher BMI was significantly associated with shorter time to transfer to HD therapy (P for trend < 0.001), longer time to kidney transplantation (P for trend < 0.001), and, with borderline significance, more frequent peritonitis-related hospitalization (P for trend = 0.05). Compared with lean patients, obese patients had faster declines in residual kidney function (P for trend < 0.001) and consistently achieved lower total Kt/V over time (P for trend < 0.001) despite greater increases in dialysis Kt/V (P for trend < 0.001). There was a U-shaped association between BMI and mortality, with the greatest survival associated with the BMI range of 30 to < 35kg/m2 in the case-mix adjusted model. Compared with matched HD patients, PD patients had lower mortality in the BMI categories of < 25 and 25 to

Background: Although technological improvements in intravascular ultrasound (IVUS) may reduce technical failures in endovascular therapy (EVT), perioperative complications (POCs) associated with IVUS use may increase., Aims: This study investigated the impact of IVUS on periprocedural outcomes in symptomatic lower-extremity artery disease (LEAD) patients undergoing EVT., Methods: This study evaluated 28,088 symptomatic LEAD patients who underwent EVT between January 2021 and December 2021 using a prospective nationwide registry in Japan. Outcome measures included periprocedural outcomes, including technical failure and POCs. To compare outcomes with and without IVUS use, propensity score matching analysis was performed for overall and for each arterial region (aortoiliac [AI], femoropopliteal [FP], and infrapopliteal [IP] arteries) using a binary logistic regression model., Results: IVUS was used in 75%, 72%, and 37% of AI, FP, and IP lesions, respectively. After propensity matching extraction, the IVUS group had a tendency of lower technical failure rate than the non-IVUS group, although not statistically different (3.9% vs. 5.4%, p = 0.054), without an increase in the POC rate (1.8% vs. 1.6%, p = 0.54). Regarding the per-regional analysis, the technical failure rate of FP-EVT was significantly lower in the IVUS group (3.1% vs. 4.2%, p = 0.006), whereas those of AI-EVT (2.2% vs. 3.1%, p = 0.12) and IP-EVT (6.8% vs. 6.1%, p = 0.37) were not significantly different between the two groups. Furthermore, IVUS did not increase the POC rate for any region (AI-EVT: 1.3% vs. 1.3%, p = 1.00; FP-EVT: 1.8% vs. 1.7%, p = 0.75; and IP-EVT: 2.0% vs. 1.7%, p = 0.56)., Conclusion: The current study revealed that IVUS did not increase the POCs and technical failure for overall lesions but reduced the incidence of FP-EVT technical failure., (© 2024 Wiley Periodicals LLC.)

Water management infrastructures such as floodgates are critical and increasingly operated by Industrial Control Systems (ICS). These systems are becoming more connected to the internet, either directly or through the corporate networks. This makes them vulnerable to cyber-attacks. Abnormal behaviour in floodgates operated by ICS could be caused by both (intentional) attacks and (accidental) technical failures. When operators notice abnormal behaviour, they should be able to distinguish between those two causes to take appropriate measures, because for example replacing a sensor in case of intentional incorrect sensor measurements would be ineffective and would not block corresponding the attack vector. In the previous work, we developed the attack-failure distinguisher framework for constructing Bayesian Network (BN) models to enable operators to distinguish between those two causes, including the knowledge elicitation method to construct the directed acyclic graph and conditional probability tables of BN models. As a full case study of the attack-failure distinguisher framework, this paper presents a BN model constructed to distinguish between attacks and technical failures for the problem of incorrect sensor measurements in floodgates, addressing the problem of floodgate operators. We utilised experts who associate themselves with the safety and/or security community to construct the BN model and validate the qualitative part of constructed BN model. The constructed BN model is usable in water management infrastructures to distinguish between intentional attacks and accidental technical failures in case of incorrect sensor measurements. This could help to decide on appropriate response strategies and avoid further complications in case of incorrect sensor measurements. [ABSTRACT FROM AUTHOR]

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II gastrectomy patients is technically demanding and factors affecting its technical difficulty have not yet been clarified. This study aimed to investigate the outcomes of ERCP in Billroth II gastrectomy patients and identify potential factors affecting its technical failure. Patients and Methods: A large retrospective study of 308 consecutive patients (391 procedures) with Billroth II gastrectomy—who underwent ERCP from January 2002 to December 2016—was conducted. The outcomes of ERCP and potential factors affecting its technical failure were analyzed. Results: The success rate of duodenal ampullary access, selective duct cannulation and the accomplishment of expected procedures was 81.3% (318/391), 86.5% (275/318) and 97.3% (256/263), respectively, and the technical success rate was 70.3% (275/391). The overall ERCP-related complication rate was 15.3% (60/391). The multivariate analysis indicated that first-time ERCP attempt [odds ratio (OR) 4.29, 95% confidence interval (CI) 2.34–7.85, P < 0.001], Braun anastomosis (OR 3.65, 95% CI 1.38–9.64, P < 0.009), and no cap-assisted gastroscope (OR 3.05, 95% CI 1.69–5.51, P < 0.001) were significantly associated with technical failure. Conclusions: ERCP is safe, effective and feasible for Billroth II gastrectomy patients. Previous ERCP history, absence of Braun anastomosis and the use of a cap-assisted gastroscope are the predictive factors for its technical success.

Objective: The aim of the study was to evaluate the effect of cardiac arrest time (CAT) in donors after brain death (DBD) donors on pancreas transplant outcome. Summary of Background Data: Results from donors after circulatory death report good outcomes despite warm ischemia times up to 57 minutes. Previous cardiac arrest in DBD has been addressed as a potential risk factor, but duration of the CAT has never been evaluated. Methods: We conducted a retrospective analysis including 342 pancreas transplants performed at our center from 2000 to 2016, and evaluated the effect of previous cardiac arrest in DBD (caDBD) on pancreas transplant outcomes. Results: A total of 49 (14.3%) caDBD were accepted for transplantation [median CAT of 5.0 min (IQR 2.5–15.0)]. Anoxic encephalopathy was most frequent and P-PASS higher (16.9 vs 15.6) in caDBD group when compared with other DBD. No differences were found in all other characteristics evaluated. Graft survival was similar between both groups, as was the incidence of early graft failure (EGF). CAT increased the risk for EGF [OR 1.09 (95% CI, 1.01– 1.17)], and the duration of CPR discriminated for EGF [AUC of 0.86 (95% CI, 0.74–0.98)], with a sensitivity and specificity of 100% and 75% at a cutoff of 15 minutes. When evaluated separately, caDBD >15 min increased over 5 times the risk for EGF [HR 5.80 (95% CI, 1.82–18.56); P = 0.003], and these presented fewer days on the ICU (1.0 vs 3.0 d). Conclusion: CaDBD donors are suitable for routine pancreas transplantation without increasing EGF risk, and in those with longer CAT it may be prudent to postpone donation a few days to allow a thorough evaluation of organ damage following cardiac arrest. [ABSTRACT FROM AUTHOR]

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has been performed as an alternative to percutaneous drainage in surgically high-risk patients. Technical failures of EUS-GBD made by beginners are often attributed to failure of over-the-wire insertion of a fistula-dilating device or stent delivery system into the gallbladder, or stent misplacement in the final technical step. We herein report technical tips to prevent the failure of fistula dilation and provide tricks to avoid inward or outward stent misplacement. [ABSTRACT FROM AUTHOR]

Background/Aims: Gender-specific differences between patients on renal replacement therapy have so far rarely been investigated. In the present study we aimed to describe gender-specific differences in a large cohort of peritoneal dialysis (PD) patients. Methods: Clinical information for all patients who started PD at our center has been collected since the start of the PD-program in 1979. We used Cox regression to examine associations between technique failure and gender. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs). Results: A total of 745 patients (315 women and 430 men with a median age of 57 years; IQR 43–67) started PD between 1979 and 2015 in our center. Women were significantly younger at PD start 54 (40-65) years vs. 58 (47-68) years, p

The essence of the concepts of «force majeure» and «emergency» has been clarified, revealed their contents; individual circumstances as grounds for acquittance from the carrier’s civil liability with the practice of the European Court of Justice are considered. In civil law single questions of the grounds carrier acquittance from civil liability for breach of contract are analyzed by national and foreign scientists as A. Vyhodyanskyy, A. Dombruhova, B. P. Eliseev, E. V. Passyek, G. V. Tsirat, P. S. Dempsey, H. Manuel and others. Some aspects are still controversial, particularly value the concepts of «force majeure» and «emergency» as grounds for acquittance from civil liability carrier, always the fault of the aircraft is the factor to release the air carrier from civil liability and so on. The purpose of this article is consideration the issue of air carrier grounds for acquittance of civil liability in case of breach of contract of carriage of passengers and baggage, namely the delay or cancellation highlighting with illumination of the practice of the European Court of Justice and national courts. Legislative grounds for acquittance from civil liability of the air carrier are determined by different concepts – the «emergency», «force majeure», and therefore there is a need to clarify their essence. Legal understanding of the concept of «emergency» is identical to the concept of «force majeure» because their essence is revealed with the help of the same characteristics, namely urgency and inevitability. Summarizing the views of scientists and legislative approach to determine the origins of force majeure and their list can be noted that these include such circumstances that caused the social, natural, technological, environmental and other phenomena. Emergency may also be caused by natural, social, technical, political and other phenomena too. Thus, the circumstances and the nature of their origin, content of analyzed concepts are identical. Technical problem can be considered urgency only when it, at first, is not typical of the normal exercise of an air carrier and, secondly, is beyond the actual control of the carrier due to its nature or origin. Technical problems which appear in connection with the maintenance of aircraft or through failure to carry out proper maintenance can not be by themselves qualify as «emergency». Firstly, the concept of «emergency» covered by the concept of «force majeure» because the urgency is one of the signs of the latter. Secondly, when the legislator uses the concept of «emergency», or does not use it, the conditions of release the air carrier from civil liability of are urgency and inevitability of the circumstances. This actually shows the identification of the concept of «emergency» and the concept of «force majeure». Thirdly, the contents of the analyzed concepts form the fact that usually has the same origin. Prevalence of technical challenges faced by carriers themselves is not the factor that indicates the presence or absence of «emergency».

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II gastrectomy patients is technically demanding and factors affecting its technical difficulty have not yet been clarified. This study aimed to investigate the outcomes of ERCP in Billroth II gastrectomy patients and identify potential factors affecting its technical failure. Patients and Methods: A large retrospective study of 308 consecutive patients (391 procedures) with Billroth II gastrectomy—who underwent ERCP from January 2002 to December 2016—was conducted. The outcomes of ERCP and potential factors affecting its technical failure were analyzed. Results: The success rate of duodenal ampullary access, selective duct cannulation and the accomplishment of expected procedures was 81.3% (318/391), 86.5% (275/318) and 97.3% (256/263), respectively, and the technical success rate was 70.3% (275/391). The overall ERCP-related complication rate was 15.3% (60/391). The multivariate analysis indicated that first-time ERCP attempt [odds ratio (OR) 4.29, 95% confidence interval (CI) 2.34–7.85, P < 0.001], Braun anastomosis (OR 3.65, 95% CI 1.38–9.64, P < 0.009), and no cap-assisted gastroscope (OR 3.05, 95% CI 1.69–5.51, P < 0.001) were significantly associated with technical failure. Conclusions: ERCP is safe, effective and feasible for Billroth II gastrectomy patients. Previous ERCP history, absence of Braun anastomosis and the use of a cap-assisted gastroscope are the predictive factors for its technical success. [ABSTRACT FROM AUTHOR]

In biotechnological processes, technical failures in the upstream process often lead to batch loss. It is of great interest to investigate the empirical impact of technical failures to understand and mitigate their impact accurately and reduce economic damage. We investigated the impact in the upstream and downstream of a recombinant antibody fragment inclusion body production process chain to provide integrated empirical data and knowledge. First, we provided a reproducible process chain that yielded high inclusion body content, high specific product titer, and a refolding yield of 30%. The inclusion body downstream proved to be of high reproducibility. Through the intended introduction of technical failures, we were not only able to shed more light on the empirical responses in the upstream and downstream, but also on process-boosting parameters that would have been neglected. Herein, a short increase in temperature during the cultivation clearly increased the refolding yield. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of available literature describing the frequency of technical success of liver two-dimensional (2-D) ultrasound (US) shear wave elastography (SWE) in children and young adults.Objective: To determine the frequency of technical success of liver 2-D ultrasound (US) SWE in children and young adults based on the interquartile range (IQR)/median of 10 shear wave speed (SWS) measurements.Materials and Methods: Clinical 2-D US SWE exams performed between February 2016 and March 2018 were retrospectively identified. Patient age and gender, median/mean liver stiffness (10 SWS measurements), IQR/median, abdominal wall thickness, body mass index (BMI) and serum alanine aminotransferase (ALT) were documented. The number of technically inadequate exams was calculated using three methods: 1) IQR/median >0.3, 2) IQR/median >95th percentile for our study population and 3) statistical outlier identification using the Tukey method. The effect of age, gender, median SWS, abdominal wall thickness, BMI, US transducer and ALT on measurement variability (IQR/median) was assessed using multivariable linear regression.Results: During the study period, 573 exams were performed. Mean age was 12.6±7.1 years; 274 (47.8%) exams were in male patients. Average median liver stiffness was 1.75±0.47 m/s. Based on Methods 1, 2 and 3, 29/573 (5.1%), 28/573 (4.9%, IQR/median cutoff value=0.303) and 30/573 (5.2%) exams were technically inadequate. Predictors of IQR/median included age (P=0.03), abdominal wall thickness (P=0.003), median SWS (P<0.0001) and transducer (P<0.0001).Conclusion: Approximately 95% of liver 2-D US SWE exams are technically successful based on IQR/median in children and young adults. [ABSTRACT FROM AUTHOR]

Abstract: Background: Our objective was to investigate trends over time in longevity and reasons for replacement with or without extraction of pacemaker leads after first implantation. Methods: Data collected between 1984 and 2006 in the national Dutch pacemaker registry were used. This registry covered 84% of sold leads. First lead replacement with or without extraction of one or more leads implanted with a first pacemaker generator was the endpoint of interest. The time interval of and reason for first replacement were analyzed. A 7‐year follow‐up interval after first implantation was used to analyze changes over time. Results: During 22 years of data collection, 138,225 leads were implanted with a first pacemaker generator. Within a mean 5.5 (SD 4.4) years for 7,377 patients one or more leads were extracted for the first time. In total, 8,849 leads (6.4%) were replaced or extracted. The main reasons for first replacement of leads with or without extraction were insulation failures (14.6%), infection (8.8%), displacement (7.6%), or for elective reasons (10.0%). The number of insulation failures peaked during 1991–1995. Conclusions: Despite improvements in pacing techniques and experience with cardiac devices, we found that insulation and conductor failures, and complications such as infections, did not diminish over the 20 years of the registry. Continuing attention in clinical practice for the evaluation of these adverse outcomes and maintaining quality registries is warranted, whereas manufacturers should use this information to further improve their devices. [ABSTRACT FROM AUTHOR]

Background: Fluid overload is a major risk factor for mortality in patients undergoing peritoneal dialysis (PD). However, few studies have investigated the effect of chronic exposure to sustained fluid overload on long-term outcomes.Method: A total of 284 prevalent PD patients were included in this prospective study. Repeated multifrequency body composition analysis was performed 12 months apart, and 1-year cumulative chronic fluid overload were used to predict all-cause mortality and the risk for transfer to hemodialysis (HD) during the ensuing 15.6 ± 9.1 months.Results: The prevalence of fluid overload was approximately 27%. Interestingly, a substantial number of hypervolemic patients at first test were persistently hypervolemic at their second test. With this, chronic fluid overload was observed in 18.3% (n = 52). Notably, most of chronic fluid overload patients had diabetes (86.5%), and it was accompanied by concomitant changes in peritoneal membrane characteristics, a higher progression rate to high transporter. The risk of transfer to HD increased 2.8 times in patients with chronic fluid overload than in those without. Also, it significantly increased the risk of mortality (p = 0.038). Surprisingly, subgroup analysis found that patients with euvolemic status at follow-up experienced no mortality despite being in a fluid overload state at baseline.Conclusions: One-year chronic exposure to fluid overload is a strong independent risk factor for transfer to HD and death in prevalent PD patients. Although the fluid status of most PD patients is not easily changed over time, becoming euvolemic during the entire PD treatment period seems to be very important. [ABSTRACT FROM AUTHOR]

Background/Aims: Gender-specific differences between patients on renal replacement therapy have so far rarely been investigated. In the present study we aimed to describe gender-specific differences in a large cohort of peritoneal dialysis (PD) patients. Methods: Clinical information for all patients who started PD at our center has been collected since the start of the PD-program in 1979. We used Cox regression to examine associations between technique failure and gender. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs). Results: A total of 745 patients (315 women and 430 men with a median age of 57 years; IQR 43-67) started PD between 1979 and 2015 in our center. Women were significantly younger at PD start 54 (40-65) years vs. 58 (47-68) years, p<0.001. Within the last almost 15 years, more man than women started PD, but technical survival rates were significantly better in female compared to men (HR=0.662, CI 95% (0.496-0.885) P=0.005). Cardiovascular events were the main cause of death over the study period in both sexes, but decreased over time. Additionally, death due to PD-associated peritonitis decreased significantly over the three decades in both sexes. Conclusions: Our data suggest that technical survival rates were significantly better in female compared to men over three decades and death due to cardiovascular events and PD-associated peritonitis decreased significantly over the three decades in both sexes. [ABSTRACT FROM AUTHOR]

The analysis of functioning ofcomplex production systems in agroindustrial sphere — largecrop farms and livestock farms — shows that the basis for dynamic development of their productive activities is based on a reliable and stable operation of the complex biotech (human-machine) systems. Urgent problems, whose solution promotes a dynamic and efficient operation of complex biotechnological systems, are to create mathematical models of the total biotech system, allowing sufficiently informatively guide the work of major agricultural organizations. This paper discusses an alternative methodological approach to assessing and forecasting financial sustainability of an enterprise. An important place among the factors that shape the financial stability of the economic entity, takes the human factor (decision maker). Financial sustainability of the enterprise is seen from the perspective of bio-approach that includes elements of the system MME (man, machine, and environment). This approach improves the results when evaluating the adequacy of the financial stability of companies in various states of the economy. Newly developed approaches and mathematical models to managesystems of biotechnology makeit possibleto significantly increase the productivity of animals, crop production and the level of socio-economic status of people in the country.

Human-robot interactions are often affected by error situations that are caused by either the robot or the human. Therefore, robots would profit from the ability to recognise when error situations occur. We investigated the verbal and non-verbal social signals that humans show when error situations occur in human-robot interaction experiments. For that, we analysed 201 videos of five human-robot interaction user studies with varying tasks from four independent projects. The analysis shows that there are two types of error situations: social norm violations and technical failures. Social norm violations are situations in which the robot does not adhere to the underlying social script of the interaction. Technical failures are caused by technical shortcomings of the robot. The results of the video analysis show that the study participants use many head movements and very few gestures, when in an error situation with the robot. We also found that the participants talked more in the case of social norm violations and less during technical failures. Finally, the participants use fewer non-verbal social signals (for example smiling, nodding, and head shaking), when they are interacting with the robot alone and no experimenter or other human is present. The results suggest that participants do not see the robot as a social interaction partner with comparable communication skills. Our findings have implications for builders and evaluators of human-robot interaction systems. The builders need to consider including modules for recognition and classification of head movements to the robot input channels. The evaluators need to make sure that the presence of an experimenter does not skew the results of their user studies.

The prevalence of cardiac implantable electronic devices ( CIEDs), pacemakers and implantable cardioverter defibrillators ( ICDs) is increasing. However, postmortem analysis of CIEDs is not performed routinely. Fourteen consecutive CIEDs were analyzed. The indication for and date of implantation, technical data, CIED reprogramming, heart rhythm disturbances, patient demographics and medical consultations were investigated. Death during the first year after implantation was seen in 54%, whereof 71% consulted a physician within 10 days before death. The time of death was attributed to a particular day in 29%. There was a relationship between CIEDs and cause/manner of death in 50%. Although limited by a small sample size, this study advocates the routine postmortem CIED analysis for forensic and clinical purposes in selected cases. Patients with CIEDs seem to show an increased risk of death during the first year after implantation. The analysis of CIEDs can be helpful in evaluating the time/cause/manner of death. [ABSTRACT FROM AUTHOR]

Purpose: To minimize cold ischemia time, transplantations with kidneys from deceased donors are frequently performed during the night. However, sleep deprivation of those who perform the transplantation may have adverse effects on cognitive and psychomotor performance and may cause reduced cognitive flexibility. We hypothesize that renal transplantations performed during the night are associated with an increased incidence of pure technical graft failure. Methods: A retrospective analysis of data of the Dutch Organ Transplant Registry concerning all transplants from deceased donors between 2000 and 2013 was performed. Nighttime surgery was defined as the start of the procedure between 8 p.m. and 8 a.m. The primary outcome measure was technical graft failure, defined as graft loss within 10 days after surgery without signs of (hyper)acute rejection. Results: Of 4.519 renal transplantations in adult recipients, 1.480 were performed during the night. The incidence of pure technical graft failure was 1.0 % for procedures started during the night versus 2.6 % for daytime surgery ( p = .001). In a multivariable model, correcting for relevant donor, recipient and graft factors, daytime surgery was an independent predictor of pure technical graft failure ( p < .001). Conclusions: Limitation of this study is mainly to its retrospective design, and the influence of some relevant variables, such as the experience level of the surgeon, could not be assessed. We conclude that nighttime surgery is associated with less pure technical graft failures. Further research is required to explore factors that may positively influence the performance of the surgical team during the night. [ABSTRACT FROM AUTHOR]

Objectives The aims of this study were to describe the 10-year experience of a single operator dedicated to chronic total occlusion (CTO) and to establish a model for predicting technical failure. Background During the last decade, the interest in percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) has increased, allowing the improvement of success rate. Methods One thousand nineteen patients with CTO underwent 1,073 CTO procedures performed by a single CTO-dedicated operator. The study population was subdivided into 2 groups by time period: period 1 (January 2005 to December 2009, n = 378) and period 2 (January 2010 to December 2014, n = 641). Observations were randomly assigned to a derivation set and a validation set (in a 2:1 ratio). A prediction score was established by assigning points for each independent predictor of technical failure in the derivation set according to the beta coefficient and summing all points accrued. Results Lesions attempted in period 2 were more complex in comparison with those in period 1. Compared with period 1, both technical and clinical success rates significantly improved (from 87.8% to 94.4% [p = 0.001] and from 77.6% to 89.9% [p < 0.001], respectively). A prediction score for technical failure including age ≥75 years (1 point), ostial location (1 point), and collateral filling Rentrop grade <2 (2 points) was established, stratifying procedures into 4 difficulty groups: easy (0), intermediate (1), difficult (2), and very difficult (3 or 4), with decreasing technical success rates. In derivation and validation sets, areas under the curve were comparable (0.728 and 0.772, respectively). Conclusions With growing expertise, the success rate has increased despite increasing complexity of attempted lesions. The established model predicted the probability of technical failure and thus might be applied to grading the difficulty of CTO procedures. [ABSTRACT FROM AUTHOR]

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Background: Population-based data on hospital procedure volume and outcome of endoscopic retrograde cholangiopancreatography (ERCP) are limited. Aims: To investigate procedural failure, early re-admission, and all-cause mortality following ERCP performed due to benign disease and to examine their relation to hospital procedure volume. Methods: All patients with a first ERCP in 2005-2008 in Sweden were identified from the Swedish Hospital Discharge Registry. Data on indication, admission method, length of stay (LOS), and comorbid illness were extracted. Patients were linked to the Swedish Death and Cancer Registries. Factors associated with failed index ERCP, early re-admission, and all-cause mortality were identified by multiple logistic analyses. Results: Overall, 12,695 first ERCPs for benign disease were analyzed. The 30-day re-admission rate was 13 % and all-cause 30-day mortality 2.2 %. Failed index ERCP was more common in low-volume than high-volume institutions ( p = 0.007). In logistic regression analysis, low hospital procedure volume was an independent predictor of failed index ERCP (odds ratio (OR) 2.72 vs. high), but not 30-day re-admission ( p > 0.05). LOS was longer in cases of procedural failure ( p < 0.001). All-cause 30-day mortality was independently related to low hospital ERCP volume (OR 1.41 vs. high) and failed ERCP (OR 5.65 vs. successful). Conclusion: In this population-based cohort of first ERCPs due to benign disease, lower hospital ERCP volume was related to failed ERCP, which, in turn, was associated with longer LOS. Failed ERCP and lower hospital procedure volume were associated with poor survival, but not with early re-admission following index ERCP. These findings may have implications for service development. [ABSTRACT FROM AUTHOR]