The Experts below are selected from a list of 37761 Experts worldwide ranked by ideXlab platform
Barbara L. Lundrigan - One of the best experts on this subject based on the ideXlab platform.
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the spotted hyena crocuta crocuta as a model system for study of the evolution of intelligence
Journal of Mammalogy, 2007Co-Authors: Kay E Holekamp, Sharleen T. Sakai, Barbara L. LundriganAbstract:Large brains and great intelligence are metabolically costly, but the social complexity hypothesis suggests that these traits were favored nonetheless in primates by selection pressures associated with life in complex societies. If so, then cognitive abilities and nervous systems with primatelike attributes should have evolved convergently in nonprimate mammals living in large, elaborate societies in which social dexterity enhances individual fitness. Societies of spotted hyenas (Crocuta crocuta) are remarkably similar to those of cercopithecine primates with respect to size, structure, and patterns of competition and cooperation. These similarities set an Ideal Stage for comparative analysis of social intelligence and nervous system organization. As in cercopithecine primates, spotted hyenas use multiple sensory modalities to recognize their kin and other conspecifics as individuals, they know that some group-mates are more valuable social partners than others, they recognize 3rd-party kin and rank relationships among their clan-mates, and they use this knowledge adaptively during social decision-making. Examination of the available data strongly suggests convergent evolution of intelligence between spotted hyenas and primates. Evidence that less gregarious members of the family Hyaenidae lack some of the cognitive abilities found in spotted hyenas would provide further support for the idea that social complexity favors enhancement of intelligence in mammals.
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social intelligence in the spotted hyena crocuta crocuta
Philosophical Transactions of the Royal Society B, 2007Co-Authors: Kay E Holekamp, Sharleen T. Sakai, Barbara L. LundriganAbstract:If the large brains and great intelligence characteristic of primates were favoured by selection pressures associated with life in complex societies, then cognitive abilities and nervous systems with primate-like attributes should have evolved convergently in non-primate mammals living in large, elaborate societies in which social dexterity enhances individual fitness. The societies of spotted hyenas are remarkably like those of cercopithecine primates with respect to size, structure and patterns of competition and cooperation. These similarities set an Ideal Stage for comparative analysis of social intelligence and nervous system organization. As in cercopithecine primates, spotted hyenas use multiple sensory modalities to recognize their kin and other conspecifics as individuals, they recognize third-party kin and rank relationships among their clan mates, and they use this knowledge adaptively during social decision making. However, hyenas appear to rely more intensively than primates on social facilitation and simple rules of thumb in social decision making. No evidence to date suggests that hyenas are capable of true imitation. Finally, it appears that the gross anatomy of the brain in spotted hyenas might resemble that in primates with respect to expansion of frontal cortex, presumed to be involved in the mediation of social behaviour.
Løgstrup Poulsen - One of the best experts on this subject based on the ideXlab platform.
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Review: Early renal involvement in Type 1 diabetes mellitus — Part 2: ACE inhibitor intervention in Type 1 diabetes with low grade microalbuminuria
Journal of the renin-angiotensin-aldosterone system : JRAAS, 2003Co-Authors: Løgstrup PoulsenAbstract:Several clinical trials have consistently shown that antihypertensive treatment, particularly with angiotensin-converting enzyme inhibitors (ACE-I) reduces albuminuria in Type 1 diabetic patients. More recently, data on the beneficial effects of ACE-I on the preservation of glomerular filtration rate and renal ultrastructure have emerged. However, in general, these trials have recruited a wide spectrum of diabetics, including some patients with severe albuminuria. Thus, the question of the Ideal Stage at which to instigate what is likely to be lifelong therapy in young people still remains unanswered.Exercise is known to significantly increase both blood pressure (BP) and urinary albumin excretion (UAE), both of which are important determinants of progression of nephropathy in diabetes. Thus, it is possible that exercise may have an adverse effect on diabetic renal disease. The effects of ACE-I on exercise-BP and exercise-UAE in microalbuminuric Type 1 diabetic patients has not been examined in long-term ...
Kay E Holekamp - One of the best experts on this subject based on the ideXlab platform.
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the spotted hyena crocuta crocuta as a model system for study of the evolution of intelligence
Journal of Mammalogy, 2007Co-Authors: Kay E Holekamp, Sharleen T. Sakai, Barbara L. LundriganAbstract:Large brains and great intelligence are metabolically costly, but the social complexity hypothesis suggests that these traits were favored nonetheless in primates by selection pressures associated with life in complex societies. If so, then cognitive abilities and nervous systems with primatelike attributes should have evolved convergently in nonprimate mammals living in large, elaborate societies in which social dexterity enhances individual fitness. Societies of spotted hyenas (Crocuta crocuta) are remarkably similar to those of cercopithecine primates with respect to size, structure, and patterns of competition and cooperation. These similarities set an Ideal Stage for comparative analysis of social intelligence and nervous system organization. As in cercopithecine primates, spotted hyenas use multiple sensory modalities to recognize their kin and other conspecifics as individuals, they know that some group-mates are more valuable social partners than others, they recognize 3rd-party kin and rank relationships among their clan-mates, and they use this knowledge adaptively during social decision-making. Examination of the available data strongly suggests convergent evolution of intelligence between spotted hyenas and primates. Evidence that less gregarious members of the family Hyaenidae lack some of the cognitive abilities found in spotted hyenas would provide further support for the idea that social complexity favors enhancement of intelligence in mammals.
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social intelligence in the spotted hyena crocuta crocuta
Philosophical Transactions of the Royal Society B, 2007Co-Authors: Kay E Holekamp, Sharleen T. Sakai, Barbara L. LundriganAbstract:If the large brains and great intelligence characteristic of primates were favoured by selection pressures associated with life in complex societies, then cognitive abilities and nervous systems with primate-like attributes should have evolved convergently in non-primate mammals living in large, elaborate societies in which social dexterity enhances individual fitness. The societies of spotted hyenas are remarkably like those of cercopithecine primates with respect to size, structure and patterns of competition and cooperation. These similarities set an Ideal Stage for comparative analysis of social intelligence and nervous system organization. As in cercopithecine primates, spotted hyenas use multiple sensory modalities to recognize their kin and other conspecifics as individuals, they recognize third-party kin and rank relationships among their clan mates, and they use this knowledge adaptively during social decision making. However, hyenas appear to rely more intensively than primates on social facilitation and simple rules of thumb in social decision making. No evidence to date suggests that hyenas are capable of true imitation. Finally, it appears that the gross anatomy of the brain in spotted hyenas might resemble that in primates with respect to expansion of frontal cortex, presumed to be involved in the mediation of social behaviour.
Akshay Sood - One of the best experts on this subject based on the ideXlab platform.
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robotic kidney transplantation with regional hypothermia versus open kidney transplantation for patients with end Stage renal disease an Ideal Stage 2b study
The Journal of Urology, 2021Co-Authors: Rajesh Ahlawat, Akshay Sood, Wooju Jeong, Firas Abdollah, Prasun Ghosh, Jacob Keeley, Vijay Kher, Phil Olson, Guillaume Farah, Hallie WurstAbstract:Purpose:We report on comparative effectiveness of minimally invasive versus traditional open kidney transplantation.Materials and Methods:We undertook a prospective cohort study of 654 patients who...
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Robotic Kidney Transplantation with Regional Hypothermia Versus Open Kidney Transplantation for Patients with End Stage Renal Disease: An Ideal Stage 2B Study.
The Journal of urology, 2020Co-Authors: Rajesh Ahlawat, Akshay Sood, Wooju Jeong, Firas Abdollah, Prasun Ghosh, Jacob Keeley, Vijay Kher, Phil Olson, Guillaume Farah, Hallie WurstAbstract:Purpose:To report on comparative effectiveness of minimally invasive versus traditional open kidney transplantation.Materials and Methods:We undertook a prospective cohort study of 654 patients who...
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The Precision Prostatectomy: an Ideal Stage 0, 1 and 2a Study
BMJ Surgery Interventions & Health Technologies, 2019Co-Authors: Akshay Sood, Wooju Jeong, Kanika Taneja, Firas Abdollah, Isaac Palma-zamora, Sohrab Arora, Nilesh S. Gupta, Mani MenonAbstract:Objective This study aimed to develop a preclinical model of prostate cancer (CaP) for studying focal/hemiablation of the prostate (Ideal Stage 0), and to use the information from the Stage 0 investigation to design a novel focal surgical treatment approach—the precision prostatectomy (Ideal Stage 1/2a). Methods The Ideal Stage 0 study included simulation of focal/hemiablation in whole-mount prostate specimens obtained from 100 men who had undergone radical prostatectomies, but met the criteria for focal/hemiablation. The Ideal Stage 1/2a was a prospective, single-arm, Institutional Review Board-approved study of precision prostatectomy undertaken in eight men, who met the predetermined criteria. Criteria for both Stages included (1) prostate-specific antigen (PSA) ≤15 ng/mL, (2) Stage ≤cT2, (3) dominant unilateral lesion with Gleason ≤4+3 with any number of cores or % cores involved ipsilaterally on transrectal biopsy, (4) no primary Gleason ≥4 contralaterally on transrectal biopsy, and (5) preoperative erectile function score (International Index of Erectile Function (IIEF)-5) of ≥17 (out of 25) without PDE-5i (applicable only to the Stage 1/2a study participants). Feasibility and safety of the precision prostatectomy technique, and short-term urinary, sexual and oncological outcomes were studied. Results Analysis of whole-mount specimens in the 100 men showed an index lesion (>1 cm in diameter) in all. Ninety-eight men had satellite lesions smaller than 0.5 cm∧3 in volume—46 on the side of the dominant lesions and 52 in the contralateral lobe. If the men in this modeling cohort had undergone focal ablation with a 5–10 mm untreated margin, all except one would have had at least Gleason 6 residual cancer. If they had undergone hemiablation with no untreated tissue on the ablated side, 56 men would have had residual cancer on the contralateral side, of whom 21 would have had clinically significant cancer (Gleason 7 or higher). If these men had undergone precision prostatectomy, with preservation of 5–10 mm of tissue on the non-dominant side, 10% and 4% would have had Gleason 3+4 and Gleason 4+3 disease left behind, respectively. For the Stage 1/2a study, the median (IQR) age, PSA and IIEF-5 scores at the time of surgery were 54 (52–57) years, 4.4 (3.8–6.1) ng/mL and 24 (23-25), respectively. All eight patients were continent and sexually active at 12 months with a median IIEF-5 score of 21 (out of 25). At 24–30 months from surgery, the median PSA was 0.2 (range 0.1–0.7) ng/mL. Six men had undergone follow-up protocol biopsies, two, with undetectable PSA, had refused. Two men had residual Gleason 3+3 cancer, with PSA of 0.7 and 0.4 ng/mL, and remain on active surveillance. No man has undergone secondary whole-gland therapy. Conclusions Examination of whole-mount radical prostatectomy specimens in men who fit the conventional criteria of focal/hemiablation showed that approximately 21%–68% of men would have clinically significant CaP in the untreated tissue. In a small development cohort, precision prostatectomy was technically feasible, with excellent postoperative functional recovery. At 30 months of follow-up, no patient had clinically significant residual cancer or required secondary treatment. Pending long-term follow-up, a risk-stratified surgical approach may avoid whole-gland therapy and preserve erectile function in the majority of men with intermediate-risk CaP.
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robotic anatrophic nephrolithotomy utilizing near infrared fluorescence image guidance idea development exploration assessment and long term monitoring Ideal Stage 0 animal model study
Urology, 2016Co-Authors: Akshay Sood, Mani Menon, Ashok K Hemal, Dean G Assimos, James O Peabody, Khurshid R GhaniAbstract:Objective To test the feasibility of robotic anatrophic nephrolithotomy (RANL) using near-infrared fluorescence (NIRF) image-guidance for treating staghorn stones, in an in vivo stone surgery model. Methods We developed a novel technique of RANL in a preclinical setting following guidelines on safe surgical innovation from the Idea, Development, Exploration, Assessment, Long-term monitoring (Ideal) collaborative. We performed 2 RANL procedures on 2 live Yorkshire porcine females (Ideal Stage 0 study). The robot was docked in the flank position and a mini-GelPOINT was placed periumbilically as an assistant port. A model staghorn “stone” was created in vivo by injecting low-viscosity DenMat precision material into the renal pelvis. NIRF image-guidance, following clamping of the posterior renal artery, was used to determine if an anatrophic plane could be identified. One procedure was assessed under cold ischemia, with ice-slush injected onto the renal surface via the mini-GelPOINT. Results Both porcine subjects underwent RANL successfully. Replica staghorn models could be created reliably (mean size 5.1 cm; solidification time 2-3 minutes). NIRF image-guidance afforded clear vascular demarcation for precise scoring of an anatrophic plane in both kidneys. The staghorn models were removed in toto through the anatrophic incision in both subjects. Mean blood loss was 160 cc. Mean console and ischemia times were 114 minutes and 34.5 minutes, respectively; ice-slush hypothermia led to a renal surface temperature of 15.4°C. Conclusion In this Ideal Stage 0 preclinical study, we demonstrated that NIRF image-guidance is able to accurately identify the renal avascular plane, thus permitting an anatrophic approach for robotic excision of staghorn stones.
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ontogeny of a surgical technique robotic kidney transplantation with regional hypothermia
International Journal of Surgery, 2016Co-Authors: Akshay Sood, Peter Mcculloch, Wooju Jeong, Mahendra Bhandari, Rajesh Ahlawat, Philipp Dahm, Mani MenonAbstract:Abstract Introduction Innovation is a hallmark of surgical practice. It is generally accepted that a new procedure will undergo technical changes during its evolution; however, quantitative accounts of the process are limited. Methods Multiple groups, including our own, have recently described a minimally-invasive approach to conventional kidney transplantation (KT) operation. Unique to our experience is a structured development of the technique within the confines of a safe surgical innovation framework – the Ideal framework (idea, development, exploration, assessment, long-term monitoring; Stages 0–4). We here provide a first-hand narrative of the progress of robotic KT operation from preclinical trial to clinical application. Results Overall, 54 patients underwent robotic KT with regional hypothermia successfully. Major technical changes including selection of optimal patient position (flank vs. lithotomy), robotic instrumentation, vascular occlusion method (bulldog vs. tourniquet) and suture material (prolene vs. GoreTex) occurred early during the procedure development (Ideal Stage 0, preclinical). Minor technical changes such as utilization of the aortic punch for arteriotomy (case 3), use of barbed suture during ureteroneocystostomy (case 6) and extraperitonealization of the graft kidney (case 6) that increased the efficiency and safety of the procedure continued throughout procedure development (Ideal Stages 1–2, clinical Stages). Conclusions We demonstrate that a surgical technique evolves continually; although, the majority of technical alterations occur early in the life-cycle of the procedure. Development of a new technique within the confines a structured surgical innovation framework allows for evidence based progression of the technique and may minimize the risk of harm to the patient.
Daniel Margolis - One of the best experts on this subject based on the ideXlab platform.
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Feasibility of in-office MRI-targeted partial gland cryoablation for prostate cancer: an Ideal Stage 2A study
BMJ Surgery Interventions & Health Technologies, 2020Co-Authors: Spyridon P Basourakos, Daniel Margolis, Fernando J. Bianco, Neal Patel, Aaron A. Laviana, Juan M. Mosquera, Timothy D. McclureAbstract:Objectives Cryoablation for prostate cancer is typically performed under general anaesthesia. We explore the safety, feasibility and costs of in-office MRI-targeted prostate partial gland cryoablation (PGC) under local anaesthesia. We hypothesise that an office-based procedure under local anaesthesia may yield greater patient convenience and lower health costs with similar outcomes to a general anaesthesia approach. Design/participants/setting/interventions Retrospective study of men diagnosed with clinically significant prostate cancer (grade group (GG) ≥2) who elected to undergo in-office PGC under local anaesthesia. Main outcome measures A total of 55 men with GG ≥2 prostate cancer underwent PGC under local anaesthesia, and 35 of 43 men (81.4%) who attained ≥6 months of follow-up post-treatment underwent MRI-targeted surveillance biopsy. We used MRI findings and targeted biopsy to characterise post-PGC oncological outcomes. Complications were categorised using Common Terminology Criteria for Adverse Events (CTCAE). Expanded Prostate Cancer Index-Clinical Practice was used to characterise urinary and sexual function scores at baseline, 4 and 9 months post-PGC. Time-driven activity-based costing was used to determine healthcare costs of in-office PGC. Results Five (9.1%) men experienced CTCAE score 3 adverse events. Urinary and sexual function did not change significantly from baseline to 4 months (p=0.20 and p=0.08, respectively) and 9 months (p=0.23 and p=0.67, respectively). Twenty-two men (62.9%) had no cancer or GG1 and 13 (37.1%) men had GG≥2 on post-PGC biopsy. Moreover, the median cost of in-office PGC was US$4,463.05 (range US$4,087.19–US7,238.16) with disposables comprising 69% of the cost. Conclusions In-office PGC is feasible under local anaesthesia with favourable functional outcome preservation and adverse events profile at significantly lower costs compared with a general anaesthesia approach.
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Ideal Stage 2a experience with in-office, transperineal MRI/ultrasound software fusion targeted prostate biopsy
BMJ Surgery Interventions & Health Technologies, 2019Co-Authors: Michael Tzeng, Eliza Cricco-lizza, Morgan Pantuck, Daniel MargolisAbstract:Objective Although the feasibility of transperineal biopsy under local anesthesia has been demonstrated, little is known regarding the application of MRI/ultrasound software fusion targeted biopsy for transperineal biopsy under local anesthesia. The objective of our study is to describe our initial experience with in-office transperineal MRI/ultrasound software fusion targeted biopsy (Idea, Development, Exploration, Assessment, Long-term Follow-up [Ideal] Stage 2a). Methods Between October 2017 and July 2019, 33 men underwent in-office transperineal MRI-targeted biopsy using the Artemis (Eigen, Grass Valley, CA, USA) fixed-robotic arm system. The indication for biopsy was elevated prostate specific antigen (PSA) (n=14), prior negative biopsy (n=10), active surveillance (n=6), and surveillance after partial gland cryoablation (n=3). We prospectively captured patient demographic and clinical characteristics, biopsy outcomes, and complications. Complications were classified according to Common Terminology Criteria for Adverse Events (CTCAE) V.5.0. Results The median patient age was 67 years (IQR 61–71) and the median serum PSA level was 7.0 ng/mL (IQR 5.1–11.4). The median duration of in-office MRI-targeted transperineal biopsy was 26 min (IQR 23–28). Overall, transperineal MRI-targeted biopsy detected prostate cancer in 18 (54.6%) men, with 8 (24.2%) being clinically significant (Gleason Score ≥3+4, Grade Group ≥2). Clinically significant prostate cancer was detected in four (28.6%) biopsy naive men, two (20.0%) men with a prior negative, one (16.7%) man on active surveillance and one (33.3%) man following partial gland ablation. Three (9.1%) men experienced complications: two hematuria and one urinary retention. Conclusion Our findings demonstrate the feasibility of the fixed-robotic arm fusion platform for in-office transperineal MRI-targeted biopsy and a low rate of adverse events. However, larger prostate size precludes MRI/ultrasound software fusion and pubic arch interference hindered the transperineal MRI-targeted approach in 9.1% of men. Pubic arch interference was overcome by a free-hand approach with software fusion guidance.
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Ideal Stage 2a experience with in office transperineal mri ultrasound software fusion targeted prostate biopsy
BMJ Surgery Interventions & Health Technologies, 2019Co-Authors: Michael Tzeng, Morgan Pantuck, Eliza Criccolizza, Daniel MargolisAbstract:Objective Although the feasibility of transperineal biopsy under local anesthesia has been demonstrated, little is known regarding the application of MRI/ultrasound software fusion targeted biopsy for transperineal biopsy under local anesthesia. The objective of our study is to describe our initial experience with in-office transperineal MRI/ultrasound software fusion targeted biopsy (Idea, Development, Exploration, Assessment, Long-term Follow-up [Ideal] Stage 2a). Methods Between October 2017 and July 2019, 33 men underwent in-office transperineal MRI-targeted biopsy using the Artemis (Eigen, Grass Valley, CA, USA) fixed-robotic arm system. The indication for biopsy was elevated prostate specific antigen (PSA) (n=14), prior negative biopsy (n=10), active surveillance (n=6), and surveillance after partial gland cryoablation (n=3). We prospectively captured patient demographic and clinical characteristics, biopsy outcomes, and complications. Complications were classified according to Common Terminology Criteria for Adverse Events (CTCAE) V.5.0. Results The median patient age was 67 years (IQR 61–71) and the median serum PSA level was 7.0 ng/mL (IQR 5.1–11.4). The median duration of in-office MRI-targeted transperineal biopsy was 26 min (IQR 23–28). Overall, transperineal MRI-targeted biopsy detected prostate cancer in 18 (54.6%) men, with 8 (24.2%) being clinically significant (Gleason Score ≥3+4, Grade Group ≥2). Clinically significant prostate cancer was detected in four (28.6%) biopsy naive men, two (20.0%) men with a prior negative, one (16.7%) man on active surveillance and one (33.3%) man following partial gland ablation. Three (9.1%) men experienced complications: two hematuria and one urinary retention. Conclusion Our findings demonstrate the feasibility of the fixed-robotic arm fusion platform for in-office transperineal MRI-targeted biopsy and a low rate of adverse events. However, larger prostate size precludes MRI/ultrasound software fusion and pubic arch interference hindered the transperineal MRI-targeted approach in 9.1% of men. Pubic arch interference was overcome by a free-hand approach with software fusion guidance.
