bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous Tranexamic Acid for Reducing Perioperative Blood Loss During Revision Surgery for Vancouver Type B Periprosthetic Femoral Fractures After Total Hip Arthroplasty: A Retrospective Study
Authors: Wang Qiu‐ru , Yeersheng Releken , Li Dong‐hai , Yang Zhou‐yuan , Kang Peng‐de 
Published: December 2019

ObjectiveTo explore the efficacy and safety of intravenous tranexamic acid for reducing perioperative blood loss and allogeneic blood transfusions in revision surgery for Vancouver type B periprosthetic femoral fractures after total hip arthroplasty (THA).MethodsWe retrospectively reviewed 129 patients who underwent revision surgeries because of Vancouver type B periprosthetic femoral fractures from January 2008 to September 2018. Patients were divided into two groups according to whether they received intravenous tranexamic acid (n = 72) or not (n = 57). The two groups were compared in terms of estimated intraoperative blood loss, visible blood loss, hidden blood loss, the volume of allogeneic blood transfusion and the incidence of symptomatic venous thromboembolism (VTE). Patients were also compared depending on the Vancouver classification (Vancouver type B1, B2, and B3).ResultsRegardless of the subtype of Vancouver classification, patients who received tranexamic acid showed significantly lower estimated intraoperative blood loss, visible blood loss, hidden blood loss, and allogeneic blood transfusion volume. Use of tranexamic acid was not associated with significant changes in the incidence of postoperative symptomatic VTE. Similar results were obtained with subgroups of patients who had the Vancouver type B1, B2, or B3 periprosthetic femoral fractures.ConclusionsThe administration of intravenous tranexamic acid can safely and effectively reduce perioperative blood loss and allogeneic blood transfusions in revision surgery for Vancouver type B periprosthetic femoral fractures, without increasing the risk of symptomatic VTE.
Limited Influence of Comorbidities on Length of Stay after Total Hip Arthroplasty: Experience of Enhanced Recovery after Surgery
Authors: Ding Zi‐chuan , Xu Bing , Liang Zhi‐min , Wang Hao‐yang , Luo Ze‐yu , Zhou Zong‐ke 
Published: December 2019

ObjectivesTo identify predictors of length of stay (LOS) after total hip arthroplasty (THA) in an enhanced recovery after surgery (ERAS) program and evaluate the safety and cost‐efficiency of the ERAS program with reduced LOS for unselected patients in a Chinese population.MethodsA total of 311 consecutive, unselected patients undergoing primary THA at a single institution were retrospectively reviewed and divided into two groups: LOS ≤ 3 and LOS > 3 group. All patients were managed with the same ERAS protocol and went back home after discharge. Multivariate logistic regression analysis was used to determine independent risk factors for LOS > 3. Harris Hip Score at 90‐day follow‐up, 90‐day readmission rate, and hospitalization costs were compared between two groups.ResultsMultivariate regression analysis identified female gender (odds ratio [OR] = 2.623), living alone (OR = 4.127), and primary osteoarthritis of hip (OR = 3.565) to be correlated with LOS > 3. Preoperative hemoglobin (HB), postoperative HB, drain use, blood transfusion, diabetes, respiratory disease, osteoporosis, number of comorbidities, and CCI score showed no significant influence on LOS after adjusting for other risk factors in the multivariate model. Harris Hip Score and readmission rate at 90‐day follow‐up showed no significant differences between two groups. Patients in LOS > 3 group had approximately 3948.6 Chinese yuan higher hospital costs.ConclusionFemale gender, living alone, and primary osteoarthritis of hip were identified as independent risk factors for prolonged LOS. The experience from our institution suggested aggressive management of comorbidities in the ERAS program can minimize the influence of comorbidities on LOS. The safety, efficiency, and costs‐saving benefits of the ERAS program with reduced LOS for unselected patients was confirmed in this study.
Neuromuscular‐blocking agents for tracheal intubation in pediatric patients (0‐12 years): A systematic review and meta‐analysis
Authors: Vanlinthout Luc E. , Geniets Bénédicte , Driessen Jacques J. , Saldien Vera , Lapré Raphaël , Berghmans Johan , Uwimpuhwe Germaine , Hens Niel 
Published: December 2019

AbstractBackgroundThe benefit of using neuromuscular‐blocking agents to facilitate tracheal intubation in pediatric patients remains unclear due to variations in design, treatments, and results among trials. By combining the available evidence, we aimed to establish whether scientific findings are consistent and can be generalized across various populations, settings, and treatments.MethodsA systematic search for randomized controlled trials, related to the use of neuromuscular‐blocking agents for tracheal intubation in American Society of Anesthesiologists class I‐II participants (0‐12 years), was performed. We considered all randomized controlled trials that studied whether intubation conditions and hemodynamics obtained by using neuromuscular‐blocking agents were equivalent to those that were achieved without neuromuscular‐blocking agents. We combined the outcomes in Review Manager 5.3 (RevMan, The Cochrane Collaboration) by pairwise random‐effects meta‐analysis using a risk ratio (RR) for intubation conditions and mean difference for hemodynamic values (mean [95% Confidence Intervals]). Heterogeneity among trials was explored using sensitivity analyses.ResultsWe identified 22 eligible randomized controlled trials with 1651 participants. Overall, the use of a neuromuscular‐blocking agent was associated with a clinically important increase in the likelihood of both excellent (RR = 1.41 [1.19‐1.68], I2 = 76%) and acceptable (RR = 1.13 [1.07‐1.19], I2 = 68%) intubating conditions. There is strong evidence that both unacceptable intubation conditions (RR = 0.35 [0.22‐0.46], I2 = 23%) and failed first intubation attempts (RR = 0.25 [0.14‐0.42], I2 = 0%) were less likely to occur when a neuromuscular‐blocking agent was used compared with when it was not. Higher systolic or mean arterial pressures (mean difference = 13.3 [9.1‐17.5] mm Hg, I2 = 69%) and heart rates (mean difference = 15.9 [11.0‐20.8] beats/min, I2 = 75%) as well as a lower incidence of arrhythmias were observed when tracheal intubation was facilitated by neuromuscular‐blocking agents.ConclusionThe use of a neuromuscular‐blocking agent during light‐to‐moderate depth of anesthesia can improve the quality as well as the success rate of tracheal intubation and is associated with better hemodynamic stability during induction of anesthesia.
Woody tissue photosynthesis reduces stem CO2 efflux by half and remains unaffected by drought stress in young Populus tremula trees
Authors: De Roo Linus , Salomón Roberto Luis , Steppe Kathy 
Published: December 2019

AbstractA substantial portion of locally respired CO2 in stems can be assimilated by chloroplast‐containing tissues. Woody tissue photosynthesis (Pwt) therefore plays a major role in the stem carbon balance. To study the impact of Pwt on stem carbon cycling along a gradient of water availability, stem CO2 efflux (EA), xylem CO2 concentration ([CO2]), and xylem water potential (Ψxylem) were measured in 4‐year‐old Populus tremula L. trees exposed to drought stress and different regimes of light exclusion of woody tissues. Under well‐watered conditions, local Pwt decreased EA up to 30%. Axial CO2 diffusion (Dax) induced by distant Pwt caused an additional decrease in EA of up to 25% and limited xylem [CO2] build‐up. Under drought stress, absolute decreases in EA driven by Pwt remained stable, denoting that Pwt was not affected by drought. At the end of the dry period, when transpiration was low, local Pwt and Dax offset 20% and 10% of stem respiration on a daily basis, respectively. These results highlight (a) the importance of Pwt for an adequate interpretation of EA measurements and (b) homeostatic Pwt along a drought stress gradient, which might play a crucial role to fuel stem metabolism when leaf carbon uptake and phloem transport are limited.
Insulin therapy for hyperglycemia in neonatal sepsis using a preterm mouse model
Authors: Miyauchi Harunori , Fujioka Kazumichi , Okubo Saki , Nishida Kosuke , Ashina Mariko , Ikuta Toshihiko , Okata Yuichi , Maeda Kosaku , Iijima Kazumoto , Bitoh Yuko 
Published: December 2019

AbstractBackgroundStress‐induced hyperglycemia is a frequent complication of neonatal sepsis. Hyperglycemia induces oxidative stress and immunosuppression. We investigated the glucose kinetics and effect of insulin administration during stress‐induced hyperglycemia in a neonatal sepsis mouse model.MethodsA stock cecal slurry (CS) solution was prepared from adult cecums and 3.0 mg of CS/g (LD40) was administered intraperitoneally to 4‐day‐old FVB mouse pups. Blood glucose levels were measured at 1.5, 3, 6, and 9 h post‐sepsis induction and compared with basal levels. Two different doses of ultrafast‐acting insulin were administered subcutaneously, and blood glucose levels and survival rates were monitored.ResultsBlood glucose levels were significantly higher than those of baseline levels with a peak at 3 h, which progressively decreased from 6 to 9 h post‐sepsis induction. Insulin treatment reduced post‐sepsis‐induced hyperglycemia at 1.5 and 3 h. The mortality rate of CS‐only pups (39%) was similar to that of CS + 1 U/kg insulin pups (60%). However, the mortality rate of CS + 5 U/kg insulin pups (82%) was significantly higher than that of CS‐only pups.ConclusionsMarked hyperglycemia was induced immediately after post‐sepsis induction, and the high‐dose insulin treatment increased mortality post‐induction. Stress‐induced hyperglycemia could therefore be a physiological and protective response for preterm sepsis, and aggressive treatment of this hyperglycemia might be contraindicated.
Gaps in the elimination of congenital syphilis in a tertiary care center in Thailand
Authors: Anugulruengkitt Suvaporn , Yodkitudomying Chatnapa , Sirisabya Anongnart , Chitsinchayakul Thaninee , Jantarabenjakul Watsamon , Chaithongwongwatthana Surasith , Puthanakit Thanyawee 
Published: December 2019

AbstractBackgroundThe World Health Organization has set a goal to eliminate mother‐to‐child transmission of syphilis to a target of <50 cases per 100 000 live births. This study aimed to determine the rate of congenital syphilis and identify gaps in prevention.MethodsA retrospective chart review was conducted in a tertiary care center in Bangkok, Thailand. The study included all pregnant women with positive syphilis serology and their infants. All congenital syphilis cases were categorized according to Centers for Disease Control criteria.ResultsFrom 2013 to 2017, 69 syphilis‐infected pregnant women were included, with 30 congenital syphilis cases. The rate of congenital syphilis was 115 cases (95% CI 78–164) per 100 000 live births. The median (interquartile range) maternal age was 21 (18–32) years and 12 (17%) women had human immunodeficiency virus co‐infection. Regarding maternal treatment, 28 (41%) women had inadequate treatment due to 13 cases (19%) of late or no antenatal care, six cases (8%) of recent infection near delivery, five cases (7%) of failure of treatment provision, and four (6%) others. There were three syphilitic stillbirths who were prematurely born to untreated pregnant women and 67 live births (one set of twins) of which 27 met definitions of probable congenital syphilis. They received complete treatment with penicillin and had non‐reactive rapid plasma reagin within the first 6 months of life, with the exception of one who had non‐reactive rapid plasma reagin at the age of 7 months.ConclusionsCongenital syphilis remains a problem in our setting. Nearly half of pregnant women who had syphilis had inadequate treatment. There is an urgent need to strengthen diagnosis and the treatment cascade of syphilis during antenatal care.
Motor outcome, executive functioning, and health‐related quality of life of children, adolescents, and young adults after ventricular assist device and heart transplantation
Authors: Barron Lucie‐Charlotte , Haas Nikolaus , Hagl Christian , Schulze‐Neick Ingram , Ulrich Sarah , Lehner Anja , Heinen Florian , Weinberger Raphael , Rosenthal Lale , Gerstl Lucia , Dalla‐Pozza Robert 
Published: December 2019

AbstractObjectiveThe aim of the current study is to measure long‐term executive function, motor outcome, and QoL in children, adolescents, and young adults after VAD and Htx.MethodsPatients were examined during routine follow‐up. Investigation tools were used as follows: Examination for MND of motor outcomes, Epitrack® for attention and executive functioning, and Kidscreen‐52 and EQ‐5D‐5L questionnaires for QoL. Additional data were retrospectively obtained by an analysis of patient medical records.ResultsOut of 145 heart transplant recipients at the department of pediatric cardiology of the University Hospital Munich, 39 were implanted with a VAD between 1992 and 2016. Seventeen (43.6%) patients died before or after Htx; 22 (56.4%) patients were included in our study. Mean age at transplant was 9.52 years (range: 0.58‐24.39 years, median 9), and the mean follow‐up time after Htx was 6.18 years (range: 0.05‐14.60 years, median 5.82). MND examination could be performed in 13 patients (normal MND: n = 11, simple MND: n = 1, complex MND: n = 1). Executive functioning was tested in 15 patients. Two (13.3%) patients had good results, six (40%) average results, three (20%) borderline results, and four (26.7%) impaired results. QoL (Kidscreen n = 7, EQ‐5D‐5L n = 8) was similar to a healthy German population.ConclusionMotor outcome, executive functioning and QoL in survivors of VAD bridging therapy and Htx can be good, though underlying diseases and therapies are associated with a high risk of cerebral ischemic or hemorrhagic complications.
Fluorescence and Treatment Light Monitoring for Interstitial Photodynamic Therapy
Authors: Heckl Christian , Aumiller Maximilian , Rühm Adrian , Sroka Ronald , Stepp Herbert 
Published: December 2019

AbstractIn interstitial photodynamic therapy, light is distributed to the tumor via light diffusers. The light dose and the related phototoxic effect achieved throughout the target volume critically depend on absorption, scattering and diffuser positioning. Using liquid tissue phantoms, we investigated the dependencies of treatment light transmission and protoporphyrin IX (PpIX) fluorescence on these parameters. This enabled monitoring hemoglobin oxygenation and methemoglobin formation during irradiation (635 nm, 200 mW cm−1 diffuser length). Starting with two parallel cylindrical diffusers at 10 mm radial separation, the light transmitted between the fibers was largely determined by the minimal distance between the diffusers, but rather insensitive to an additional axial displacement or tilting of one fiber with respect to the other. For fixed distance between the diffusor centers, however, tilting up to direct contact resulted in a 10‐fold signal increase. For hemoglobin within erythrocytes, irradiation leads to photobleaching of PpIX without marked change in hemoglobin oxygenation until hemolysis occurs. Afterward, hemoglobin is rapidly deoxygenized and methemoglobin is formed, leading to a dramatic increase in absorption. For lysed blood, these effects start immediately. A comparison of intraoperative monitoring of the signals with the experimental results might help prevent insufficient treatment by reconsidering treatment planning or prolonging irradiation.
Materials Science Challenges in Skin UV Protection: A Review
Authors: Egambaram Orielia Pria , Kesavan Pillai Sreejarani , Ray Suprakas Sinha 
Published: December 2019

AbstractUV radiation is one of the critical environmental stress factors for human skin, which can trigger various problems such as pruritus, burning, erythema, premature skin aging and skin cancer. Hence, UV protection has become an indispensable daily routine and the use of topical sunscreen products is rapidly increasing. However, there are emerging concerns over the efficiency and safety of existing chemical and physical UV filters used in consumer products. Furthermore, there is no universally approved method for assessing sun protection efficiency regardless of the immediate end user need to develop safer sunscreen products that afford broad‐spectrum photoprotection. It is evident that the current organic and inorganic UV filters have significant unfavorable impacts on human, environmental, and marine safety. Therefore, effective alternative UV filters should be established. This article comprehensively reviews the properties, safety, health and ecological concerns of various UV filters including TiO2 and ZnO nanoparticles as well as the limitations of the testing protocols and guidelines provided by major regulatory bodies. The photoreactivity of UV filters used in sunscreen remains a major challenge, and it is crucial to develop new sunscreen ingredients, which not only protect the consumer, but also the environment.
Toxoplasma gondii protects from IgE sensitization and induces Th1/Th2 immune profile
Authors: Andrade Milena M. C. , Carneiro Valdirene L. , Galvão Alana A. , Fonseca Thales R. , Vitor Ricardo W. A. , Alcantara‐Neves Neuza Maria , Cruz Álvaro A. , Figueiredo Camila A. 
Published: December 2019

AbstractToxoplasma gondii (T gondii) infection has been associated with protection against allergy and autoimmune diseases. We investigated the effects of T gondii infection on cytokine and antibody responses in atopic and nonatopic Brazilian subjects. We have measured in whole‐blood cultures, Th1 (IFN‐γ and IL‐12), Th2 (IL‐5) and regulatory cytokine IL‐10 in blood cells unstimulated and stimulated with pokeweed mitogen or T gondii soluble tachyzoites antigen (STAg) or Dermatophagoides pteronyssinus antigen. A significant negative association was found between high levels of anti‐dust mite IgE and T gondii seropositivity (OR = 0.46; 95%CI = 0.25‐0.85). STAg stimulation induced a mixed profile of Th1 and Th2 cytokines (IFN‐γ, IL‐12 and IL‐5) in Tg‐positive atopic individuals compared with Tg‐negative atopic individuals (P < .0001, P = .033 and P = .003, respectively). In contrast, IL‐10 production was not different between these groups. No association was found between T gondii infection and asthma. We hypothesized that the protective effect on atopy might be related to the strong Th1 immune response to T gondii found on the seropositive subjects. From our knowledge, this is the first study to investigate the association between atopy and T gondii infection in Brazilian subjects, analysing the cellular immune responses.
U.S. R&D internationalization in less‐developed countries: Determinants and insights from Brazil, China, and India
Authors: Chiarini Tulio , Caliari Thiago , Bittencourt Pablo Felipe , Siqueira Rapini Marcia 
Published: December 2019

AbstractThe growing U.S. R&D internationalization has historically been concentrated in developed countries. However, in the past few decades, the internationalization has moved toward less‐developed countries (LDCs), particularly Brazil, China, and India. What location factors are making some LDCs more “inviting” for U.S. R&D offshore? To answer this first question, we constructed a panel data using secondary data from the U.S. Bureau of Economic Analysis regarding the R&D investment made by the majority‐owned foreign affiliates of U.S. parent companies in 71 countries. We then applied a Heckman two‐step correction for selection bias test. The results highlight some important differences between developed countries’ and LDCs’ attractiveness. Based on these initial results, we conducted a detailed analysis of the determinants of U.S. R&D investments in Brazil, China, and India, which revealed that China’s determinants mostly match those found in more developed countries.
Impact of oral conditions of children/adolescents with Down syndrome on their families’ quality of life
Authors: Carrada Camila Faria , Scalioni Flávia Almeida Ribeiro , Abreu Lucas Guimarães , Ribeiro Rosangela Almeida , Paiva Saul Martins 
Published: December 2019

AbstractAimsTo assess the impact of oral conditions among children/adolescents with Down syndrome (DS) on the Oral Health‐related Quality of Life (OHRQoL) of their families in comparison with a group without DS.Methods and resultsFamilies of 144 children/adolescents with DS aged 4‐18 years were compared with families of individuals without DS. Dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), gingival bleeding (GBI), visible plaque (VPI), and malocclusion were evaluated. Parents/caregivers answered the Family Impact Scale (FIS) and questionnaires on sociodemographic conditions and the health of children/adolescents. Data analysis included chi‐square test and Poisson regression. There was no difference between groups regarding the impact of the children's/adolescents' oral condition on their families’ OHRQoL for all domains and the total FIS score (P > 0.05). A negative impact on the OHRQoL of families of children/adolescents with DS was determined by dental caries (PR = 3.95, CI = 2.09‐7.46), clinical consequences of untreated dental caries (PR = 1.83, CI = 1.18‐2.84), defined malocclusion (PR = 2.75, CI = 1.23‐6.13), and severe malocclusion (PR = 2.82, CI = 1.02‐7.74).ConclusionThere is no difference on the OHRQoL of families of children/adolescents with and without DS. Dental caries experience, clinical consequences of untreated dental caries, defined malocclusion, and severe malocclusion determined the negative impact on the OHRQoL of families of children/adolescents with DS.
School choice's idealized premises and unfulfilled promises: How school markets simulate options, encourage decoupling and deception, and deepen disadvantages
Authors: Chen Katherine K. , Moskop Megan 
Published: December 2019

AbstractIn school choice systems, families choose among publicly funded schools, and schools compete for students and resources. Using neoinstitutionalist and relational inequality theories, our article reinterprets recent critical sociological and education research to show how such markets involve actors' enacting myths; these beliefs and their associated practices normalized white, privileged consumption as a basis for revamping public education as market exchanges between schools and families. Proponents argue that choice empowers individuals, focuses organizations on improving quality, and benefits society more broadly by reducing inequality and segregation. We argue that such school choice myths' excessive emphases on individual decision‐making and provider performance obscure the actual impacts of school choice systems upon people, organizations, and society. First, rather than enlarging alternatives that families can easily research, select, and (if needed) exit, school choice systems often simulate options, especially for disadvantaged populations. Second, rather than focusing schools' efforts on performance, innovation, and accountability, they can encourage organizational decoupling, homogeneity, and deception. Third, rather than reducing societal harms, they can deepen inequalities and alienation. Future research should examine both how markets are animated by bounded relationality—routines that enable them to form, maintain, and complete exchanges with organizations—and how activism can challenge marketization.