bluuebunny/crossref_metadata_2025_split huggingface dataset:
A proposed redosing interval of del Nido cardioplegia solution in adult cardiac surgery: a propensity-matched study
Authors: Koda Yojiro , Kitahara Hiroto , Nishida Hidefumi , Jeevanandam Valluvan , Ota Takeyoshi 
Published: September 2020

Background: Recently, del Nido cardioplegia solution (DN) has been utilized in adult cardiac surgery. However, adequate interval of maintenance dose(s) is still unclear. The purpose of this study was to assess the safety and efficacy of our DN protocol by comparing with conventional cold whole blood cardioplegia (CWB). Methods: A total of 1003 consecutive patients (DN group, N = 350 vs. CWB group, N = 653) underwent cardiovascular surgery between July 2013 and September 2018 were included in this study. The DN protocol was to administer 1000 to 1200 ml as an initial dose and to add maintenance dose(s) (500 ml each) every 60 minutes when the estimated cross-clamp time was over 90 minutes. CWB was given every 20 minutes, regardless of cross-clamp time. Propensity matching identified 254 matched pairs for analysis. The preoperative and postoperative data were reviewed. Results: Cross-clamp time was significantly shorter in the DN group compared with the CWB group (107 ± 56 minutes vs. 116 ± 49 minutes, p = 0.0458). A retrograde cannula was used in 124 (48.8%) patients in the DN group and 181 (71.3%) patients in the CWB group (p < 0.0001). There were no significant differences in requiring postoperative cardiac supports (inotropes, mechanical circulatory supports) and major complications. In-hospital mortality was similar between two groups (DN group: 3.2% vs. CWB group: 2.4%, p = 0.5872). Conclusions: Short-term clinical outcomes in the patients underwent cardiovascular surgery with the DN protocol including the redosing interval strategy were acceptable. Also, DN protocol was associated with shortened cross-clamp time and less usage of the retrograde cannula.
Trimetazidine can prevent the occurrence of contrast-induced nephropathy after percutaneous coronary intervention in elderly patients with renal insufficiency
Authors: Fu Han , Zhang Jing , Zhang Hong , Zhang Peng , Fu Xiaofeng , Zeng Zhican , Zhang Xue , Li Wenyuan , Yang Shicheng , Liu Xiaogang , Fu Naikuan 
Published: September 2020

Background: Contrast-induced nephropathy (CIN) has become a common cause of hospital-acquired acute kidney injury in elderly patients. Trimetazidine (TMZ) is a type of anti-ischemic drug developed in recent years, which can reduce the incidence of CIN. This study aimed to evaluate the efficacy of TMZ in the prevention of contrast-induced nephropathy in elderly patients with renal insufficiency undergoing percutaneous coronary intervention (PCI) and to explore the mechanism of action. Methods: A total of 310 elderly patients with renal insufficiency undergoing elective PCI were enrolled and randomly assigned to a control group (n = 155, hydration only) and a TMZ group (n = 155, 20 mg thrice daily orally 24 hours before and 72 hours after PCI). The primary endpoint of the study was the incidence of CIN, which was defined as an increase of 25% or more, or an absolute increase of 0.5 mg/dL or more in serum creatinine from baseline value, at 48 to 72 hours following the exposure to contrast media (CM). Results: The incidence of CIN was significantly lower in the TMZ group than that in the control group (3.2% vs. 9.7%, p = 0.021). There was no difference regarding the incidence of major adverse events during hospitalization between the TMZ group and control group (1.9% vs. 2.6%, p = 1.000). Binary logistic regression results showed that TMZ was protective factors of CIN (OR = 0.274; 95% CI: 0.089–0.847; p = 0.025). Conclusion: Therefore, we came to the conclusion that prophylactic administration of TMZ can prevent the occurrence of CIN in elderly patients with renal insufficiency undergoing PCI and has a certain protective effect on the renal function of patients. According to the experimental results and the mechanism of TMZ on cardiomyocytes, we speculate that TMZ increases kidney glucose metabolism, reduces fatty acid oxidation, and also has a protective effect on kidney free radical damage and ischemia-reperfusion injury.
Split renal function after treatment of small renal masses: comparison between radiofrequency ablation and laparoscopic partial nephrectomy
Authors: Acosta Ruiz Vanessa , Båtelsson Sarah , Onkamo Elina , Wernroth Lisa , Nilsson Thomas , Lönnemark Maria , Dahlman Pär , Magnusson Anders 
Published: September 2020

Background Radiofrequency ablation (RFA) and laparoscopic partial nephrectomy (LPN) are used to treat small renal masses (SRM; ≤4 cm), although there are conflicting results in the changes in creatinine and estimated glomerular filtration rate (eGFR) after treatment. On contrast-enhanced computed tomography (CE-CT) images, the quantity and quality of renal function can be evaluated by calculating the split renal function (SRF). Purpose To compare renal function after RFA or LPN treatment of SRMs through evaluation of the SRF in the affected kidney. Material and Methods Single T1a renal tumors successfully treated with RFA (n = 60) or LPN (n = 31) were retrospectively compared. The SRF was calculated on pre-treatment CE-CT images and the first follow-up exam after completed treatment. Serum creatinine and eGFR values were collected simultaneously. To compare renal function outcomes, Student’s t-test and multivariable linear regression models (adjusted to RFA/LPN treatment, pre-treatment SRF/eGFR, BMI, age, tumor characteristics, and Charlson Comorbidity Index) were used. Results SRF was reduced in both groups, although reduction was greater in the LPN group (LPN –5.7%) than in the RFA group (RFA –3.5%; P = 0.013). After adjusted analysis, the LPN group still had greater SRF reduction (difference 3.2%, 95% confidence interval 1.3–1.5; P = 0.001). There was no difference between groups in the change of creatinine/eGFR after treatment. Conclusion Both RFA and LPN are nephron-sparing when treating SRMs. However, in this series, reduction of SRF in the affected kidney was smaller after RFA, having a more favorable preservation of renal function than LPN.
Microwave ablation of 105 T1 renal tumors: technique efficacy with a mean follow-up of two years
Authors: Acosta Ruiz Vanessa , Dahlman Pär , Brekkan Einar , Lönnemark Maria , Magnusson Anders 
Published: September 2020

Background Thermal ablation (TA) with radiofrequency (RFA) or cryoablation (CA) are established treatments for small renal masses (≤4 cm). Microwave ablation (MWA) has several potential benefits (decreased ablation time, less susceptibility to heat-sink, higher lesion temperatures than RFA) but is still considered experimental considering the available small-sample studies with short follow-up. Purpose To evaluate technique efficacy and complications of our initial experience of renal tumors treated using percutaneous MWA with a curative intent. Material and Methods A total of 105 renal tumors (in 93 patients) were treated between April 2014 and August 2017. MWA was performed percutaneously with computed tomography (CT) guidance under conscious sedation (n=82) or full anesthesia. Patients were followed with contrast-enhanced CT scans at six months and yearly thereafter for a minimum of five years. The mean follow-up time was 2.1 years. The percentage of tumors completely ablated in a single session (primary efficacy rate) and those successfully treated after repeat ablation (secondary efficacy rate) were recorded. Patient and tumor characteristics as well as complications were collected retrospectively. Results The median patient age was 70 years and median tumor size was 25 mm. Primary efficacy rate was 96.2% (101/105 tumors). After including two residual tumors for a second ablation session, secondary efficacy was 97.1% (102/105). Periprocedural complications were found in 5.2% (5/95) sessions: four Clavien-Dindo I and one Clavien-Dindo IIIa. One postprocedural Clavien-Dindo II complication was found. Conclusion MWA has high efficacy rates and few complications compared to other TA methods at a mean follow-up of two years.
Effect of parathyroid hormone-related protein on intracellular calcium ion and cyclic adenosine monophosphate concentrations in cardiac fibroblasts
Authors: Zhou Ping , Xiao Qiong , Su Zhao-Ting , Zhu Lin , Jin Fang-Xia , Du Xuan-Yi 
Published: September 2020

Objective This study aimed to determine the effect of parathyroid hormone-related protein (PTHrP) on proliferation of cardiac fibroblasts (CFs) in primary cultures of neonatal Wistar rats. Methods Different PTHrP concentrations were added to CFs of neonatal Wistar rats and the cells were grouped according to the concentrations added. A verapamil (VPL) group and a calcitriol (CAL) group were also established. Changes in cell proliferation and in cyclic adenosine monophosphate and calcium ion levels were identified and recorded. Results We found that as the concentration of PTHrP increased, 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT, a tetrazolium salt) colorimetric absorbance values (A values) decreased. These values in the PTHrP groups were significantly lower than those in the control group. MTT colorimetric A values and 3H-thymidine deoxyribose intake were lower in the VPL group, low-dose CAL group, and the PTHrP 10−7 mol/L group compared with the control group. However, MTT colorimetric A values and 3H-thymidine deoxyribose intake were higher in the high-dose CAL group than in the PTHrP 10−7 mol/L group. As PTHrP concentrations increased, intracellular cyclic adenosine monophosphate concentrations also increased. Conclusion PTHrp, VPL, and low-dose CAL inhibit proliferation of CFs, while high-dose CAL promotes proliferation of CFs.
Correlation between level of autophagy and frequency of CD8+ T cells in patients with chronic obstructive pulmonary disease
Authors: Zhuang Hong , Li Na , Chen Sida , Shen Yan , Zhan Wugen , Xu Xiangqun , Zhuo Songming 
Published: September 2020

Objective The pathogenesis of chronic obstructive pulmonary disease (COPD) remains elusive. Here, we assessed the correlation between CD8+ T cell frequencies and autophagy in COPD patients. Methods Subjects were divided into three groups (n = 30 patients/group): (1) COPD patients in the stable phase; (2) smokers with normal lung function; and (3) non-smokers with normal lung function. Flow cytometry was used to enumerate CD8+ T cell subsets (CD8+, CD8+ effector, and CD8+ memory T cells) and quantitate T-cell apoptosis. RT-PCR and western blotting were used to measure levels of LC3 and p62. Results Frequencies of CD8+ T cell subsets and expression of p62 and LC3 II/I were significantly higher in COPD patients compared with the other two groups, while the rate of apoptosis was lower. In COPD patients, LC3 II/I and p62 expression were positively correlated with CD8+ T cell subset frequencies. Moreover, a significant correlation was observed between LC3 II/I and p62 expression and T cell subset frequencies. Conclusion Autophagy level is positively correlated with the frequencies of CD8+ T cells, suggesting that autophagy might be involved in COPD pathogenesis.
Evidence on the trade-off between corporate social responsibility and mergers and acquisitions investment
Authors: Krishnamurti Chandrasekhar , Shams Syed , Chowdhury Hasibul 
Published: September 2020

In this article, we investigate whether there is a trade-off between corporate social responsibility (CSR) and mergers and acquisitions (M&A) investments. Consistent with conflict resolution view of stakeholder theory, our results document a negative relationship between CSR scores and M&A activity. We further show that the tendency of CSR firms’ low engagements in M&A investmen ts is valid only for firms with no slack. We also find that firms choosing to trade off pay a lower bid premium to targets to create value for acquiring shareholders. These findings are robust to several alternative proxies and endogeneity tests. JEL Classification: G32, G34
Atrial septostomy in patients supported with venoarterial extracorporeal membrane oxygenation: Analysis of the IMPACT registry data
Authors: Deshpande Shriprasad R , Kennedy Kevin F , Vincent Robert N , Maher Kevin O 
Published: September 2020

Background: Patients with severe cardiac dysfunction, supported on extra-corporeal membrane oxygenation (ECMO), develop left atrial hypertension and often warrant atrial decompression. The procedural risks and outcomes, however, are not well established. Objective of this study is to understand the utilization, safety, and outcomes of atrial septostomy in children supported on venoarterial ECMO utilizing the IMPACT registry database. Methods: Data from 55 independent sites reporting to the registry was used for this descriptive study. Patients supported with cardiac ECMO that underwent percutaneous atrial septostomy (PAS) were included and data analyzed. Results: Between 2011 and 2018, 223 patients underwent atrial septostomy and were reported to the registry. Mean age was 4.65 years with 52% being males. Diagnoses of heart failure, sepsis, arrhythmia, and renal insufficiency were commonly noted prior to ECMO. The procedure was performed urgently or emergently in most cases (80%). PAS was associated with significant procedural complications such as arrhythmia (6.8%), tamponade (5.4%), and unplanned surgery (3.6%) but no procedural mortality. Overall hospital mortality was 46% (103/223) with 46 of these deaths occurring within 7 days of procedure. Regression analysis showed that African American race (vs Caucasian), race other than Caucasian, chronic lung disease and emergent procedure need were significantly associated with early post-procedural mortality (all p < 0.05). Conclusion: Using a large multicenter cardiac catheterization registry, we found that left atrial decompression can be performed without procedural mortality but is associated with significant morbidity. Impact of race, chronic lung disease and procedural urgency on early mortality warrant further studies.
Assessment of work-related symptoms, perceived knowledge, and attitude among nail salon technicians
Authors: Lteif Maria , El Hayek Marylene Samia , Azouri Hayat , Antonios Diane 
Published: September 2020

Objectives: Beauty is a Lebanese stereotype, as Lebanese women often feel urged to decorate themselves. Recent studies have raised concerns about nail salon technicians’ (NSTs) health and safety issues. The aim of our study was to evaluate the occupational symptoms reported by NSTs, to assess their knowledge and document their awareness regarding hazardous chemicals found in nail cosmetics. Methods: NSTs completed a researcher-administered questionnaire. Data were gathered on sociodemographic characteristics, perceived knowledge, and safety issues. Work-related symptoms reported by NSTs were evaluated, and their responses were compared to those of the office employees. Results: A total of 120 NSTs and 120 office employees were interviewed. Compared to the control group, NSTs reported a higher prevalence of work-related respiratory, dermal, and irritative symptoms, all significantly associated with smoking and a poor ventilation system. In addition, musculoskeletal complaints were common among NSTs and significantly linked to a poor ventilation system, an increased number of customers per day, and a longer service duration. Furthermore, a longer career duration was significantly associated with an increased prevalence of irritative symptoms. When a binary logistic regression was carried out, it demonstrated a 25 times higher prevalence of work-related symptoms among NSTs compared to the office employees. Interestingly, 84% of the respondents had an inaccurate knowledge of nail cosmetics’ risks with their educational level acting as key factor. Conclusions: Based on these findings, it is warranted to perform a clinical assessment, implement a stringent regulatory framework, and improve knowledge toward nail cosmetics’ risk.
Selection of Retirement Saving Plan for a Private-sector Employee in Pakistan
Authors: Naqvi Bushra , Rizvi Syed Kumail Abbas , Shahzad Arsalan 
Published: September 2020

Tehmina Khan, a 35-year-old, married mother of two, had been working as an assistant professor at a private sector university, University of Management and Information (UMI), School of Business. For the last few years, she had been saving for her retirement via a provident fund (PF) with her employer. The fund had been posting generous returns for years up until July 2018, when it posted earnings well below the inflation rate for the same period. Tehmina wanted to be financially self-sufficient in her post-retirement years and sought no financial dependence on her posterity for that matter. The meagre returns heightened her concerns about the future eventualities, so she had to decide if she should switch to another retirement plan. She needed to explore alternative retirement plans and identify how she could participate in a voluntary pension system (VPS) outside her employer’s PF. Also, if she decided to go ahead with VPS, she had to decide which asset management company(s) and portfolio manager(s) to allocate her savings to. The case comprehensively discusses the details about different retirement benefits and mechanisms and distinguishes aspects of private and public sector retirement plans in Pakistan. Most importantly, the case includes data on the performance of seventeen out of a total of nineteen pension plans operating in Pakistan. It also includes data on asset allocations of pension funds; overall macroeconomic, historical and stock market performances; and yield curve for the last 10 years.
Electroconvulsive therapy, personal protective equipment and aerosol generating procedures: a review to guide practice during Coronavirus Disease 2019 (COVID-19) pandemic
Authors: Purushothaman Subramanian , Fung David , Reinders Jonathan , Garrett-Walcott Simone , Buda Margaret , Moudgil Vikas , Emmerson Brett 
Published: September 2020

Objective: To review the literature on the definition of aerosol-generating procedures (AGPs), identify high-risk AGPs, guidelines to use personal protective equipment (PPE) and review evidence to see if electroconvulsive therapy (ECT) is a high-risk AGP requiring the use of PPE. Methods: Existing guidelines and research data were reviewed to answer the questions. Results: There is consensus about the type of anaesthesia used during ECT, what constitutes AGPs and what PPE should be used. It was not clear if ECT was an AGP, but we argue that it is one based on evidence. Conclusion: We conclude that ECT is an AGP and that it requires the appropriate use of PPE after taking in to account local supply and demand.
Teaching hip surgery to orthopaedic residents: what’s new?
Authors: De Boey Sara , Maes Michael , Mertens Peter 
Published: September 2020

Purpose: The purpose of this study is to provide an overview of the published literature on the existing educational methods used to teach surgical skills, with a specific focus on hip surgery, to orthopaedic residents. Methods: A total of 31 articles were selected from a PubMed literature search on the topic of teaching surgical skills to orthopaedic residents, and 9 articles on hip surgery are included in this review. Results: Although several methods are included in the published literature to teach orthopaedic residents, only arthroscopy of the knee and shoulder joint is well described. Hip arthroscopy has a steeper learning curve and thus the use of simulation training as a complementary teaching method is even more important. Conclusions: Currently, open surgery skills for joint arthroplasty are largely acquired by apprenticeship learning. Simulation training in the form of virtual reality could contribute to better performance of residents, decreasing operation time and improving patient safety.
Debridement, antibiotic pearls, and retention of the implant in the treatment of infected total hip arthroplasty
Authors: Ghirardelli Stefano , Fidanza Andrea , Prati Paolo , Iannotti Ferdinando , Indelli Pier F 
Published: September 2020

In this article the authors describe a modified surgical technique developed to enhance the classical irrigation and debridement procedure to improve the possibilities of retaining a total hip arthroplasty (THA) undergoing acute periprosthetic joint infection (PJI). This technique, debridement antibiotic pearls and retention of the implant (DAPRI), aims to remove the intra-articular biofilm allowing a higher and prolonged local antibiotic concentration by using calcium sulphate antibiotic-added beads. The combination of 3 different surgical techniques (tumour-like synovectomy, Argon Beam application and chlorhexidine gluconate brushing) might enhance the disruption and removal of the bacterial biofilm which is the main responsible of antibiotics and antibodies resistance. The timing of the diagnosis (6 weeks from the original surgery or 1 week from clinical symptoms appearance in the case of an hematogenous infection) and the preoperative isolation of the germ are fundamental in order to obtain a satisfactory outcome. A 12-week course of postoperative antibiotic therapy (6 weeks I.V. and 6 weeks oral) complete the postoperative protocol used by the authors. The DAPRI technique might represent a safe and more conservative treatment for acute and early hematogenous PJI.
How reliable is the next generation of multiplex-PCR for diagnosing prosthetic joint infection compared to the MSIS criteria? Still missing the ideal test
Authors: Lausmann Christian , Kolle Kim Niklas , Citak Mustafa , Abdelaziz Hussein , Schulmeyer Juan , Delgado Gio D , Gehrke Thorsten , Gebauer Matthias , Zahar Akos 
Published: September 2020

Introduction: Identification of the pathogen in case of a periprosthetic joint infection (PJI) remains 1 of the greatest challenges in septic surgery. Rapid germ identification enables timely, specific, antimicrobial therapy. The first multiplex PCR (polymerase chain reaction) generation (Unyvero-i60) enables germ detection within 5 hours with a sensitivity of 78.8% and a specificity of 100%. The aim of this study is to investigate the performance of the new generation of cartridges (Unyvero-ITI) of multiplex PCR in the case of a PJI. Methods: In a prospective study, intraoperatively aspirated synovial fluid from 97 patients with aseptic or septic hip or knee revision surgery (49 aseptic, 48 septic) was examined with the multiplex PCR system (Unyvero-ITI) and the results were compared with the MSIS criteria. In addition, the time until the microbiological result was obtained in the event of a germ detection was documented. Results: The multiplex PCR showed a germ detection with a sensitivity of 85.1% and a specificity of 98.0%. In 7 cases a false negative result was found and in one patient a false positive result was found. The general accuracy of this test procedure was 91.8%. The detection of germs was carried out within 5 hours with the multiplex PCR compared to 4.9 days in conventional microbiological diagnostics. Conclusions: The new generation of multiplex-PCR was able to improve germ detection. The possibility of prompt detection of germs offers the option of faster, targeted antimicrobial therapy. This diagnostic tool offers significant advantages, particularly in the context of an acute periprosthetic infection.