bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perfusion parameters of intravoxel incoherent motion based on tumor edge region of interest in cervical cancer: evaluation of differentiation and correlation with dynamic contrast-enhanced MRI
Authors: Wang Hongyan , Zhu Lixia , Li Guohua , Zuo Menzhe , Ma Xi , Wang Jianliang 
Published: December 2019

Background Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) is a functional magnetic resonance imaging (MRI) sequence. Purpose To evaluate the value of perfusion parameters derived from IVIM-DWI based on tumor edge region of interest (ROI) in differentiation in cervical cancer and investigate the relationship between IVIM and dynamic contrast-enhanced MRI (DCE-MRI). Material and Methods Thirty-three patients with pathologically diagnosed squamous cell carcinoma who underwent IVIM-DWI (nine b-values: 1–1000 s/mm2) and DCE-MRI were retrospectively assessed in this study. Parameters of IVIM (D, f, D*, fD*) and quantitative parameters of DCE-MRI (Ktrans, Kep, Ve) were derived using tumor edge ROI. Mann–Whitney U test was used to compare parameters between pathological grades and receiver operating characteristic (ROC) curves were used. Pearson’s correlation coefficient (r) evaluated the correlation between perfusion parameters derived from IVIM and DCE-MRI. Results The poorly differentiated group showed the significantly lower D value and the higher f, Ktrans and Kep values than the well-to-moderately differentiated group ( P < 0.05). ROC curves indicated that f < 26%, Ktrans <0.38/min, and Kep <1.62/min could differentiate the poorly differentiated group from the well-to-moderately differentiated group (AUC 0.753–0.808). Significantly positive correlations were found between f and Ktrans (r = 0.422, P = 0.014) and between fD* and Ktrans (r = 0.448, P = 0.009). Conclusion Perfusion parameters derived from IVIM based on tumor edge ROI may offer additional value in differentiation in cervical cancer, and the IVIM perfusion parameters showed moderate positive correlations with quantitative perfusion parameters from DCE-MRI, while f and fD* showed promising significance.
Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures
Authors: Wang Dong , Sun Kai , Jiang Wenxue 
Published: December 2019

Objective To conduct a meta-analysis to show the associations of perioperative and postoperative outcomes of mini-plate internal fixation (MPIF) versus Kirschner wire internal fixation (KWIF) for treating metacarpal and phalangeal fractures. Methods A literature search was performed in PubMed, Web of Science, Cochrane Library, and Embase from the earliest date of data collection to April 2018. Studies that compared perioperative and postoperative outcomes of MPIF with those of KWIF in patients with metacarpal and phalangeal fractures were included. Results Twenty-six articles met the inclusion and exclusion criteria (n = 2029 patients; 1042 with MPIF and 987 with KWIF). MPIF was related to a greater increase in length of surgery, hospital days, excellent and good rate of outcome, short-form health survey-36 score, and flexion and extension range compared with KWIF. MPIF was related to a greater decrease in intraoperative blood loss, finger visual analog scale score, functional exercise time, fracture healing time, incidence of complications, and postoperative infection rate compared with KWIF. Conclusions Patients with MPIF have sufficient pressure and strength, and MPIF promotes successful joint fusion and reduces complications of the operation. MPIF is ideal for reduction and stability of patients with metacarpal and phalangeal fractures.
The Effect of Psychological Impairment on Outcomes in Patients With Prearthritic Hip Disorders: A Systematic Review and Meta-analysis
Authors: Cheng Abby L. , Schwabe Maria , Doering Michelle M. , Colditz Graham A. , Prather Heidi 
Published: December 2019

Background: Recent studies have suggested that mental health disorders negatively affect postoperative outcomes in patients with femoroacetabular impingement (FAI). However, the outcome measures reported and the effect sizes have varied. Furthermore, it is unknown whether similar effects are present in young adults with other hip disorders such as acetabular dysplasia. Purpose: To synthesize current evidence regarding the effect of baseline psychological impairment on postintervention outcomes in patients with prearthritic hip disorders. Study Design: Systematic review and meta-analysis. Methods: In February 2019, the Ovid Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov databases were searched for longitudinal studies that evaluated the effect of baseline psychological impairment (such as depression or anxiety) on a postintervention clinical outcome in patients with prearthritic hip disorders including FAI, acetabular dysplasia, and/or acetabular labral tears. Descriptive measures of study quality and bias were recorded, and studies that reported statistically comparable outcomes were analyzed in meta-analyses through use of random effects models. Results: We identified 12 eligible studies, all of which specifically evaluated patients with FAI after hip arthroscopy. No eligible studies described patients with acetabular dysplasia. Of the included studies, 8 studies reported odds ratios (ORs). The other 4 studies reported mean postoperative scores on patient-reported outcome measures (PROMs), all of which were scored from 0 to 100, with higher numbers being favorable. Patients with psychological impairment were less likely to achieve a favorable outcome after arthroscopy (OR, 0.74; 95% CI, 0.62 to 0.88; P < .001), and they reported worse postoperative PROM scores compared with nonimpaired patients (weighted mean difference, −20.2 points; 95% CI, −32.9 to −7.5; P < .001). Conclusion: Baseline psychological impairment is associated with clinically significantly worse outcomes in patients with femoroacetabular impingement who undergo hip arthroscopy. More standardized reporting would facilitate improved understanding of this important, potentially modifiable risk factor. Registration: CRD42019124836 (PROSPERO).
Extracorporeal Membrane Oxygenation in Pregnant and Postpartum Women: A Systematic Review and Meta-Regression Analysis
Authors: Zhang John J. Y. , Ong Jamie Ann-Hui , Syn Nicholas L. , Lorusso Roberto , Tan Chuen Seng , MacLaren Graeme , Ramanathan Kollengode 
Published: December 2019

Background: Although extracorporeal membrane oxygenation (ECMO) is frequently utilized as a salvage therapy for patients with cardiopulmonary failure, outcomes of its use in peripartum patients have not been clearly established. We aimed to review peer-reviewed publications on the use of ECMO in pregnant and postpartum patients, with analyses of maternal and fetal outcomes. Methods: Data were retrieved from MEDLINE, EMBASE, and Scopus databases from 1972 up to November 2017 for publications on ECMO in peripartum patients. Search terms included “ECMO,” “ECLS,”, “pregnancy,” “postpartum,” and “peripartum.” Publications with 3 or more patients were reviewed for quality using the Joanna Briggs Institute checklist for prevalence studies and case series. Results: After reviewing 143 publications, 9 observational studies met our inclusion criteria. Pooled prevalence of maternal survival was 77.2% (95% confidence interval [CI]: 64.1%-88.4%). Pooled prevalence of fetal survival was 69.1% (95% CI: 44.7%-89.8%). The level of heterogeneity across studies was low for both outcomes. Meta-regression did not reveal any correlation between pregnant women with pulmonary or cardiac indications and maternal survival. Individual patient data meta-regression demonstrated higher odds of survival for patients on venovenous ECMO compared to those on venoarterial ECMO that was close to statistical significance (odds ratio = 3.016, 95% CI: 0.901-11.144; P = .081) after adjusting for pregnancy status. Conclusions: Extracorporeal membrane oxygenation can be considered as an acceptable salvage therapy for pregnant and postpartum patients with critical cardiac or pulmonary illness.
Osteoporosis in a murine model of postmenopausal lupus
Authors: Nordqvist J , Lagerquist M K , Grahnemo L , Koskela A , Islander U , Carlsten H 
Published: December 2019

Background/objective Postmenopausal women with systemic lupus erythematosus have an increased risk of osteoporosis and associated fractures. Their increased osteoporosis risk is probably caused by a high level of inflammation, use of glucocorticoids, impaired kidney function, and early menopause as these are known risk factors for osteoporosis. Due to these risk factors and the lack of safe and effective treatments, new therapies for the treatment of osteoporosis in this group of patients are needed. Ovariectomized MRL/ lpr mice constitute a well-established model for studies of postmenopausal systemic lupus erythematosus; however, it is not clear to what extent this experimental model is associated with the development of osteoporosis. Thus, the aim of this study was to characterize the skeleton of ovariectomized MRL/ lpr mice to determine the suitability of this model in studies of prospective new therapies for osteoporosis in postmenopausal systemic lupus erythematosus patients. Methods Skeletal parameters were measured in MRL/ lpr mice and MRL/++ control mice, using peripheral quantitative computed tomography, high-resolution micro-computed tomography and biomechanical analyses. mRNA expression of bone-remodeling markers was measured by quantitative polymerase chain reaction and serological markers of lupus disease were evaluated using ELISA. Results Total bone mineral density was reduced in MRL/ lpr mice compared with MRL/++ mice and MRL/ lpr mice had reduced cortical and trabecular bone thickness compared with MRL/++ mice. In line with the low bone mass of MRL/ lpr mice, gene expression analysis of cortical bone from these mice indicated an increased osteoclast activity as well as a decreased osteoblastogenesis and osteoblast activity, compared with MRL/++ mice. Conclusion Ovariectomized MRL/ lpr mice constitute a valuable experimental model for studies of osteoporosis development in postmenopausal systemic lupus erythematosus and this model is thus suitable for future studies of osteoporosis treatment in systemic lupus erythematosus.
Grant Kaplan’s René Girard, Unlikely Apologist: Mimetic Theory and Fundamental Theology
Authors: Dadosky John D. 
Published: December 2019

This article review’s Grant Kaplan’s, René Girard, Unlikely Apologist: Mimetic Theory and Fundamental Theology. The content of the book offers the occasion to comment on some themes in Girard’s thought in relation to theology. In particular it expands upon it with reference to some of the insights from Bernard Lonergan. Girard’s legacy can contribute to a reaffirmation of the uniqueness of Christian identity in a pluralistic age, and a contribution to Catholic social teaching --i.e. a preferential option for the scapegoated and marginalized. Although he reclaimed his Christian roots, Girard was neither a philosopher nor a theologian. Therefore, some of his provocative insights, while valuable, stand in need of a critical appropriation. Kaplan’s important study provides an oppurtunity to raise some of those questions.
Can the fistula arm be used to lift heavy items? Six-pound dumbbells versus handgrip exercise in a 6-month follow-up secondary analysis of a randomized controlled trial
Authors: Mo Ya-wen , Song Li , Huang Jing-ya , Sun Chun-yan , Zhou Li-fang , Zheng Shu-qian , Zhuang Ting-ting , Chen Ying-gui , Chen Yuan-han , Liu Shuang-xin , Liang Xin-ling , Fu Xia 
Published: December 2019

Introduction: Patients with arteriovenous fistulas are advised to avoid carrying heavy objects draped over the fistula arm. Awareness gradually leads to overprotection and a reduction in the use of the fistula arm. However, restricting motion in the fistula arm leads to decreased quality of life and diminished muscle strength. The current safety recommendations regarding lifting heavy items with the fistula arm are primarily based on experience. Few studies have provided evidence clarifying the scope of safe activity and the influence of load bearing on the continued patency of arteriovenous fistulas. Methods: This prospective observation was based on a long-term follow-up study in which 86 hemodialysis recipients with arteriovenous fistulas were randomized into either a dumbbell group or a handgrip group. The dumbbell group exercised with 6-lb dumbbells, while the handgrip group squeezed rubber balls. Postintervention primary patency and adverse events at the 6-month follow-up were analyzed. Results: No significant difference in postintervention primary patency was observed between the dumbbell group and the handgrip group at 6 months (97.4% vs 95.0%). There were two participants with high-flow fistulas in the dumbbell group and three in the handgrip group, with no significant difference between the two groups (5.3% vs 7.5%). In both groups, there were no other adverse events reported regarding cardiac failure, aneurysm, puncture site hematoma, or hemorrhage. Conclusion: Hemodialysis patients can safely use their fistula arm to lift objects weighing less than 6 lb, which encourages increased motion and helps preserve the functionality of the fistula arm.
Surgical Infections and Antibiotic Stewardship: In Need for New Directions
Authors: Andersson R. , Søreide K. , Ansari D. 
Published: December 2019

Background and Aims: Patients undergoing surgery are prone to infections, either at the site of surgery (superficial or organ-space) or at remote sites (e.g. pneumonia or urinary tract). Surgical site infections are associated with substantial morbidity and mortality, increased length of hospital stay and represent a huge burden to the health economy across all healthcare systems. Here we discuss recent advances and challenges in the field of surgical site infections. Material and Methods: Review of pertinent English language literature. Results: Numerous guidelines and recommendations have been published in order to prevent surgical site infections. Compliance with these evidence-based guidelines vary and has not resulted in any major decrease in the surgical site infection rate. To date, most efforts to reduce surgical site infection have focused on the role of the surgeon, but a more comprehensive approach is necessary. Conclusion: Surgical site infections need to be addressed in a structured way, including checklists, audits, monitoring, and measurements. All stakeholders, including the medical profession, the society, and the patient, need to work together to reduce surgical site infections. Most surgical site infections are preventable—and we need a paradigm shift to tackle the problem.
NF-κB activation triggers NK-cell stimulation by monocyte-derived dendritic cells
Authors: Bosch Naomi C. , Voll Reinhard E. , Voskens Caroline J. , Gross Stefanie , Seliger Barbara , Schuler Gerold , Schaft Niels , Dörrie Jan 
Published: December 2019

Background: In therapeutic cancer vaccination, monocyte-derived dendritic cells (moDCs) efficiently activate specific T-cell responses; however, optimizing the activation of innate immune cells could support and improve the antitumor effects. A major disadvantage of moDCs matured with the standard cytokine cocktail (consisting of IL-1β, IL-6, TNFα, and PGE2) is their inability to secrete IL-12p70. IL-12 prominently activates natural killer (NK) cells, which are crucial in innate antitumor immunity, as they act as helper cells for the induction of a cytotoxic T lymphocyte (CTL) response and are also able to directly kill the tumor. Methods: Previously we have shown that triggering the NF-κB pathway in moDCs by transfection of mRNA encoding constitutively active IKKβ (caIKKβ) led to IL-12p70 secretion and improved the dendritic cells’ capability to activate and expand CTLs with a memory-like phenotype. In this study, we examined whether such dendritic cells could activate autologous NK cells. Results: moDCs matured with the standard cytokine cocktail followed by transfection with the caIKKβ-RNA were able to activate autologous NK cells, detected by the upregulation of CD54, CD69, and CD25 on the NK cells, their ability to secrete IFNγ, and their high lytic activity. Moreover, the ability of NK-cell activation was not diminished by simultaneous T-cell activation. Conclusion: The capacity of caIKKβ-DCs to activate both the adaptive and innate immune response indicates an enhanced potential for clinical efficacy.
Improving care coordination in community physical rehabilitation: A qualitative study of the change framework
Authors: Symons Jane L , Jamison Julie , Dening Jane , Murray Linda , Pearson Sue 
Published: December 2019

Introduction Contemporary rehabilitation change relies on effective collaboration and ongoing social interactions among stakeholders. The study objective was to explore the influence of the selected change framework and underlying social interactions during a care coordination improvement project. Methods A qualitative study collected data from 35 employees in a community physical rehabilitation service. Participants were not only undergoing change to improve client care coordination but were also facilitating the change processes themselves. Symbolic interactionism guided the research design, and data were collected using interviews and observation. Blumer’s six root beliefs were used for deductive data analysis and provided the framework for the findings. Results Findings highlight that the perceptions of the selected change framework were mixed yet dynamic, with modification occurring via social interaction. Elements of Kotter’s eight steps, lean thinking, and transformational change models were trialed. Implementation of the change processes required formal and informal group social interactions. Participants’ different outlooks explained their mixed response to the change processes. Participants who supported the implemented changes believed the processes and outcomes were clear, appropriate, and inclusive. Time, energy, and positive social interactions enabled employees to drive change, with more of these resources desired to refine the vision, problem-solve implementation, and further improve care coordination. Discussion This study enhances the understanding of how employees and the community physical rehabilitation service shaped each other during the change processes. The focus on social interactions highlights the slow rate of improved care coordination and need for increased resources and/or duration for successful change.
Pregnancy and multiple sclerosis: Risk of unplanned pregnancy and drug exposure in utero
Authors: Smith Andrew L , Cohen Jeffrey A , Ontaneda Daniel , Rensel Mary 
Published: December 2019

Background Multiple sclerosis is a central nervous system demyelinating disease that affects women of reproductive potential. It is important to identify the frequency and risk factors of unplanned or disease-modifying therapy-exposed pregnancies to create interventions to reduce these. Methods This retrospective, single-center, observational chart review study aims to identify risk factors for unplanned pregnancy to identify a target population for family counseling. Results In total, 63 live births in 45 patients (20 unplanned and 43 planned) were analyzed. The percentage of unplanned pregnancy was 32%. The proportion of those receiving family planning counseling was lower in the patients with unplanned pregnancies ( p < 0.001). The main risk factors for unplanned pregnancy were younger age ( p = 0.004), disease-modifying therapy exposure ( p < 0.001), and being unmarried ( p < 0.001). Overall, 16 pregnancies had disease-modifying therapy exposure and in a subsequent study the risk for disease-modifying therapy exposure was unplanned status ( p < 0.001). Birth outcomes were not different between groups. There were more enhancing lesions in the post-partum magnetic resonance imaging of women with planned pregnancy ( p < 0.04). Conclusion Prevention of unplanned pregnancy could lead to less disease-modifying therapy exposed pregnancies. This study suggests a targeted intervention of family planning counseling in younger, unmarried multiple sclerosis patients could potentially lead to less unintended in utero disease-modifying therapy exposure.
Financial Reforms, Capital Investment and Financial Intermediation in China
Authors: Ibhagui Oyakhilome 
Published: December 2019

China has witnessed remarkable changes in its capital investment and financial system since initiating economic and financial sector reforms more than three decades ago. However, there is a dearth of studies examining what impact these reforms have had on financial intermediation, measured by credit growth, in the country. This article addresses this vacuum and investigates the effect of financial sector and capital investment reforms on credit growth in China between 1986 and 2016. We examine how real interest rate (the financial reform indicator) and gross fixed capital formation (the economic capital investment indicator) are linked with financial intermediation in China. Our empirical results suggest that although gross fixed capital formation positively influences credit growth, there is no evidence that real interest rates influence credit growth in China. The main message is that credit has grown in China, not because of financial intermediation but because of the increased need to finance growing fixed capital investment. JEL Classification: E43, E44, F65
Optimized chemical preconditioning of Philippine natural zeolites
Authors: Olegario Eleanor M. , Taaca Kathrina Lois M. , Morillo John Christopher Lawrence , Mendoza Herman D. 
Published: December 2019

AbstractNatural zeolites in the Aksitero sedimentary formation of the western Luzon area of the Philippines were evaluated. The natural washed zeolite (NW-Z) was preconditioned with acid to purify it and increase its surface area. Acid treatment with 3 M HCl for 12 h yielded optimum acid treatment of the NW-Z, causing increases in the Si/Al ratio, the specific surface area by 32.5% and the porosity of the acid-treated zeolite (HC-Z). The HC-Z was washed with 4 M NaCl for 3, 6, 12, 18, 24, 48 and 72 h to improve its cation-exchange capacity for copper. The sodium-treated zeolite (Na-Z) was immersed in 100 ppm CuSO4 solution to test the copper-uptake capacity. Pretreatment of HC-Z with 4 M NaCl for 24 h is optimal for sodium treatment of the preconditioned HC-Z. The preconditioning techniques did not significantly alter the structure and morphology of the zeolite samples. It is suggested that the preconditioned Philippine natural zeolite samples are readily available for further functionalization that will enhance their antibacterial, catalytic and adsorption properties, with various useful applications in the field of catalysis, biomedicine, environmental mitigation and wastewater treatment.