bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of early mortality after surgical treatment of infective endocarditis: a single-center experience
Authors: Jakuska Povilas , Ereminiene Egle , Muliuolyte Egle , Kosys Vidas , Pavlavičius Lukas , Zukovas Giedrius , Karciauskas Dainius , Benetis Rimantas 
Published: September 2019

Objective: Surgical management of infective endocarditis continues to be challenging and is associated with significant morbidity and mortality. The objective of our study was to determine the risk factors and conditions associated with poor early infective endocarditis surgical treatment outcomes—30-day postoperative mortality. Methods: A total of 124 patients who underwent surgery for infective endocarditis at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics from January 2010 to December 2017 were retrospectively included in this study. The primary endpoints were 30-day postoperative mortality and identification of risk factors associated with it. Secondary endpoints were early postoperative outcomes and complication rates. Results: During the study period, 124 patients with infective endocarditis underwent cardiac surgery, presenting an overall 30-day postoperative mortality rate of 10.48%. Mean age was 58 ± 14.4 years with 95 (76.61%) males. Independent predictive factors of early mortality were age >63 years (odds ratio = 6.4, 95% confidence interval = 1.66-24.66, p = 0.003), body mass index >30 kg/m² (odds ratio = 7.74, 95% confidence interval = 2.20-27.27, p = 0.003), and ischemic heart disease (odds ratio, 6.6, 95% confidence interval = 1.62-26.90, p = 0.003), as well as intraoperative parameters—prolonged aortic cross-clamp >84.5 minutes (odds ratio = 3.79, 95% confidence interval = 1.10-13.08, p = 0.03) and cardiopulmonary bypass time >107.5 minutes (odds ratio = 10.0, 95% confidence interval = 1.26-79.58, p = 0.023). Staphylococcus aureus infection (odds ratio = 5.04, 95% confidence interval = 1.29-19.64, p = 0.012), infective endocarditis–related intracardiac complication such as paravalvular abscess detected by transesophageal echocardiography (odds ratio = 4.32, 95% confidence interval = 1.31-14.25, p = 0.01), and infective endocarditis complicated by septic or cardiogenic shock (odds ratio, 18.43, 95% confidence interval = 4.59-73.98, p = 0.001) were statistically significant factors for increased risk of 30-day postoperative mortality. Conclusion: Surgical treatment of infective endocarditis showed good results in our center. The independent predictors of 30-day postoperative mortality for patients who underwent cardiac surgery for infective endocarditis were age, body mass index, ischemic heart disease, prolonged aortic cross-clamp and cardiopulmonary bypass time, Staphylococcus aureus infection, paravalvular abscess, and septic or cardiogenic shock.
Suicide Means Used by the Older Adults in Rural China: A Comparison Between Those Using Pesticides and Other Means
Authors: Zhu Rong-Ting , Ma Zhenyu , Jia Cunxian , Zhou Liang 
Published: September 2019

Background: The most frequently used means of committing suicide was pesticide poisoning in rural China, yet little is known about the characteristics and risk factors for suicides committed with pesticides compared to those committed via other means in older adults. Methods: The participants were 242 older adults (aged 60 or older) who had committed suicide in the rural areas of 3 provinces (Shandong, Hunan, and Guangxi) in China. This study was conducted using the psychological autopsy (PA) method. Results: In univariate analyses, no statistically significant differences were found between those who committed suicide with pesticide or with other means in terms of demographic and clinical variables except age, prevalence of mental disorders, suicidal intent, number of recent life events, social support, hopelessness, impulsivity, and depressive symptoms ( P > .05); age, history of suicide attempts, having pesticides available at home, the total number of life events, and the number of long-term life events were significantly different ( P < .05) between the 2 groups. In multivariate logistic regression model, the factors associated with committing suicide with pesticides were the availability of pesticides at home (odds ratio [OR] = 3.48, 95% confidence interval [CI]: 1.99-6.08) and the number of long-term life events (OR = 0.87, 95% CI: 0.78-0.97). Conclusion: The older adults who committed suicide by pesticides and those using other means are probably the same population. The main determinant of choosing pesticides as suicide means was likely the availability of pesticides at home. Suicide risk among older adults might be reduced by placing appropriate restrictions on access to pesticides.
Smartphone “Selfies”—A reliable and accurate tool for measuring elbow range of motion
Authors: Shields Maegan N , Vaichinger Anthony M , O’Driscoll Shawn W 
Published: September 2019

Background To determine if self-taken photographs (“selfies”), performed independently after instruction by video or illustrated handout, would be an accurate and reliable tool for capturing elbow range of motion in patients with elbow contractures. Methods Fifty patients presenting with elbow contractures participated in the study. After completion of the selfie, the senior author clinically measured flexion and extension with a goniometer. The angles from the photographs were measured and analyzed. Results The agreement between goniometer and “selfie” measurements correlated closely (R2 = 0.98) and agreement was excellent in both extension and in flexion with intra-class correlation coefficients of 0.95 (95% CI 0.92 to 0.97) in extension with a mean difference of 2° (95% CI −3° to 7°), and 0.93 (95% CI 0.89 to 0.96) in flexion with a mean difference of 4° (95% CI 0° to 8°). Systematic errors were low in extension, 0° (95% CI, ±11°) and in flexion −3° (95% CI, ±10°). Six patients demonstrated ≥10° difference between clinical and selfie measurements. Ability to take a usable selfie was inversely correlated with age (R2 = 0.97). Discussion Self-taken flexion–extension photographs are a reliable and accurate tool for measuring elbow range of motion. Errors in the selfie technique are well tolerated and appear to have a negligible effect upon measurements of motion. This important parameter of elbow function can therefore be obtained outside a normal clinic visit, thereby improving frequency of follow-up assessments (and minimizing loss to follow-up) necessary for quality control and research.
Distal clavicle autograft for anterior-inferior glenoid augmentation: A comparative cadaveric anatomic study
Authors: Hudson Parke W , Pinto Martim C , Brabston Eugene W , Hess Matthew C , Cone Brent M , Williams Johnathan F , Brooks William S , Momaya Amit M , Ponce Brent A 
Published: September 2019

Introduction The aim of this study was to anatomically compare distal clavicle and coracoid autografts and their potential to augment anterior-inferior glenoid bone loss. Methods Ten millimeters of distal clavicle and 20 mm of coracoid were harvested bilaterally from 32 cadavers. Length, weight, and height were measured and surface area and density were calculated. For each graft, ipsilateral measurements were compared and the ability to restore corresponding glenoid bone loss was calculated. Results Distal clavicle grafts were larger than coracoid grafts with respect to length (22.3 mm versus 17.7 mm; p < 0.001), height (12.49 mm versus 9.65 mm; p < 0.001), mass (2.72 g versus 2.45 g; p = 0.0437), and volume (2.36 cm3 versus 1.96 cm3; p = 0.002). Coracoid grafts had larger widths (14.56 mm versus 10.52 mm; p < 0.001) and greater density (1.24 g/cm3 versus 1.18 g/cm3; p < 0.001). Distal clavicle surface area was greater on both the articular (2.93 cm2 versus 1.5 cm2; p < 0.001) and superior surfaces (2.76 cm2 versus 1.5 cm2; p < 0.001) when compared to lateral coracoid surface area. Discussion Distal clavicle grafts were larger and restored larger bony defects but had greater variability and lower density than coracoid grafts. Clinical studies are needed to compare these graft options.
Does prior antithrombotic therapy influence recurrence and bleeding risk in stroke patients with atrial fibrillation or atrial flutter?
Authors: Gamble David T , Buono Romain , Mamas Mamas A , Leslie Stephen , Bettencourt-Silva Joao H , Clark Allan B , Bowles Kristian M , Metcalf Anthony K , Potter John F , Myint Phyo K 
Published: September 2019

Background Whilst antithrombotic therapy is recommended in people with atrial fibrillation, little is known about the survival benefits of antithrombotic treatment in those with both high ischaemic and bleeding risk scores. We aim to describe the distribution of these risk scores in those with a prior diagnosis of atrial fibrillation who have suffered stroke and to determine the net clinical benefit of antithrombotic treatment. Methods We used regional stroke register data in the UK. Patients with a prior diagnosis of atrial fibrillation and ischaemic or haemorrhagic stroke patients were selected and their ischaemic stroke risk score (CHA2DS2-VASc) and bleeding risk score (HEMORR2HAGES) scores retrospectively calculated. Logistic regression and Cox proportional hazards models were constructed to determine the association between antithrombotic therapy prior to stroke and in-hospital and long-term mortality. Results A total of 1928 stroke patients (mean age 81.3 years (standard deviation 8.5), 56.8% women) with prior atrial fibrillation were included. Of these, 1761 (91.3%) suffered ischaemic stroke. The most common phenotype (64%) was of those with both high CHA2DS2-VASc (≥2) and high HEMORR2HAGES score (≥4). In our fully adjusted model, patients on antithrombotic treatment with both high ischaemic and bleeding risk had a significant reduction in odds of 31% for in-hospital mortality (odds ratio 0.69 (95% confidence interval 0.48–1.00: p = 0.049)) and 17% relative risk reduction for long-term mortality (hazard ratio 0.83 (95% confidence interval 0.71–0.97: p = 0.02)). Conclusions Our study suggests that antithrombotic treatment has a prognostic benefit following incident stroke in those with both high ischaemic risk and high bleeding risk. This should be considered when choosing treatment options in this group of patients.
Musculoskeletal Simulation Tools for Understanding Mechanisms of Lower-Limb Sports Injuries
Authors: Bulat Muge , Korkmaz Can Nuray , Arslan Yunus Ziya , Herzog Walter 
Published: September 2019

Abstract
Musculoskeletal simulation and dynamic modeling programs have been used to gain insight into lower-limb musculoskeletal injury mechanisms. In addition to the temporospatial, kinematic, and kinetic data obtained from motion analysis systems, musculoskeletal simulation programs also can provide information on joint contact and muscle forces, musculotendinous lengths and velocities, and muscle activation levels. Musculoskeletal simulation platforms may help in the assessment of risk factors for sports-related injuries. Using musculoskeletal simulations for injury prevention programs may help lower the incidence of sports injuries, and may allow for fast recovery from injury. In this review, injury mechanisms and risk factors of some of the most common lower-limb musculoskeletal injuries, including anterior cruciate ligament, patellofemoral, and hamstring injuries were summarized from a biomechanical perspective. Also, the efficacy of musculoskeletal modeling and dynamic simulation tools in helping our understanding of these injury mechanisms was discussed.
Running Dose and Risk of Developing Lower-Extremity Osteoarthritis
Authors: Gessel Trevor , Harrast Mark A. 
Published: September 2019

Abstract
Whether or not running leads to the development of knee and hip osteoarthritis has been a much-debated topic and is often a question patients pose to their physicians. Recent literature adds to a growing body of evidence suggesting that lower-dose running may be protective against the development of osteoarthritis, whereas higher-dose running may increase one's risk of developing lower-extremity osteoarthritis. However, running dose remains challenging to define, leading to difficulty in providing firm recommendations to patients regarding the degree of running which may be safe. Furthermore, when counseling patients regarding their risk of developing lower-extremity osteoarthritis secondary to running, clinicians must consider many additional factors, such as the numerous health benefits from running and individual risk factors for developing osteoarthritis.
Intermittent Fasting and Its Effects on Athletic Performance: A Review
Authors: Levy Emily , Chu Thomas 
Published: September 2019

Abstract
Intermittent fasting (IFast) has been around for most of human history, and its proposed health benefits have been mentioned in ancient civilizations. However, recently, there has been a renewed public interest in IFast. Given the importance of nutrition in optimizing athletic performance, there is a concern about the effects of IFast on athletics. Most of the studies looking at performance and fasting are regarding athletes who observe Ramadan. Looking at high-intensity, endurance, and resistance exercises, studies have been varied but are uniform in showing that there is no benefit to athletic performance while fasting. More long-term studies need to be done to evaluate specific fasting protocols during sport.
Aprendendo com o erro
Authors: Wilner Adriana , Dos Santos Aline Lilian 
Published: September 2019

“Coloque no arquivo APP”, dizia a mensagem cifrada. “A” significa “2”, e “P”, “5”, um alto executivo explicou aos investigadores. Significava que uma propina de 2,55% havia sido autorizada. Poderia ser um trecho da Lava Jato, mas se trata de um depoimento que fez parte do escândalo de corrupção envolvendo a alemã Siemens, em 2006. À época, descobriu-se que a empresa mantinha um esquema de pagamentos ilegais em diversos países para conseguir contratos de obras públicas.Em meio a multas, baixa nas ações e demissão de executivos, entre eles o então presidente global Klaus Kleinfeld, a empresa criou e instaurou um programa de compliance que se tornou referência para outras corporações e instituições. Uma das primeiras medidas implantadas foi o canal de denúncias, que permitiu, por exemplo, que, dois anos depois do escândalo inicial, um funcionário da filial brasileira trouxesse à tona o pagamento de propinas em obras do Metrô de São Paulo. Hoje, no site nacional da Siemens, o primeiro item que aparece para pesquisa quando se quer conhecer a empresa é compliance.Nesta entrevista à GV-executivo, André Clark, CEO da Siemens no Brasil, revela como a empresa fez para superar o momento difícil e de que forma busca ampliar o conceito de compliance na organização associando o comportamento ético e responsável ao meio ambiente, à diversidade e à sociedade. O executivo também fala sobre as vantagens e os desafios da gestão no atual momento econômico e político do país, além das oportunidades que enxerga no campo da infraestrutura.
Biological effects of nicotine exposure: A narrative review of the scientific literature
Authors: Price Leonie R. , Martinez Javier 
Published: September 2019

The emergence of new tobacco heating products and electronic nicotine delivery systems (ENDS) is changing the way humans are exposed to nicotine. The purpose of this narrative review is to provide a broad overview of published scientific literature with respect to the effects of nicotine on three key health-related areas: 1) cardiovascular risk, 2) carcinogenesis and 3) reproductive outcomes. These areas are known to be particularly vulnerable to the effects of cigarette smoke, and in addition, nicotine has been hypothesized to play a role in disease pathogenesis. Acute toxicity will also be discussed.The literature to February 2019 suggests that there is no increased cardiovascular risk of nicotine exposure in consumers who have no underlying cardiovascular pathology. There is scientific consensus that nicotine is not a direct or complete carcinogen, however, it remains to be established whether it plays some role in human cancer propagation and metastasis. These cancer progression pathways have been proposed in modelsin vitroand in transgenic rodent linesin vivobut have not been demonstrated in cases of human cancer.Further studies are needed to determine whether nicotine is linked to decreased fertility in humans. The results from animal studies indicate that nicotine has the potential to act across many mechanisms during fetal development. More studies are needed to address questions regarding nicotine exposure in humans, and this may lead to additional guidance concerning new ENDS entering the market.
The direct-medical costs associated with interferon-based treatment for Hepatitis C in Vietnam
Authors: Nguyen Huyen Anh , Cooke Graham S. , Day Jeremy N. , Flower Barnaby , Phuong Le Thanh , Hung Trinh Manh , Dung Nguyen Thanh , Khoa Dao Bach , Hung Le Manh , Kestelyn Evelyne , Thwaites Guy E. , Chau Nguyen Van Vinh ,   SEARCH Investigators, Turner Hugo C. 
Published: September 2019

Background: Injectable interferon-based therapies have been used to treat hepatitis C virus (HCV) infection since 1991. International guidelines have now moved away from interferon-based therapy towards direct-acting antiviral (DAA) tablet regimens, because of their superior efficacy, excellent side-effect profiles, and ease of administration. Initially DAA drugs were prohibitively expensive for most healthcare systems. Access is now improving through the procurement of low-cost, generic DAAs acquired through voluntary licenses. However, HCV treatment costs vary widely, and many countries are struggling with DAA treatment scale-up. This is not helped by the limited cost data and economic evaluations from low- and middle-income countries to support HCV policy decisions. We conducted a detailed analysis of the costs of treating chronic HCV infection with interferon-based therapy in Vietnam. Understanding these costs is important for performing necessary economic evaluations of novel treatment strategies. Methods: We conducted an analysis of the direct medical costs of treating HCV infection with interferon alpha (IFN) and pegylated-interferon alpha (Peg-IFN), in combination with ribavirin, from the health sector perspective at the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, in 2017. Results: The total cost of the IFN treatment regimen was estimated to range between US$1,120 and US$1,962. The total cost of the Peg-IFN treatment regimen was between US$2,156 and US$5,887. Drug expenses were the biggest contributor to the total treatment cost (54-89%) and were much higher for the Peg-IFN regimen. Conclusions: We found that treating HCV with IFN or Peg-IFN resulted in significant direct medical costs. Of concern, we found that all patients incurred substantial out-of-pocket costs, including those receiving the maximum level of support from the national health insurance programme. This cost data highlights the potential savings and importance of increased access to generic DAAs in low- and middle-income countries and will be useful within future economic evaluations.
The conjunctival transcriptome in Ethiopians after trichiasis surgery: associations with the development of eyelid contour abnormalities and the effect of oral doxycycline treatment
Authors: Derrick Tamsyn , Habtamu Esmael , Tadesse Zerihun , Callahan E. Kelly , Worku Abebaw , Gashaw Bizuayehu , Macleod David , Mabey David C.W. , Holland Martin J. , Burton Matthew J. 
Published: September 2019

Background: Surgery to correct trichiasis is a key component of the World Health Organisation trachoma control strategy, however unfavourable outcomes such as eyelid contour abnormalities (ECA) following surgery are relatively common. This study aimed to understand the transcriptional changes associated with the early development of ECA and the impact of doxycycline, which has anti-inflammatory and anti-fibrotic properties, upon these transcription patterns. Methods: One thousand Ethiopians undergoing trichiasis surgery were enrolled in a randomised controlled trial following informed consent. Equal groups of randomly assigned individuals were orally administered with 100mg/day of doxycycline (n=499) or placebo (n=501) for 28 days. Conjunctival swabs were collected immediately prior to surgery and at one- and six-months post-surgery. 3’ mRNA sequencing was performed on paired baseline and one-month samples from 48 individuals; 12 in each treatment/ECA outcome group. qPCR validation was then performed for 46 genes of interest in 145 individuals who developed ECA at one month and 145 matched controls, using samples from baseline, one and six months. Results: All treatment/outcome groups upregulated genes associated with wound healing pathways at one month relative to baseline, however no individual differences were detected between groups. The summed expression of a highly coexpressed cluster of pro-fibrotic genes was higher in patients that developed ECA in the placebo group relative to controls. qPCR validation revealed that all genes in this cluster and a number of other pro-inflammatory genes were strongly associated with ECA, however these associations were not modulated by trial arm. Conclusions: The development of post-operative ECA is associated with overexpression of pro-inflammatory and pro-fibrotic genes including growth factors, matrix metalloproteinases, collagens and extracellular matrix proteins. There was no evidence that doxycycline modulated the association between gene expression and ECA.
CONVERSA SOBRE EDUCAÇÃO COM RAEWYN CONNELL
Authors: Mattos Carmen Lúcia Guimarães de , Caetano Márcio Rodrigo Vale , Castro Paula Almeida de 
Published: September 2019

A conversar com Raewyn Connell tever início pela sua trajetória acadêmica a partir do livro Making the Difference: Schools, Families and Social Division (1982), cuja publicação em língua portuguesa ampliou o interesse de pesquisadores em educação pelos estudos de gênero. Dada a amplitude da produção da autora nesta linha de estudos a conversa continua com indagações sobre a importância para escola em lidar com esse tema, assim como sua interconexão com os estudos sobre masculinidades e suas teorizações internacionais e mais particularmente no Hemisfério Sul, visto que Connell, à época estava divulgando o seu livro Southern Theory: The Global Dynamics of Knowledge in Social Science. Discutiu-se as possibilidades teóricas do Sul pelo Sul, o papel da escola na introdução dos temas sobre as ordenações de gênero e finalmente apresenta-se reflexões dos autores sobre seus próprios questionamentos a cerca da obra da autora.