bluuebunny/crossref_metadata_2025_split huggingface dataset:
Possible beneficial association between renin-angiotensin-aldosterone-system blockade usage and graft prognosis in allograft IgA nephropathy: A retrospective cohort study
Authors: Park Sehoon , Baek Chung Hee , Go Heounjeong , Kim Young Hoon , Min Sang-il , Ha Jongwon , Kim Yong Chul , Lee Jung Pyo , Kim Yon Su , Moon Kyung Chul , Park Su-Kil , Lee Hajeong 
Published: July 2019

Abstract
Background

Although immunoglobulin A nephropathy (IgAN) is associated with a high risk of renal allograft failure, evidences for its treatment, including renin-angiotensin-aldosterone system blockade (RAASB) usage, remain limited.

Methods

In this bi-center retrospective cohort study, we included patients who were recently diagnosed with IgAN through allograft biopsies. We identified their 6-month antihypertensive medication prescriptions and investigated the association between the medication types, albuminuria changes, and consequent 5-year death-censored-graft-failure (DCGF). The mixed effect model and cox regression analysis were used.

Results

A total of 464 allograft IgAN patients were included: 272, 38, 33, and 121 patients in the no antihypertensive medication, single agent RAASB, single agent beta blocker (BB)/calcium channel blocker (CCB), and combination therapy groups, respectively. High-degree albuminuria after 6 months of allograft IgAN diagnosis was an important prognostic parameter and a partial mediator for the association between the subgroups and 5-year DCGF. The usage of single RAASB was associated with decrement of albuminuria from allograft diagnosis (P for interaction = 0.03). The single BB/CCB group demonstrated significantly worse prognosis than the single RAASB group (adjusted hazard ratio, 2.76 [1.09-6.98]; P=0.03).

Conclusions

In conclusion, RAASB may be beneficial for graft prognosis in early allograft IgAN patients who require single antihypertensive medication therapy, by means of reducing albuminuria. Further investigation of treatment strategy in allograft IgAN is warranted.
Impact of secondary roads on wildlife of coastal center region Portugal and differences between before and post fire.
Authors: Cruz Tiago Miguel Regateiro , Lima Joana , Azeiteiro Ulisses 
Published: July 2019

Abstract
• Context: Anthropogenic activities affect ecosystems creating stress regimes and new disturbances. Among these anthropogenic activities, we highlight roads that are main cause of habitat segmentation. On the other hand, as roads were built to accommodate traffic in rural areas, rate of vehicle-wildlife collisions has significantly expanded, thereby causing a direct decrease in population size.
• Objectives: This study was conducted in Portugal (country's western central coast) and assessed impact of secondary roads on wildlife, as well as the influence that a catastrophic event, like a great fire, has on this wildlife.
• Methods: Practical work was carried out during 15 months (from October 2016 to December 2017), two consecutive days per week, first day being used for "road cleaning", that is, collection of all animals found on road, followed of their identification, and second day for morning and afternoon collection and identification of dead animals found on same tracks.
• Results: In Agricultural Zone, vertebrate deaths on the road covered 17 species. Birds were the most affected , followed by amphibians, mammals and reptiles. The most fragile species were Passer domesticus and Salamandra salamandra. Two hotspots were recognized, one on each road. In Forestral Zone, vertebrate deaths on road included 26 species. Mammals were most vulnerable in this area followed by birds, amphibians and reptiles. Bufo bufo and Salamandra salamandra were the most vulnerable species.
• Conclusions: On the contrary, differences between roads composition were clear: there were only deaths on asphalted roads. Differences between before and after fire are evident. Mitigation measures were suggested.
Longitudinal Study on Functional and Cognitive Outcomes in Patients with Postoperative Delirium after Femoral Fracture
Authors: Balzer-Geldsetzer Monika , Buecking Benjamin , Ruchholtz Steffen , Kis Bernhard , Dodel Richard , Hessmann Philipp 
Published: July 2019

Abstract
Background

Proximal femoral fractures are frequent injuries of elderly people and are often associated with declines in physical function and high rates of morbidity and mortality. A severe and frequent complication after hip surgery is postoperative delirium (POD), potentially associated with poorer clinical outcomes. We hypothesized that elderly patients with POD after hip fracture showed significantly worse clinical outcomes within one year after the fracture, compared to patients not suffering from POD. Additionally, relevant predictors of POD were evaluated.

Methods

Patients with proximal femoral fractures aged ≥ 60 years were included in a prospective, single-center observational study in Germany and followed up for 12 months. POD was evaluated by daily application of the Confusion Assessment Method (CAM) during the acute hospital stay. A variety of standardized instruments were used to evaluate patients’ functional and cognitive capacity, mobility, quality of life (HrQoL), depression, pain, etc., at baseline, discharge, and follow-up. A multiple logistic regression analysis was conducted to determine socio-demographic and clinical predictors of POD.

Results

Among 402 included patients (mean age: 81.3 ± 8.2 years), 184 (45.8%) developed POD (mean duration: 6.5 ± 4.4 days). At baseline, POD patients were significantly older, more often institutionalized, cognitively and physically more impaired, reported lower HrQoL, and had significantly more complications during the hospital stay. Multiple logistic regression analyses explained 22% of the variance, while prolonged intensive care unit stays, level of pain after surgery, and diminished pre-operative physical and cognitive state were significant predictors of POD. In-hospital mortality and overall mortality after 12 months were significantly higher in POD patients. Twelve months after the fracture, POD was significantly associated with diminished mobility, HrQoL, cognitive and functional capacity, and higher risk of falls.

Conclusions

Pain management is an important and controllable variable during hospital stay and should be a specific focus of the postoperative period, especially in functionally and cognitively impaired patients. Since patients with POD showed significantly worse clinical outcomes at discharge and 12 months post-fracture, prevention and effective treatment of POD should be of high priority in elderly patients with hip fractures.
“Being in good hands”: Next of kin’s perceptions of continuity of care in patients with heart failure
Authors: Östman Malin , Bäck-Pettersson Siv , Sandvik Ann-Helén , Sundler Annelie J 
Published: July 2019

Abstract
Background
Heart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin's perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF.
Methods
This study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n=15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants' perceptions of the phenomenon.
Results
The analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin's perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities.
Conclusions
Next of kin perceive continuity of care to entail well-functioning, long-term and reliable contact with healthcare providers that support them in reducing unnecessary medical and nursing hindrances. They have a variety of needs for continuity and support in connection with their caregiving activities so they can continue to live a meaningful life under the prevailing circumstances. In order to strengthen the next of kin's contact with healthcare providers, it is important to consider the need for continuity of care in relation to patients with HF.
Keywords
Continuity of care, Heart failure, Next of kin, Phenomenography, Qualitative research
Comparison of Oxycodone and Sufentanil for intravenous patient-controlled analgesia after hip surgery: a prospective, randomized controlled trial
Authors: Li Jingyi , Zhu Haibei , Liao Ren 
Published: July 2019

Abstract
Background

Intravenous patient-controlled analgesia (PCA) after hip surgery should be focused on the balance of sufficient analgesia and the risk of associated adverse reactions. Sufentanil has high analgesic efficacy as a common used drug for PCA while with obvious side effects. Oxycodone is a semi-synthetic opioid which has been reported to have good analgesic effect and lower incidence of adverse reactions related to long-acting opioid. We hypothesize that in hip surgery, compared with sufentanil PCA, the equipotency dose of oxycodone PCA could achieve the same postoperative analgesic efficacy and may also reduce the incidence of adverse reactions associated with long-acting opioids.

Methods/Design

This trial is a prospective, randomized, controlled clinical trial comparing the safety and efficacy of oxycodone and sufentanil for postoperative patient-controlled analgesia in patients undergoing hip surgery. A total of 570 subjects undergoing hip surgery will be randomly allocated to either sufentanil PCA group or oxycodone PCA group. The primary outcome is the resting numerical rating scales (NRS) pain scores at 30 min, 2 h, 6 h, 24 h, 48 h, and 72h after surgery. The secondary outcomes include postoperative NRS pain scores on movement, in-hospital complications, range of motion of hip joints, mobilization time, length of hospital stay, total in-hospital cost, and readmission rate by 30 days after discharge from the hospital.

Discussion

This trial is designed to compare the safety and efficacy of oxycodone and sufentanil PCA in patients undergoing hip surgery, in order to find an optimal postoperative analgesic regime with fewer adverse reactions and promoting patients’ rehabilitation. The results will provide evidence for anesthetic choice in clinical practice.
A new type of canned meat-based food for infants
Authors: Georgieva O. V. , Kon' I. Ya. , Pyryeva E. A. , Makarkin D. V. , Nefedov S. S. 
Published: June 2019

The article discusses the role of meat and meat products in the diet of younger children. It contains the data on the chemical composition of raw meat, traditionally used in the children’s diet. The authors outline modern sanitary and hygienic requirements to meat products for children of early age. They present new types of pate canned meat and canned poultry meat, their ingredients and chemical composition. There are recommendations on their use by children over eighteen months of life.
Gender problems in newborns: social, medical and legal aspects
Authors: Komkova G. N. , Basova A. V. 
Published: June 2019

Objective of the study. To analyze the modern literature on the legal regulation of the determination of the sex of newborns with disturbances of sexual development in Russia and abroad, as well as the right of these children for self-determination of their sex upon coming of age. Material and methods. The review is based on the domestic and foreign literature published overthe past 7 years, including in Pubmed. Results. There were revealed the modern problems of the legal regulation of determining the sex of newborns with developmental disorders in the territory of the Russian Federation. Conclusion. The right to the sex self-determination of the children born with impaired sexual development upon coming of age requires careful analysis by medical experts, as from a legal point of view it contributes to a more complete implementation of the constitutional principle of equality regardless of gender and ensures human rights in accordance with their perception and attitude.
Case of early diagnosis of hereditary thrombophilia in a 16 days child
Authors: Podsvirova E. V. , Balakireva E. A. , Romanova T. A. , Churnosov M. I. , Rudykh N. A. , Golovchenko O. V. , Yudina N. B. 
Published: June 2019

The article describes a clinical case of early diagnosis of hereditary thrombophilia in a child in the neonatal period, based on clinical, laboratory and genetic examination. Clinical suspicion to hereditary hemostatic disorders, careful analysis of hereditary and family history allowed to identify and confirm with the help of PCR polymorphism of genes associated with hemostatic system in a child of two weeks of age. Early diagnosis allows to make an individual plan of observation and dynamic examination to prevent increased thrombosis and possible vascular catastrophe in the child, to prevent metabolic and hemostatic disorders in both the mother and her relatives, and in the probable future siblings of the patient, and in the long term and in his descendants.
Causes of overdiagnosis of epilepsy in children
Authors: Belousova E. D. 
Published: June 2019

Misdiagnosis of epilepsy is a common phenomenon (up to 20% of the total population of patients with epilepsy and up to 30–40% in the population of pharmacoresistant epilepsy) and dangerous, leads to significant social restrictions and is accompanied by significant unjustified medical expenses. The objective reasons for misdiagnosis include a large number (about 40) of conditions that are similar and often indistinguishable in their clinical manifestations from epileptic seizures, descriptive character and lack of obligatory diagnostic criteries (especially electroencephalographic), limiting medical access to the necessary research methods. The subjective errors include insufficiently collecting anamnesis, exaggerating the possibility of developing a more rare disease (in this case epilepsy), a false impression of the doctor that if epilepsy is not diagnosed, then it will have the most terrible consequences. The situation of misdiagnosis is aggravated by the fact that neurophysiologists are more likely to overestimate the EEG in the direction of epileptic and epileptiform (interictal) phenomena. Subjective errors are eliminated by learning and self-learning. Even the most experienced epileptologists can make mistakes with the diagnosis, and in a certain sense mistakes are inevitable. We can’t always wait for the final diagnosis and often have to start treatment without being 100% sure of the diagnosis of epilepsy. Therefore, it is necessary to practice the periodic revision of the diagnosis of epilepsy, especially in cases where the disease is difficult to treat.
TECHNIQUE FOR RESECTION OF ATHEROSCLEROTIC ABDOMINAL AORTIC ANEURYSM WITH ANOMALOUS ORIGIN OF RENAL ARTERIES AND PELVIC DYSTOPIA OF THE LEFT KIDNEY
Authors: Zotikov A. E. , Ilyin S. S. , Kulbak V. A. , Maryan D. I. , Gogiya B. Sh. 
Published: June 2019

This article describes the clinical observation of a patient with an atherosclerotic abdominal aortic aneurysm and pelvic dystopia of the left kidney. Due to the anomalous origin of renal arteries, we have chosen a method of treatment consisted of resection and an aortic prosthetics and reimplantation of vessels extending from the aortic aneurysm. 5 years after surgery, the patient had an aneurysm of the left iliac artery, which required repeated intervention. Our approach allowed us to preserve all the renal arteries and renal function.
A STRATEGY FOR MANAGING A PATIENT WITH ATRIAL FIBRILLATION TO REDUCE THE RISK OF THROMBOEMBOLIC COMPLICATIONS
Authors: Kudryavtseva L. I. , Filippov E. V. 
Published: June 2019

Over the past 20 years, the burden of atrial fibrillation (AF) has increased. AF is associated with increased risk of death, ischemic stroke and disability, hospitalization rates, and reduced quality of life. Treatment for this pathology is based on the correction of risk factors, underlying disease and anticoagulant therapy. The review considers strategies to minimize the risk of complications during oral anticoagulant therapy.
POSSIBILITIES OF INHIBITING ANTICOAGULANT ACTIVITIES THAT INHIBIT XA-FACTOR
Authors: Erlich A. D. 
Published: June 2019

The article deals with the possibility of suppressing the effect of drugs inhibiting the activity of the Xa-Factor of the clotting blood system. Wide indications for oral anticoagulants are atrial fibrillation, venous thrombosis, thromboembolism, etc. - more and more patients are involved in this treatment, and the use of nonvitamin-K-associated (NOAC) anticoagulants is increasing. Although these drugs have a relatively good safety profile, their use may also lead to “large”, including life-threatening, bleeding. Current approaches to the treatment of such bleeding include, in addition to a wide range of non-specific hemostatic measures, the use of drugs that can selectively suppress the effects of NOAC. A specific antagonist, the andexanet-alfa, has been developed relatively recently for anticoagulants that suppress the activity of the coagulation Xa-factor (such as Apixaban and Rivaroxaban). This drug represents a molecule of catalytically inactive modified human recombinant Xa-factor, obtained from human Xa-factor by genetically engineered modification. Being inactive with respect to coagulation, the drug molecule has the ability to bind the molecules of Xa-factor inhibitors with a high degree of strength, neutralizing their action.In the recently completed ANNEXA-4 clinical trial, 352 patients (average age 77 years) were injected with Rivaroxaban (36%), Apixaban (55%), Edoxaban (3%) or Enoxaparin (6%), with life-threatening bleeding (intracranial - 64%, gastrointestinal - 26%). The study showed that the anti-Ha activity of NOAC decreased by more than 90% in the first minutes after the introduction of andexanet and remained reduced 12 hours after its infusion. In 82% of patients in the ANNEXA-4 study, the hemostatic effect of the andexanet was assessed as excellent or good, and it did not differ significantly depending on the sex, age of the patients, the dose of the andexanet and the place of bleeding. No significant procoagulant or immunogenic effect of the andexanet was found. Thus, in the case of life-threatening bleeding with Xa-factor inhibitory anticoagulants, the use of their specific andexanet-alfa antagonist is recommended by clinical guidelines and should be an integral part of the hemostatic therapy and may potentially extend the safety spectrum of these anticoagulants.
Implementasi program desa vokasi berbasis pelatihan kewirausahan tata boga
Authors: Ikhsan Norma Laili 
Published: July 2019

Tujuan penelitian ini adalah untuk mengetahui implementasi program pelatihan kewirausahaan tata boga di Desa Vokasi Grujugan, Penilaian hasil, faktor pendukung dan penghambat kegiatan usaha, dan dampak program. Penelitian ini menggunakan pendekatan deskriptif kualitatif. Subjek penelitian adalah pengelola, tutor, peserta didik di Desa Vokasi Grujugan. Pengumpulan data dilakukan dengan menggunakan metode observasi, wawancara, dokumentasi. Teknik analisis data melalui reduksi data, penyajian data, dan penarikan kesimpulan. Hasil penelitian mengungkapkan sebagai berikut. (1) Implementasi pelatihan kewirausahaan tata boga Desa Vokasi Grujugan terdiri atas empat tahap yaitu tahap persiapan, pelaksanaan, monitoring dan evaluasi, dan tindak lanjut. (2) Penilaian hasil pelatihan menunjukan terjadi perubahan sikap peserta didik dalam menjalankan kegiatan usaha mandiri. (3) Faktor mendukung meliputi motivasi; perencanaan yang baik; pendampingan usaha yang baik; dan kemampuan mengenal peluang, kesempatan. Faktor penghambat meliputi kurangnya pengalaman, kemampuan manajerial dan SDM; kurangnya modal, kemampuan mengatur aliran kas dan kemampuan dalam kemampuan menghadapi resiko. (4) Dampak pelaksanaan program, meliputi: peningkatan ketrampilan (SDM), kemampuan berwirausaha, peningkatan status sosial, peningkatan aspek sosial ekonomi. The Implementation of the Vocational Village Program Based on Culinary Entrepreneurship Training AbstractThe purpose of this study was to determine The implementation of entrepreneurship training program in the village of vocational culinary Grujugan, the rating results, the factors supporting and hindering business activity, and the impact of the program. This study used a qualitative descriptive approach. Subjects were managers, tutors, learners in vocational Grujugan village. The data collection is done by using the method of observation, interviews, documentation. Mechanical analysis of data through data reduction, data presentation, and conclusion. Results of the study revealed the following. (1) The Implementation of entrepreneurship training vocational culinary Grujugan village consists of four phases: preparation, implementation, monitoring and evaluation, and follow-up. (2)The ratings training results indicate a change in attitudes of learners in running an independent business. (3) The factors include motivational support; good planning; Good business assistance; and the ability to recognize an opportunity, a chance. Inhibiting factors include a lack of experience, managerial ability and resources; lack of capital, the ability to manage cash flow and ability to ability to face risks. (4) The impact of the implementation of the program, including: increasing the skills (human resources), entrepreneurship skills, increase social status, improvement of socio-economic aspects.Keywords: