bluuebunny/crossref_metadata_2025_split huggingface dataset:
When to stop renal replacement therapy in anticipation of renal recovery in AKI: The need for consensus guidelines
Authors: Kelly Yvelynne P. , Waikar Sushrut S. , Mendu Mallika L. 
Published: January 2019

AbstractThere is wide variation in clinical practice regarding timing of discontinuation of renal replacement therapy (RRT) in patients with acute kidney injury (AKI). Prolonged, unnecessary RRT treatment can contribute to length of stay, overall hospital costs, and risk of complications associated with RRT. In addition, prolonged RRT can paradoxically lengthen the time for which the patient remains dialysis‐dependent. Well‐designed, randomized clinical trials have utilized varied discontinuation criteria specifically related to urine output and creatinine clearance, which impedes the comparison of outcomes from such studies. Other observational studies have attempted to assess the sensitivity and specificity of various criteria for discontinuation of RRT. Whether diuretics influence renal recovery has not been fully elucidated as well. In this article, we propose a starting framework for RRT discontinuation criteria to guide clinicians and clinical researchers. We emphasize the importance of frequent clinical assessment while considering discontinuation of RRT for AKI patients with a creatinine clearance >15 mL/min on a timed urine collection and/or a urine output >400 mL/24 h without diuretics, or >2000 mL/24 h with diuretics. We also discuss newer biomarkers, methods of GFR estimation, and imaging techniques that may play a greater role in the future. Clinical trials objectively comparing the success of RRT discontinuation criteria will be required to provide high‐quality evidence for our proposed guidelines.
Shoe‐mounted accelerometers should be used with caution in gait retraining
Authors: Cheung Roy T. H. , Zhang Janet H. , Chan Zoe Y. S. , An Winko W. , Au Ivan P. H. , MacPhail Aislinn , Davis Irene S. 
Published: January 2019

Real‐time biofeedback gait retraining has been reported to be an effective intervention to lower the impact loading during gait. While many of the previous gait retraining studies have utilized a laboratory‐based setup, some studies used accelerometers affixed at the distal tibia to allow training outside the laboratory environment. However, many commercial sensors for gait modification are shoe‐mounted. Hence, this study sought to compare impact loading parameters measured by shoe‐mounted and tibia sensors in participants before and after a course of walking or running retraining using signal source from the shoe‐mounted sensors. We also compared the correlations between peak positive acceleration measured at shoe (PPAS) and tibia (PPAT) and vertical loading rates, as these loading rates have been related to injury. Twenty‐four and 14 participants underwent a 2‐week visual biofeedback walking and running retraining, respectively. Participants in the walking retraining group experienced lower PPAS following the intervention (P < 0.005). However, they demonstrated no change in PPAT (P = 0.409) nor vertical loading rates (P > 0.098) following the walking retraining. In contrast, participants in the running retraining group experienced a reduction in the PPAT (P = 0.001) and vertical loading rates (P < 0.013) after running retraining. PPAS values were four times that of PPAT for both walking and running suggesting an uncoupling of the shoe with tibia. As such, PPAS was not correlated with vertical loading rates for either walking or running, while significant correlations between PPAT and vertical loading rates were noted. The present study suggests potential limitations of the existing commercial shoe‐mounted sensors.
Hypocalcaemia and hyponatraemia masquerading the diagnosis of Gitelman syndrome
Authors: Gopinath Bhargav , Chauhan Nupur , Achappa Basavaprabhu 
Published: January 2019

Gitelman syndrome is the most common renal tubulopathy, recently exhibiting a dramatic rise of incidence in Asia.A 50-year-old woman presented with vomiting, fatigue and quadriparesis. Physical examination revealed a positive Trousseau sign , hypotonia and areflexia.Suspecting hypocalcaemia, she was given intravenous 10% calcium gluconate (10 mL administered slowly over 10 min) but her manifestations persisted. An exhaustive laboratory work up revealed the diagnosis of Gitelman syndrome.The peculiarity of this case however, is entailed in its coexistence with hypocalcaemia and hyponatraemia. In addition, the age of primary presentation being 50 years further culminates its atypicality.Multiple electrolyte imbalances were corrected by oral and intravenous supplementation and a high sodium-potassium diet was advocated. Administration of spironolactone imposed a pitfall in the management of our patient due to exacerbation of pre-existing hyponatraemia.On follow-up, her electrolyte profile was stable and corresponding symptoms were alleviated.
Risk factors associated with paediatric unplanned hospital readmissions: a systematic review
Authors: Zhou Huaqiong , Roberts Pam A , Dhaliwal Satvinder S , Della Phillip R 
Published: January 2019

ObjectiveTo synthesise evidence on risk factors associated with paediatric unplanned hospital readmissions (UHRs).DesignSystematic review.Data sourceCINAHL, EMBASE (Ovid) and MEDLINE from 2000 to 2017.Eligibility criteriaStudies published in English with full-text access and focused on paediatric All-cause, Surgical procedure and General medical condition related UHRs were included.Data extraction and synthesisCharacteristics of the included studies, examined variables and the statistically significant risk factors were extracted. Two reviewers independently assessed study quality based on six domains of potential bias. Pooling of extracted risk factors was not permitted due to heterogeneity of the included studies. Data were synthesised using content analysis and presented in narrative form.ResultsThirty-six significant risk factors were extracted from the 44 included studies and presented under three health condition groupings. For All-cause UHRs, ethnicity, comorbidity and type of health insurance were the most frequently cited factors. For Surgical procedure related UHRs, specific surgical procedures, comorbidity, length of stay (LOS), age, the American Society of Anaesthesiologists class, postoperative complications, duration of procedure, type of health insurance and illness severity were cited more frequently. The four most cited risk factors associated with General medical condition related UHRs were comorbidity, age, health service usage prior to the index admission and LOS.ConclusionsThis systematic review acknowledges the complexity of readmission risk prediction in paediatric populations. This review identified four risk factors across all three health condition groupings, namely comorbidity; public health insurance; longer LOS and patients<12 months or between 13–18 years. The identification of risk factors, however, depended on the variables examined by each of the included studies. Consideration should be taken into account when generalising reported risk factors to other institutions. This review highlights the need to develop a standardised set of measures to capture key hospital discharge variables that predict unplanned readmission among paediatric patients.
Financial performance of English NHS trusts and variation in clinical outcomes: a longitudinal observational study
Authors: Nagendran Myura , Kiew Grace , Raine Rosalind , Atun Rifat , Maruthappu Mahiben 
Published: January 2019

ObjectivesTo examine the association between financial performance as measured by operating margin (surplus/deficit as a proportion of turnover) and clinical outcomes in English National Health Service (NHS) trusts.SettingLongitudinal, observational study in 149 acute NHS trusts in England between the financial years 2011 and 2016.ParticipantsOur analysis focused on outcomes at individual NHS Trust-level (composed of one or more acute hospitals).Primary and secondary outcomesOutcome measures included readmissions, inpatient satisfaction score and the following process measures: emergency department (Accident and Emergency (A&E)) waiting time targets, cancer referral and treatment targets and delayed transfers of care (DTOCs).ResultsThere was a progressive increase in the proportion of trusts in financial deficit: 22% in 2011, 27% in 2012, 28% in 2013, 51% in 2014, 68% in 2015 and 91% in 2016. In linear regression analyses, there was no significant association between operating margin and clinical outcomes (readmission rate or inpatient satisfaction score). There was, however, a significant association between operating margin and process measures (DTOCs, A&E breaches and cancer waiting time targets). Between the best and worst financially performing Trusts, there was an approximately 2-fold increase in A&E breaches and DTOCs overall although this variation decreased over the 6 years. Between the best and worst performing trusts on cancer targets, the magnitude of difference was smaller (1.16 and 1.15-fold), although the variation slowly rose during the 6 years.ConclusionsOperating margins in English NHS trusts progressively worsened during 2011–2016, and this change was associated with poorer performance on several process measures but not with hospital readmissions or inpatient satisfaction. Significant variation exists between the best and worst financially performing Trusts. Further research is needed to examine the causal nature of relationships between financial performance, process measures and outcomes.
Prostate care and prostate cancer from the perspectives of undiagnosed men: a systematic review of qualitative research
Authors: Kannan Ashwini , Kirkman Maggie , Ruseckaite Rasa , Evans Sue M 
Published: January 2019

ObjectivesTo summarise and evaluate evidence from men who had not been diagnosed with prostate cancer about their perspectives on prostate care and prostate cancer.DesignA systematic review of qualitative research, on the perspectives of non-cancerous men regarding prostate cancer prevention and care.SettingA wide range of settings including primary and secondary care.ParticipantsMen from varied demographic backgrounds ranging between 40 to 80 years of age.Data sourcesThree databases (Ovid MEDLINE, Informit, PsychInfo) and Google Scholar were searched for peer-reviewed papers in English reporting research using qualitative methods (in-depth or semistructured interviews and focus groups).Review methodsThematic analysis using inductive and deductive codes. Thematic synthesis was achieved through iterative open, axial and thematic coding.ResultsEight papers (reporting seven studies conducted in Australia, UK and Germany) met inclusion criteria. Four major themes were identified: understanding prostate cancer, masculinity and prostate cancer, barriers to prostate healthcare and managing prostate health. It was reported that men often did not understand screening, prostate anatomy or their prostate cancer risk, and that concerns about masculinity could deter men from seeking health checks. There was evidence of a need to improve doctor–patient communication about case finding.ConclusionFurther investigation is required to identify and understand any differences in the perspectives and experiences of men who have not been diagnosed with prostate cancer in metropolitan and regional areas, especially where there may be variations in access to healthcare
Is microfinance associated with changes in women’s well-being and children’s nutrition? A systematic review and meta-analysis
Authors: Gichuru Wanjiku , Ojha Shalini , Smith Sherie , Smyth Alan Robert , Szatkowski Lisa 
Published: January 2019

BackgroundMicrofinance is the provision of savings and small loans services, with no physical collateral. Most recipients are disadvantaged women. The social and health impacts of microfinance have not been comprehensively evaluated.ObjectiveTo explore the impact of microfinance on contraceptive use, female empowerment and children’s nutrition in South Asia, Sub-Saharan Africa and Latin America and the Caribbean.DesignWe conducted a systematic search of published and grey literature (1990–2018), with no language restrictions. We conducted meta-analysis, where possible, to calculate pooled ORs. Where studies could not be combined, we described these qualitatively.Data sourcesEMBASE, MEDLINE, LILACS, CENTRAL and ECONLIT were searched (1990–June 2018).Eligibility criteriaWe included controlled trials, observational studies and panel data analyses investigating microfinance involving women and children.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias. The methodological quality of included studies was assessed using the Cochrane risk-of-bias tool for controlled trials and quasi-experimental studies and a modified Newcastle Ottawa Scale for cross-sectional surveys and analyses of panel data. Meta-analyses were conducted using STATA V.15 (StataCorp).ResultsWe included 27 studies. Microfinance was associated with a 64% increase in the number of women using contraceptives (OR 1.64, 95% CI 1.45 to 1.86). We found mixed results for the association between microfinance and intimate partner violence. Some positive changes were noted in female empowerment. Improvements in children’s nutrition were noted in three studies.ConclusionMicrofinance has the potential to generate changes in contraceptive use, female empowerment and children’s nutrition. It was not possible to compare microfinance models due to the small numbers of studies. More rigorous evidence is needed to evaluate the association between microfinance and social and health outcomes.PROSPERO registration numberCRD42015026018.
Design characteristics and statistical methods used in interrupted time series studies evaluating public health interventions: protocol for a review
Authors: Turner Simon L , Karahalios Amalia , Forbes Andrew B , Taljaard Monica , Grimshaw Jeremy M , Cheng Allen C , Bero Lisa , McKenzie Joanne E 
Published: January 2019

IntroductionAn interrupted time series (ITS) design is an important observational design used to examine the effects of an intervention or exposure. This design has particular utility in public health where it may be impracticable or infeasible to use a randomised trial to evaluate health system-wide policies, or examine the impact of exposures (such as earthquakes). There have been relatively few studies examining the design characteristics and statistical methods used to analyse ITS designs. Further, there is a lack of guidance to inform the design and analysis of ITS studies.This is the first study in a larger project that aims to provide tools and guidance for researchers in the design and analysis of ITS studies. The objectives of this study are to (1) examine and report the design characteristics and statistical methods used in a random sample of contemporary ITS studies examining public health interventions or exposures that impact on health-related outcomes, and (2) create a repository of time series data extracted from ITS studies. Results from this study will inform the remainder of the project which will investigate the performance of a range of commonly used statistical methods, and create a repository of input parameters required for sample size calculation.Methods and analysisWe will collate 200 ITS studies evaluating public health interventions or the impact of exposures. ITS studies will be identified from a search of the bibliometric database PubMed between the years 2013 and 2017, combined with stratified random sampling. From eligible studies, we will extract study characteristics, details of the statistical models and estimation methods, effect metrics and parameter estimates. Further, we will extract the time series data when available. We will use systematic review methods in the screening, application of inclusion and exclusion criteria, and extraction of data. Descriptive statistics will be used to summarise the data.Ethics and disseminationEthics approval is not required since information will only be extracted from published studies. Dissemination of the results will be through peer-reviewed publications and presentations at conferences. A repository of data extracted from the published ITS studies will be made publicly available.
Stochastic KEMIRA-M Approach with Consistent Weightings
Authors: Toktaş Pelin , Can Gülin Feryal 
Published: January 2019

This study proposes an advanced Modified KEmeny Median Indicator Rank Accordance (KEMIRA-M) approach based on stochastic evaluation process considering consistent weights to improve effective usage of KEMIRA-M. In the proposed approach, tasks related to the decision issue are performed by decision makers to ensure the understanding sufficiency of alternatives in terms of criteria more clearly. The weighting procedure of Analytic Hierarchy Process (AHP) is implemented in a stochastic manner benefited from discrete uniform distribution to provide obtaining consistent criteria weights considering median priority components. Therefore, different trials including different number of replications that shows the number of decision makers are performed and the most consistent weightings are determined for each trial in the stochastic process. In this way, the dependency to the limited numbers of decision makers and to determine criteria weights in a heuristic manner in KEMIRA-M is prevented. Additionally, the effect of the number of decision makers on criteria weightings and alternatives’ ranking process is shown. To obtain the most consistent weighting results, this stochastic process is utilized until acquiring approximate consistency ratios. The proposed stochastic KEMIRA-M approach is utilized to rank nine shopping malls (SMs) in Ankara in terms of technical criteria (TC) and universal design criteria (UDC). It was seen from the ranking results that the first SM (SM1) is the best one.
Measuring the impact of a successful DDoS attack on the customer behaviour of managed DNS service providers
Authors: Abhishta Abhishta , van Rijswijk-Deij Roland , Nieuwenhuis Lambert J. M. 
Published: January 2019

Distributed Denial-of-Service (DDoS) attacks continue to pose a serious threat to the availability of Internet services. The Domain Name System (DNS) is part of the core of the Internet and a crucial factor in the successful delivery of Internet services. Because of the importance of DNS, specialist service providers have sprung up in the market, that provide managed DNS services. One of their key selling points is that they protect DNS for a domain against DDoS attacks. But what if such a service becomes the target of a DDoS attack, and that attack succeeds?
In this paper we analyse two such events, an attack on NS1 in May 2016, and an attack on Dyn in October 2016. We do this by analysing the change in the behaviour of the service's customers. For our analysis we leverage data from the OpenINTEL active DNS measurement system, which covers large parts of the global DNS over time. Our results show an almost immediate and statistically significant change in the behaviour of domains that use NS1 or Dyn as a DNS service provider. We observe a decline in the number of domains that exclusively use NS1 or Dyn as a managed DNS service provider, and see a shift toward risk spreading by using multiple providers. While a large managed DNS provider may be better equipped to protect against attacks, these two case studies show they are not impervious to them. This calls into question the wisdom of using a single provider for managed DNS. Our results show that spreading risk by using multiple providers is an effective countermeasure, albeit probably at a higher cost.
Intravesical Ty21a Vaccine Promotes Dendritic Cells and T Cell–Mediated Tumor Regression in the MB49 Bladder Cancer Model
Authors: Domingos-Pereira Sonia , Sathiyanadan Karthik , La Rosa Stefano , Polák Lenka , Chevalier Mathieu F. , Martel Paul , Hojeij Rim , Derré Laurent , Haefliger Jacques-Antoine , Jichlinski Patrice , Nardelli-Haefliger Denise 
Published: January 2019

AbstractPreclinical data show that intravesical instillation of Ty21a/Vivotif, a commercial vaccine against typhoid fever, is an effective alternative option to standard Bacillus Calmette–Guérin (BCG) immunotherapy for non–muscle-invasive bladder cancer (NMIBC). Here, we characterized the inflammatory effects of Ty21a on the bladder and investigated the immune mechanisms underlying tumor regression toward the use of this bacterial vaccine in NMIBC patients. MB49 bladder tumor–bearing mice had significantly improved survival after intravesical instillations of Ty21a doses of 106 to 108 colony-forming units. By IHC and morphology, both BCG and Ty21a instillations were associated with bladder inflammation, which was decreased with the use of low, but effective doses of Ty21a. Flow-cytometry analysis showed a significant infiltration of T cells, natural killer (NK) cells, and myeloid cells, compared with controls, after a single dose of Ty21a, whereas this was only observed after multiple doses of BCG. The induced myeloid cells were predominantly neutrophils and Ly6C+CD103+ dendritic cells (DC), the latter being significantly more numerous after instillation of Ty21a than BCG. Ex vivo infection of human leukocytes with Ty21a, but not BCG, similarly significantly increased DC frequency. CD4+ and CD8+ T cells, but not NK cells nor neutrophils, were required for effective bladder tumor regression upon Ty21a treatment. Thus, the generation of antitumor adaptive immunity was identified as a key process underlying Ty21a-mediated treatment efficacy. Altogether, these results demonstrate mechanisms behind intravesical Ty21a therapy and suggest its potential as a safe and effective treatment for NMIBC patients.
The global distribution and richness of frog crabs (Raninoidea)
Authors: Lam-Gordillo Orlando , Ardisson Pedro-Luis 
Published: January 2019

Abstract
The study of species distributions is fundamental for environmental research, conservation planning, and resource management. However, it is not always possible to obtain access to these data, making it difficult to reach the goal of quantifying biodiversity. The distribution of many crustacean groups is poorly studied; such is the case of the superfamily Raninoidea (frog crabs). In order to reduce this information gap, herein we mapped and described the world distribution of members of this superfamily by performing a data visualization analysis. We carried out an extensive review of species records and distribution data from different databases, collections, and unpublished data. Furthermore, we conducted a species richness analysis and an agglomerative cluster analysis to identify biogeographic regions. Both analyses were carried out using the software Biodiverse (v. 2.0). Results showed that Raninoidea is composed of 46 species across a pantropical distribution. For this study, the globe was divided into 30 pre-established biogeographical regions, ranging from the Indo-Pacific seas & Indian Ocean (IPSIO) region, represented by 19 species and a maximum richness of eight species, to the Southern Ocean (SO) region, represented by only one species. Some species are distributed across regions while some are found exclusively in a single region. Due to issues with accuracy and sufficiency of raw data, we also calculated the Chao 1 and ACE indices, which suggest that other species have yet to be recorded.