bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing Allogenic Blood Transfusion in Pediatric Scoliosis Surgery:: Reporting 15 Years of a Multidisciplinary, Evidence-Based Quality Improvement Project
Authors: Dick Alastair G. , Pinder Richard J. , Lyle Shirley A. , Ember Tom , Mallinson Claire , Lucas Jonathan 
Published: April 2019

Study Design: Retrospective review of prospectively collected spinal surgery and transfusion databases. Objectives: To evaluate the efficacy of a care pathway developed at our institution since 2003 with a focus on reducing the need for blood transfusions in children undergoing scoliosis correction surgery. The care pathway includes nurse-led clinics facilitating preoperative hemoglobin optimization, intraoperative cell salvage, the use of tranexamic acid, and a transfusion criteria awareness program. Methods: Retrospective review of our institution’s prospectively recorded spinal surgery and transfusion databases including all cases of scoliosis surgery in patients 18 years and younger between 2001 and 2015. Results: A total of 1039 procedures were included in the analysis. Overall, 24.4% of patients received a transfusion. The proportion of patients transfused was 89.2% in 2001-2003, 39.6% in 2004-2006, 16.5% in 2007-2009, 15.6% in 2010-2012, and 20.1% in 2013-2015. The volume of blood products transfused in those undergoing transfusion was 9.1 units in 2001-2003, 4.8 units in 2004-2006, 5.0 units in 2007-2009, 2.3 units in 2010-2012, and 2.1 units in 2013-2015. A multivariate logistic regression demonstrated adjusted odds ratios for the probability of receiving any transfusion of 5.45 (95% confidence interval 3.62-8.11) for patients with neuromuscular diagnoses and 11.17 (5.02-24.86) for those undergoing combined anterior and posterior surgical approach. Conclusions: We have demonstrated over a 15-year period that the introduction of a multifaceted, multidisciplinary pathway can dramatically and sustainably reduce the need for blood transfusions and their attendant risks in pediatric scoliosis surgery. This data lends weight to the adoption of such a care pathway in pediatric scoliosis surgery.
Combination of 15 lipid metabolites and motilin to diagnose spleen-deficiency FD
Authors: Zhang Jiaqi , Wang Xue , Shi Xiaoshuang , Xie Jingyi , Zhang Min , Ma Jinxin , Wang Fengyun , Tang Xudong 
Published: April 2019

AbstractBackgroundThis study aims to assess clinical characteristics in FD with spleen deficiency syndrome and metabolic perturbations involved in FD progress. We combined metabolic biomarkers and clinical features into a better prediction for FD with Spleen Deficiency syndrome.MethodsA total of 276 people were recruited, including 215 FD patients and 61 healthy control group (HC). The clinical characteristics and gastric emptying rate were compared between spleen deficiency-FD group and non-spleen deficiency-FD. The serum lipids metabonomics analysis was performed to determine the metabolic differences in spleen deficiency-FD group and HC.ResultsThe symptoms of postprandial discomfort in Spleen Deficiency group were more severe (P < 0.05), and delayed gastric emptying was more pronounced (P < 0.05) vs. non-Spleen deficiency. Decreased motilin (OR = 0.990, 95% confidence interval (CI) 0.982–0.997) was independent risk factor related to Spleen Deficiency group. We identified 15 metabolites for spleen deficiency group vs. HC, majority of those biomarkers belonged to the glycerophospholipid metabolic pathway. The combination of 15 metabolics could diagnose spleen deficiency-FD, with the AUC of 0.9943, 95% CI 0.9854–1.0000), and the combination of 15 metabolics and motilin could diagnose spleen deficiency-FD, with the AUC of 0.9615, 95% CI 0.9264–9967).ConclusionsThis study provides supportive evidence that Spleen deficiency syndrome was associated with delayed gastric emptying and the glycerophospholipid metabolic pathway was perturbed in FD patients. The combination of metabolic biomarkers and clinical features provided us with new ideas for multidimensional diagnosis of FD.Trial registrationhttp://www.chictr.org.cn, no: ChiCTR-TRC-13003200. clinicaltrials.gov, no: NCT02762136
Duration of Oxaliplatin-Containing Adjuvant Therapy for Stage III Colon Cancer: ASCO Clinical Practice Guideline
Authors: Lieu Christopher , Kennedy Erin B. , Bergsland Emily , Berlin Jordan , George Thomas J. , Gill Sharlene , Gold Philip J. , Hantel Alex , Jones Lee , Mahmoud Najjia , Meyerhardt Jeffrey , Morris Arden M. , Ruíz-García Erika , You Y. Nancy , Baxter Nancy 
Published: April 2019

PURPOSE To develop recommendations for duration of adjuvant chemotherapy with a fluoropyrimidine and oxaliplatin for patients with completely resected stage III colon cancer based on the results of trials of 3 months compared with 6 months of treatment. METHODS ASCO convened an Expert Panel and conducted a systematic review of relevant studies. The guideline recommendations were based on the review of evidence by the Expert Panel. RESULTS Pooled data from the six International Duration Evaluation of Adjuvant Chemotherapy (IDEA) Collaboration randomized controlled trials comprise the evidence base for these guideline recommendations. RECOMMENDATIONS The recommendations for therapy duration apply to patients with completely resected stage III colon cancer who are being offered adjuvant chemotherapy with oxaliplatin and a fluoropyrimidine. Recommendations are informed by the findings of a recent pooled analysis of clinical trials that compared 6 months versus 3 months of oxaliplatin-based chemotherapy. For patients at a high risk of recurrence (T4 and/or N2), adjuvant chemotherapy should be offered for a duration of 6 months. For patients at a low risk of recurrence (T1, T2, or T3 and N1), either 6 months of adjuvant chemotherapy or a shorter duration of 3 months may be offered on the basis of a potential reduction in adverse events and no significant difference in disease-free survival with the 3-month regimen. In determining duration of therapy, the Expert Panel recommends a shared decision-making approach, taking into account patient characteristics, values and preferences, and other factors and including a discussion of the potential for benefit and risks of harm associated with treatment duration. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines .
Factors associated with pseudoaneurysm development and necessity for reintervention: a single centre study
Authors: Delf Jonathan , Ramachandran Sanjeev , Mustafa Syed , Saeed Abdullah , Kandiyil Neghal 
Published: April 2019

Objective: Evaluate the factors associated with pseudoaneurysm development and morphology. Measure ultrasound-guided thrombin injection (UGTI) and surgical treatment outcomes for pseudoaneurysms, and the necessity for post-primary intervention (reintervention) Methods: Retrospective analysis of ultrasound scans and CT angiography of peripheral pseudoaneurysm interventions from February 2011 to April 2017. 99 patients (61.6% female) were identified; median age 72 years (range 12–89). Multivariate analysis of patient demographics, including pre-intervention anticoagulant and antiplatelet medication was performed. Results: Primary intervention for peripheral pseudoaneurysms (62.6% common femoral artery) included 93 UGTI and 6 surgical repairs; with 12 reinterventions (9 UGTI and 3 surgical). Pseudoaneurysm incidence for vascular interventional radiology (VIR) was 0.48% (31/6451) and cardiology was 0.24% (60/25,229). Rates for primary success, immediate complications, 30-day mortality and reintervention were measured respectively for UGTI (98.9%, 3.0%, 2.0%, and 11.8%) and surgical repair (100%, 0.0%, 22.2% and 16.7%). Reintervention risk factors included pre-intervention thrombocytopaenia (<150 × 109/L) ( p = 0.025) and pseudoaneurysms following vascular surgery (p = 0.033). Other positive associations for reintervention (non-significant) included use of a sheath size > 6 Fr ( p = 0.108) or arterial closure device ( p = 0.111) during the pseudoaneurysm causative procedure. The pre-intervention warfarin subgroup developed a larger mean pseudoaneurysm sac size (4.21 cm, range 0.9–7.6), compared to no treatment (p = 0.003), aspirin (p = 0.005) and clopidogrel (p = 0.026) subgroups. UGTI dosage for thrombosis had a positive correlation with incremental sac size increase (p < 0.001). Conclusion: The main reintervention risk factor was pre-intervention thrombocytopaenia, with additional positive associations including pseudoaneurysms caused by surgery, increased sheath size and arterial closure devices. Warfarinized patients developed larger sac-sized pseudoaneurysms compared with other pre-intervention regimens, with positive correlation of higher UGTI dosage required for thrombosis. Advances in knowledge: Patients with pre-intervention thrombocytopaenia and pseudoaneurysms attributed to vascular surgery are subgroups that may benefit from post-intervention imaging surveillance due to significant reintervention risk.
Clinical 18F-FDG and amyloid brain positron emission tomography/CT in the investigation of cognitive impairment: where are we now?
Authors: Dumba Maureen , Khan Sairah , Patel Neva , Perry Laura , Malhotra Paresh , Perry Richard , Nijran Kuldip , Barwick Tara , Wallitt Kathryn , Win Zarni 
Published: April 2019

The number of people living with dementia is increasing, but as yet there remains no cure or disease-modifying treatment. This review aims to help readers understand the role of 18F-FDG PET/CT imaging in the investigation of cognitive impairment and how the advent of amyloid PET/CT imaging may hold the key to radically changing management of the most common form of dementia - Alzheimer’s disease.
The indications for 18F-FDG PET/CT and amyloid PET/CT imaging in cognitive impairment are outlined. Additionally, the mechanisms of action, technique, patient preparation and acquisition parameters for both are detailed. We conclude by providing a framework for interpreting 18F-FDG PET/CT and amyloid PET/CT imaging in the more common conditions that lead to cognitive impairment conditions with tips on avoiding pitfalls in interpretation.
Residential exposure to radon and DNA methylation across the lifecourse: an exploratory study in the ALSPAC birth cohort
Authors: de Vocht Frank , Suderman Matthew , Ruano-Ravina Alberto , Thomas Richard , Wakeford Richard , Relton Caroline , Tilling Kate , Boyd Andy 
Published: April 2019

Background: Radon (and its decay products) is a known human carcinogen and the leading cause of lung cancer in never-smokers and the second in ever-smokers. The carcinogenic mechanism from radiation is a combination of genetic and epigenetic processes, but compared to the genetic mechanisms, epigenetic processes remain understudied in humans. This study aimed to explore associations between residential radon exposure and DNA methylation in the general population. Methods: Potential residential radon exposure for 75-metre area buffers was linked to genome-wide DNA methylation measured in peripheral blood from children and mothers of the Accessible Resource for Integrated Epigenomic Studies subsample of the ALSPAC birth cohort. Associations with DNA methylation were tested at over 450,000 CpG sites at ages 0, 7 and 17 years (children) and antenatally and during middle-age (mothers). Analyses were adjusted for potential residential and lifestyle confounding factors and were determined for participants with complete data (n = 786 to 980). Results: Average potential exposure to radon was associated in an exposure-dependent manner with methylation at cg25422346 in mothers during pregnancy, with no associations at middle age. For children, radon potential exposure was associated in an exposure-dependent manner with methylation of cg16451995 at birth, cg01864468 at age 7, and cg04912984, cg16105117, cg23988964, cg04945076, cg08601898, cg16260355 and cg26056703 in adolescence. Conclusions: Residential radon exposure was associated with DNA methylation in an exposure-dependent manner. Although chance and residual confounding cannot be excluded, the identified associations may show biological mechanisms involved in early biological effects from radon exposure.
Modifiable Factors Associated with Quality of Bowel Preparation Among Hospitalized Patients Undergoing Colonoscopy
Authors: Garber Ari , Sarvepalli Shashank , Burke Carol A , Bhatt Amit , Ibrahim Mounir , McMichael John , Morris‐Stiff Gareth , Rizk Maged K , Vargo John J , Rothberg Michael B 
Published: April 2019

INTRODUCTIONInadequate bowel preparation (IBP) is a common problem in hospitalized patients; however, little is known about how to prevent IBP. In a large, multihospital system, we evaluated the association between modifiable factors and IBP rate.METHODSWe reviewed data from adult (≥18 years) inpatients undergoing colonoscopy between January 2011 and June 2017. Colonoscopies performed in the intensive care unit or lacking descriptions of bowel preparation quality were excluded. Multivariate logistic regression analysis was performed to identify factors associated with IBP. A counterfactual analysis was performed to assess the potential contribution of modifiable factors to IBP.RESULTSOf 8,819 patients that were included (median age of 64 years; 50.5% female), 51% had IBP. Patients with IBP stayed in the hospital one day longer than those with adequate bowel preparation (P < .001). Modifiable factors associated with IBP include opiate use within three days of colonoscopy (OR, 1.31; 95% CI, 1.18, 1.45), colonoscopy performed after 12:00 pm (OR, 1.25; 95% CI, 1.1, 1.41), and solid diet the day before colonoscopy (OR, 1.37; 95% CI, 1.18, 1.59). In the counterfactual analysis, if all patients avoided these three conditions, adjusted IBP rates were reduced by 5.6%.CONCLUSIONSAmong hospitalized patients undergoing colonoscopy, IBP rates are high and associated with an increased length of stay. Avoiding opiates before colonoscopy, performing colonoscopy before noon, and maintaining patients on a liquid diet or nil per os might significantly reduce IBP rates.
UMA REVISÃO SISTEMÁTICA DE TEXTOS COLONIAIS SOBRE A PROVÍNCIA DO NAMIBE (EX- MOÇÂMEDES) DE 1800 a 1920
Authors: Ribeiro Simões Anibal 
Published: April 2019

O objectivo deste estudo é efectuar um mapeamento sistemático dos textos coloniais sobre Moçâmedes (actual Namibe) escritos entre anos 1800 e 1920. Para definir a nossa amostra, realizámos uma pesquisa formal nas bases de dados PORBASE (Banco Nacional de Dados de Portugal) e no PORTAL DAS MEMÓRIAS DA ÁFRICA E ORIENTE. Como metodologia, utilizou-se a revisão sistemática da literatura. Trata-se, como tal, de um estudo de carácter qualitativo-exploratório. Os dados foram inseridos no SPSS e usado o procedimento de validação. Utilizou-se o índice de concordância kappa para os aspectos: hegemonia, práticas, status quo e decisão pela inclusão/ exclusão. Com base no índices de concordância inconclusivos e fracos, enfatiza-se a necessidade da releitura inicial dos trabalhos por outros avaliadores (dois), não se baseando apenas nos títulos, mas também nos resumos ou nos textos completos.
VALORIZAR A TRADIÇÃO COMO UMA DAS VIAS PARA A MORALIZAÇÃO DA SOCIEDADE ANGOLANA: O CASO DA OMBALA EKOVONGO
Authors: Guebe António 
Published: April 2019

Com a colonização portuguesa e com o longo, mortífero e destruidor conflito armado interno pós-Independência, a sociedade angolana perdeu muitos de seus valores tradicionais que, antigamente, contribuíram e poderiam contribuir para a moralização da sociedade em referência. Na atualidade, as políticas sociais do Governo angolano incidem, fundamentalmente, sobre a recuperação de tais tradições e dos valores morais, envolvendo famílias, igrejas, autoridades tradicionais, enfim, toda a sociedade. O estudo sob o título: “Valorizar a tradição como uma das vias para a moralização da sociedade angolana: o caso da Ombala Ekovongo”, mostra que a Ombala Ekovongo é detentora de normas seculares que, no passado, jogaram e podem continuar a jogar papel importante nesta ingente tarefa.
PERCEPÇÃO AMBIENTAL E QUALIDADE DE VIDA NO BAIRRO SANTA MADALENA NA CIDADE DE SANTO ANTÔNIO DE JESUS-BA
Authors: Santos Neuza Xavier dos , Estevam André Luiz Dantas 
Published: April 2019

A distribuição populacional de forma desigual no espaço urbano tem como uma de suas consequências a precarização dos serviços ofertados nas áreas periféricas. Neste sentido, esse trabalho busca compreender a percepção dos moradores do Bairro Santa Madalena na cidade de Santo Antônio de Jesus sobre sua própria qualidade de vida, considerando o serviço de esgotamento sanitário. Buscando alcançar o objetivo proposto, realizou-se a caracterização do bairro, análise do perfil socioeconômico dos moradores, além da análise da oferta de esgotamento sanitário e a relação com a qualidade de vida dos moradores. Conclui-se, portanto, que os moradores do bairro estudado, percebem qualidade de vida como bem estar pessoal e do meio em que vivem, além do atendimento a seus direitos. Ressalta-se a importância da rede de esgotamento sanitário na qualidade de vida, considerando que o mesmo contribui na prevenção de doenças, mantendo, portanto a saúde humana e do próprio meio ambiente.
Cardiac and Inflammatory Biomarkers Are Associated with Worsening Renal Outcomes in Patients with Type 2 Diabetes Mellitus: Observations from SAVOR-TIMI 53
Authors: Zelniker Thomas A , Morrow David A , Mosenzon Ofri , Gurmu Yared , Im Kyungah , Cahn Avivit , Raz Itamar , Steg Philippe Gabriel , Leiter Lawrence A , Braunwald Eugene , Bhatt Deepak L , Scirica Benjamin M 
Published: April 2019

Abstract

BACKGROUND
Cardiac and renal diseases commonly occur with bidirectional interactions. We hypothesized that cardiac and inflammatory biomarkers may assist in identification of patients with type 2 diabetes mellitus (T2DM) at high risk of worsening renal function.

METHODS
In this exploratory analysis from SAVOR-TIMI 53, concentrations of high-sensitivity cardiac troponin T (hs-TnT), N-terminal pro–B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP) were measured in baseline serum samples of 12310 patients. The primary end point for this analysis was a ≥40% decrease in estimated glomerular filtration rate (eGFR) at end of treatment (EOT) at a median of 2.1 years. The relationships between biomarkers and the end point were modeled using adjusted logistic and Cox regression.

RESULTS
After multivariable adjustment including baseline renal function, each biomarker was independently associated with an increased risk of ≥40% decrease in eGFR at EOT [Quartile (Q) Q4 vs Q1: hs-TnT adjusted odds ratio (OR), 5.63 (3.49–9.10); NT-proBNP adjusted OR, 3.53 (2.29–5.45); hs-CRP adjusted OR, 1.84 (95% CI, 1.27–2.68); all P values ≤0.001]. Furthermore, each biomarker was independently associated with higher risk of worsening of urinary albumin-to-creatinine ratio (UACR) category (all P values ≤0.002). Sensitivity analyses in patients without heart failure and eGFR &gt;60 mL/min provided similar results. In an adjusted multimarker model, hs-TnT and NT-proBNP remained significantly associated with both renal outcomes (all P values &lt;0.01).

CONCLUSIONS
hs-TnT, NT-proBNP, and hs-CRP were each associated with worsening of renal function [reduction in eGFR (≥40%) and deterioration in UACR class] in high-risk patients with T2DM. Patients with high cardiac or inflammatory biomarkers should be treated not only for their risk of cardiovascular outcomes but also followed for renal deterioration.
Struktur Komunitas Zooplankton Di Perairan Desa Mangunharjo Kecamatan Tugu Semarang
Authors: Paramudhita Widya , Endrawati Hadi , Azizah Ria 
Published: April 2019

Perairan Desa Mangunharjo merupakan perairan yang mengalami perubahan kondisi lingkungan akibat abrasi yang berdampak pada kerusakan ekosistem mangrove dan tambak. Kondisi tersebut berpengaruh terhadap keberadaan biota perairan salah satunya adalah zooplankton. Oleh karena itu penelitian ini dilakukan untuk mengetahui struktur komunitas zooplankton di perairan Desa Mangunharjo. Pengambilan sampel dilakukan pada bulan Maret–April 2017 di perairan Desa Mangunharjo, Kecamatan Tugu, Semarang. Metode yang digunakan adalah metode deskriptif eksploratif. Analisis data yang digunakan untuk mendeskripsikan komunitas zooplankton meliputi: kompisisi dan kelimpahan, indeks keanekaragaman, indeks keseragaman dan indeks dominansi. Hasil penelitian menunjukkan bahwa zooplankton yang ditemukan secara keseluruhan sebanyak 23 genera yang terbagi atas 5 fila. Kelimpahan tertinggi sebesar 126.76 ind/L dan terendah 28.17 ind/L. Arthropoda merupakan filum yang paling banyak ditemukan pada penelitian ini. Indeks keanekaragaman yang diperoleh berkisar antara 0.72 – 2.49 dan dikatagorikan keanekargaman rendah dan sedang. Untuk indeks keseragaman yang diperoleh berkisar antara 0.44 – 0.98 dan dikatagorikan keseragaman sedang dan tinggi. Dan untuk indeks dominansi diperoleh nilai berkisar antar 0.02 – 0.98 dan dikatagorikan tidak ada dominasi. Mangunharjo Village waters have changed environmental conditions due to abrasion that damage the mangrove ecosystems and ponds. These conditions affect the presence one of aquatic biota which is zooplankton. Therefore this research is done to know the structure of zooplankton community in Mangunharjo Village waters. Sampling was conducted in March-April 2017 in the waters of Mangunharjo Village, Tugu Sub-district, Semarang. The method used is descriptive explorative method. The data analysis used to describe the zooplankton community includes: composition and abundance, diversity index, uniformity index and dominance index. The results showed that zooplankton found as a whole 23 genera of 5 fila. The highest abundance was 126.76 Ind/L and the lowest was 28.17 Ind/L. Arthropods are the most common phyla in this study. The index of diversity obtained ranges from 0.72 to 2.49 and categorized at low and medium diversity. As for the uniformity index obtained ranged from 0.44 to 0.98 and categorized at medium and high uniformity. And for the dominance index obtained values ranged between 0.02 - 0.98 and categorized at non dominance.