bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Remote Ischemic Preconditioning on Complications After Elective Abdominal Aortic Aneurysm Repair: A Meta-Analysis With Randomized Control Trials
Authors: Zhang Min-Hong , Du Xin , Guo Wei , Liu Xiao-Ping , Jia Xin , Wu Ye 
Published: April 2019

Objective: This meta-analysis was to evaluate the effect of remote ischemic preconditioning (RIP) on complications after abdominal aortic aneurysm repair. Methods: A literature search was conducted in Google scholar, PubMed, Embase, and Web of Science databases up to February 2019. The pooled risk difference (RD) as well as their 95% confidence interval (CI) were calculated by RevMan 5.3 software. Results: A total of 249 patients receiving abdominal aortic aneurysm repair with RIP and 248 receiving abdominal aortic aneurysm repair without RIP in 7 included studies were reanalyzed in this meta-analysis. The results showed that RIP cannot significantly reduce the postoperative mortality (RD = −0.01, 95% CI: −0.07 to 0.06, P = .87), myocardial infarction (RD = −0.01, 95% CI, −0.09 to 0.07, P = .79), and renal impairment (RD = 0.06, 95% CI: −0.41 to 0.30, P = .89) and renal failure (RD = 0.04, 95% CI: −0.03 to 0.10, P = .30). Moreover, the pooled estimate indicated that the RIP significantly increased the risk of arrhythmia after abdominal aortic aneurysm repair surgery (RD = 0.08, 95% CI: 0.01 to −0.16, P = .03). Nevertheless, sensitivity analyses indicated unreliable results for risk of arrhythmia. Conclusion: There is no evidence that RIP reduces mortality after abdominal aortic aneurysm repair. Moreover, the current evidence is not robust enough to prove the effect of RIP on kidney- and cardiac-related complications.
Endovascular Therapy of Vascular Trauma—Current Options and Review of the Literature
Authors: Glaser Julia D. , Kalapatapu Venkat R. 
Published: April 2019

Objective: To review the current use of endovascular techniques in trauma. Summary Background Data: Multiple studies have demonstrated that, despite current guidelines, endovascular therapies are used in instances of arterial trauma. Methods: The existing literature concerning arterial trauma was reviewed. Studies reviewed included case reports, single-center case series, large database studies, official industry publications and instructions for use, and society guidelines. Results: Endovascular therapies are used in arterial trauma in all systems. The use of thoracic endografts in blunt thoracic aortic trauma is accepted and endorsed by society guidelines. The use of endovascular therapies in other anatomic locations is largely limited to single-center studies. Advantages potentially include less morbidity due to smaller incisions as well as shorter operating room times. Many report using endovascular therapies even with hard signs of injury. Long-term results are limited by a lack of long-term follow-up but, in general, suggest that these techniques produce acceptable outcomes. The adoption of these techniques may be limited by resource and surgeon availability. Conclusions: The use of endovascular therapies in trauma has gained acceptance despite not yet having a place in official guidelines.
Medium-term results of undersized angioplasty and stenting for symptomatic high-grade intracranial atherosclerotic stenosis with Enterprise
Authors: Salik Aysun Erbahceci , Selcuk Hatem H , Zalov Hasanagha , Kilinc Fatih , Cirak Musa , Kara Batuhan 
Published: April 2019

Purpose The aim of this retrospective study is to evaluate medium-term results of undersized balloon angioplasty and stenting for symptomatic high-grade (70–99%) stenosis of a major intracranial artery with Enterprise stent. Methods This study included 68 consecutive symptomatic (recurrent transient ischemic attack (TIA) or ischemic stroke under dual antiplatelet treatment) patients with high-grade (70–99%) stenosis of a major intracranial artery who were endovascularly treated with undersized balloon angioplasty and Enterprise stent deployment between July 2012 and December 2017. Primary outcomes were any stroke or death within 30 days after procedure. Secondary outcomes were technical success rates, stroke and restenosis during the follow-up period. Results A total of 68 lesions in 68 patients (mean age: 62 ± 7 years) were treated with a technical success rate of 99%. The degree of pre-procedural stenosis was 92 ± 6% and dropped to 12 ± 10% after stent deployment. No patient developed any stroke or death during the periprocedural period. Intracranial hemorrhage was observed in 1 (1.5%) patient. In 60 (88%) patients with available imaging follow-up in-stent restenosis was observed in 2 patients. Mean follow-up period was 22 ± 17 months (range 6–72) and none of the patients experienced recurrent TIA or stroke during the follow-up period. Conclusion In this retrospective single-center study undersized balloon angioplasty and deployment of a self-expandable stent with relatively low radial force was safe and effective for endovascular treatment of high-grade intracranial arterial stenosis with high technical success rate, low periprocedural complication rates and favorable medium-term follow-up results.
Cost-Effectiveness of Multifaceted Built Environment Interventions for Reducing Transmission of Pathogenic Bacteria in Healthcare Facilities
Authors: Squire Marietta M. , Igusa Takeru , Siddiqui Sauleh , Sessel Gareth K. , Squire Edward N. 
Published: April 2019

Objectives: The objective of this study is to determine the optimal allocation of budgets for pairs of alterations that reduce pathogenic bacterial transmission. Three alterations of the built environment are examined: handwashing stations (HW), relative humidity control (RH), and negatively pressured treatment rooms (NP). These interventions were evaluated to minimize total cost of healthcare-associated infections (HAIs), including medical and litigation costs. Background: HAIs are largely preventable but are difficult to control because of their multiple mechanisms of transmission. Moreover, the costs of HAIs and resulting mortality are increasing with the latest estimates at US$9.8 billion annually. Method: Using 6 years of longitudinal multidrug-resistant infection data, we simulated the transmission of pathogenic bacteria and the infection control efforts of the three alterations using Chamchod and Ruan’s model. We determined the optimal budget allocations among the alterations by representing them under Karush–Kuhn–Tucker conditions for this nonlinear optimization problem. Results: We examined 24 scenarios using three virulence levels across three facility sizes with varying budget levels. We found that in general, most of the budget is allocated to the NP or RH alterations in each intervention. At lower budgets, however, it was necessary to use the lower cost alterations, HW or RH. Conclusions: Mathematical optimization offers healthcare enterprise executives and engineers a tool to assist with the design of safer healthcare facilities within a fiscally constrained environment. Herein, models were developed for the optimal allocation of funds between HW, RH, and negatively pressured treatment rooms (NP) to best reduce HAIs. Specific strategies vary by facility size and virulence.
Decentralized Nurse Stations: A Methodology for Using Research to Guide Design Decisions
Authors: Durham Joyce , Kenyon Ann 
Published: April 2019

Purpose: The purpose of this methodology is to define a process for facility planning teams to use to ensure research findings are used to guide decision making in the design process. Background: Over the past decade and a half, research in health facility design has developed and the body of knowledge has grown significantly, but at the same time, the process for incorporating these findings into the design process has been less defined. This methodology evolved out of the desire to develop a structured process to integrate recent research findings into the planning and programming process at the user group and planning team level. Method: This two-phase methodology consists of, first, reviewing recent, relevant research on the topic, classifying the findings into positive and negative attributes and, then, summarizing the attributes by category on a summary table and in a brief narrative. The second phase consists of reviewing the research to identify operational and facility strategies that can be used to mitigate the inconsistent and negative attributes identified. Results: In the case study, as a result of this process, one inconsistent attribute and three negative attributes were identified. In the second phase, potential research-based operational and facility strategies were identified to mitigate the inconsistent and negative attributes identified. This information served as the basis for making design decisions. Conclusions: This methodology presents an organized, efficient process for organizing and providing relevant research findings to a facility planning team to use in evaluating a new healthcare design concept and making research-based design decisions.
Effectiveness and safety of secukinumab for psoriasis in real-world practice: analysis of subgroups stratified by prior biologic failure or reimbursement
Authors: Ger Tzong-Yun , Huang Yu-Huei , Hui Rosaline Chung-yee , Tsai Tsen-Fang , Chiu Hsien-Yi 
Published: April 2019

Background: Little is known about the treatment outcomes of secukinumab in clinical practice, which differ from those in clinical trials. The effectiveness of biologics may differ in psoriasis patients with previous biologics exposure. The objective of this study was to investigate the real-world effectiveness and safety of secukinumab therapy and analyze subgroups stratified by reimbursement or prior biologic failure. Methods: This retrospective multicenter study collected data from a cohort of 118 consecutive patients who received secukinumab treatment between December 2015 and March 2018. Effectiveness was evaluated by degree of improvement in the Psoriasis Area and Severity Index (PASI) scores. Adverse events and reasons for discontinuation were also recorded. Results: The mean PASI improvement rate at weeks 4, 12, 24, and 36 was 63.5%, 77.7%, 78.7%, and 76.0%, respectively. Compared with reimbursed patients, nonreimbursed patients had a significantly lower baseline PASI and a shorter mean disease duration of psoriasis; they were more frequently biologic-naïve, had used less prior traditional antipsoriatic drugs and were more likely to be treated with secukinumab 150 mg. The effectiveness of secukinumab in nonreimbursed patients was superior despite higher discontinuation rates. Compared with patients without prior biologic failure, patients with prior biologic failure had a significantly lower mean PASI improvement at weeks 12, 24, 36, and 48. The decline in response rates to secukinumab tended to be more pronounced for patients who failed ustekinumab than tumor necrosis factor-α inhibitors. Moreover, the number of prior biologic failures was associated with a decreased response rate and increased likelihood of secondary loss of effectiveness of secukinumab therapy. Conclusion: In a real-life clinical setting, the characteristics of nonreimbursed patients receiving secukinumab treatment differed from those of reimbursed patients. The PASI improvement for secukinumab was substantial but lower than that in clinical trials. The number and classes of prior biologic failures impact the treatment response to secukinumab.
Acoustic radiation force impulse (ARFI) shear wave elastography of the bowel wall in healthy volunteers and in ulcerative colitis
Authors: Goertz Ruediger S , Lueke Christian , Schellhaas Barbara , Pfeifer Lukas , Wildner Dane , Neurath Markus F , Strobel Deike 
Published: April 2019

Background Acoustic radiation force impulse (ARFI) elastography is a non-invasive, ultrasound-based approach of evaluation of tissue elasticity. It has not yet been systematically applied to the bowel wall. Purpose To perform ARFI elastography of the bowel wall in healthy volunteers and patients with ulcerative colitis (UC). Material and Methods A high-frequency ultrasound (with bowel wall thickness and vascularization score) and an ARFI elastography of the bowel wall were performed in 20 patients with UC and 13 healthy volunteers. At least 10 ARFI measurements were obtained within the terminal ileum and the ascending, transverse, descending, and sigmoid colon and correlated with results of high-frequency ultrasound. Results The UC group had mostly moderate disease activity. All patients had signs of inflammation upon B-mode ultrasound. Eight patients showed an ulcerative (ileo)pancolitis. Overall, ARFI elastography values and wall thickness were higher in the UC group than in the group of healthy volunteers ( P = 0.021 and P < 0.001, respectively). ARFI velocities of the separate segments were significantly higher in the transverse ( P = 0.045) and sigmoid colon ( P = 0.032) in case of UC. Conclusion ARFI elastography of the bowel wall of the colonic frame and the terminal ileum is feasible but shows high standard deviation. ARFI shear wave velocities appear to be slightly higher in patients with UC than in healthy volunteers, particularly in the sigmoid and transverse colon. Further studies are needed.
Qualitative Evaluation of a Community-Based Physical Activity and Yoga Program for Men Living With Prostate Cancer: Survivor Perspectives
Authors: Culos-Reed SN , Dew M , Shank J , Langelier DM , McDonough M 
Published: April 2019

Purpose Physical activity (PA) programs for prostate cancer survivors have positive effects on many aspects of health-related quality of life. Translating this research into sustainable community-based settings is necessary to ensure access to programs for survivors. This study examines patient perspectives in the community-based TrueNTH Lifestyle Management (TrueNTH LM) program in Calgary, Canada. Methods Eleven men from programs at civic wellness centers participated in 2 small semistructured focus groups (n = 5 and 6) at the University of Calgary. Motivation for program initiation and adherence, benefits and barriers to participation, and individual satisfaction and feedback on program improvement were discussed. Audio recordings were transcribed and analyzed using thematic methodology guided by a pragmatic philosophy on the patient experience in the program. Results Themes identified included perceived benefits of participating (physical, psychological, and social), facilitators for involvement in the PA program (program design, initial free access, tailored to prostate cancer specific needs, psychosocial environment), and opportunities for improvement and sustainability (exercise as a part of standard care, cost structure, home-based options). Conclusions These findings provide valuable insight into patient perspectives on effective characteristics of prostate cancer and exercise programs. TrueNTH LM has implemented findings, and ensuring needs (benefits and barriers) are addressed for prostate cancer survivors when entering community-based PA programs.
Acromioclavicular Joint Stabilization: A Biomechanical Study of Bidirectional Stability and Strength
Authors: Hislop Patrick , Sakata Kentaro , Ackland David C. , Gotmaker Robert , Evans Matthew C. 
Published: April 2019

Background: It is important to restore horizontal and vertical stability to the acromioclavicular (AC) joint when treating dislocations of this joint. Most surgical stabilization techniques of the AC joint have primarily addressed the coracoclavicular ligament complex; however, these techniques may not satisfactorily restore horizontal stability to the AC joint. Purpose: To evaluate the strength and bidirectional stability of 3 AC joint stabilizing techniques in a cadaveric model. Study Design: Controlled laboratory study. Methods: A total of 24 cadaveric shoulders were randomly allocated to 3 treatment groups. For each group, a standardized AC joint stabilizing procedure was performed, and the specimens were potted for mechanical testing. The following reconstruction techniques were used: a single clavicular tunnel for group A, a double clavicular tunnel for group B, and a double clavicular tunnel plus suture fixation across the AC joint for group C. The specimens underwent cyclic loading in the horizontal and vertical planes and then load to failure. Eight control specimens also underwent cyclic loading in both planes. Construct stiffness during cyclic loading, change in displacement after cyclic loading in both planes, load to failure in the vertical plane, and mode of failure were evaluated, and stiffness was compared among the treatment groups as well as with a control group. Results: There was a decrease in joint stiffness for all groups, including controls, during the cyclic loading. Compared with controls, all 3 treatment groups demonstrated equivalent stiffness and displacement in the vertical plane. In the horizontal plane, all 3 treatment groups demonstrated decreased stiffness, increased displacement, or both when compared with controls. When groups were compared, no treatment arm proved superior regarding stiffness or displacement in either plane. Load-to-failure testing of the 3 treatment groups in the vertical plane demonstrated construct strength and stiffness comparable with reports for the native AC joint. The mode of failure was predominantly fracture at the point of fixation to the testing apparatus. Conclusion: There was no difference in bidirectional strength and stability between the single– and double–clavicular tunnel techniques of coracoclavicular reconstruction. The addition of a stabilizing suture across the AC joint does not improve horizontal stability in the absence of repair of the AC joint capsule and deltotrapezial fascia. Clinical Relevance: This laboratory study provides further evidence of the importance of the AC joint capsule and associated soft tissues in affording horizontal stability to that joint. Information from this and subsequent studies utilizing a bidirectional model can influence the choice of surgical procedure in the clinical treatment of AC joint dislocations.
Geotechnical and geophysical investigation techniques in Ben Ezra Synagogue in Old Cairo area, Egypt
Authors: Hemeda Sayed 
Published: April 2019

Abstract
The Ben Ezra Synagogue or El-Geniza Synagogue or the Synagogue of the Levantines, is located in the Coptic section of Old Cairo area. It is considered the oldest Synagogue or Jewish temple found in Egypt represents cultural heritage of outstanding universal values. It suffers multiple environmental, geotechnical and earthquake hazards. The integrated geotechnical and geophysical investigation techniques were done to assess the level of seismic and other geo-environmental hazards and risk that Synagogue suffers from in present and future. This knowledge is required to protect the building against seismic events. The Synagogue suffers high risk in terms of seismic and environmental hazards. The main purposes of the present study are to: (1) Assess the level of seismic and other geo-environmental hazards at Ben Ezra Synagogue. (2) Understand the damage situation for the historic building caused by the recent earthquakes. (3) Offer technical support and advice on restoration and repairs for the damaged structure. (4) Build up knowledge and case studies towards the restoration and repairs, and to survey the damage state of the historic structure. However, Ben Ezra Synagogue is the oldest Jewish temple that was constructed with little or no seismic considerations that represent the largest risk to most communities. These significant historical buildings must be assessed their level of risk determined, and unacceptable risks reduced. This paper focuses on the issues associated with detailed procedures of risk and hazards assessment for retrofitting of architectural heritage. Many forms of evaluation and related procedures for assessment of seismic risk for historical buildings have been discussed. This study, suggest moderate level of earthquake activity at Ben Ezra Synagogue and this is in a good agreement with the fact that “Egypt is a part of the stable African Shield”, but the existence of old structure such as the Ben Ezra Synagogue may reduce the ability to resist any earthquake shaking. This pilot study is important with respect to the continuous efforts for preservation and restoration of the cultural heritage worldwide.
A Machine Learning Platform to Optimize the Translation of Personalized Network Models to the Clinic
Authors: Salvucci Manuela , Rahman Arman , Resler Alexa J. , Udupi Girish M. , McNamara Deborah A. , Kay Elaine W. , Laurent-Puig Pierre , Longley Daniel B. , Johnston Patrick G. , Lawler Mark , Wilson Richard , Salto-Tellez Manuel , Van Schaeybroeck Sandra , Rafferty Mairin , Gallagher William M. , Rehm Markus , Prehn Jochen H.M. 
Published: April 2019

PURPOSE Dynamic network models predict clinical prognosis and inform therapeutic intervention by elucidating disease-driven aberrations at the systems level. However, the personalization of model predictions requires the profiling of multiple model inputs, which hampers clinical translation. PATIENTS AND METHODS We applied APOPTO-CELL, a prognostic model of apoptosis signaling, to showcase the establishment of computational platforms that require a reduced set of inputs. We designed two distinct and complementary pipelines: a probabilistic approach to exploit a consistent subpanel of inputs across the whole cohort (Ensemble) and a machine learning approach to identify a reduced protein set tailored for individual patients (Tree). Development was performed on a virtual cohort of 3,200,000 patients, with inputs estimated from clinically relevant protein profiles. Validation was carried out in an in-house stage III colorectal cancer cohort, with inputs profiled in surgical resections by reverse phase protein array (n = 120) and/or immunohistochemistry (n = 117). RESULTS Ensemble and Tree reproduced APOPTO-CELL predictions in the virtual patient cohort with 92% and 99% accuracy while decreasing the number of inputs to a consistent subset of three proteins (40% reduction) or a personalized subset of 2.7 proteins on average (46% reduction), respectively. Ensemble and Tree retained prognostic utility in the in-house colorectal cancer cohort. The association between the Ensemble accuracy and prognostic value (Spearman ρ = 0.43; P = .02) provided a rationale to optimize the input composition for specific clinical settings. Comparison between profiling by reverse phase protein array (gold standard) and immunohistochemistry (clinical routine) revealed that the latter is a suitable technology to quantify model inputs. CONCLUSION This study provides a generalizable framework to optimize the development of network-based prognostic assays and, ultimately, to facilitate their integration in the routine clinical workflow.