bluuebunny/crossref_metadata_2025_split huggingface dataset:
Areas for Quality Improvement for Airway Dilation in Children: NSQIP‐Pediatric 30‐Day Outcomes
Authors: Cheng Jeffrey , Liu Beiyu , Farjat Alfredo E. 
Published: February 2018

ObjectiveTo identify predictors of adverse events and highlight areas for quality improvement for children who underwent laryngeal or tracheal dilation, without prior tracheostomy placement.Study DesignCross‐sectional analysis using a US national database.SettingAmerican College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS NSQIP‐pediatric), years 2012 to 2015.Subjects and MethodsPatients 18 years and younger were included. Patients without prior tracheostomy placement were identified using 2017 Current Procedural Terminology (CPT) codes: 31528, 31529, and 31630.ResultsWe identified a total of 160 children who met inclusion criteria. Forty‐three (26.9%) patients experienced an adverse event. Mortality was observed postoperatively in 1 patient (0.6%) 1 day after the operation. Younger age, increased number of days from hospital admission to operation, and increased number of days from operation to discharge were noted to be associated with adverse events. Last, the risk of adverse events appears to be mitigated by concurrent other laryngeal procedures.ConclusionsThere is a high rate of adverse events reported with airway dilation in children. Unplanned reoperations and hospital readmissions are highlighted areas for quality improvement. Airway dilation in children appears to avoid tracheostomy and open laryngotracheoplasty in most cases for at least 30 days postoperatively. Further investigation may be helpful to understand if younger age and delayed operative intervention contribute to increased adverse events.
Sequelae of Index Complications following Inpatient Head and Neck Surgery: Characterizing Secondary Complications
Authors: Goel Alexander N. , Badran Karam W. , Garrett Alexander M. , St. John Maie A. , Long Jennifer L. 
Published: February 2018

ObjectiveTo characterize patterns of secondary complications after inpatient head and neck surgery.Study DesignRetrospective cohort study.SettingNational Surgical Quality Improvement Program (2005‐2015).Subjects and MethodsWe identified 18,584 patients who underwent inpatient otolaryngologic surgery. Four index complications were studied: pneumonia, bleeding or transfusion event (BTE), deep/organ space surgical site infection (SSI), and myocardial infarction (MI). Each patient with an index complication was matched to a control patient based on propensity for the index event and event‐free days. Rates of 30‐day secondary complications and mortality were compared.ResultsIndex pneumonia (n = 254) was associated with several complications, including reintubation (odds ratio [OR], 11.7; 95% confidence interval [CI], 5.2‐26.4), sepsis (OR, 8.8; 95% CI, 4.5‐17.2), and death (OR, 5.3; 95% CI, 1.9‐14.9). Index MI (n = 50) was associated with increased odds of reintubation (OR, 17.2; 95% CI, 3.5‐84.1), ventilatory failure (OR, 5.8; 95% CI, 1.8‐19.1), and death (OR, 24.8; 95% CI, 2.9‐211.4). Index deep/organ space SSI (n = 271) was associated with dehiscence (OR, 7.2; 95% CI, 3.6‐14.2) and sepsis (OR, 38.3; 95% CI, 11.6‐126.4). Index BTE (n = 1009) increased the odds of cardiac arrest (OR, 3.9; 95% CI, 1.8‐8.5) and death (OR, 2.9; 95% CI, 1.6‐5.1).ConclusionsOur study is the first to quantify the effect of index complications on the risk of specific secondary complications following inpatient head and neck surgery. These associations may be used to identify patients most at risk postoperatively and target specific interventions aimed to prevent or interrupt further complications.
Patellar Tendon Repair Augmentation With a Knotless Suture Anchor Internal Brace: A Biomechanical Cadaveric Study
Authors: Rothfeld Alex , Pawlak Amanda , Liebler Stephenie A.H. , Morris Michael , Paci James M. 
Published: February 2018

Background: Patellar tendon repair with braided polyethylene suture alone is subject to knot slippage and failure. Several techniques to augment the primary repair have been described. Purpose/Hypothesis: The purpose was to evaluate a novel patellar tendon repair technique augmented with a knotless suture anchor internal brace with suture tape (SAIB). The hypothesis was that this technique would be biomechanically superior to a nonaugmented repair and equivalent to a standard augmentation with an 18-gauge steel wire. Study Design: Controlled laboratory study. Methods: Midsubstance patellar tendon tears were created in 32 human cadaveric knees. Two comparison groups were created. Group 1 compared #2 supersuture repair without augmentation to #2 supersuture repair with SAIB augmentation. Group 2 compared #2 supersuture repair with an 18-gauge stainless steel cerclage wire augmentation to #2 supersuture repair with SAIB augmentation. The specimens were potted and biomechanically loaded on a materials testing machine. Yield load, maximum load, mode of failure, plastic displacement, elastic displacement, and total displacement were calculated for each sample. Standard statistical analysis was performed. Results: There was a statistically significant increase in the mean ± SD yield load and maximum load in the SAIB augmentation group compared with supersuture alone (mean yield load: 646 ± 202 N vs 229 ± 60 N; mean maximum load: 868 ± 162 N vs 365 ± 54 N; P < .001). Group 2 showed no statistically significant differences between the augmented repairs (mean yield load: 495 ± 213 N vs 566 ± 172 N; P = .476; mean maximum load: 737 ± 210 N vs 697 ± 130 N; P = .721). Conclusion: Patellar tendon repair augmented with SAIB is biomechanically superior to repair without augmentation and is equivalent to repair with augmentation with an 18-gauge stainless steel cerclage wire. Clinical Relevance: This novel patellar tendon repair augmentation is equivalent to standard 18-gauge wire augmentation at time zero. It does not require a second surgery for removal, and it is biomechanically superior to primary repair alone.
Assessment of oxidative stress of platelets among chronic heroin and hashish addicts
Authors: Bani-Ahmad MA , Mustafa AG , Ahmad AAB , Rahim AMA 
Published: February 2018

Introduction: Illicit drugs abuse is associated with several clinical life-threatening consequences that are primarily mediated by oxidative damage to multiple cellular components with a subsequent cellular dysfunction and death. Primarily, this study aimed to investigate oxidative stress to protein and lipid components of circulatory platelets among chronic heroin and hashish addicts. Methods: Platelet lysates were prepared from 20 chronic intravenously administrated heroin addicts and 20 chronic smoked hashish addicts. For comparative purposes, two control groups of 20 cigarette smokers and 20 nonsmokers were included in the study. Oxidative stress to platelet’s proteins and lipids was investigated using carbonyl group contents assay and thiobarbituric acid reactive substances (TBARS) assay, respectively. Results: In comparison to control groups, carbonyl group contents and TBARS concentration were significantly higher among heroin addicts but not among hashish addicts. Both of these markers were significantly correlated to the duration of addiction but not to the daily administrated dose. While in regard of the timing of the latest administrated dose (TLAD), only carbonyl group contents were significantly correlated to the TLAD. Conclusions: Considering the contribution of drug’s route of administration, drug’s pharmacokinetics, and kinetics of circulatory platelet, we concluded that chronic heroin addiction is associated with significant levels of oxidative stress to platelet’s proteins and lipids. Due to the high proteomic contents of platelets, protein’s oxidative stress is more prominent compared to lipids. Chronic hashish smoking is not associated with significant levels of oxidative stress in platelet’s proteins and lipids.
Peripheral artery disease is associated with frailty in chronic hemodialysis patients
Authors: Okuyama Michihiro , Takeuchi Hidemi , Uchida Haruhito A , Kakio Yuki , Okuyama Yuka , Umebayashi Ryoko , Wada Kentaro , Sugiyama Hitoshi , Sugimoto Ken , Rakugi Hiromi , Kasahara Shingo , Wada Jun 
Published: February 2018

Objectives The clinical condition of frailty is a common problem in the elderly population. However, the relationship between peripheral artery disease and frailty in hemodialysis patients remains unknown. The aim of this study was to identify the relationships between peripheral artery disease and frailty in Japanese chronic hemodialysis patients. Methods A total of 362 chronic hemodialysis patients who regularly visited six institutions were enrolled. To evaluate frailty, the modified Fried’s frailty phenotype adjusted for Japanese were used. Peripheral artery disease was defined as ankle-brachial index <0.9. Results Of 362 patients, 62 patients (17.1%) were categorized as peripheral artery disease group and 300 patients (82.9%) as Non-peripheral artery disease group. The prevalence of frailty in the peripheral artery disease group was significantly higher than in the Non-peripheral artery disease group (34% vs. 18%, P = 0.0103). Non-shunt side grip strength was significantly stronger in the Non-peripheral artery disease group (23.6 kg vs. 17.0 kg, P < 0.0001). Thigh circumferences were also significantly larger in the Non-peripheral artery disease group (41.7 cm vs. 39.7 cm, P = 0.0054). A multivariate logistic regression analysis demonstrated that the factors independently associated with peripheral artery disease were as follows: frailty (odds ratio = 2.06, 95% confidence interval 1.09–3.89) and myocardial infarction (odds ratio = 3.74, 95% confidence interval 2.05–6.83). Conclusions It is concluded that peripheral artery disease is closely associated with frailty in hemodialysis patients.
Off-label use of IV t-PA in patients with intracranial neoplasm and cavernoma
Authors: Schwarzbach Christopher Jan , Ebert Anne , Hennerici Michael G. , Neumaier-Probst Eva , Platten Michael , Fatar Marc 
Published: February 2018

Background: The safety of systemic thrombolysis in patients with intracranial tumor and cavernoma are unknown. So far evidence is limited to a number of case reports and few case series or unspecified data based on population-based analysis. Our aim was to comprehend the risk of systemic thrombolysis in these patients. Methods: Patients with additional evidence of intracranial tumor or cavernoma who received IV tissue plasminogen activator (t-PA) treatment at our comprehensive stroke center over a period of 7 years were identified in our stroke database and compared to the same number of matched control subjects without any evidence of intracranial tumor and cavernoma. Clinical history and imaging patterns before and after t-PA therapy were individually reviewed for each patient. Results: Thirty-four patients with additional evidence of meningioma (19/34), cavernoma (13/34) or malignant intracranial neoplasm (2/34) were identified. The incidence of secondary intracranial hemorrhage observed showed no difference between control subjects (9/34, 26%) and patients (6/34, 18%; p = 0.56). Symptomatic hemorrhage in patients with meningioma or cavernoma could not be observed. Likewise, the prevalence of stroke mimics showed no difference between patients (8/34, 24%) and control subjects (5/34, 15%; p = 0.54). However, both patients with malignant intracranial neoplasm presented with a stroke mimic and intracranial hemorrhage was observed in one of them. Conclusions: In compliance with existing evidence, treatment in patients with meningioma and cavernoma appears to be safe and reasonable, while the therapy should be avoided in patients with malignant intracranial neoplasm with blood–brain barrier disruption.
Open-label pilot for treatment targeting gut dysbiosis in myalgic encephalomyelitis/chronic fatigue syndrome: neuropsychological symptoms and sex comparisons
Authors: Wallis Amy , Ball Michelle , Butt Henry , Lewis Donald P. , McKechnie Sandra , Paull Phillip , Jaa-Kwee Amber , Bruck Dorothy 
Published: February 2018

AbstractBackgroundPreliminary evidence suggests that the enteric microbiota may play a role in the expression of neurological symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Overlapping symptoms with the acute presentation ofd-lactic acidosis has prompted the use of antibiotic treatment to target the overgrowth of species within theStreptococcusgenus found in commensal enteric microbiota as a possible treatment for neurological symptoms in ME/CFS.MethodsAn open-label, repeated measures design was used to examine treatment efficacy and enable sex comparisons. Participants included 44 adult ME/CFS patients (27 females) from one specialist medical clinic withStreptococcusviable counts above 3.00 × 105 cfu/g (wet weight of faeces) and with a count greater than 5% of the total count of aerobic microorganisms. The 4-week treatment protocol included alternate weeks of Erythromycin (400 mg of erythromycin as ethyl succinate salt) twice daily and probiotic (d-lactate free multistrain probiotic, 5 × 1010cfu twice daily). 2 × 2 repeated measures ANOVAs were used to assess sex-time interactions and effects across pre- and post-intervention for microbial, lactate and clinical outcomes. Ancillary non-parametric correlations were conducted to examine interactions between change in microbiota and clinical outcomes.ResultsLarge treatment effects were observed for the intention-to-treat sample with a reduction inStreptococcusviable count and improvement on several clinical outcomes including total symptoms, some sleep (less awakenings, greater efficiency and quality) and cognitive symptoms (attention, processing speed, cognitive flexibility, story memory and verbal fluency). Mood, fatigue and urined:llactate ratio remained similar across time. Ancillary results infer that shifts in microbiota were associated with more of the variance in clinical changes for males compared with females.ConclusionsResults support the notion that specific microorganisms interact with some ME/CFS symptoms and offer promise for the therapeutic potential of targeting gut dysbiosis in this population.Streptococcusspp. are not the primary or sole producers ofd-lactate. Further investigation of lactate concentrations are needed to elucidate any role ofd-lactate in this population. Concurrent microbial shifts that may be associated with clinical improvement (i.e., increasedBacteroidesandBifidobacteriumor decreasedClostridiumin males) invite enquiry into alternative strategies for individualised treatment.Trial RegistrationAustralian and New Zealand Clinical Trial Registry (ACTRN12614001077651) 9th October 2014.https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366933&isReview=true
Förderer von Partizipation?
Authors: Hummel Siri 
Published: February 2018

ZusammenfassungWelche Demokratisierungspotenziale bergen Stiftungen, die zum einen als Akteure in verschiedensten politischen Arenen an Bedeutung gewinnen und dort Gestaltungsanspruch erheben und zum anderen ihr Engagementzweck immer häufiger auch auf die Demokratieförderung ausrichten? Der Artikel möchte mögliche Potenziale aufzeigen und resümiert, dass ein legitimer Repräsentationsanspruch nur unter der Maßgabe der Transparenz zu halten ist.
Staat und Stiftungen in den USA
Authors: Toepler Stefan 
Published: February 2018

ZusammenfassungDieser Artikel befasst sich mit dem zum Teil schwierigen Verhältnis zwischen Staat und Stiftungen in den USA, welches nicht zuletzt auf die traditionelle Prominenz der amerikanischen Großstiftungen zurückzuführen ist. Angesprochen werden die weiter bestehenden Befürchtungen über einen unangemessenen gesellschaftspolitischen Einfluss der Grossstifter, der mittlerweile als verfehlt anzusehende Ansatz der strategischen Philanthropie sowie die Vorstöße der Obama Regierung, Stiftungen in bundesstaatliche Förderprogramme einzubinden.
Conservative treatment of postoperative chylothorax: a case report
Authors: Wagh Sachinkumar , Deshmukh Sanjay , Ankolikar Shrikant 
Published: February 2018

Abstract

Background
Chylothorax is a well-documented complication of thoracic trauma and is associated with high rates of morbidity and mortality. Treatment for chylothorax includes conservative measures (total parenteral nutrition, pleural drainage, and pleurodesis) and surgery (thoracic duct ligation).

Case presentation
We present the case of a 65-year-old man who developed chylothorax after an elective surgical procedure. In this report conservative treatment aims to reduce chyle flow, to drain the pleural cavity in an effective manner, and to prevent chronic sequelae. Optimal conservative treatment, started immediately upon diagnosis, effectively reduces the need for reoperation and long-term hospitalization, and it might prevent further sequelae of chylothorax.

Conclusions
The chylothorax was successfully treated conservatively, which may reduce the need for reoperation.
Handwritten Indic Script Recognition Based on the Dempster–Shafer Theory of Evidence
Authors: Mukhopadhyay Anirban , Singh Pawan Kumar , Sarkar Ram , Nasipuri Mita 
Published: February 2018

Abstract
In a multilingual country like India, script recognition is an important pre-processing footstep necessary for feeding any document to an optical character recognition (OCR) engine, which is, in general, script specific. The present work evaluates the performance of an ensemble of two MLP (multi-layer perceptron) classifiers, each trained on different feature sets. Here, two complementary sets of features, namely, gray-level co-occurrence matrix (GLCM) and Gabor wavelets transform coefficients are extracted from each of the handwritten text-line and word images written in 12 official scripts used in Indian subcontinent, which are then fed into an individual classifier. In order to improve the overall recognition rate, a powerful combination approach based on the Dempster–Shafer (DS) theory is finally employed to fuse the decisions of two MLP classifiers. The performance of the combined decision is compared with those of the individual classifiers, and it is noted that a significant improvement in recognition accuracy (about 4% for text-line data and 6% for word level data) has been achieved by the proposed methodology.
Afterword: Theorizing (im)politeness
Authors: Haugh Michael 
Published: February 2018

Abstract
The shift to a middle ground between classic and discursive approaches to politeness has opened
up space for the proliferation of various different theoretical accounts of (im)politeness. While this diversity
can lead to different insights into the same dataset, as we have seen in this special issue, it does beg the
question of whether the field of (im)politeness research remains a coherent enterprise. After pointing
out that different theories of (im)politeness inevitably not only afford but also constrain what we observe
and the explanations that can be developed to account for those observations, I suggest that in light of
the increasing proliferation of theoretical approaches in the field, a greater focus on metatheorization is
in order. After briefly discussing some of the key questions such a metatheoretical discussion should
address, I conclude that metatheorizing enables us to systematically examine what different theories
of (im)politeness bring to the field, thereby also drawing attention to what areas appear to be in particular
need of further theoretical development and empirical study.
Effects of epigallocatechin-3-gallate (EGCG) on a scleroderma model of fibrosis
Authors: Kocak Ayse , Harmancı Duygu , Birlik Merih , Sarıoglu Sulen , Yılmaz Osman , Cavdar Zahide , Guner Gul 
Published: February 2018

Abstract

Objective
The aim of the present study was to evaluate the potential protective effects of epigallocatechin-3-gallate (EGCG) on fibrosis in bleomycin induced scleroderma model.

Materials and methods
Thirty-two healthy female Balb-c mice with the average body weight of 22±5 g were used in this study. The mice were randomly divided into four groups as control (n=8), Bleomycin (n=8), Bleomycin+EGCG (n=8) and EGCG (n=8). Skin tissue samples were collected to quantify matrix metalloproteinases (MMP-1, MMP-8, MMP-13), p-SMAD 2/3 and SMAD 2/3 in protein homogenates by western blotting. TGF-β1 expression was determined by real-time PCR. Immunohistopathological and histopathological examinations of skin tissues were also done.

Results
When measured with Masson Trichrome, EGCG treatment was found to decrease fibrosis in connective tissue compared to the BLM injected control. EGCG was decreased dermal fibrosis. Bleomycin+EGCG group showed a significant reduction in fibrosis at the dermal surface area using hematoxylin measurements compared with the BLM group. MMP-1, MMP-8 protein levels were increased and p-SMAD 2/3 protein level was decreased. TGF-β mRNA expression was decreased in the EGCG+BLM group compared with the BLM group.

Conclusion
These results suggest an antifibrotic role for EGCG.
How to decrease the rejection rates: reasons of sample rejection and solutions
Authors: Celik Saadet , Seyrekel Tuncay , Arpa Medeni 
Published: February 2018

Abstract

Objective
Sample rejection is an important step in the laboratory related with the patient safety. Periodical analysis of rejected samples is necessary to define the causes of rejection and follow-up the requirements for staff training. In this study, we aimed to put forth the efficiency of trainings by analyzing the amount of rejected samples in Yozgat State Hospital.

Materials and methods
Taken from laboratory information system (LIS), rejected sample statistics related to 8 month-data before training was compared with 8-month data after training between 07.2015 and 10.2016 are examined. These datas were compared in itself and to each other. All statistical analyses were performed using the SPSS (V15).

Results
Before training, the average number of patients for the analysis included months was 34,733 [standard deviation (SD)±4031], the number of rejected samples was 397.7 (SD±85.3) and the average rejection percentage was 1.13 (min-max: 1–1.29). The average number of patients for the after training months was 39,426 (SD±4779), the number of rejected samples was 343.2 (SD±57.7) and the average rejection percentage was 0.87 (min-max: 0.62–0.98), Rejected sample rates were significantly lower interms of statistics in the after-training group (p=0.0001).

Conclusion
Staff training takes a very important place preventing these mistakes. As it can be seen in our study, training helps decreasing rejection rates. It is suggested to schedule more trainings in order to decrease the rates to lower degrees.
Fabrication of γ-MnO2-Ce Pillared Montmorillonite for Low Temperature NH3-SCR
Authors: Huang Xiaoyan , Xie Aijuan , Zhou Xingmeng , Xia Jianwen , Luo Shiping , Yao Chao , Li Xiazhang 
Published: February 2018

Abstract
A series of γ-MnO2-Ce/MMT catalyst materials synthesized by homogeneous precipitation method was investigated for the selective catalytic reduction (SCR) of NOx with NH3. X-ray diffraction and specific surface areas were utilized for micro structure and layer spacing investigation. And NH3-TPD, Pyridoxine IR, H2-TPR and XPS were used to investigate Brønsted acid and Lewis acid, redox properties, atomic concentrations and element chemical state for as-prepared catalysts. The results showed that the γ-MnO2-Ce/MMT had superior NOx conversion compared to the bulk particles, among which 6 wt.% γ-MnO2-Ce/MMT displayed the best deNOx of 95.3% for the low temperature selective catalytic reduction of NOx with NH3 (NH3-SCR) under the GHSV of 25,000 h−1, therefore it is a promising catalyst for low temperature NH3-SCR.