bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study of Different Techniques for the Sterilization of Poly-L-lactide Electrospun Microfibers: Effectiveness vs. Material Degradation
Authors: Rainer Alberto , Centola Matteo , Spadaccio Cristiano , Gherardi Giovanni , Genovese Jorge A. , Licoccia Silvia , Trombetta Marcella 
Published: April 2018

Electrospinning of biopolymeric scaffolds is a new and effective approach for creating replacement tissues to repair defects and/or damaged tissues with direct clinical application. However, many hurdles and technical concerns regarding biological issues, such as cell retention and the ability to grow, still need to be overcome to gain full access to the clinical arena. Interaction with the host human tissues, immunogenicity, pathogen transmission as well as production costs, technical expertise, and good manufacturing and laboratory practice requirements call for careful consideration when aiming at the production of a material that is available off-the-shelf, to be used immediately in operative settings. The issue of sterilization is one of the most important steps for the clinical application of these scaffolds. Nevertheless, relatively few studies have been performed to systematically investigate how sterilization treatments may affect the properties of electrospun polymers for tissue engineering. This paper presents the results of a comparative study of different sterilization techniques applied to an electrospun poly-L-lactide scaffold: soaking in absolute ethanol, dry oven and autoclave treatments, UV irradiation, and hydrogen peroxide gas plasma treatment. Morphological and chemical characterization was coupled with microbiological sterility assay to validate the examined sterilization techniques in terms of effectiveness and modifications to the scaffold. The results of this study reveal that UV irradiation and hydrogen peroxide gas plasma are the most effective sterilization techniques, as they ensure sterility of the electrospun scaffolds without affecting their chemical and morphological features.
Negative Dialysate to Sodium Gradient Does not Lead to Intracellular Volume Expansion Post Hemodialysis
Authors: Davenport Andrew 
Published: April 2018

Introduction Intradialytic hypotension remains the most common complication of routine outpatient hemodialysis treatments. There is debate as to the optimum dialysate sodium concentration, with hypotonic dialysates potentially causing intracellular swelling and hypertonic ones intracellular dehydration. Methods Multi-frequency bioimpedance was used to assess extracellular and intracellular fluid volumes in 53 adult hemodialysis patients. Dialysate sodium was checked by ion electrophoresis. Results The mean decrease in extracellular volume and intracellular volumes were 1.01 ±0.09 and 0.88 ±0.18 kg, respectively. The median dialysate to sodium gradient was −3 mmol/L (−1 to −6), with a median dialysate sodium of 136 mmol/L (136–138). There was no association between changes in body fluid composition and sodium concentrations, or gradients. The mean difference between dialysate sodium prescribed and delivered was 2.4 ±0.8 mmol/L. Conclusions In this study we were unable to demonstrate a relationship between predialysis serum sodium and the dialysate sodium prescribed and changes in extracellular or intracellular fluid volumes. However this study showed that using a negative sodium gradient, patients can be successfully ultrafiltrated without setting up intracompartmental fluid gradients. The caveat is that the prescribed dialysate to serum sodium gradient may differ from the actual gradient.
Fabrication of Custom-Shaped Grafts for Cartilage Regeneration
Authors: Koo Seungbum , Hargreaves Brian A. , Gold Garry E. , Dragoo Jason L. 
Published: April 2018

Purpose to create a custom-shaped graft through 3D tissue shape reconstruction and rapid-prototype molding methods using MRI data, and to test the accuracy of the custom-shaped graft against the original anatomical defect. Methods An iatrogenic defect on the distal femur was identified with a 1.5 Tesla MRI and its shape was reconstructed into a three-dimensional (3D) computer model by processing the 3D MRI data. First, the accuracy of the MRI-derived 3D model was tested against a laser-scan based 3D model of the defect. A custom-shaped polyurethane graft was fabricated from the laser-scan based 3D model by creating custom molds through computer aided design and rapid-prototyping methods. The polyurethane tissue was laser-scanned again to calculate the accuracy of this process compared to the original defect. Results The volumes of the defect models from MRI and laser-scan were 537 mm3 and 405 mm3, respectively, implying that the MRI model was 33% larger than the laser-scan model. The average (±SD) distance deviation of the exterior surface of the MRI model from the laser-scan model was 0.4±0.4 mm. The custom-shaped tissue created from the molds was qualitatively very similar to the original shape of the defect. The volume of the custom-shaped cartilage tissue was 463 mm3 which was 15% larger than the laser-scan model. The average (±SD) distance deviation between the two models was 0.04±0.19 mm. Conclusions This investigation proves the concept that custom-shaped engineered grafts can be fabricated from standard sequence 3-D MRI data with the use of CAD and rapid-prototyping technology. The accuracy of this technology may help solve the interfacial problem between native cartilage and graft, if the grafts are custom made for the specific defect. The major source of error in fabricating a 3D custom-shaped cartilage graft appears to be the accuracy of a MRI data itself; however, the precision of the model is expected to increase by the utilization of advanced MR sequences with higher magnet strengths.
Effects of Leukocyte Depletion on Cardiopulmonary Protection and Inflammation after Valve Surgery
Authors: Zhang Xiaohua , Zhou Chengbin , Zhuang Jian , Xiao Xuejun , Zheng Shaoyi , Xiong Weiping , Wang Wenxian , Wu Ruobin 
Published: April 2018

Background To evaluate the effects of leukocyte-depleting filtration on myocardial and pulmonary protection and the inflammatory response in patients undergoing valve surgery. Methods Fifty-two patients who underwent mitral valve or mitral and aortic valve replacement were randomized into two groups with or without a leukocyte-depleting filter during surgery. The filter was used from 10 minutes before the release of the aortic cross-clamp to the end of cardiopulmonary bypass. Results Total leukocyte and neutrophil counts showed a short-term reduction in patients undergoing leukocyte filtration, but there was no significant difference between the two groups during the study. Serum levels of cardiac troponin I were lower than that of the control group (p=0.030). Leukocyte depletion resulted in a significantly higher oxygenation index (p=0.002) and a lower respiratory index (p=0.003) compared with the control group. Serum levels of interleukin-8 were significantly elevated in patients undergoing leukocyte filtration compared with patients without leukocyte filtration (p=0.001). There were no statistically significant differences between the two groups with regards to the concentration of interleukin-6 and TNFα, or the duration of intensive care and hospital stay. Conclusions Leukocyte depletion is associated with improved myocardial and lung protection but does not appear to attenuate the inflammatory response in valve surgery.
Bereaved Family Members’ Perceptions of the Distressing Symptoms of Terminal Patients With Cancer
Authors: Okamoto Yoshiaki , Morita Tatsuya , Tsuneto Satoru , Aoyama Maho , Kizawa Yoshiyuki , Shima Yasuo , Miyashita Mitsunori 
Published: April 2018

Background: Few data are available on bereaved family members’ perspective on the frequency of symptoms and degree of distress among terminal patients with cancer. Methods: We sent a questionnaire to 1472 bereaved family members of terminal patients with cancer in 20 general hospitals. The questionnaire asked them (1) to indicate which symptoms the patients had, (2) to rate on a 4-point scale the extent to which the symptom was distressing, as follows: 1 = not distressing, 2 = slightly distressing, 3 = quite distressing, and 4 = very distressing at the point of 2 weeks before the patient had died. Results: We analyzed 805 questionnaires for this study. Anorexia was the commonest symptom among terminal patients with cancer experienced by bereaved family members, followed by somnolence, weight loss, fatigue, and pain. Anorexia was the most distressing symptom among terminal patients with cancer experienced by bereaved family members, followed by weight loss, pain, edema, and dyspnea. Conclusions: Anorexia and weight loss were frequent symptoms and bereaved family members felt very distressing. Furthermore, there are not means of effective treatment now. Thus, we think that further study in this field is necessary.
Lingual Frenulum Phenotypes in Brazilian Infants With Congenital Zika Syndrome
Authors: Fonteles Cristiane Sá Roriz , Marques Ribeiro Erlane , Sales Aragão Santos Marinisi , Ferreira Pequeno Leite Rebeka , Sales Assunção Gabryela , Monteiro André Jalles , Santos Pessoa André Luiz , Giacheti Célia Maria , Cavalcante Kerbage Sáile , Ribeiro Thyciana Rodrigues , Pamplona de Góes Cavalcanti Luciano 
Published: April 2018

Objective: The present study aimed to evaluate lingual frenulum in children affected by congenital Zika syndrome (CZS) and to analyze the association of lingual frenulum phenotypes with other variables. Design: This present work had a cross-sectional, descriptive study design. Setting: This study was carried out in Fortaleza (Brazil). The health professionals provided tertiary level of care. Data collection occurred during a multidisciplinary task force for evaluating infants affected by CZS in December 2 to 3, 2016. Patients: Fifty-four patients with CZS (1-12 months old; 32 girls and 22 boys) were recruited from a population of 70 infants. Interventions: A multidisciplinary group comprised of speech-language pathologist/audiologists and pediatric dentists evaluated all patients through an intraoral examination and a specific tongue maneuver protocol for infants. Main Outcome Measures: Lingual frenulum visibility was the primary outcome measure. Before initiating the study, we hypothesized that children with CZS had an absent lingual frenulum. Results: Lingual frenula were visible in 34 (63%) infants, whereas in 20 (37%) infants lingual frenula visibility required a specific maneuver to retract the tongue. Six of 20 infants presented posteriorly positioned lingual frenula that were visible after maneuver. Lingual frenula were covered by mucous tissue in 14 infants. Presence of posterior frenulum was associated with dysphagia ( P = 0.038). However, the presence of dysphagia in a multivariate model did not associate with the presence of a posterior lingual frenulum ( P = .069) or neurologic symptoms ( P = .056). Conclusion: Children with CZS showed predominance of a posterior lingual frenula covered by an overlapping curtain-like mucous membrane.
Speech in 5-Year-Olds With Cleft Palate With or Without Cleft Lip Treated With Primary Palatal Surgery With Muscle Reconstruction According to Sommerlad
Authors: Klintö Kristina , Falk Evelina , Wilhelmsson Sara , Schönmeyr Björn , Becker Magnus 
Published: April 2018

Objective: To evaluate speech in 5-year-olds with cleft palate with or without cleft lip (CP±L) treated with primary palatal surgery in 1 stage with muscle reconstruction according to Sommerlad at about 12 months of age. Design: Retrospective study. Setting: Primary care university hospital. Participants: Eight 5-year-olds with cleft soft palate (SP), 22 with cleft soft/hard palate (SHP), 33 with unilateral cleft lip and palate, and 17 with bilateral CLP (BCLP). Main Outcome Measures: Percent oral consonants correct (POCC), percent consonants correct adjusted for age (PCC-A), percent oral errors, percent nonoral errors, and variables related to velopharyngeal function were analyzed from assessments of audio recordings by 3 independent speech-language pathologists. Results: The median POCC was 75.4% (range: 22.7%-98.9%), median PCC-A 96.9% (range: 36.9%-100%), median percent oral errors 3.4% (range: 0%-40.7%), and median percent nonoral errors 0% (range: 0%-20%), with significantly poorer results in children with more extensive clefts. The SP group had significantly less occurrence of audible nasal air leakage than the SHP and the BCLP groups. Before age 5 years, 1.3% of the children underwent fistula surgery and 6.3% secondary speech improving surgery. At age 5 years, 15% of the total group was perceived as having incompetent velopharyngeal function. Conclusions: Speech was poorer in many children with more extensive clefts. Children with CP±L had poorer speech compared to normative data of peers without CP±L, but the results indicated relatively good speech compared to speech of children with CP±L in previous studies.
Improvement in Quality of Life Following Operative Correction of Midtarsal Charcot Foot Deformity
Authors: Kroin Ellen , Chaharbakhshi Edwin O. , Schiff Adam , Pinzur Michael S. 
Published: April 2018

Background: Patients with Charcot foot arthropathy report a poor quality of life following the development of deformity. Their quality of life is often not improved with “successful” historic accommodative treatment. There is increased current interest in operative correction of the acquired deformity with the stated goals of achieving both the traditional goals of resolution of infection and limb salvage as well as the desire to improve quality of life. The Short Musculoskeletal Functional Assessment (SMFA) outcomes instrument appears to be a valid tool for evaluating this complex patient population. Methods: Twenty-five consecutive patients undergoing operative reconstruction for nonplantigrade midtarsal Charcot foot arthropathy completed the SMFA patient-reported outcomes instrument prior to surgery, with 24 completing it at 1 year following the surgery. One patient died during the year following surgery from unrelated causes. Results: There was an 11.5-point (95% confidence interval [CI]: –19.7 to −3.2) decrease in the standardized functional index ( P = .01). Similarly, there was a 12.4-point (95% CI: –22.5 to −2.3) decrease in the standardized bother index ( P = .02). The standardized daily activity index demonstrated a 19.6-point decrease (95% CI: –30.5 to −8.6, P = .002), and there was a 14.7-point (95% CI: –24.1 to −5.3) decrease in the standardized emotion index ( P = .004). There was no meaningful change in the standardized arm/hand index ( P = .81). Conclusion: The results of this investigation demonstrate that successful operative reconstruction of midtarsal Charcot foot arthropathy improved quality of life. This supports the modern paradigm shift from immobilization during the active phase of the disease process followed by simple accommodation of the acquired deformity to the modern interest in operative correction to allow the use of commercially available therapeutic footwear. Level of Evidence: Level IV, case series.
Cancer-Related Internet Use and Online Social Networking Among Patients in an Early-Phase Clinical Trials Clinic at a Comprehensive Cancer Center
Authors: George Goldy C. , Buford Adrianna , Hess Kenneth , Piha-Paul Sarina A. , Zinner Ralph , Subbiah Vivek , Hinojosa Christina , Cleeland Charles S. , Meric-Bernstam Funda , Bernstam Elmer V. , Hong David S. 
Published: April 2018

Purpose We examined patterns, correlates, and the impact of cancer-related Internet use among patients with advanced cancer in a phase I clinical trials clinic for molecularly targeted oncologic agents. Methods An anonymous questionnaire on Internet use for cancer-related purposes that incorporated input from phase I clinical trial oncologists and patients was self-administered by patients age ≥ 18 years in a phase I clinic. Multivariable modeling was used. Data were analyzed for the overall sample and by generation, which was defined by year of birth. Results Of 291 patients (52% women, 82% non-Hispanic white, 50% age ≤ 60 years), 62% were cancer-related Internet users (CIUs). Cancer-related Internet use was associated with an income of ≥ $60,000 (odds ratio, 2.42; P = .004). CIUs used the Internet to learn about their cancer (85%), treatment adverse effects (65%), clinical trials (52%), new alternative treatments (42%), and symptom management (41%). CIUs most frequently used the hospital Web site (70%) to learn about clinical trials, followed by ClinicalTrials.gov (42%) and search engines (41%). The emotional impact of Internet-derived cancer information on CIUs varied—56% felt empowered, 34% anxious, 29% relieved, and 17% confused. Cancer-related Internet information made 51% of patients from the Millennial (born after 1990) and Generation X/Y (born 1965 to 1990) CIU populations anxious compared with < 29% of CIUs from older generations (born 1964 and before). Most CIUs desired more online information about new experimental drugs (91%) and US Food and Drug Administration–approved drugs for cancer (72%). Conclusion As most phase I patients use the Internet for cancer-related purposes, the Internet overall and hospital Web sites should provide more extensive, pertinent, and helpful information on clinical trials and cancer treatment to phase I patients.
Timing and Predictors of Mild and Severe Heat Illness among New Military Enlistees
Authors: NELSON D. ALAN , DEUSTER PATRICIA A. , O’CONNOR FRANCIS G. , KURINA LIANNE M. 
Published: April 2018

ABSTRACT

Purpose
Heat illnesses are important and potentially fatal conditions among physically active individuals. We determined predictors of heat illness among enlistees in a large military population experiencing common physical activity patterns.

Methods
We estimated the adjusted odds of mild (MHI) and severe (SHI) heat illness associated with demographic, health-related, and geographic factors among active-duty, US Army soldiers enlisting between January 2011 and December 2014 (N = 238,168) using discrete-time multivariable logistic regression analyses.

Results
We observed 2612 incident cases of MHI and 732 incident cases of SHI during 427,922 person-years of follow-up, with a mean and median of 21.6 and 21 months per subject. During the first 6 duty months, 71.3% of the MHIs and 60.2% of the SHIs occurred, peaking at month 2. The odds of MHI quadrupled among those with prior SHI (odds ratio [OR], 4.02; 95% confidence interval [CI], 2.67–6.03). Body mass index (BMI) extremes increased the odds substantially (OR at BMI ≥30 kg·m−2: for MHI, 1.41 (CI, 1.19–1.67); for SHI, 1.94 (CI, 1.47–2.56); OR at BMI <18.5 kg·m−2: for MHI, 1.50 (CI, 1.01–2.21); for SHI, 2.26 (CI, 1.16–4.39)). Tobacco use was associated with a 55% increase (CI, 1.37–1.77) in MHI odds. The odds of MHI increased if taking nonsteroidal anti-inflammatory drugs, opioids, or methylphenidate stimulants. Lower age and lower entry aptitude scores were associated with progressively increased MHI odds.

Conclusions
Most heat illnesses occurred at the outset of service, indicating the need for focused prevention methods at the initiation of military duty. Prior heat illness, BMI extremes, medications, and tobacco use represent potentially actionable risk factors to address by education, policy, and/or clinician intervention.
ENTREVISTA – PROFESSORA DRA. CECÍLIA GOULART – Universidade Federal Fluminense (UFF)
Authors: Goulart Cecília Maria Aldigueri , Coelho Victoria Wilson da Costa 
Published: April 2018

Na entrevista realizada ela Professora Victoria Wilson, Cecília Goular problematiza os conceito de letramento e alfabetização sob oponto de vista discursivo.
SENTIDOS DE CURRÍCULO NA ESCOLA MUNICIPAL GLAUBER XXX XXXXXXXXX: O QUE DIZEM OS PROFESSORES
Authors: Ribeiro Viviane Primo , Craveiro Clarissa Bastos , Azevedo Maicon Jefferson da Costa 
Published: April 2018

Este texto compartilha uma pesquisa sobre sentidos de Currículo em uma escola municipal localizada na Costa Verde do Estado do Rio de Janeiro. Repensa a produção curricular com os professores, no contexto da prática da escola. Os objetivos dessa pesquisa são: ampliar o entendimento de currículo com os professores da escola e articular a teorização do Ciclo de Políticas de Stephen Ball. Utilizamos o referencial teórico de Alice C. Lopes e Elizabeth Macedo para pensar a produção curricular e S. Ball como possibilidade heurística de análise dos contextos da escola. Concluímos que a diversidade da produção de currículo no contexto da prática escolar é um dos aspectos que contribui para a reconfiguração das políticas curriculares. Palavras-chave: Currículo; Escola; Formação de Professores. Sentidos de Curriculum en la escuela municipal Glauber: qué dicen los profesores Esta es una investigación sobre sentidos de Currículo en una escuela ubicada en la Costa Verde en RJ, Brazil. Se repiensa el curriculo con los profesores, en la práctica escolar. Son los objetivos: ampliar la comprension de currículo con los profesores y articular la teoría del Ciclo de Políticas de Stephen Ball. Utilizamos Alice Lopes y Elizabeth Macedo para analizar la producción curricular y S. Ball como parte heurística del análisis de los contextos de la escuela. Concluimos que la diversidad en la producción de currículo en el contexto de la práctica escolar es uno aspecto que contribuye a la reconfiguración de las políticas de currículo. Palabras clave: Currículo; escuela; Formación de profesores. Curriculum meanings in the Glauber municipal School: what teachers say This text shares a research about Curriculum meanings in a municipal school located in Costa Verde, RJ, Brazil. It rethinks the curricular production with teachers, in the context of school practice. The objectives of research are: to broaden the understanding of curriculum with teachers and articulate Stephen Ball’s Policy Cycle theory. We used the theoretical reference of Alice Lopes and Elizabeth Macedo to think about the curricular production and S. Ball as a heuristic analysis possibility in school. We conclude that diversity of curriculum production in the context of school practice is one aspect that contributes to the reconfiguration of curricular policies. Keywords: Curriculum; School; Teacher training.