bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applied Force during Piston Prosthesis Placement in a 3D‐Printed Model: Freehand vs Robot‐Assisted Techniques
Authors: Razavi Christopher R. , Wilkening Paul R. , Yin Rui , Lamaison Nicolas , Taylor Russell H. , Carey John P. , Creighton Francis X. 
Published: December 2018

ObjectivesTo describe a 3D‐printed middle ear model that quantifies the force applied to the modeled incus. To compare the forces applied during placement and crimping of a stapes prosthesis between the Robotic ENT Microsurgery System (REMS) and the freehand technique in this model.Study DesignProspective feasibility study.SettingRobotics laboratory.Subjects and MethodsA middle ear model was designed and 3D printed to facilitate placement and crimping of a piston prosthesis. The modeled incus was mounted to a 6–degree of freedom force sensor to measure forces/torques applied on the incus. Six participants—1 fellowship‐trained neurotologist, 2 neurotology fellows, and 3 otolaryngology–head and neck surgery residents—placed and crimped a piston prosthesis in this model, 3 times freehand and 3 times REMS assisted. Maximum force applied to the incus was then calculated for prosthesis placement and crimping from force/torque sensor readings for each trial. Robotic and freehand outcomes were compared with a linear regression model.ResultsMean maximum magnitude of force during prosthesis placement was 126.4 ± 73.6 mN and 105.0 ± 69.4 mN for the freehand and robotic techniques, respectively (P =. 404). For prosthesis crimping, the mean maximum magnitude of force was 469.3 ± 225.2 mN for the freehand technique and 272.7 ± 97.4 mN for the robotic technique (P =. 049).ConclusionsPreliminary data demonstrate that REMS‐assisted stapes prosthesis placement and crimping are feasible with a significant reduction in maximum force applied to the incus during crimping with the REMS in comparison with freehand.
Montelukast and Nasal Corticosteroids to Treat Pediatric Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis
Authors: Liming Bryan J. , Ryan Matthew , Mack Douglas , Ahmad Iram , Camacho Macario 
Published: December 2018

ObjectiveTo systematically review the literature on anti‐inflammatory medications for treating pediatric obstructive sleep apnea and perform meta‐analysis of the available data.Data SourcesPubMed/MEDLINE and 4 additional databases.Review MethodsThree authors independently and systematically searched through June 28, 2018, for studies that assessed anti‐inflammatory therapy for treatment of pediatric obstructive sleep apnea (OSA). Data were compiled and analyzed using Review Manager 5.3 (Nordic Cochrane Centre).ResultsAfter screening 135 studies, 32 were selected for review with 6 meeting inclusion criteria. In total, 668 patients aged 2 to 5 years met inclusion criteria for meta‐analysis. Of these, 5 studies (166 children) that evaluated montelukast alone as treatment for pediatric OSA found a 55% improvement in the apnea‐hypopnea index (AHI) (mean [SD] 6.2 [3.1] events/h pretreatment and 2.8 [2.7] events/h posttreatment; mean difference [MD] of −2.7 events/h; 95% confidence interval [CI], –5.6 to 0.3) with improvement in lowest oxygen saturation (LSAT) from 89.5 (6.9) to 92.1 (3.6) (MD, 2.2; 95% CI, 0.5‐4.0). Two studies (502 children) observing the effects of montelukast with intranasal corticosteroids on pediatric OSA found a 70% improvement in AHI (4.7 [2.1] events/h pretreatment and 1.4 [1.0] events/h posttreatment; MD of −4.2 events/h; 95% CI, –6.3 to −2.0), with an improvement in LSAT from 87.8 (3.1) to 92.6 (2.2) (MD, 4.8; 95% CI, 4.5‐5.1).ConclusionsTreatment with montelukast and intranasal steroids or montelukast alone is potentially beneficial for short‐term management of mild pediatric OSA.
Digital storytelling using co-production with vulnerable young people
Authors: Heron Gavin , Steckley Laura 
Published: December 2018

Summary The importance of listening to young people is enshrined in legislative and policy frameworks and is integral to the children’s rights agenda. However, social work has often struggled to give a voice to vulnerable young people, especially when their views conflict with adult perspectives. This project pioneers the use of digital storytelling using a co-productive approach to address an ongoing deficit in the way accommodated young people express their views at key decision making forums. A four-day residential retreat was used as the venue for co-constructing a digital story and collecting data about young people’s experiences of the process. Thematic analysis was used to identify key themes emerging from participants’ accounts of their experiences. Findings The findings suggest that child care meetings should be re-conceptualized as a process in which young people undertake the role of educator, rather than their current positioning as passive information giver. The shift from a passive provider of information to educator is theorised by linking the concepts of scaffolding and Zone of Proximal Development to co-production. Applications This study expands current conceptualisations of co-production as an approach to digital storytelling that holds transformative potential for genuine inclusion of children’s voices in decision-making forums. Whilst the study focused on accommodated young people, the findings are relevant to other service user groups. New technology presents exciting opportunities for practitioners and policy makers to involve those most excluded in society, and at a time when key decisions are made about their lives.
Granulocyte Colony-Stimulating Factor Treatment During Radiotherapy Is Associated With Survival Benefit in Patients With Lung Cancer
Authors: Du Rui , Hu Pingping , Liu Qiqi , Zhang Jingxin , Deng Guodong , Hu Dan , Zhang Jiandong 
Published: December 2018

Objectives: Granulocyte colony-stimulating factor, an agent commonly used for neutropenia treatment, plays an important role in cancer treatment. However, the effect of granulocyte colony-stimulating factor treatment on patient’s survival during radiation therapy in lung cancer remains unknown. Materials and Methods: A retrospective study of patients with lung cancer who underwent radiation therapy from 2012 to 2015 at Shandong Provincial Qianfoshan Hospital was performed. Granulocyte colony-stimulating factor was administered when grade 3 or 4 leukopenia and/or neutropenia occurred during radiation therapy, and no prophylactic granulocyte colony-stimulating factor was used in this study. Patients were classified into high and low granulocyte colony-stimulating factor group according the dosage of granulocyte colony-stimulating factor use during radiation therapy. The influence of granulocyte colony-stimulating factor on survival was investigated. In addition, the predict value of granulocyte colony-stimulating factor in concurrent chemoradiotherapy group and radiation therapy alone group was also evaluated, respectively. Results: A total of 231 patients were enrolled, with 56 in the high granulocyte colony-stimulating factor group and 175 in the low granulocyte colony-stimulating factor group. High dose of granulocyte colony-stimulating factor for the entire population group was associated with a favorable overall survival (hazard ratio [95% confidence interval] = 1.798 [1.260-2.568]; P = .001) and a longer progression-free survival (hazard ratio = 1.550 [1.127-2.132]; P = .007). However, compared with a lower granulocyte colony-stimulating factor, a higher granulocyte colony-stimulating factor was associated with significant better overall survival and progression-free survival in radiation therapy group, not in concurrent chemoradiotherapy group. Although there was no statistical significance in concurrent chemoradiotherapy group, the median overall survival and progression-free survival of patients in the higher granulocyte colony-stimulating factor group were longer than those in the lower group. Furthermore, the treatment strategy was also associated with the overall survival, not the progression-free survival. Conclusion: This study suggests that granulocyte colony-stimulating factor treatment during radiation therapy has favorable impact on outcome in patients with lung cancer. Besides, results showed that patients treated with concurrent chemoradiotherapy had better prognosis than those treated with radiation therapy alone.
Paclitaxel blocks Th2‐mediated TGF‐β activation in Schistosoma mansoni‐induced pulmonary hypertension
Authors: Kassa Biruk , Mickael Claudia , Kumar Rahul , Sanders Linda , Koyanagi Dan , Hernandez‐Saavedra Daniel , Tuder Rubin M. , Graham Brian B. 
Published: December 2018

Schistosomiasis is a leading cause of pulmonary hypertension (PH) worldwide. Recent studies reveal that the type‐2 immune cytokines IL‐4 and IL‐13, as well as consequent activation of TGF‐β, are key factors in the pathogenesis of Schistosoma‐PH. Paclitaxel has been reported to act as an adjuvant for Th2 inflammation while downregulating TGF‐β activation. Moreover, paclitaxel blocks PH in monocrotaline and SU5416‐hypoxia models. We hypothesized that paclitaxel would augment Th2 inflammation while blocking TGF‐β activation and PH after schistosomiasis exposure. Wild‐type mice (C57BL6/J; 6/group) were intraperitoneally (IP) sensitized and then intravenously (IV) challenged with Schistosoma mansoni eggs. One day after IV egg challenge, the mice were treated with a single IP dose of 25 mg/kg paclitaxel or vehicle. Right ventricular (RV) catheterization was performed and granuloma volumes and vascular remodeling were quantified. Lung cytokines were quantified by ELISA and reverse transcription polymerase chain reaction, and the quantity of active TGF‐β was determined using a cell reporter line. We also investigated hypoxia‐induced PH. Paclitaxel treatment significantly protected mice from Schistosoma‐PH, with decreased RV systolic pressure (P = 0.005) and pulmonary vascular media thickness. Inflammation was significantly suppressed, contrary to our hypothesis, with decreased IL‐4 and IL‐13 levels, smaller granulomas, and less active TGF‐β following paclitaxel treatment. There was no change in IFN‐γ or FoxO1 or FoxO3 expression. Paclitaxel did not suppress chronic hypoxia‐induced PH, which is also TGF‐β‐driven but independent of type‐2 immunity. Paclitaxel protects against Schistosoma‐induced PH in mice, although by blocking proximate Th2 inflammation rather than suppressing distal TGF‐β activation.
Clinical and endoscopic findings to assist the early detection of duodenal adenoma and adenocarcinoma
Authors: Matsuzaki Juntaro , Suzuki Hidekazu , Shimoda Masayuki , Mori Hideki , Fukuhara Seiichiro , Miyoshi Sawako , Masaoka Tatsuhiro , Iwao Yasushi , Kanai Yae , Kanai Takanori 
Published: December 2018

BackgroundSporadic nonampullary duodenal adenocarcinoma is a rare malignant neoplasm in which poor prognosis is often associated with delayed diagnosis.ObjectiveA case‐control study was designed to evaluate the clinical and endoscopic characteristics of patients with nonampullary duodenal epithelial tumours (NADETs).MethodsPatients with NADETs were chronologically divided into a discovery and a validation sets. Two age‐ and sex‐matched control individuals for each case in the discovery set were randomly selected from individuals without NADET. A prediction model for the presence of NADET, constructed in the discovery set, was evaluated in the validation set.ResultsIn total, 368 adenomas, 81 adenocarcinomas, and 314 controls were analysed. Current smoking, Barrett oesophagus, fundic gland polyps, history of malignant disease, and absence of dyslipidaemia were independently associated with the presence of NADET. The combination of these five factors enabled significant discrimination for NADET in the bulb with a sensitivity of 0.81 in the validation set. We also showed that duodenal adenocarcinomas in the bulb had greater invasive potential than adenocarcinomas in the second portion.ConclusionThe presence of a duodenal tumour in the bulb could be predicted by clinical and endoscopic findings, which helps improve the prognosis and quality of life of patients.
Lessons learned from implementing a principled approach to resolution following patient harm
Authors: Smith Kelly M , Smith Larry L , (Jack) Gentry John C , Mayer David B 
Published: December 2018

Background Communication and resolution programs have emerged as central to organizational responses to serious patient harm events, with demonstrated evidence of patient safety and medicolegal outcome improvements within a handful of healthcare systems. Hospitals, including those with open medical staffs, have struggled implementing communication and resolution programs, particularly around the components supporting resolution. Here, we describe our lessons learned early after implementing the resolution (“R”) component of Communication and Optimal Resolution, a comprehensive contemporary communication and resolution program at MedStar Health, a large community health system in the United States. Context MedStar Health is a regional healthcare system with 10 hospitals, 250 ambulatory care delivery sites, and 20 diversified businesses in the mid-Atlantic region of the United States. MedStar Health initiated Communication and Optimal Resolution implementation in 2015. Approach Our approach to resolution following patient harm yielded seven strategies supporting our resolution process. These included infrastructure and processes to (i) provide immediate support to patients and families, (ii) hold and waive bills, (iii) activate event review processes early to inform resolution, (iv) embrace a paradigm shift in legally defensible cases, (v) develop a communication and resolution program legal community, (vi) accept sacrifices with a principled resolution, and (vii) commit to address challenges with open medical staffs. Summary The resolution process in response to serious patient harm is complex. Our early experience in implementing the “R” of Communication and Optimal Resolution required enhanced infrastructure, embracing the clinician, legal, and insurance communities and instructing them in the principles of communication and resolution program, and a strong organizational commitment to “doing the right thing” for patients and families.
Novel susceptibility variants at the ERG locus for childhood acute lymphoblastic leukemia in Hispanics
Authors: Qian Maoxiang , Xu Heng , Perez-Andreu Virginia , Roberts Kathryn G. , Zhang Hui , Yang Wenjian , Zhang Shouyue , Zhao Xujie , Smith Colton , Devidas Meenakshi , Gastier-Foster Julie M. , Raetz Elizabeth , Larsen Eric , Burchard Esteban G. , Winick Naomi , Bowman W. Paul , Martin Paul L. , Borowitz Michael , Wood Brent , Antillon-Klussmann Federico , Pui Ching-Hon , Mullighan Charles G. , Evans William E. , Hunger Stephen P. , Relling Mary V. , Loh Mignon L. , Yang Jun J. 
Published: December 2018

Abstract
Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Characterized by high levels of Native American ancestry, Hispanics are disproportionally affected by this cancer with high incidence and inferior survival. However, the genetic basis for this disparity remains poorly understood because of a paucity of genome-wide investigation of ALL in Hispanics. Performing a genome-wide association study (GWAS) in 940 Hispanic children with ALL and 681 ancestry-matched non-ALL controls, we identified a novel susceptibility locus in the ERG gene (rs2836365; P = 3.76 × 10−8; odds ratio [OR] = 1.56), with independent validation (P = .01; OR = 1.43). Imputation analyses pointed to a single causal variant driving the association signal at this locus overlapping with putative regulatory DNA elements. The effect size of the ERG risk variant rose with increasing Native American genetic ancestry. The ERG risk genotype was underrepresented in ALL with the ETV6-RUNX1 fusion (P &lt; .0005) but enriched in the TCF3-PBX1 subtype (P &lt; .05). Interestingly, ALL cases with germline ERG risk alleles were significantly less likely to have somatic ERG deletion (P &lt; .05). Our results provide novel insights into genetic predisposition to ALL and its contribution to racial disparity in this cancer.
Attitude and perception of medical interns about antimicrobial resistance: a multi center cross-sectional study in Ethiopia
Authors: Mersha Amanual Getnet 
Published: December 2018

Abstract
Background
Antibiotic resistance is a global burden and reduction of antimicrobial resistance requires change in antimicrobial prescribing behavior of health workers. The current study aimed to evaluate the attitude and perception of Ethiopian medical interns towards antimicrobials resistance.

Methods
A multi center cross-sectional institutional based survey was conducted from August 2016 to October 2016 among medical interns in Ethiopia. Data entered and analyzed using Statistical Package for Social Sciences program (SPSS) software version 21.0 for Windows. Descriptive statistics, chi-square test and binary logistic regression analysis were used and statistical significance was set at P-value < 0.05 as a cut of point.

Results
Out of the 278 questionnaires distributed, 270 were returned completed giving a response rate of 97.1%. Most of the participants 256 (94.8%) wants to receive further education about antimicrobial stewardship. Chi-square test showed a significant difference between institutions about interns’ attitude and perception concerning over usage of antimicrobials in their institutions; description of correct antimicrobial coverage; handling patients who demands antimicrobial therapy that is not indicated and finding reliable sources of information to treat infections (P-value < 0.05). Attaching at internal medicine wards during the survey and receiving antimicrobial stewardship training during the past 6 months were found to improve their attitude significantly by 2.68 and 3.48 times respectively.

Conclusions
The current study demonstrates an enormous desire of medical interns for further education about antimicrobial stewardship. Hence, it is strongly recommended to provide a comprehensive, regular, standard and up to date educational training in all medical institutions for our future prescribers. Medical institutions and stakeholders are recommended to advocate curriculums and policies that build up antimicrobial stewardship programs.
Does metformin usage improve survival in head and neck squamous cell carcinoma? A population-based study
Authors: Quimby Alexandra E. , Lebo Nicole L. , Griffiths Rebecca , Hall Stephen , Dimitroulakos Jim , Johnson-Obaseki Stephanie 
Published: December 2018

Background We sought to expand upon preliminary data suggesting that metformin confers a survival benefit to patients with head and neck squamous cell carcinoma (HNSCC). Methods A large-scale retrospective cohort study of all patients in Ontario diagnosed with squamous cancer of the larynx, hypopharynx, and nasopharynx between Dec 1st 2007 to Dec 1st 2012 was undertaken. The Institute for Clinical and Evaluative Sciences was accessed to obtain patient demographic, treatment and outcome information. We included patients on metformin at the time of diagnosis. Kaplan Meier methods and Cox Regression models were used. Results Patients taking metformin at the time of diagnosis had a higher comorbid status but were otherwise similar to patients without metformin usage. Using multivariate analysis, neither overall survival nor disease specific survival was improved in patients on metformin (OS: HR 1.123, p = .338; DSS: HR 1.048, p = .792). Conclusions No survival advantage was observed in patients with HNSCC taking metformin at the time of diagnosis.
The association between early‐onset cardiac events caused by neoadjuvant or adjuvant chemotherapy in triple‐negative breast cancer patients and some novel autophagy‐related polymorphisms in their genomic DNA: a real‐world study
Authors: Liu Binliang , An Tao , Li Meiying , Yi Zongbi , Li Chunxiao , Sun Xiaoying , Guan Xiuwen , Li Lixi , Wang Yanfeng , Zhang Yuhui , Xu Binghe , Ma Fei , Zeng Yixin 
Published: December 2018

AbstractBackgroundAn increasing number of cancer patients die of cardiovascular diseases. The cardiotoxicity of chemotherapy is particularly important in triple‐negative breast cancer (TNBC) with limited therapeutic options. Cardiac autophagy is an important mechanism of cardiotoxicity. This research was aimed to investigate the cardiotoxicity of chemotherapy in TNBC, screen the susceptible population, and determine the relationship between cardiotoxicity and autophagy‐related polymorphisms.MethodsFrom a total of 2450 stage I‐III TNBC patients, 147 met the inclusion criteria and finally recruited. Electrocardiography (ECG) was performed before most chemotherapy cycles, and echocardiography (UCG) was performed according to clinical needs. All ECG and UCG records were re‐interpreted by cardiologists at the National Center for Cardiovascular Disease, Fuwai Hospital. According to the National Center for Biotechnology Information and the Catalog of Somatic Mutations in Cancer database, we selected 25 single nucleotide polymorphisms (SNPs) related to autophagy and genotyped the 147 TNBC patients. Paired‐sample T tests, Chi squared tests, and logistic regression models were employed for the analysis.ResultsOnly 46 (31.3%) patients had normal ECG records after every chemotherapy cycle. Among the 16 patients who underwent UCG, 2 (12.5%) had a reversible decrease of left ventricular ejection fraction. The use of anthracyclines and excessive alcohol consumption were risk factors of ECG abnormalities. With the continuation of chemotherapy, heart rate gradually increased. Anthracyclines were associated with QRS duration abnormalities (P = 0.043). After genotyping for 25 autophagy‐related SNPs, we found that the G allele of autophagy‐related 13 (ATG13) rs10838611 was significantly associated with ECG abnormalities (odds ratio = 2.258, 95% confidence interval = 1.318–3.869; P = 0.003).ConclusionECG abnormalities caused by chemotherapy are common in the real world. Autophagy‐related SNPs are associated with chemotherapy‐induced cardiotoxicity, thereby providing new evidence for autophagy as a cause of chemotherapy‐induced cardiac damage.
Eco(il)logical Knowledge
Authors: Baptista João Afonso 
Published: December 2018

AbstractIn this article, I narrate an ethnographic storyline that involves forest inhabitants, local politicians, development professionals, and scientific researchers in both representational and nonrepresentational worlds of knowing. I discuss how and why, in Angola, making forest knowledge through relations of distance to the forests is crucial for attaining institutional legitimacy over the forests. This way of acquiring authority and influence is championed by a broad epistemological tendency to address only the absent, which is then made present by accredited representers. Yet this technique disempowers local forest dwellers in their everyday territories and disallows the capacity that the ecological knowns have to reveal themselves. Knowing Angolan forests through absence and distance is not just a potent contemporary form of knowledge that qualifies as a way of ruling the forests, but is also integral to widespread (neo)colonial processes of distinction and separation: the knower and the known, the representer and the represented, the “cosmopolitan intellectual” and the “rustic bestial” Other. Finally, I discuss different forms of ecological knowledge in light of ethical stances toward knowing, relationality, and, ultimately, being.