bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microcalcification in the arterial wall and its relationship to the ultrasound criteria of maturation of the arteriovenous fistula
Authors: Tang Weng Jun , Adnan Azreen Syazril , Md Salleh Md Salzihan , Mat Saad Arman Zaharil 
Published: October 2018

Introduction: A functioning and reliable arteriovenous fistula is a lifeline for individuals suffering from chronic kidney disease. The success and failure to arteriovenous fistula maturation have been frequently related to patient and surgeon factors. Method: In total, 138 participants with stage IV and V chronic kidney disease were included in this prospective observational study. Preoperative vascular mapping using ultrasound was performed to evaluate the condition and size of the vessels to fulfil the inclusion criteria. Intraoperatively, the vessel size was measured prior to anastomosis under magnified view. A specimen from the arterial wall of 5 mm in diameter was obtained from the arterotomy for histopathology assessment. Arteriovenous maturation was assessed at 6 weeks with the guidance of the ultrasound criteria of rule of sixes. Results: From the total of 138 participants, 110 participants (79.7%) had matured arteriovenous fistula in 6 weeks. The mean size of the artery measured intraoperatively was 3.82 ± 1.33 mm and the vein was 4.05 ± 1.20 mm. Microcalcification in the arterial media which was hypothesised to be the cause of the arteriovenous fistula failure was insignificant, with a p value of 0.115. Despite having atherosclerosis in the artery, 83.3% of the arteriovenous fistula matured. Conclusion: Microcalcification and atherosclerosis are frequently seen in the arteries of chronic kidney disease patients, but they do not explain arteriovenous fistula non-maturation.
Fecal SCFAs and SCFA‐producing bacteria in gut microbiome of human NAFLD as a putative link to systemic T‐cell activation and advanced disease
Authors: Rau Monika , Rehman Ateequr , Dittrich Marcus , Groen Albert K. , Hermanns Heike M. , Seyfried Florian , Beyersdorf Niklas , Dandekar Thomas , Rosenstiel Philip , Geier Andreas 
Published: October 2018

BackgroundIntestinal microbiota and their metabolites (e.g. short‐chain fatty acids (SCFAs)) may influence nonalcoholic fatty liver disease (NAFLD).ObjectiveThe objective of this article is to analyze gut bacterial diversity together with fecal SCFA concentrations and immunophenotyping of peripheral blood in histology‐proven NAFLD patients.MethodsThirty‐two NAFLD patients (14 nonalcoholic fatty liver (NAFL), 18 nonalcoholic steatohepatitis (NASH)) and 27 healthy controls (HCs)) were included in this study. Bacterial communities in feces were profiled by 16S ribosomal RNA gene sequencing of the V3–V4 region. Fecal SCFA levels were analyzed by high‐performance liquid chromatography. Fluorescence‐activated cell sorting analysis was performed of peripheral blood mononuclear cells.ResultsNASH patients were characterized by higher abundance of Fusobacteria and Fusobacteriaceae compared to NAFL and HCs. Conforming to our finding that NAFLD patients had higher fecal acetate and propionate levels, taxonomical differences of fecal bacteria were dominated by SCFA‐producing bacteria. Higher fecal propionate and acetate levels were associated with lower resting regulatory T‐cells (rTregs) (CD4+CD45RA+CD25++) as well as higher Th17/rTreg ratio in peripheral blood as immunological characteristics of NASH patients.ConclusionsNASH patients are characterized by a different gut microbiome composition with higher fecal SCFA levels and higher abundance of SCFA‐producing bacteria in NAFLD. These changes are associated with immunological features of disease progression. Our data suggest an important role of the intestinal microbiome and immunomodulatory bacterial metabolites in human NAFLD.
Open reduction and internal fixation for Mason type III radial head fractures: Is it different from that for Mason type II fractures?
Authors: Lee Yong-Suk , Kang Young-Hoon , Chung Yang-Guk , Shin Seung-Han 
Published: October 2018

Purpose: The objective of this study was to investigate whether the outcomes of Mason type III radial head fractures (RHFs) treated by open reduction and internal fixation (ORIF) were comparable to those of Mason type II RHFs treated by ORIF. Methods: A total of 87 surgically treated RHF patients were reviewed. Their fractures were Mason type II in 39 patients (all treated by ORIF) and Mason type III in 48 patients (40 treated by ORIF, 7 by radial head arthroplasty, and 1 by resection). Although ORIF was preferred for Mason type III RHFs in our series, an arthroplasty was performed when the fracture accompanied severe associated injuries or multiple traumas. Radiological and functional outcomes were evaluated and complications were reviewed. Results: When Mason type II and Mason type III in general were compared, QuickDASH score, a shortened version of the Disabilities of the Arm, Shoulder and Hand (DASH) score, and forearm rotation were significantly worse in Mason type III. However, when comparing Mason type II and Mason type III treated by ORIF in which the proportion of associated injuries were not significantly different, there was no significant difference in QuickDASH score, range of extension/flexion, or complication rate. Forearm rotations were significantly more limited in Mason type III treated by ORIF (7° for pronation and 7° for supination), and Mason type had an independent effect on forearm rotations in multivariate analysis. Conclusion: ORIF for Mason type III fractures with low level of associated injury can be as good as that for Mason type II fractures, except for less forearm rotation.
Synthesis of Novel Layered Zinc Glycolate and Exchange of Ethylene Glycol with Manganese Acetate Complex
Authors: Takase Kaori , Nishizawa Hitoshi , Imamura Kazuya , Onda Ayumu , Yanagisawa Kazumichi , Yin Shu 
Published: October 2018

Abstract
The novel layered zinc glycolate (LZG) with a lamella structure was successfully synthesized from zinc acetate by solvothermal reactions in ethylene glycol (EG) without water. The octahedral-shaped zinc glycolate (OZG) particles were formed in EG containing 1% water. LZG and OZG are crystal polymorphs with the same composition, Zn(OCH2CH2O). At 5% water content, the uniform and spherical particles of ZnO were formed. EG moieties in LZG were partially exchanged with Mn acetate complex in Mn acetate solution and the interlayer spacing of LZG was increased from 1.09 nm to 1.42 nm. ZnO and ZnMn2O4 were formed by heating the exchanged LZG at 600 °C. Acetate ions in the exchanged LGZ were exchanged with salicylic ions. EG moieties in OZG were mainly exchanged with OH in Mn acetate solution to form an amorphous phase.
Human rhinovirus spatial-temporal epidemiology in rural coastal Kenya, 2015-2016, observed through outpatient surveillance
Authors: Morobe John Mwita , Nyiro Joyce U. , Brand Samuel , Kamau Everlyn , Gicheru Elijah , Eyase Fredrick , Otieno Grieven P. , Munywoki Patrick K. , Agoti C.N. , Nokes D.J. 
Published: October 2018

Background: Human rhinovirus (HRV) is the predominant cause of upper respiratory tract infections, resulting in a significant public health burden. The virus circulates as many different types (~160), each generating strong homologous, but weak heterotypic, immunity. The influence of these features on transmission patterns of HRV in the community is understudied. Methods: Nasopharyngeal swabs were collected from patients with symptoms of acute respiratory infection (ARI) at nine out-patient facilities across a Health and Demographic Surveillance System between December 2015 and November 2016. HRV was diagnosed by real-time RT-PCR, and the VP4/VP2 genomic region of the positive samples sequenced. Phylogenetic analysis was used to determine the HRV types. Classification models and G-test statistic were used to investigate HRV type spatial distribution. Demographic characteristics and clinical features of ARI were also compared. Results: Of 5,744 NPS samples collected, HRV was detected in 1057 (18.4%), of which 817 (77.3%) were successfully sequenced. HRV species A, B and C were identified in 360 (44.1%), 67 (8.2%) and 390 (47.7%) samples, respectively. In total, 87 types were determined: 39, 10 and 38 occurred within species A, B and C, respectively. HRV types presented heterogeneous temporal patterns of persistence. Spatially, identical types occurred over a wide distance at similar times, but there was statistically significant evidence for clustering of types between health facilities in close proximity or linked by major road networks. Conclusion: This study records a high prevalence of HRV in out-patient presentations exhibiting high type diversity. Patterns of occurrence suggest frequent and independent community invasion of different types. Temporal differences of persistence between types may reflect variation in type-specific population immunity. Spatial patterns suggest either rapid spread or multiple invasions of the same type, but evidence of similar types amongst close health facilities, or along road systems, indicate type partitioning structured by local spread.
AVALIAÇÕES EXTERNAS NAS ESCOLAS ORGANIZADAS EM CICLOS: UMA ESQUIZOFRENIA NO ESPAÇO EDUCACIONAL
Authors: Fetzner Andrea Rosana , Corrêa da Silva Nathalia Santos 
Published: October 2018

Este artigo discute a relação entre a enturmação escolar em ciclos e as avaliações externas, políticas presentes nas salas de aula e em permanente conflito político, teórico e pedagógico. Busca-se compreender como os ciclos, enquanto projeto de democratização escolar, e as avaliações externas, orientadas pela mensuração e pelo controle, coexistem em uma escola da rede pública municipal de Nova Iguaçu, no estado do Rio de Janeiro. Trata-se de uma pesquisa qualitativa que realiza estudos bibliográficos, documentais e entrevistas com três educadores do município. Como resultado, observaram-se as interferências das avaliações externas sobre as práticas docentes e a persistência de algumas práticas avaliativas que se sustentam, apesar destas interferências.
Altered kinematics after anterior cruciate ligament reconstruction, and their role in the prevention of osteoarthritis
Authors: Somthavil Sompiya 
Published: October 2018

Background/Aims:Anterior cruciate ligament injury is common, and anterior cruciate ligament reconstruction has become the standard of care that aims to restore knee stability, return to activity, and prevent secondary injury.Methods:A literature review was carried out using PubMed and Science Direct databases from 1998 through 2017. Search terms included: anterior cruciate ligament reconstruction and knee osteoarthritis; kinematics after anterior cruciate ligament reconstruction; and prevention of knee osteoarthritis. A total of 356 studies matched the search terms. After removing duplicates and any studies that were not relevant, 73 studies remained.Findings:Individuals usually have impaired neuromuscular control after reconstruction, and abnormal biomechanical patterns may lead to loading of cartilage areas that are not commonly loaded and that, longitudinally, can lead to osteoarthritis. The knee adduction moment indicates loading of the knee joint and has been associated with the development of osteoarthritis and altered gait mechanics have also been implicated in the increased rate of osteoarthritis after anterior cruciate ligament reconstruction, including differences in tibial rotation during walking. Furthermore, altered ankle joint mechanics may be the result of deviations in ankle joint alignment secondary to the structural changes at the knee. It is clear that abnormal mechanical stimulation may cause dysfunction of articular chondrocytes and breakdown of cartilage extracellular matrix, leading to articular cartilage degradation and chondrocyte death. The affected joint will progress to post-traumatic osteoarthritis.Conclusions:The restoration of normal knee anatomy and mechanics, such as returning the joint to normal function, improving muscle strength, functional movement prevention programmes, restoring gait symmetry and weight management are recommended.
Teaching about diagnostic errors through virtual patient cases: a pilot exploration
Authors: Geha Rabih , Trowbridge Robert L. , Dhaliwal Gurpreet , Olson Andrew P.J. 
Published: October 2018

Abstract

Background:
Diagnostic error is a major problem in health care, yet there are few medical school curricula focused on improving the diagnostic process and decreasing diagnostic errors. Effective strategies to teach medical students about diagnostic error and diagnostic safety have not been established.

Methods:
We designed, implemented and evaluated a virtual patient module featuring two linked cases involving diagnostic errors. Learning objectives developed by a consensus process among medical educators in the Society to Improve Diagnosis in Medicine (SIDM) were utilized. The module was piloted with internal medicine clerkship students at three institutions and with clerkship faculty members recruited from listservs. Participants completed surveys on their experience using the case and a qualitative analysis was performed.

Results:
Thirty-five medical students and 25 faculty members completed the survey. Most students found the module to be relevant and instructive. Faculty also found the module valuable for students but identified insufficient curricular time as a barrier to implementation.

Conclusions:
Medical students and faculty found a prototype virtual patient module about the diagnostic process and diagnostic error to be educational.
Effective long-term temozolomide rechallenge in a macroprolactinoma
Authors: Zampetti Benedetta , Simonetti Giorgia , Attanasio Roberto , Silvani Antonio , Cozzi Renato 
Published: October 2018

Summary
We describe the 20-year course of a 63-year-old male with a macroprolactinoma that acquired resistance to treatment and aggressive behavior after a 4-year successful treatment with cabergoline. He was submitted to multiple surgical resections by a skilled surgeon, fractionated radiotherapy and was eventually treated with temozolomide. After a first 6-month standard cycle, a relapse occurred and he was treated again successfully.

Learning points:

Prolactinomas are the most frequent type of pituitary adenoma.

They usually have a benign course.

In most cases dopamine-agonist drugs, mainly cabergoline, are first-line (and usually only) treatment.

Occasionally prolactinomas can have or acquire resistance to treatment and/or aggressive behavior.

Temozolomide (TMZ), an oral alkylating drug, can be effective in such aggressive tumors.

Multimodal treatment (surgery, radiation, cabergoline and TMZ) is warranted in aggressive pituitary tumors.

We describe here successful rechallenge with TMZ after relapse occurring 18 months after a first TMZ cycle.
Decreasing Racemic Epinephrine for Bronchiolitis in an Academic Children’s Hospital
Authors: McCoy Elisha , Chumpia Maryanne 
Published: October 2018

BACKGROUND AND OBJECTIVES:
Bronchiolitis is a leading cause of pediatric hospitalizations in the United States. Although the American Academy of Pediatrics recommends against routine use of bronchodilators in bronchiolitis management, racemic epinephrine was persistently used for this purpose at Le Bonheur Children’s Hospital. Our aim was to decrease racemic epinephrine use for bronchiolitis by 50% within 8 months.

METHODS:
Our multidisciplinary team used the Institute for Healthcare Improvement’s Model for Improvement to develop an aim statement, choose metrics, and perform plan-do-study-act cycles to reduce racemic epinephrine use. We used focused education through in-person and online methods and provided direct feedback to residents, respiratory therapists, and nurses primarily caring for these children. The percentage of all patients admitted for bronchiolitis receiving at least 1 dose of racemic epinephrine was collected from the medical record and recorded on statistical process control charts for distribution to their work areas. Albuterol use and length of stay were collected as balancing measures. We used statistical process control charts to establish special cause variation and identify statistically significant differences in our measures.

RESULTS:
During our intervention period, the percentage of bronchiolitis patients receiving at least 1 dose of racemic epinephrine to treat bronchiolitis decreased from an average of 26% to 5%, and similarly, albuterol use decreased from an average of 48% to 34%. There was no clinically significant difference in length of stay.

CONCLUSIONS:
Using a multidisciplinary approach and focused education techniques may be an effective way to reduce racemic epinephrine use for children with bronchiolitis.
Integración auditiva, visual y propioceptiva como sustrato del desarrollo del lenguaje
Authors: Echeverría-Palacio Carlos Mario , Uscátegui-Daccarett Angélica , Talero-Gutiérrez Claudia 
Published: October 2018

Introducción. El desarrollo del lenguaje es un proceso complejo considerado como marcador evolutivo del ser humano y puede ser comprendido a partir de la contribución de los sistemas sensoriales y de los eventos que ocurren en periodos críticos del desarrollo.Objetivo. Realizar una revisión de cómo se da la integración de la información auditiva, visual y propioceptiva y cómo se refleja en el desarrollo del lenguaje, destacando el papel de la interacción social como contexto que favorece este proceso.Materiales y métodos. Se utilizaron los términos MeSH “Language Development”; “Visual Perception”; “Hearing”; y “Proprioception en las bases de datos MEDLINE y Embase, limitando la búsqueda principal a artículos escritos en inglés, español y portugués.Resultados. El punto de partida lo constituye la información auditiva, la cual, en el primer año de vida, permite la discriminación de los elementos del ambiente que corresponden al lenguaje; luego un pico en su adquisición y posteriormente una etapa de máxima discriminación lingüística. La información visual proporciona la correspondencia del lenguaje en imágenes, sustrato de nominación y comprensión de palabras, además de la interpretación e imitación del componente emocional en la gesticulación. La información propioceptiva ofrece la retroalimentación de los patrones de ejecución motora empleados en la producción del lenguaje.Conclusión. El estudio del desarrollo lenguaje desde la integración sensorial ofrece nuevas perspectivas para el abordaje e intervención de sus desviaciones.
Enzymes and cytokines disease in total hip arthroplasty: promoters of immune loosening
Authors: Pacheco-Martelo Victorino , Roldán-Vasco Sebastián 
Published: October 2018

Introducción. Una de las causas más importantes de falla de la prótesis de cadera lo constituye el fenómeno de aflojamiento, el cual se relaciona con la liberación de enzimas mediada por citocinas y produce la lisis del hueso que soporta el implante.Objetivo. Describir los mecanismos de interacción biológica de las moléculas promotoras del aflojamiento de la prótesis total de cadera que con mayor frecuencia están presentes en el proceso.Materiales y métodos. Se realizó una búsqueda de artículos originales y casos clínicos en las bases de datos PubMed y Scopus, sin límite de fecha de publicación, utilizando los términos MeSH “hip prosthesis loosening”, “aseptic loosening”, “cytokines” y “hip arthroplasty failure”. La extracción de datos se hizo mediante la lectura de 250 estudios, de los cuales se seleccionaron 66 para fines de redacción.Resultados. Los autores describen las moléculas más representativas implicadas en el aflojamiento de la prótesis de cadera, además se presentan las interacciones entre ellas.Conclusiones. Enzimas y citocinas han sido ampliamente estudiadas por cuatro décadas, aunque sus mecanismos de interacción son poco conocidos. Los autores proponen un mecanismo de interacción, proceso que podría denominarse “enfermedad de las enzimas y citocinas” o “aflojamiento inmunológico”.
Intervención en un niño con autismo mediante el juego
Authors: González-Moreno Claudia Ximena 
Published: October 2018

Introducción. El autismo es una alteración en el neurodesarrollo en la que se compromete el desarrollo comunicativo, emocional y simbólico del niño, así como la capacidad de establecer relaciones con el adulto y los objetos.Objetivo. Identificar el impacto del juego en el desarrollo comunicativo, emocional y simbólico de un niño con autismo de 3 años y 6 meses.Materiales y métodos. Se hizo una entrevista a los padres del niño y una observación a este en el contexto educativo y clínico. Se aplicó una evaluación del desarrollo infantil antes y después de realizar una intervención en la que se empleó el método experimental formativo propuesto por Vigotsky. La investigación fue de carácter cualitativo de tipo descriptivo. La intervención se diseñó considerando las necesidades de desarrollo psicológico del niño en lo que se refiere a la actividad rectora de juego.Resultados. El juego es un medio efectivo que contribuye con el desarrollo de habilidades comunicativas, emocionales y simbólicas en casos de autismo.Conclusión. La intervención clínica desde la aproximación psicológica histórico-cultural y la teoría de la actividad tiene impacto positivo en el desarrollo psicológico del niño, se propone de manera intencional y promueve el desarrollo de habilidades de corregulación social que facilitan la interacción comunicativa en casos de autismo.
Scope of Occupational Therapy postgraduate degrees around the world
Authors: Serrata- Malfitano Ana Paula , Monzeli Gustavo Artur , Bardi Giovanna , Esquerdo-Lopes Roseli 
Published: October 2018

Introduction: The production of knowledge in Occupational Therapy has been making progress worldwide.Objective: To understand how Occupational Therapy has developed as an academic discipline, particularly with respect to its areas of research at different universities.Methods: The Occupational Therapy postgraduate programs around the world (such as master’s degrees and doctoral programs), registered at World Federation of Occupational Therapists (WFOT) until 2015, were mapped and the websites of each program were visited to complete the information.Results: Data from 266 institutions that offered postgraduate programs were collected and analyzed. As of 2015, there were 348 programs in 11 countries; 225 professional master’s degrees, 69 academic master’s degrees, 30 post-professional doctorates in Occupational Therapy (PPOTD), and 24 academic doctorates (PhD). Such programs have existed since 1918 and had two major growth periods in 1940 and 1990.Conclusions: The number of postgraduate programs in occupational therapy is fairly limited. Only 16% of the countries that offer undergraduate courses also have master’s or doctoral programs. There are few postgraduate programs, especially at the doctoral level, which has limited the academic scope of this field.
La falta de medición y seguimiento en las MyPes colombianas: ¿Cuestión cultural o reflejo de una carencia de formación empresarial En sus directivos?
Authors: Gaviria Rincón Fabio Iván 
Published: October 2018

En este artículo se realizará un análisis de las causas que están generando el cierre de un gran número de empresas enmarcadas dentro del sector de las MyPes (Micros y pequeñas empresas) en Colombia y se desarrolla en el marco del análisis de tres aspectos fundamentales sobre los cuales se soporta la causa del cierre de más del 80% de las empresas que cada año se crean en Colombia. Se analizará el problema de la improductividad y cierre definitivo de un gran número de ellas, debido a un tema básicamente cultural de informalidad y falta de formación empresarial de los directivos y jefes de área de todas estas organizaciones.
Se reflexiona acerca de la posibilidad de que existan prácticas empresariales fundamentales como la Medición y el Seguimiento permanentes que no son manejadas con disciplina, o sencillamente han sido abandonadas y requieren de un replanteamiento e implementación de parte de los empresarios.