bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lumbar Epidural Abscesses: A Systematic Review
Authors: de Leeuw Charles N. , Fann Patrick R. , Tanenbaum Joseph E. , Buchholz Avery L. , Freedman Brett A. , Steinmetz Michael P. , Mroz Thomas E. 
Published: December 2018

Study Design: Systematic review. Objectives: Spinal epidural abscesses (SEAs) are rare, but when missed or when diagnosis is delayed, SEA can lead to permanent neurological impairment or death. Limited information exists on the optimal treatment modalities for SEA, especially in the lumbar spine. We synthesize the current literature to identify the clinical features, diagnosis, management, and outcomes of lumbar SEA. Methods: Queries in 4 databases—EMBASE, MEDLINE, Scopus, and Web of Science—were performed using comprehensive search terms to locate published literature on lumbar SEA. Results: Ten articles reporting results for 600 cases of lumbar SEA were included, published between 2000 and 2017. Negative prognostic factors included diabetes, older age, methicillin-resistant Staphylococcus aureus, immune compromise, and more severe disease at presentation. Early first-line surgically treated patients responded better, specifically in terms of motor recovery, than those undergoing medical management or failing medical treatment, despite generally worse initial presentation. Elevated C-reactive protein, leukocytosis, and positive blood cultures predicted medical management failure. Conclusions: This systematic review provides guidance to neurological and orthopedic spine surgeons seeking the best treatment for lumbar-localized SEA. This study is limited by a dearth of high-quality publications to support evidenced-based management recommendations. Surgical treatment appears to provide better outcomes than medical treatment alone, especially in those who present with a motor deficit. Further investigation is needed to confirm this finding. What is clear is that early recognition and treatment remains crucial to minimizing morbidity and mortality of SEA.
Risk Factors and Prevention of Surgical Site Infections Following Spinal Procedures
Authors: Nasser Rani , Kosty Jennifer A. , Shah Sanjit , Wang Jeffrey , Cheng Joseph 
Published: December 2018

Study Design: Focused literature review. Objective: The objective of this article was to help identify potential risk factors as well as strategies to help prevent surgical site infections (SSIs) in spine surgery. Methods: An article search was performed using PubMed, EMBASE, and the Cochrane database of systematic reviews using the terms “surgery” OR “surgical” AND “spine” OR “spinal” AND “infection”. Systematic review articles, meta-analyses, and clinical trials with more than 100 patients were reviewed. Results: Both patient and perioperative factors contribute to the development of SSIs. Patient factors such as smoking, obesity, diabetes, Methicillin-resistant Staphylococcus aureus (MRSA) colonization, and malnutrition are all modifiable risk factors that can lead to SSIs. Procedural steps, including preoperative MRSA screening and treatment for colonization, preoperative antibiotics, skin preparation, minimizing operative time, antibiotic or betadine irrigation, avoiding personnel turnover, and postoperative wound care have also been shown to decrease infection rates. Conclusion: There are several measures a spine practitioner may be able to take in the preoperative, intraoperative, and postoperative settings. Protocols to counsel patients regarding modification of preexisting risk factors and ensure adequate antimicrobial therapy in the perioperative period may be developed to reduce SSIs in spine surgery.
Current State of Shared Decision-Making for CT Lung Cancer Screening and Improvement Strategies
Authors: Hill Paul Armstrong 
Published: December 2018

Introduction: Lung cancer remains the leading cause of oncologic mortality in the United States. Computed tomography (CT) screening has begun to combat this prevalent health problem. Prior to enrollment, a shared decision-making conversation is required to ensure a patient preference decision. This is the first and only imaging study to hold this requirement and compliance has been suspected to be low, but there is limited literature proving this. Methods: At a single academic institution, 30 patients who declined and 38 patients who enrolled in CT lung cancer screening were interviewed about their shared decision-making provider conversation. All referring providers were surveyed regarding their methods of shared decision-making for CT lung cancer screening. Clinical notes were evaluated 9 months prior to 2 interventions and 6 months following the first intervention to improve clinical documentation. Results: 85% to 89% of the interviewed patients could not recall a decision aid used during the shared decision-making conversation. Zero percent of clinical notes met the Centers for Medicare/Medicaid Services (CMS) encounter requirements for shared decision-making despite interventions to improve knowledge and ease accessibility to decision aids and documentation templates. Discussion: Lack of compliance with CMS requirements has a low patient decision satisfaction. This also places the institution at risk for financial repercussions of reimbursement which may jeopardize the longevity of screening programs. Development of strategies to improve the patient experience and provider facilitation are nascent and require a dedicated leadership team with carefully constructed electronic health record support.
Evidence Versus Practice: Operative Treatment Preferences in Hallux Valgus
Authors: Noback Peter C. , Trofa David P. , Vosseller J. Turner 
Published: December 2018

Background: There is substantial variability in the operative treatment of hallux valgus despite the existence of high quality evidence to guide treatment decisions. The purpose of this study was to determine the current trends in the treatment of mild, moderate, and severe hallux valgus and if greater degrees of consensus correlate with the presence of higher-level evidence. Methods: Members of the American Orthopaedic Foot & Ankle Society completed a 14-item survey. A total of 131 (14%) of 922 members completed the survey. Three cases representing 3 stages of HV were presented, and respondents selected their preferred treatment. Preferred forms of proximal and distal metatarsal osteotomies, as well as mode of fixation for each, were inquired. Results: In the treatment of mild hallux valgus without second metatarsalgia, 80% of those surveyed chose a distal metatarsal osteotomy, while, if second metatarsalgia was present, 56% chose a distal metatarsal osteotomy with a second metatarsal-shortening osteotomy. In the treatment of moderate hallux valgus, there was generally less consensus, while, in the treatment of severe hallux valgus, a majority of those surveyed chose a Lapidus procedure, with the addition of a second metatarsal-shortening osteotomy in the presence of second metatarsalgia. The most popular distal and proximal metatarsal osteotomies, respectively, were chevron osteotomy (80%) and opening wedge osteotomy (33%). The presence of Level I evidence did not significantly correlate with higher degrees of consensus. Conclusion: Despite the existence of high-quality evidence supporting the use of certain procedures in the treatment of HV, there exists an apparent lack of consensus among surgeons about the choice of surgical procedures. Moreover, higher-level evidence was not correlated with greater consensus in hallux valgus. Level of Evidence: Level II.
Bruton tyrosine kinase degradation as a therapeutic strategy for cancer
Authors: Dobrovolsky Dennis , Wang Eric S. , Morrow Sara , Leahy Catharine , Faust Tyler , Nowak Radosław P. , Donovan Katherine A. , Yang Guang , Li Zhengnian , Fischer Eric S. , Treon Steven P. , Weinstock David M. , Gray Nathanael S. 
Published: December 2018

Abstract
The covalent Bruton tyrosine kinase (BTK) inhibitor ibrutinib is highly efficacious against multiple B-cell malignancies. However, it is not selective for BTK, and multiple mechanisms of resistance, including the C481S-BTK mutation, can compromise its efficacy. We hypothesized that small-molecule–induced BTK degradation may overcome some of the limitations of traditional enzymatic inhibitors. Here, we demonstrate that BTK degradation results in potent suppression of signaling and proliferation in cancer cells and that BTK degraders efficiently degrade C481S-BTK. Moreover, we discovered DD-03-171, an optimized lead compound that exhibits enhanced antiproliferative effects on mantle cell lymphoma (MCL) cells in vitro by degrading BTK, IKFZ1, and IKFZ3 as well as efficacy against patient-derived xenografts in vivo. Thus, “triple degradation” may be an effective therapeutic approach for treating MCL and overcoming ibrutinib resistance, thereby addressing a major unmet need in the treatment of MCL and other B-cell lymphomas.
The addition of avibactam renders piperacillin an effective treatment for Mycobacterium abscessus infection in an in vivo model
Authors: Meir Michal , Bifani Pablo , Barkan Daniel 
Published: December 2018

AbstractTreating M. abscessus infection is challenging due to the potent β-lactamase BlaMab (Beta-lactamase of M. abscessus). Avibactam is a non-β-lactam, β-lactamase inhibitor shown to inhibit BlaMab. We tested whether avibactem can render piperacillin effective against M. Abscessus. In-vitro, avibactam enhanced the activity of piperacillin by 16–32 fold, with no significant effect on meropenem. In an in-vivo Galleria mellonella model, meropenem and piperacillin/avibactam significantly decreased infection burden compared to untreated controls. Neither piperacillin nor avibactam alone had a significant effect.
Cytokine, Chemokine, and Cytokine Receptor Changes Are Associated With Metabolic Improvements After Bariatric Surgery
Authors: Wolf Risa M , Jaffe Andrew E , Steele Kimberley E , Schweitzer Michael A , Magnuson Thomas H , Wolfe Andrew , Wong G William 
Published: December 2018

AbstractContextAltered cytokine levels and chronic low-grade inflammation contribute to metabolic dysfunction in obesity. The extent of cytokine changes and their impact on metabolic improvements after bariatric surgery have not been fully explored.ObjectiveTo compare 76 circulating cytokines, chemokines, and secreted cytokine receptors in subjects with obesity and lean subjects and determine how these cytokines are altered by bariatric surgery.Design, Setting, and ParticipantsA total of 37 patients with obesity and 37 lean patients in a cross-sectional study at an academic medical center. We also investigated cytokine changes in 25 patients with obesity after bariatric surgery.InterventionBariatric surgery (Roux-en-Y gastric bypass and vertical sleeve gastrectomy).Main Outcome MeasuresQuantification of 76 circulating cytokines, chemokines, and secreted cytokine receptors.ResultsA total of 13 cytokines were significantly higher, and 4 lower, in patients with obesity relative to lean controls. Soluble vascular endothelial growth factor receptor 2 (sVEGFR2), soluble TNF receptor (sTNFR) 1, and sTNFR2 were positively correlated, and soluble receptor for advanced glycation end-products was inversely correlated, with weight and body mass index. sTNFR2 was positively correlated with fasting glucose, homeostatic model assessment of insulin resistance, and hemoglobin A1c. After bariatric surgery, adiponectin increased, and leptin decreased. Elevated sVEGFR2 levels in patients with obesity were decreased (P = 0.01), whereas reduced chemokine (C-X-C motif) ligand (CXCL) 12 levels in patients with obesity increased (P = 0.03) after surgery. Patients with higher soluble interleukin receptor (sIL) 1R2 and sIL-6R levels before surgery had greater weight loss after surgery (P &lt; 0.05).ConclusionsWe demonstrate that chemokine (C-C motif) ligand (CCL) 14, sVEGFR2, and platelet-derived growth factor BB are elevated in obesity, and CXCL12, CCL11, and CCL27 are lower in obesity. We found clinically concordant directionality between lean and patients with obesity and before vs after surgery for six cytokines, suggesting that bariatric surgery shifted the cytokine profiles of patients with obesity toward that of lean controls.
A survey of quality of life indicators in the Romanian Roma population following the ‘Decade of Roma Inclusion’
Authors: Powell Doherty Rebecca , Telionis Pyrros A. , Müller-Demary Daniel , Hosszu Alexandra , Duminica Ana , Bertke Andrea , Lewis Bryan , Eubank Stephen 
Published: December 2018

Background: This study explores how the Roma in Romania, the EU’s most concentrated population, are faring in terms of a number of quality of life indicators, including poverty levels, healthcare, education, water, sanitation, and hygiene. It further explores the role of synthetic populations and modelling in identifying at-risk populations and delivering targeted aid.Methods: 135 surveys were conducted across five geographically diverse Romanian communities. Household participants were selected through a comprehensive random walk method. Analyses were conducted on all data using Pandas for Python. Combining land scan data, time-use survey analyses, interview data, and ArcGIS, the resulting synthetic population was analysed via classification and regression tree (CART) analysis to identify hot-spots of need, both ethnically and geographically.Results: These data indicate that the Roma in Romania face significant disparities in education, with Roma students less likely to progress beyond 8 th grade. In addition, the Roma population remains significantly disadvantaged with regard to safe and secure housing, poverty, and healthcare status, particularly in connection to diarrheal disease. In contrast, however, both Roma and non-Roma in rural areas face difficulties regarding full-time employment, sanitation, and water, sanitation, and hygiene infrastructure. In addition, the use of a synthetic population can generate information about ‘hot spots’ of need, based on geography, ethnicity, and type of aid required.Conclusions: These data demonstrate the challenges that remain to the Roma population in Romania, and also point to the myriad of ways in which all rural Romanians, regardless of ethnicity, are encountering hardship. This study highlights an approach that combines traditional survey data with more wide-reaching geographically based data and CART analysis to determine ‘hot spot’ areas of need in a given population. With the appropriate inputs, this tool can be extrapolated to any population in any country.
La arbitrabilidad subjetiva en el contrato de fiducia en Colombia.
Authors: Ortegón Obando Sebastián 
Published: December 2018

El objetivo del presente artículo es hacer una reflexión práctica sobre los problemas alrededor de los pactos arbitrales en materia de contratos de fiducia. En particular, sobre los problemas que pueden surgir para los no signatarios del pacto arbitral. La metodología empleada para la elaboración del presente estudio fue el análisis dogmático de casos jurisdiccionales, así como de la doctrina nacional e internacional sobre la materia. En primer lugar, se revisan detenidamente las diferentes aproximaciones teóricas que se han realizado con el fin de caracterizar lo que este artículo cataloga como 2 tendencias en la materia: rígida y flexible. Posteriormente se estudian algunas hipótesis prácticas que pueden surgir dada la estructura del contrato, para demostrar que las figuras que en la actualidad son utilizadas pueden redundar en la violación de los derechos de terceros.
Significado das ações educativas na consulta de enfermagem para clientes renais crônicos e familiares
Authors: Menezes Harlon França de , Rosas Ann Mary Machado Tinoco Feitosa , Camacho Alessandra Conceição Leite Funchal , Souza Flávia Silva de , Rodrigues Benedita Maria Rêgo Deusdará , Da Silva Richardson Augusto Rosendo 
Published: December 2018

Objetivo: compreender o significado das ações educativas na consulta de enfermagem para clientes renais crônicos em tratamento conservador e seus familiares. Método: estudo orientado pela Fenomenologia Social. Entre novembro de 2015 e abril de 2016, realizaram-se entrevistas com 12 clientes renais crônicos de um ambulatório de nefrologia de um hospital universitário e seus familiares, localizado no estado do Rio de Janeiro, Brasil, após aprovação dos Comitês de Ética em Pesquisa da instituição proponente e coparticipante. As entrevistas foram transcritas e submetidas à análise de acordo com a literatura relacionada. Resultados: emergiram duas categorias: Expectativas ao ir à consulta de enfermagem e Cuidando do outro para enfrentar as adversidades impostas pela doença. Conclusão: o estudo permitiu compreender que, no cotidiano desses indivíduos, eles adquirem habilidade e prática para lidar com suas limitações. As relações que possuem possibilitam subsídios para o reconhecimento dos valores não apenas da clínica como do valor enfocado no cuidado relacional.
When results matter: reliable creatinine concentrations in hyperbilirubinemia patients
Authors: Roelofsen-de Beer Roseri J.A.C. , van Zelst Bertrand D. , Vroling Aram B. , de Rijke Yolanda B. , Ramakers Christian 
Published: December 2018

Abstract

Background
Failure to report a creatinine concentration, especially in icteric patients who are eligible for a liver transplant, can result in a life-threatening situation. We assessed the influence of bilirubin interference on several creatinine assays and investigated ways to circumvent icteric interference without interfering with our normal automated sample logistics.

Methods
Using icteric patient sera (total bilirubin >255 μmol/L) we determined creatinine concentrations using an enzymatic and Jaffé assay (Roche Diagnostics) in both normal (i.e. undiluted) and decreased mode (i.e. diluted) as well as an enzyme-coupled amperometric assay on a Radiometer ABL837 FLEX analyzer. Creatinine concentrations from the five methods were compared with an in-house developed LC-MS/MS method. Passing and Bablok (proportional and constant bias) as well as difference plot parameters (bias and 95% limits of agreement [LoA]) were calculated. Interferograph-based regression analysis of the enzymatic and Jaffé results was used to investigate if such an approach could be used to report corrected creatinine concentrations in icteric patient sera.

Results
In icteric patient sera the enzyme-coupled amperometric assay was hardly influenced by icteric interference as shown by a difference plot bias of −1.5% (95% LoA −11.6 to +8.5%). The undiluted Jaffé method had a bias of −1.4% with a very broad 95% LoA (−35.1 to +32.2%) emphasizing the poor specificity of this method. The undiluted enzymatic method had the largest bias (−13.4%, 95% LoA −35.8 to +9.0%). Diluting sera in the enzymatic method did not improve the bias (−10.5%, 95% LoA −25.4 to 4.4%), while diluting the Jaffé method resulted in a bias increase (+11.4%, 95% LoA −14.7 to 37.5%). Using interferograph-based regression analysis we were able to reliably correct enzymatic creatinine concentrations in 97 out of 100 icteric patient sera.

Conclusions
Analytically, quantifying creatinine in icteric sera using the Radiometer ABL837 FLEX analyzer is the method of choice within our laboratory. However, not all laboratories are equipped with this method and even if available, the limited number of highly icteric patient sera makes this method costly. For those laboratories using the Roche enzymatic method, mathematically correcting an icteric creatinine concentration using an interferograph based on an LC-MS/MS reference method is a suitable alternative to report reliable creatinine results in icteric patients.
A Diffusion Cell for the Mass Transfer Investigation in the Solid Porous Media
Authors: Zhokh Alexey , Trypolskyi Andrey , Strizhak Peter 
Published: December 2018

Abstract
A diffusion cell for the mass transfer investigation of the gases through the solid porous media is developed. The diffusion cell may be configured in two different ways. One configuration corresponds to the reflecting boundary condition, whereas another configuration satisfies the absorbing boundary. The mass balance equations for different cell configurations are provided. The mass balance equations are applicable for the calculations of the diffusate quantity decays. The latter are suitable for the mass transfer parameters estimation using the solutions of the transport equations, obtained for the boundary conditions that correspond to the diffusion cell configurations. Accounting for the impact of the apparatus function of the diffusion cell on the experimental data is also revisited. In addition, the practical use of the diffusion cell based on the installation of the cell into the gas chromatograph for the investigation of the methane transport through the porous silica pellet as an example is demonstrated.
Why bother: usefulness and effect of young surgeon committees in surgical societies
Authors: Lutz Brigitta M. , Braun Benedikt J. , Blank Beate , Mutschler Manuel 
Published: December 2018

AbstractWork-time constraints during surgical residency along with managing a private life usually take up the majority of the time of young surgeons. For many, work with a surgical society seems like something neither generally promising nor personally worthwhile, thus raising the question, why bother? This article sets out to show examples of the effects that surgical societies and young surgeon committees can have on surgery and residency training. Additionally, we highlight the personal side of being active on a committee. Our aim is to raise interest in participating in societal work by showing the rewarding general effects as well as personal benefits. While this article is based primarily on experiences made in Germany, we believe that aspects can be transferred to other medical systems.
Structural Performance of Concrete Beams with Micro-reinforcement Strengthened with GFRP Laminates under Monotonic Loading
Authors: Rex L. K. , Premalatha P. V. 
Published: December 2018

Abstract
The behavior of structural elements under different loading conditions decides the performance of the built structures. Fiber-reinforced concrete and fiber-reinforced polymers (FRPs) have received increasing attention in recent years for many structural applications. Steel fibers, when added into concrete as micro-reinforcement, impart a bridging effect, resulting in enhanced mechanical properties. FRPs are most commonly composed of glass, aramid, or carbon fibers in a polymeric matrix and can be tailor-made to provide a large variety of material properties to suit the prerequisites of the engineer. This article presents an experimental investigation of steel fiber reinforced concrete beams externally strengthened with glass fiber reinforced polymer (GFRP) laminates to study their static flexural behavior and failure modes. The experimental program consisted of six concrete beams strengthened with GFRP laminates, and one concrete beam was left unstrengthened to serve as the control beam. The beams were designed for under-reinforced conditions and cast with different fiber volume fractions (Vf) and GFRP laminate thickness (tf). The beams were tested under monotonic loading until failure. The experimental results showed that the strengthened beams exhibit significantly improved performance compared with the control beams in terms of strength, deformation, ductility, and crack resistance under monotonic loads.