bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human factors enablers and barriers for successful airway management – an in‐depth interview study
Authors: Schnittker R. , Marshall S. , Horberry T. , Young K. L. 
Published: April 2018

SummaryHuman factors are the individual, team, environmental and organisational aspects of the anaesthetic environment that affect performance and decision‐making of anaesthesia teams. This study aimed to identify which human factors were enablers and/or barriers to anaesthesia teams during airway management challenges. Sixteen interviews were conducted with experienced anaesthetists and anaesthetic nurses using an in‐depth interview technique (the Critical Decision Method) to identify human factors enablers and/or barriers during successful management of a significant airway challenge. Thematic analysis identified three overarching enablers: equipment location and storage; experience and learning; teamwork and communication. Five overarching barriers were also identified: time and resource limitations; teamwork and communication; equipment location and storage; experience and learning; insufficient back‐up planning; and equipment preparation. This study showed that a variety of human factors issues affect the handling of airway challenges, ranging from individual and team to organisational and environmental aspects. Recommendations for the design of airway management decision support tools that relate to equipment standardisation, decision support complexity, inclusive mutual learning and teamwork are discussed.
Repair of a Giant Omphalocele in an Infant With a Pericardial Implant Crosslinked With Oligourethane
Authors: Vargas‐Mancilla Juan , Torrero‐Serrato María A. , Palacios‐Rodríguez Aarón J. , Rodríguez‐de León Gloria B. , Montes‐Rodríguez Metzeri I. , Mendoza‐Novelo Birzabith 
Published: April 2018

AbstractThe giant omphalocele (GO) represents a challenge for the pediatric surgeon in its management and wall abdominoplasty. Here, we report the outcome of a case in which a GO in a newborn patient was repaired with an implant derived from decellularized bovine pericardium crosslinked with oligourethane. The implantation time was extended for 6 months. This was then followed up by the retrieval of the implant and the subsequent reconstruction in a second surgical time by the closure of the abdominal wall fascia. A short hospital stay, early integration into the patient's family environment, as well as early onset of the oral route without special care of the implant or reconstructed wall nor food restrictions were observed. The reduced presence of the complications described in the literature after application of surgical meshes suggests that this implant can be an effective and safe alternative method in the treatment of abdominal wall defects such as GO.
Impact of Different Perfusion Modalities on Coronary and Carotid Blood Flow Velocities in an Adult ECLS Swine Model
Authors: Wang Shigang , Patel Sunil , Izer Jenelle M. , Clark Joseph B. , Kunselman Allen R. , Wilson Ronald P. , Ündar Akif 
Published: April 2018

AbstractThe objective of this study was to compare the effects of nonpulsatile and ECG‐synchronized pulsatile extracorporeal life support on coronary and carotid blood flow velocities using transthoracic echocardiography and vascular ultrasound, respectively. Nine adult swine were randomly separated into nonpulsatile (NP, n = 5) and pulsatile (P, N = 4) groups and placed on ECLS for 24 h using an i‐cor ECLS system. Noninvasive transthoracic images of the left and right coronary artery and the left carotid artery were acquired at the pre‐ECLS (baseline), 30 min, 3, 6, 9, 12, and 24 h on‐ECLS stages. The mean diastolic velocity of the left and right coronary arteries in the NP group significantly decreased after 24 h on ECLS compared to the baseline and 30 min ECLS stages (P < 0.05). There was no statistical difference in the mean diastolic velocity of the coronary arteries in the P group at 30 min, 3‐, 6‐, 9‐, 12‐, and 24‐h ECLS compared to baseline. The P group showed a smaller decrease in the mean diastolic velocity of coronary arteries between the 30‐min ECLS and 3‐, 6‐, 9‐, 13‐, 24‐h ECLS stages compared to the NP group. The diastolic velocity of the left carotid artery in the NP group significantly decreased during 24‐h ECLS compared to the P group (P < 0.05). An ECG‐synchronized pulsatile ECLS system appeared to maintain coronary and carotid artery diastolic velocities better than conventional nonpulsatile ECLS. Further investigation of the perfusion modes during ECLS is warranted.
Ocular trauma in the Finnish elderly – Helsinki Ocular Trauma Study
Authors: Sahraravand Ahmad , Haavisto Anna‐Kaisa , Holopainen Juha M. , Leivo Tiina 
Published: April 2018

AbstractPurposeTo describe epidemiology, causes, treatments and outcomes of all ocular injuries in southern Finland among people aged 61 and older.MethodsAll new ocular trauma patients, admitted to the Helsinki University Eye Hospital, during 1 year in 2011–2012. The data were from hospital records and prospectively from patient questionnaires. The follow‐up time was 3 months.ResultsThe incidence for ocular injuries among the elderly was 38/100 000/year. From 118 patients 69% were men. The mean age was 70.9 years old (median 67). The hospitalization rate was 14%. Injury types were minor traumas (48%), contusions (22%), chemical injuries (10%), eyelid wounds (8%), open globe injuries (OGI; 7%) and orbital fractures (5%). The injuries occurred at home (58%), institutions (12%) and in other public places (12%). The main causes of ocular injury were falls (22%), sticks (19%), superficial foreign bodies (18%) and chemicals (12%). All OGI and 88% of contusions needed a lifelong follow‐up. A permanent visual or functional impairment occurred in 15 (13%) patients. Of these 53% were OGI, 40% contusions and 7% chemical injuries. The causes of permanent injuries were falls (seven cases, 47%), work tools, sports equipment, sticks, chemicals and eyeglasses. The incidence for legal blindness was 2.3/100 000.ConclusionMinor trauma was the most frequent type, and home was the location of the most occurred eye injuries. Falls were the most frequent and serious cause, but behavioural causes were not significant. Preventive measures should be directed towards the main identified causes and risk factors of the eye injuries in the elderly.
Optic disc drusen: understanding an old problem from a new perspective
Authors: Hamann Steffen , Malmqvist Lasse , Costello Fiona 
Published: April 2018

AbstractOptic disc drusen (ODD) are acellular deposits located in the optic nerve head of up to 2.4% of the population. They may develop as by‐products of impaired axonal metabolism in genetically predisposed individuals, in whom a narrow scleral canal is hypothesized to play a role. Although ODD are often considered as benign innocent bystanders, recognized as part of a routine ophthalmological examination, the vast majority of patients with ODD have visual field defects. Optic disc drusen (ODD)‐associated complications with severe visual loss, most often due to anterior ischaemic optic neuropathy, are also known to occur. There are no treatments available to prevent or ameliorate the vision loss caused by ODD. In children, the ODD are usually uncalcified and buried within the optic nerve head tissue. In these cases, the condition can be difficult to diagnose, as it often resembles a papilloedema with optic nerve head swelling caused by raised intracranial pressure. During the teenage years, the ODD progressively become more calcified and probably also larger, which allow them to be visible on ophthalmoscopy. With the advent and proper utilization of high‐resolution modalities of optical coherence tomography (OCT), it has now become possible to detect even the smallest and most deeply located ODD. This allows for ODD detection at a much earlier developmental stage than has previously been possible and enhances the possibilities of research in underlying mechanisms. A review of the literature on ODD was conducted using the PUBMED database. The review focuses on the current knowledge regarding pathogenesis, diagnostics, clinical disease‐tracking methodologies, structure–function relationships and treatment strategies of ODD.
High G2 and S‐phase expressed 1 expression promotes acral melanoma progression and correlates with poor clinical prognosis
Authors: Xu Tianxiao , Ma Meng , Chi Zhihong , Si Lu , Sheng Xinan , Cui Chuanliang , Dai Jie , Yu Sifan , Yan Junya , Yu Huan , Wu Xiaowen , Tang Huan , Yu Jiayi , Kong Yan , Guo Jun 
Published: April 2018

G2 and S‐phase expressed 1 (GTSE1) regulates cell cycle progression in human cancers. However, its significance and mechanism of action in acral melanoma (AM) remain unknown. In the present study, we found that GTSE1 expression was upregulated in advanced stage/metastatic AM tissues and metastatic cell lines, and correlated with higher stage (P = .028) and poor disease‐free survival (DFS) in patients with AM (P = .003). Cox regression assays validated GTSE1 expression to be an independent prognostic factor of DFS for patients with AM (P = .004). Ectopic expression of GTSE1 enhanced primary AM cell proliferation, invasion, and migration. Loss‐of‐function in GTSE1 attenuated metastatic AM cell proliferation and metastatic ability in vitro and in vivo. We additionally observed that inhibition of migration and invasion occurred concomitantly with a GTSE1 knockdown‐mediated increase in E‐cadherin and decreases in N‐cadherin and Slug. We further showed that integrin subunit alpha 2 (ITGA2) interacts with GTSE1 and is a downstream effector of GTSE1. Further, ITGA2 levels were positively correlated with GTSE1 expression in human AM tissues. Ectopic ITGA2 expression rescued siGTSE1‐mediated inhibition of migration and invasion, thereby restoring epithelial‐to‐mesenchymal transition (EMT). In conclusion, GTSE1 expression promotes AM progression and correlates with clinical outcomes of patients with AM, and may represent a promising therapeutic target to suppress AM progression.
Airway stenting for patients with airway stenosis because of small cell lung cancer
Authors: Oki Masahide , Saka Hideo 
Published: April 2018

AbstractBackgroundAirway stenting has been reported to be useful for patients with malignant airway stenosis as a bridge to tumour‐specific therapy, such as chemotherapy and radiation therapy, as well as palliative therapy. However, its role in patients with small‐cell lung cancer (SCLC), the most aggressive lung cancer subtype, is unclear. We investigated the efficacy of airway stenting for patients with airway stenosis resulting from SCLC.MethodsAll stenting procedures were performed using both rigid and flexible bronchoscopes under general anaesthesia. Among 512 patients who underwent rigid bronchoscopy during a 9‐year period at a single centre, those who underwent airway stenting for airway stenosis because of SCLC were retrospectively reviewed.ResultsTwenty‐one SCLC patients with airway stenosis who underwent stenting were eligible for analysis. Twelve patients (57%) were chemoradiotherapy‐naïve. Supplemental oxygen was reduced after the procedure in 11 out of 12 patients (92%) who had previously required it. Fourteen patients (67%) received tumour‐specific therapy after the procedure. The median post‐procedural survival was 47 days (range, 5‐617 days). Longer survival was associated with the performance of post‐procedural tumour‐specific therapy, low serum lactate dehydrogenase levels and either tracheal or bronchial stenosis.ConclusionsSCLC patients with airway stenting experienced longer survival when post‐procedural tumour‐specific therapy was performed, when they showed low serum lactate dehydrogenase levels, and when they had either tracheal or bronchial stenosis.
The association of nasal patency with small airway resistance in children with allergic and nonallergic rhinitis
Authors: Song Joo Young , Ha Eun Kyo , Sheen Yoon Ho , Kim Mi‐Ae , Lee Seung Won , Yoon Jung Won , Lee Seung Jin , Jung Young‐Ho , Lee Kyung Suk , Ahn Jae‐Cheul , Jee Hye Mi , Han Man Yong 
Published: April 2018

AbstractIntroductionAllergic rhinitis (AR) is immunologically and morphologically related to disorders in the lower airway. We investigated the relationship between the anatomy of the intranasal cavity and small airway resistance in subjects with nonallergic rhinitis (NAR).MethodsWe enrolled 226 children who were 7 years old and participated in the Seongnam Atopy Project 2016. We evaluated nasal patency using acoustic rhinometry to measure the volume of the nasal cavity at 0‐5 cm, and measured lung function of the lower airway using an impulse oscillometry system (IOS) and spirometry. We also performed skin prick tests for 18 aero‐allergens, and measured blood total eosinophil counts (TEC) and rhinitis symptom scores for the previous month using a visual analog scale (VAS, range: 0‐10).ResultsWe examined 226 children, 71 (31.7%) with AR, and 62 (27.7%) with NAR. Nasal patency in children with AR (median: 8.28 mm3, IQR: 7.07‐9.83) was lower than that of healthy children (median: 9.3 mm3, IQR: 7.69‐10.64, P = 0.011). Multivariate regression analysis showed that nasal patency was inversely associated with IOS resistance at 5 Hz after adjustment for compounding factors (B = −0.005, SE = 0.0032, P = 0.041). Analysis of NAR subjects, according to quartiles of nasal patency and quartiles of small airway resistance (Rrs5), indicated that nasal patency decreased as Rrs5 increased (linear trend: P = 0.020).ConclusionNasal symptoms and TEC negatively correlated with nasal patency. Children with AR and NAR who had poor nasal patency had increased small airway resistance.
Recovery process and determinants of adverse event occurrence in bronchoscopic procedures performed under general anaesthesia
Authors: Özden Omaygenç Derya , Ünal Nermin , Edipoğlu Saadet İpek , Barca Şeker Tuğçe , Özgül Mehmet Akif , Turan Demet , Özdemir Cengiz , Karaca İbrahim Oğuz , Çetinkaya Erdoğan 
Published: April 2018

AbstractObjectiveRegarding the fact that rigid bronchoscopy is generally performed under general anaesthesia and this patient subgroup is remarkably morbid, encountering procedure and/or anaesthesia related complications are highly likely. Here, we aimed to assess factors influencing recovery and detect possible determinants of adverse event occurrence during these operations performed in a tertiary referral centre.MethodsEighty‐one consecutive ASA I‐IV patients were recruited for this investigation. In the operating theatre after induction of anaesthesia and advancement of the device, maintenance was provided with total intravenous anaesthesia. Neuromuscular blockage was invariably administered, and patients were ventilated manually. In addition to preoperative demographic and procedural characteristics, perioperative hemodynamic variables, recovery times and observed adverse events were noted.ResultsBasic demographic properties, ASA and Mallampati scores, and procedure specific variables as lesion localization, lesion and procedure type were comparable among groups assembled with reference to event occurrence. Patients who had experienced adverse event had higher heart rates. Recovery times were comparable between Event (–) and Event (+) groups. Relationship of recovery process were individually tested with all variables and only lesion type was detected to have an effect on respiration and extubation times. Among all parameters only procedural time seemed to be associated with adverse event occurrence (mins, 22.9 ± 11.9 vs 41.6 ± 28.8, P < .001).ConclusionRecovery times related with return of spontaneous respiration were significantly lower in procedures performed for treatment of tumoral diseases in this study and procedure length was determined to be the ultimate factor which had an impact on adverse event occurrence.
Real‐time lexical comprehension in young children learning American Sign Language
Authors: MacDonald Kyle , LaMarr Todd , Corina David , Marchman Virginia A. , Fernald Anne 
Published: April 2018

AbstractWhen children interpret spoken language in real time, linguistic information drives rapid shifts in visual attention to objects in the visual world. This language–vision interaction can provide insights into children's developing efficiency in language comprehension. But how does language influence visual attention when the linguistic signal and the visual world are both processed via the visual channel? Here, we measured eye movements during real‐time comprehension of a visual‐manual language, American Sign Language (ASL), by 29 native ASL‐learning children (16–53 mos, 16 deaf, 13 hearing) and 16 fluent deaf adult signers. All signers showed evidence of rapid, incremental language comprehension, tending to initiate an eye movement before sign offset. Deaf and hearing ASL‐learners showed similar gaze patterns, suggesting that the in‐the‐moment dynamics of eye movements during ASL processing are shaped by the constraints of processing a visual language in real time and not by differential access to auditory information in day‐to‐day life. Finally, variation in children's ASL processing was positively correlated with age and vocabulary size. Thus, despite competition for attention within a single modality, the timing and accuracy of visual fixations during ASL comprehension reflect information processing skills that are important for language acquisition regardless of language modality.
First‐year GFR slope and long‐term renal outcome in IgA nephropathy
Authors: Lee Kyungho , Shin Jungho , Park Jeeeun , Hwang Subin , Jang Hye Ryoun , Huh Wooseong , Kwon Ghee Young , Kim Yoon‐Goo , Oh Ha Young , Lee Jung Eun , Kim Dae Joong 
Published: April 2018

AbstractBackgroundIgA nephropathy (IgAN) is the most frequent primary glomerular disease and the leading cause of end‐stage renal disease. We investigated clinicopathologic predictors of renal survival in patients with IgAN with a focus on glomerular filtration rate (GFR) decline slope.Materials and methodsWe screened all patients with primary IgAN between 1995 and 2012. Renal progression was defined as doubling of serum creatinine. Using serial serum creatinine levels during the first‐year, we calculated the GFR decline slopes. Further, we defined patients in the steepest GFR slope quartile as rapid decliners and those in the second steepest GFR slope quartile as slow decliners. Others were defined as nondecliners.ResultsOf 214 participants, baseline GFR was 81 (62, 100) mL/min/1.73 m2, which was not different among the 3 groups. Rapid decliners and slow decliners had higher levels of urinary protein/creatinine ratio (0.88, 0.89 and 0.58 g/gCr, respectively, P < .001). Five‐year renal survival was 76% in rapid decliners, 91% in slow decliners and 100% in nondecliners (P < .001, rapid or slow decliners vs nondecliners). After adjustment for clinicopathologic variables, slow decliners were associated with an 8.8‐fold higher risk of progression (P = .011), and rapid decliners were associated with a 10.2‐fold increased risk of progression (P = .007) compared with nondecliners.ConclusionsFirst‐year GFR slope was associated with increased risk of renal progression, independent of proteinuria and histologic findings. Further studies are needed to investigate whether early GFR change can identify high‐risk patients who benefit from immunosuppressive treatment in IgAN.
The role of radiotherapy as salvage and/or consolidation treatment in relapsed/refractory and high‐risk diffuse large B‐cell lymphoma
Authors: Grignano Eric , Laurent Jérémy , Deau Bénédicte , Burroni Barbara , Bouscary Didier , Kirova Youlia M. 
Published: April 2018

AbstractObjectiveMany salvage therapies have been proposed for relapsed/refractory (R/R) diffuse large B‐cell lymphomas or for consolidation in the case of suboptimal response. Radiotherapy (RT) is one modality of salvage therapy, but its place is currently not well defined.MethodThis study reports a retrospective review of patients receiving unplanned radiotherapy for R/R diffuse large B‐cell lymphoma (DLBCL) or primary mediastinal B‐cell lymphoma (PMBCL), or as consolidation therapy after second‐line chemotherapy, treated in our hospital.ResultsFifty‐one patients with a median age of 53.5 years [19‐89] were selected. The histologic type was DLBCL in 35 cases (68%), PMBCL in 8 cases (16%), and secondary transformed NHL in 8 cases (16%). Median aaIPI was 1 [0‐4], and 17 patients (33%) had a high tumor burden (bulky disease). Sixteen patients (31%) were irradiated for a response considered to be insufficient, 18 patients (36%) were refractory, and 17 patients (33%) had relapsed. Patients were irradiated with a median dose of 40 Gy [15‐44], 29 (57%) by a conformal 3D technique and 22 (43%) by tomotherapy. With a median follow‐up of 36 months [1.0‐127.8] after irradiation, 5‐year progression‐free survival (PFS) and overall survival (OS) were 62% and 72%, respectively. In multivariate analysis, adverse factors associated with PFS and OS in our cohort were age >70 years (HR = 5.06, P = .02) and post‐RT relapse (HR = 12.24, P = .002), whereas favorable factors were number of lines of chemotherapy <3 (HR = 0.02, P = .03) and bulky disease (HR = 0.02, P = .009).ConclusionDue to its low toxicity and ease of use, radiotherapy should therefore remain an available option in patients with R/R DLBCL or as consolidation therapy in patients with high‐risk disease, mostly in patients with chemo‐sensitive disease or bulky disease.
Severe adverse events by tyrosine kinase inhibitors decrease survival rates in patients with newly diagnosed chronic‐phase chronic myeloid leukemia
Authors: Ota Shuichi , Matsukawa Toshihiro , Yamamoto Satoshi , Ito Shinichi , Shindo Motohiro , Sato Kazuya , Kondo Takeshi , Kohda Kyuhei , Sakai Hajime , Mori Akio , Takahashi Tohru , Ikeda Hiroshi , Kuroda Hiroyuki , Haseyama Yoshihito , Yamamoto Masaki , Sarashina Takeo , Yoshida Makoto , Kobayashi Ryoji , Nishio Mitsufumi , Ishihara Toshimichi , Hirayama Yasuo , Kakinoki Yasutaka , Kobayashi Hajime , Fukuhara Takashi , Imamura Masahiro , Kurosawa Mitsutoshi 
Published: April 2018

AbstractObjectiveThis multicenter cooperative study aimed to analyze the adverse events (AEs) associated with tyrosine kinase inhibitors (TKIs) used as initial treatment for chronic‐phase chronic myeloid leukemia (CML‐CP) and their impact on outcome.MethodsWe retrospectively evaluated 450 patients with CML‐CP who received TKIs between 2004 and 2014.ResultsThe 5‐year overall survival (OS) and event‐free survival (EFS) rates were 95.1% and 89.0%, respectively. Patients with comorbidities (46.4%) and aged ≥60 years (50.4%) at diagnosis had significantly inferior OS to those without comorbidities and aged <60. Patients achieved higher rates of major molecular response (MMR) at 6 and 12 months after initial treatment with dasatinib or nilotinib compared to imatinib, but final MMR rates were almost the same. Sixty‐six percent of patients required treatment modifications from first‐line TKI therapy; the main reasons were AEs (48.4%) and failure (18%). Grade III‐IV AEs in first‐line TKI therapy were significantly correlated to inferior OS/EFS compared to grade 0‐II AEs.ConclusionAlthough long‐term outcomes were similar in CML‐CP patients treated with each TKI regardless of first‐line TKI selection, severe AEs in first‐line TKI therapy decreased their survival rates. Early change in TKIs is recommended, when faced with severe AEs of specific TKIs.