bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomedical engineering undergraduate education: A Canadian perspective
Authors: Knowles Nikolas K , DeCoito Isha 
Published: October 2018

Background With an aging population and increasing demand on health care systems, biomedical engineering as an undergraduate program fits a growing societal need. As such, many Canadian universities have implemented biomedical engineering undergraduate programs. This provides a unique opportunity for core engineering faculty, engineering education researchers, and curriculum specialists to implement proven educational theories in the core curriculum of these programs to ensure exemplary and competent Canadian-trained biomedical engineering graduates. Purpose This paper discusses the need for biomedical engineering as a core undergraduate program in Canada, the historical context of educational theories as related to biomedical undergraduate engineering education, a framework for the implementation of proven strategies, and learner-centric methods that benefit the learner, mentor, and society as a whole. Scope/method: The historical context of curriculum theories related to biomedical engineering undergraduate education, evaluation of the intrinsic and extrinsic curriculum theories in current biomedical engineering undergraduate education, educating progressive learners and development of future biomedical engineering undergraduate education curriculum, is explored. Conclusion The integration of educational theories in the development of a biomedical engineering undergraduate engineering education is essential to ensure learners are provided with opportunities to experience cutting edge, quality engineering education. Empirical evidence demonstrates the successful implementation of applied methodologies such as model-electing activities, problem-based learning, and the flipped classroom. Providing biomedical engineering faculty with professional development opportunities around the successfully implementation of these tools aimed at culturally diverse, globalized 21st-century learners, can be catalytic in shifting to a new paradigm for engineering education in Canada and globally.
Comparison of articular manifestations of mixed connective tissue disease and systemic lupus erythematosus on clinical examination and musculoskeletal ultrasound
Authors: Gunashekar S , Prakash M , Minz R W , Sharma A , Sharma S , Dhir V 
Published: October 2018

Background Polyarthritis is common to both mixed connective tissue disease (MCTD) and systemic lupus erythematosus (SLE). Apart from being erosive and deforming in the former, we speculated that it was more common and the extent of joints involved would be higher in MCTD. Methods This was a cross-sectional study that included patients with MCTD aged 18–75 years fulfilling the Kasukawa criteria. An equal number of patients with SLE matched for disease duration and gender were included. Clinical manifestations were compared between patients with MCTD and with SLE. Examination of joints was done for the presence of tenderness or swelling and deformity. Musculoskeletal ultrasound was done on the non-dominant hand for detection of synovitis and tenosynovitis and radiographs of the hands were obtained. The use of methotrexate and non-steroidal anti-inflammatory drugs (NSAIDs) for arthritis was noted. Statistical tests used were non-parametric. Results Forty patients with MCTD and forty patients with SLE were included in this study, with patients being slightly older in MCTD than SLE (36 ± 10.2, 31.8 ± 13.3 years, p = 0.01). There were no significant differences in disease duration (4.7 ± 3.1, 3.7 ± 2.3, p = 0.1) or gender (females = 38, 38). Nearly one-half of patients with MCTD had at least one swollen joint compared with only 15% of patients with SLE. Median (95% confidence interval) tender joint count (5 (4.8–10.4), 0 (1.3–7.2), p = 0.01) and swollen joint count (0 (0.9–2.6), 0 (0–1.2), p = 0.002) was significantly higher in patients with MCTD compared with SLE. More patients with MCTD than SLE had tender or swollen proximal interphalangeal joints (12, 4, p = 0.025). More patients with MCTD than SLE had received methotrexate (8,2, p = 0.04) and NSAIDs (39, 32, p = 0.03) for arthritis. There was no difference in the number of patients with MCTD or SLE who had evidence of synovitis or tenosynovitis on ultrasound. There was no difference in erosive disease on hand radiographs, but acro-osteolysis was higher among MCTD patients. Conclusions A higher proportion of patients with MCTD had at least one swollen and tender joint as compared with patients with SLE, as well as higher use of methotrexate and NSAIDs. However, there was no difference in ultrasound detected synovitis or tenosynovitis.
What We Do: Povidone-Iodine Solution to Delineate the Cutaneous Roll
Authors: Morzycki Alexander , Gillis Joshua , Bezuhly Michael 
Published: October 2018

Background: Establishing continuity of the cutaneous roll is critical to cleft lip repair. Unfortunately, this landmark can be difficult to appreciate depending on the patient’s skin tone, surgical lighting, or preexisting scar. Solution: When applied to the lip, dilute povidone-iodine solution beads off the cutaneous roll and dry vermilion, clearly defining these structures. What We Do: We use dilute povidone-iodine solution not only to prep the lip but to delineate landmarks critical to cleft lip repair.
Pharmacokinetics of cisplatin in an esophageal cancer patient on hemodialysis who was treated with a full-dose cisplatin-fluorouracil regimen: A case report
Authors: Amagai Hiroyuki , Murakami Kentaro , Sakata Haruhito , Uesato Masaya , Hayano Koichi , Kano Masayuki , Fujishiro Takeshi , Toyozumi Takeshi , Yoshihide Senba , Yamamoto Kohei , Hayashi Hideki , Matsubara Hisahiro 
Published: October 2018

Introduction Cancer patients undergoing hemodialysis might be under-treated because the pharmacokinetics of anti-cancer drugs in such patients remain unknown and out of concern related to the potential development of severe adverse effects. However, patients with chemosensitive cancer, such as esophageal cancer, should receive chemotherapy at a dose that is sufficient to attain a favorable therapeutic effect. We herein present an interesting case involving an esophageal cancer patient who was successfully treated with subtotal thoracic esophagectomy, and adjuvant full-dose chemotherapy with cisplatin and 5-fluorouracil while concomitantly undergoing hemodialysis. We carried out a pharmacokinetics analysis of cisplatin, and also conducted a systematic review on the dose and pharmacokinetics. Case report A 57-year-old male patient with esophageal cancer who was undergoing hemodialysis was referred to our hospital. He underwent subtotal thoracic esophagectomy. The pathological diagnosis was T1b, N2 (5/26), M0, ly2, v2, stage IIIA (Union for International Cancer Control, 8th edition). Because of the high degree of lymph node metastasis, adjuvant chemotherapy with cisplatin was recommended. Cisplatin (80 mg/m2) was infused intravenously within 30 min on day 1, and 5-fluorouracil (800 mg/m2) was infused continuously on days 1–5 of a 28-day cycle. Thrombocytopenia (grade 3) occurred on day 16, leucopenia (grade 3) occurred on day 23, and anemia (grade 3) occurred on day 30. The onset of hematologic toxicities was prolonged in comparison to patients with a normal renal function.
Acute sarcoidosis in a multiple sclerosis patient after alemtuzumab treatment
Authors: Graf Jonas , Ringelstein Marius , Lepka Klaudia , Schaller Jörg , Quack Helmut , Hartung Hans-Peter , Aktas Orhan , Albrecht Philipp 
Published: October 2018

Background: Understanding the long-term effect of alemtuzumab on the immune system of multiple sclerosis (MS) patients is crucial. Objective: To report a case of acute sarcoidosis (Löfgren’s syndrome) in a relapsing-remitting MS patient, 1.5 years after the second course of alemtuzumab treatment. Case report: Sarcoidosis was confirmed dermatohistologically, radiologically, and serologically. Analysis of the lymphocyte subpopulations showed a persistent effect of alemtuzumab treatment (CD4/CD8 ratio increased, absolute lymphocyte count of CD19-positive cells increased while CD3/4/8-positive cells were decreased). Conclusion: Our case highlights the profound effect of alemtuzumab on the immune system and its possible risk for autoimmune complications.
The association between social characteristics, alcoholic beverage preferences, and binge drinking in a Serbian adult population
Authors: Pakovic Ljubica , Todorovic Jovana , Santric-Milicevic Milena , Bukumiric Dragica , Terzic-Supic Zorica 
Published: October 2018

Aim: To determine the association of sociodemographic characteristics and type of alcoholic beverage consumed during binge drinking in Serbia. Method: We conducted a secondary analysis of data from the 2014 national survey on Serbian lifestyles focusing on substance abuse and gambling. The sample consisted of 5385 individuals. The respondents were divided into non-binge drinkers and binge drinkers, according to the quantity of alcohol consumed during one occasion. Binge drinkers reported consuming more than 60 g of pure alcohol (7.5 units of alcohol) during one occasion at least once during the previous year. Results: The prevalence of binge drinking in the past year among 2676 female and 2709 male participants aged 18–64 years was 28.4%. The multivariate logistic regression model showed that binge drinkers were more likely to be male (95% CI 3.58–4.94), single (95% CI 1.01–1.53), to be former (95% CI 1.06–1.62) or current smokers (95% CI 1.57–2.19), and to consume more than one type of alcoholic beverage (95% CI 2.04–3.44). There was a negative association of binge drinking with age (95% CI 0.98–0.99), living outside Northern Serbia-Vojvodina region, and drinking only spirits (95% CI 0.39–0.93). Conclusion: Focusing on the positive association of sociodemographic factors and binge drinking could help policy makers create public health interventions against alcohol misuse. These interventions should be directed to males, smokers, and those who consume more than one type of alcoholic beverage.
Clinical outcomes of extended endovascular recanalization of 16 consecutive Buerger’s disease patients
Authors: Kacmaz Fehmi , Kaya Adnan , Keskin Muhammed , Keceoglu Serdar , Algin Ibrahim Halil , Yilmazkaya Bayram , Ilkay Erdogan 
Published: October 2018

Objective Buerger’s disease is one of the worst diseases causing peripheral artery occlusions (especially lower extremity) with increased morbidity and mortality. Endovascular treatment of the diseased arteries gains preference over bypass surgery nowadays. Here, we aimed to present the clinical outcomes of 16 consecutive Buerger’s disease patients underwent extended endovascular recanalization which is a new technique to restore direct blood flow to at least one foot artery, with the performance of angioplasty for each tibial and foot artery obstructions. Methods A total of 16 consecutive patients with confirmed diagnosis of Buerger’s disease that percutaneously treated in our center between February 2014 and March 2018 were included in the study. The mean age of the patients was 44.25 ± 4.28 ranging from 36 to 50 years. After physical examination and complementary diagnostic tests, performance of extended angioplasty for occluded arteries was intended to restore direct blood flow to at least one of the blow-the-knee arteries. Results A successful extended endovascular treatment was performed in 20 of 22 limbs, achieving a technical success of 91%. All patients were successfully discharged without any complication. Mean follow-up duration was 21.43 ± 7.08 months. Reintervention was performed in one patient and minor amputation was needed in one of the failed limbs. Limb salvage rate was 100%. A significant difference was observed based on Rutherford classification, ankle brachial index, direct blood flow to foot, presence of ulcer and rest pain when compared before and after the intervention. Conclusion We showed successful extended endovascular recanalization of Buerger’s disease patients with a high technical success rate and sustained clinical improvement. Extended endovascular recanalization could be a therapeutic option in Buerger’s disease patients, since they are not good candidates for surgery.
Effectiveness of a continuous patient position monitoring system in improving hospital turn protocol compliance in an ICU: A multiphase multisite study in India
Authors: Renganathan BS , Nagaiyan Sridhar , Preejith SP , Gopal Shameer , Mitra Susovan , Sivaprakasam Mohanasankar 
Published: October 2018

Purpose Hospital-acquired pressure ulcers are a significant cause of morbidity and consume considerable financial resources. Turn protocols (repositioning patients at regular intervals) are utilized to reduce incidence of pressure ulcers. Adherence to turn protocols is particularly challenging for nursing teams, given the high number of interventions in intensive care unit, and lack of widely available tools to monitor patient position and generate alerts. We decided to develop and evaluate usefulness of a continuous patient position monitoring system to assist nurses in improving turn protocol compliance. Methods We conducted a prospective, non-randomized, multiphase, multicentre trial. In Phase I (control group), the function of the device was not revealed to nurses so as to observe their baseline adherence to turn protocol, while Phase II (intervention group) used continuous patient position monitoring system to generate alerts, when non-compliant with the turn protocol. All consecutive patients admitted to one of the two intensive care units during the study period were screened for enrolment. Patients at risk of acquiring pressure ulcers (Braden score < 18) were considered for the study (Phase I (N = 22), Phase II (N = 25)). Results We analysed over 1450 h of patient position data collected from 40 patients (Phase I (N = 20), Phase II (N = 20)). Turn protocol compliance was significantly higher in Phase II (80.15 ± 8.97%) compared to the Phase I (24.36 ± 12.67%); p < 0.001. Conclusion Using a continuous patient position monitoring system to provide alerts significantly improved compliance with hospital turn protocol. Nurses found the system to be useful in providing automated turn reminders and prioritising tasks.
Effect of time of day and daily endoscopic workload on outcomes of endoscopic mucosal resection for large sessile colon polyps
Authors: Hillman Yonatan J , Hillman Bari S , Sejpal Divyesh V , Lee Calvin , Miller Larry S , Benias Petros C , Trindade Arvind J 
Published: October 2018

BackgroundEndoscopic mucosal resection of large non‐pedunculated colon polyps is challenging.ObjectiveTo determine if the time of day or daily endoscopic workload play a role in outcomes of endoscopic mucosal resection for large non‐pedunculated colon polyps greater than 20 mm.MethodsThis is a retrospective study of patients who underwent endoscopic mucosal resection of large non‐pedunculated colon polyps. The time of day and endoscopic workload were compared across the following outcomes: the rate of complete resection of the polyp, the rate of referral for surgery, and the rate of residual neoplasia on follow‐up.ResultsOne hundred and three endoscopic mucosal resection procedures were performed. There were no differences in the rates of complete resection (80.8% vs. 70.0%; P = 0.25), the need for surgery (27.4% vs. 33.3%; P = 0.55), and rate of residual neoplasia (24.5% vs. 50.0%; P = 0.07) when comparing the time of day. Colon polyps greater than 40 mm were less likely to be completely resected versus polyps sized 20–39 mm (56.8% vs. 91.9%; P < 0.001). In cases with no residual neoplasia on follow‐up, the mean duration for the index procedure was 45.6 minutes versus 60.7 minutes when there was residual neoplasia (P < 0.01).ConclusionThe time of day and endoscopic workload does not affect outcomes for endoscopic mucosal resection of large non‐pedunculated colon polyps, but the size of large non‐pedunculated colon polyps and resection times do.
Anatomic and Histological Study of the Anterolateral Aspect of the Knee: A SANTI Group Investigation
Authors: Daggett Matt , Stephenson Clark , Dobson John , Whitaker Amy , Redler Andrea , Monaco Edoardo , Wright Barth , Saithna Adnan , Sonnery-Cottet Bertrand 
Published: October 2018

Background: The structure and function of the anterolateral aspect of the knee have been significantly debated, with renewed interest in this topic since the description of the anterolateral ligament (ALL). Purpose: To define and describe the distinct structures of the lateral knee and to correlate the macroscopic and histologic anatomic features. Study Design: Descriptive laboratory study. Methods: Twelve fresh-frozen human cadavers were used for anatomic analysis. In the left knee, a layer-by-layer dissection and macroscopic analysis were performed. In the right knee, an en bloc specimen was obtained encompassing an area from the Gerdy tubercle to the posterior fibular head and extending proximally from the anterior aspect to the posterior aspect of the lateral femoral epicondyle. The en bloc resection was then frozen, sliced at the level of the joint line, and reviewed by a musculoskeletal pathologist. Results: Macroscopically, the lateral knee has 4 main layers overlying the capsule of the knee: the aponeurotic layer, the superficial layer including the iliotibial band (ITB), the deep fascial layer, and the ALL. Histologically, 8 of 12 specimens demonstrated 4 consistent, distinct structures: the ITB, the ALL, the lateral collateral ligament, and the meniscus. Conclusion: The lateral knee has a complex orientation of layers and fibers. The ALL is a distinct structure from the ITB and is synonymous to the previously described capsulo-osseous layer of the ITB. Clinical Relevance: Increasingly, lateral extra-articular procedures are performed at the time of anterior cruciate ligament reconstruction. Understanding the anatomic features of the anterolateral aspect of the knee is necessary to understand the biomechanics and function of the structures present and allows surgeons to attempt to replicate those anatomic characteristics when performing extra-articular reconstruction.
Gfi1aa and Gfi1b set the pace for primitive erythroblast differentiation from hemangioblasts in the zebrafish embryo
Authors: Moore Chris , Richens Joanna L. , Hough Yasmin , Ucanok Deniz , Malla Sunir , Sang Fei , Chen Yan , Elworthy Stone , Wilkinson Robert N. , Gering Martin 
Published: October 2018

AbstractThe transcriptional repressors Gfi1(a) and Gfi1b are epigenetic regulators with unique and overlapping roles in hematopoiesis. In different contexts, Gfi1 and Gfi1b restrict or promote cell proliferation, prevent apoptosis, influence cell fate decisions, and are essential for terminal differentiation. Here, we show in primitive red blood cells (prRBCs) that they can also set the pace for cellular differentiation. In zebrafish, prRBCs express 2 of 3 zebrafish Gfi1/1b paralogs, Gfi1aa and Gfi1b. The recently identified zebrafish gfi1aa gene trap allele qmc551 drives erythroid green fluorescent protein (GFP) instead of Gfi1aa expression, yet homozygous carriers have normal prRBCs. prRBCs display a maturation defect only after splice morpholino-mediated knockdown of Gfi1b in gfi1aaqmc551 homozygous embryos. To study the transcriptome of the Gfi1aa/1b double-depleted cells, we performed an RNA-Seq experiment on GFP-positive prRBCs sorted from 20-hour-old embryos that were heterozygous or homozygous for gfi1aaqmc551, as well as wt or morphant for gfi1b. We subsequently confirmed and extended these data in whole-mount in situ hybridization experiments on newly generated single- and double-mutant embryos. Combined, the data showed that in the absence of Gfi1aa, the synchronously developing prRBCs were delayed in activating late erythroid differentiation, as they struggled to suppress early erythroid and endothelial transcription programs. The latter highlighted the bipotent nature of the progenitors from which prRBCs arise. In the absence of Gfi1aa, Gfi1b promoted erythroid differentiation as stepwise loss of wt gfi1b copies progressively delayed Gfi1aa-depleted prRBCs even further, showing that Gfi1aa and Gfi1b together set the pace for prRBC differentiation from hemangioblasts.
Maternal blood pressure and hypertensive disorders during pregnancy and childhood respiratory morbidity: the Generation R Study
Authors: Wilmink Freke A. , den Dekker Herman T. , de Jongste Johan C. , Reiss Irwin K.M. , Jaddoe Vincent W.V. , Steegers Eric A. , Duijts Liesbeth 
Published: October 2018

Pre-eclampsia is associated with an increased risk of bronchopulmonary dysplasia, wheezing and asthma in later childhood. Currently, there are no studies available investigating maternal blood pressure measurements during multiple time-points in pregnancy and respiratory outcome measures in the child.We examined the associations of maternal blood pressure and hypertensive disorders with the risk of lower lung function, wheezing and asthma in children aged 10 years. This study among 4894 children was embedded in a population-based prospective cohort study. We used multivariate analyses, taking lifestyle and socioeconomic factors into account.We observed consistent associations per 5 mmHg higher maternal blood pressure in early pregnancy with a lower forced expiratory volume in 1 s/forced vital capacity ratio (z-score −0.03 (95% CI −0.05– −0.01)) and per 5 mmHg higher blood pressure in late pregnancy with a higher risk for current wheezing and current asthma (OR 1.07 (95% CI 1.02–1.12) and 1.06 (95% CI 1.00–1.11), respectively). We found no associations of maternal hypertensive disorders during pregnancy with child lung function, current wheezing or current asthma.Our results suggest that higher blood pressure in pregnant women is associated with lower lung function and increased risks of current wheezing and current asthma in children. The associations may be trimester specific.
Safety of benzodiazepines and opioids in interstitial lung disease: a national prospective study
Authors: Bajwah Sabrina , Davies Joanna M. , Tanash Hanan , Currow David C. , Oluyase Adejoke O. , Ekström Magnus 
Published: October 2018

Safety concerns are a barrier to prescribing benzodiazepines (BDZs) and opioids in interstitial lung disease (ILD). We therefore examined the association of BDZs and opioids on risk of admission to hospital and death.We conducted a population-based longitudinal cohort study of fibrotic ILD patients starting long-term oxygen therapy in Sweden between October 2005 and December 2014. Effects of BDZs and opioids on rates of admission to hospital and mortality were analysed using Fine–Gray and Cox regression while adjusting for potential confounders.We included 1603 patients (61% females). BDZs were used by 196 (12%) patients and opioids were used by 254 (15%) patients. There was no association between BDZs and increased admission. Treatment with high-versuslow-dose BDZs was associated with increased mortality (subdistribution hazard ratio (SHR) 1.46, 95% CI 1.08–1.98versus1.13, 95% CI 0.92–1.38). Opioids showed no association with increased admission. Neither low-dose opioids (≤30 mg·day−1oral morphine equivalent) (SHR 1.18, 95% CI 0.96–1.45) nor high-dose opioids (>30 mg·day−1oral morphine equivalent) (SHR 1.11, 95% CI 0.89–1.39) showed association with increased mortality.This first ever study to examine associations between BDZ and opioid use and harm in ILD supports the use of opioids and low-dose BDZs in severely ill patients with respiratory compromise.