bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a prognostic model for survival in patients treated with venoarterial extracorporeal membrane oxygenation: the PREDICT VA-ECMO score
Authors: Wengenmayer Tobias , Duerschmied Daniel , Graf Erika , Chiabudini Marco , Benk Christoph , Mühlschlegel Sven , Philipp Alois , Lubnow Matthias , Bode Christoph , Staudacher Dawid Leander 
Published: July 2018

Aims: Several scoring systems have been introduced for prognostication after initiating venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy. However, static scores offer limited guidance once VA-ECMO is implanted, although continued allocation of healthcare resources is critical. Patients requiring continued VA-ECMO support are extremely unstable, with minimal heart function and multi-organ failure in most cases. The aim of the present study was to develop and validate a dynamic prognostic model for patients treated with VA-ECMO. Methods and results: A derivation cohort included 205 all-comers undergoing VA-ECMO implantation at a tertiary referral hospital (51% received VA-ECMO during resuscitation and 43% had severe shock). Two prediction models based on point-of-care biomarkers were developed using penalised logistic regression in an elastic net approach. A validation cohort was recruited from an independent tertiary referral hospital. Comparators for the prediction of hospital survival were the SAVE score (area under the receiver operation characteristic curve (AUC) of 0.686), the SAPS score (AUC 0.679), the APACHE score (AUC 0.662) and the SOFA score (AUC 0.732) in 6-hour survivors. The 6-hour PREDICT VA-ECMO score (based on lactate, pH and standard bicarbonate concentration) outperformed the comparator scores with an AUC of 0.823. The 12-hour PREDICT VA-ECMO integrated lactate, pH and standard bicarbonate concentration at 1 hour, 6 hours and 12 hours after ECMO insertion allowed even better prognostication (AUC 0.839). Performance of the scores in the external validation cohort was good (AUCs 0.718 for the 6-hour score and 0.735 for the 12-hour score, respectively). Conclusion: In patients requiring VA-ECMO therapy, a dynamic score using three point-of-care biomarkers predicts hospital mortality with high reliability. Furthermore, the PREDICT scores are the first scores for extracorporeal cardiopulmonary resuscitation patients.
Evaluation of Montelukast for the Treatment of Children With Japanese Cedar Pollinosis Using an Artificial Exposure Chamber (OHIO Chamber)
Authors: Hashiguchi Kazuhiro , Okubo Kimihiro , Inoue Yoichi , Numaguchi Hirotaka , Tanaka Kumi , Oshima Nobuyuki , Mehta Anish , Nishida Chisato , Saito Itori , Philip George 
Published: July 2018

Background This study evaluated the efficacy of montelukast in reducing seasonal allergic rhinitis symptoms in Japanese children with Japanese cedar (JC) pollinosis induced in an artificial exposure chamber (OHIO Chamber). Methods Pediatric patients aged 10 to 15 years sensitive to JC pollen entered a randomized, double-blind, single-site, crossover study. After confirmation of an allergic response to a JC pollen exposure for 3 hours in the OHIO Chamber during the screening period, subjects received either montelukast 5 mg chewable tablets or placebo for a 7-day treatment period, followed by a 3-hour pollen exposure in the chamber. After a 7-day washout period, subjects crossed over to the other treatment. Subjects were instructed to self-assess their nasal symptoms using 5-point scale for every 30 minutes. The primary end point was the change from baseline (just before entering the exposure chamber for each exposure) in total nasal symptom score (TNSS; the sum of nasal congestion, nasal discharge, and sneezing scores) over 3 hours of pollen exposure. Adverse events (AEs) were evaluated throughout the study. Results A total of 220 subjects (median age, 12 years) received treatment. For TNSS, the between-group difference in the change (95% confidence interval) was −0.01 (−0.11 to 0.10); the change between placebo and montelukast 5 mg was not significant. TNSS in the screening and treatment periods after receiving placebo for 7 days was 1.58 and 1.31, respectively, suggesting a placebo response. On account of high placebo response, a post hoc analysis was conducted. The analysis in a subgroup of subjects who did not show placebo response demonstrated a difference in the efficacy between montelukast and placebo (nominal P < .037). The most common AE was positive urine protein (4.6% with montelukast vs 7.8% with placebo). Conclusions Although montelukast was well tolerated, this study did not demonstrate a treatment difference between active drug and placebo in Japanese children exposed to JC pollen in the OHIO Chamber. Trial Registry: ClinicalTrials.gov, NCT01852812
Integrating Unbanked Rural Populations through Frugal Innovation: A Case of Gramateller in India
Authors: Raju Prageetha G. 
Published: July 2018

Vortex Engineering Private Limited is based at Chennai in Tamil Nadu state in southern part of India. This company came into news with its breakthrough innovation in manufacturing, selling, installing and servicing the world’s lowest power-consuming automated teller machines (ATMs), named, the GramatellerTM targeted at the semi-urban and rural segments of India. With a mission to help banks reach out gainfully to every nook and corner of the country, Vortex, after seven years of diligent research, has designed highly reliable, eco-friendly, easy to use and rugged ATM, which can save power up to 90 per cent and can be operated using solar power. The ATM hitherto was an unviable proposition in rural areas to any bank but GramatellerTM broke the stereotype with its low power-consuming ATM, which not only provided financial access to remote areas but also increased deposits in banks. The case presents a coherent depiction about the business, and growth of Gramateller, an innovation that is unique by virtue of its frugality, disruptivity and game-changing characteristics vis-à-vis its role in integrating isolated geographies. The facts are compiled from published sources.
Patient and Provider’s Experience and Perspective in Addressing Barriers to Medication Adherence Among Noncommunicable Disease Patients in Rural Puducherry, South India—A Qualitative Study
Authors: Krishnamoorthy Yuvaraj , Giriyappa Dinesh Kumar , Eliyas Salin K , Priyan Shanthosh , Saya Ganesh Kumar , Lakshminarayanan Subitha 
Published: July 2018

Background: Trend in morbidity and mortality due to noncommunicable diseases (NCDs) is rising because of poor control status. Medication nonadherence is one of the most common and modifiable causes of inadequate control status. Objectives: To examine the barriers in drug adherence among NCD patients in rural Puducherry. Methods: This qualitative study includes in-depth and key informant interview conducted among 6 NCD patients and 4 health-care providers. Interviews were audio-recorded, and transcript was prepared in verbatim format. Thematic content analysis was done to derive the categories and themes. Results: Major barriers for nonadherence to medications found were stress, substance abuse, forgetfulness, lack of family support, and high case load of health facilities. Corrective measures suggested to address the barriers were to provide health education to patients and family members, awareness campaigns in community, and health education sessions at the clinic. Conclusion: Psychological factors such as stress, social isolation, and negligence are major barriers for drug adherence. Health education session at community and health system is needed to improve the adherence.
The role of ADAMTS13 testing in the diagnosis and management of thrombotic microangiopathies and thrombosis
Authors: Masias Camila , Cataland Spero R. 
Published: July 2018

Abstract
ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, 13) is a metalloprotease responsible for cleavage of ultra-large von Willebrand factor (VWF) multimers. Severely deficient activity of the protease can trigger an acute episode of thrombotic thrombocytopenic purpura (TTP). Our understanding of the pathophysiology of TTP has allowed us to grasp the important role of ADAMTS13 in other thrombotic microangiopathies (TMAs) and thrombotic disorders, such as ischemic stroke and coronary artery disease. Through its action on VWF, ADAMTS13 can have prothrombotic and proinflammatory properties, not only when its activity is severely deficient, but also when it is only moderately low. Here, we will discuss the biology of ADAMTS13 and the different assays developed to evaluate its function in the context of TTP, in the acute setting and during follow-up. We will also discuss the latest evidence regarding the role of ADAMTS13 in other TMAs, stroke, and cardiovascular disease. This information will be useful for clinicians not only when evaluating patients who present with microangiopathic hemolytic anemia and thrombocytopenia, but also when making clinical decisions regarding the follow-up of patients with TTP.
Post-migration follow-up programme for migrants at increased risk of developing tuberculosis: a cohort study
Authors: Kaushik Nishta , Lowbridge Chris , Scandurra Gabriella , Dobler Claudia C. 
Published: July 2018

Following pre-migration screening for tuberculosis (TB), migrants who are deemed to be at a high risk of developing TB must attend post-entry follow-up in Australia. We aimed to evaluate the effectiveness of post-migration TB follow-up in the state of New South Wales to diagnose TB in these high-risk migrants.In this retrospective cohort study, we assessed the risk of TB in migrants who arrived in New South Wales between 2000 and 2015 and were referred for post-migration follow-up. Clinical notes were examined for a nested cohort to determine whether TB was diagnosedviathe follow-up programme orviapassive case finding.Of the 32 550 migrants referred for follow-up, 428 (1.3%) developed TB. The incidence of TB was 436 per 100 000 person-years (95% CI 384–491 per 100 000 person-years) in the first 2 years after arrival and 128 per 100 000 person-years (95% CI 116–140 per 100 000 person-years) over the mean study observation period of 10.3 years. An estimated 63% of cases were diagnosedviafollow-up. TB notifications occurred 0.55 years earlier since time of arrival in Australia in migrants who attended follow-up than in those who did not.Post-migration follow-up detected 63% of TB cases in high-risk migrants and potentially prevented delay of TB diagnosis.
Comparison of different analysis algorithms to calculate multiple-breath washout outcomes
Authors: Anagnostopoulou Pinelopi , Kranz Nadja , Wolfensberger Jeremias , Guidi Marisa , Nyilas Sylvia , Koerner-Rettberg Cordula , Yammine Sophie , Singer Florian , Latzin Philipp 
Published: July 2018

Lung clearance index (LCI) is the main outcome of the multiple-breath washout (MBW) test. Current recommendations for LCI acquisition are based on low-grade evidence. The aim of this study was to challenge those recommendations using alternative methods for LCI analysis.Nitrogen MBW measurements from school-aged children, 20 healthy controls, 20 with cystic fibrosis (CF) and 17 with primary ciliary dyskinesia (PCD), were analysed using 1) current algorithms (standard), 2) three alternative algorithms to detect with higher precision the end of MBW testing and 3) two alternative algorithms to determine exhaled tracer gas concentrations. LCI values, intra-test repeatability, and ability to discriminate between health and lung disease were compared between these methods.The analysis methods strongly influenced LCI (mean±sdoverall differences (%) between standard and alternative analysis methods: −4.9±5.7%; range: −66–19%), but did not improve intra-test variability. Discrimination between health and disease was comparable as areas under the receiver operator curves were not greater than that from standard analysis.This study supports current recommendations for LCI calculation in children. Alternative methods influence LCI estimates and hamper comparability between MBW setups. Alternative algorithms, whenever used, should be carefully reported.
Lateral Hypothalamic Area Neurotensin Neurons Are Required for Control of Orexin Neurons and Energy Balance
Authors: Brown Juliette , Sagante Andrew , Mayer Thomas , Wright Anna , Bugescu Raluca , Fuller Patrick M , Leinninger Gina 
Published: July 2018

AbstractThe lateral hypothalamic area (LHA) is essential for motivated ingestive and locomotor behaviors that impact body weight, yet it remains unclear how the neurochemically defined subpopulations of LHA neurons contribute to energy balance. In particular, the role of the large population of LHA neurotensin (Nts) neurons has remained ambiguous due to the lack of methods to easily visualize and modulate these neurons. Because LHA Nts neurons are activated by leptin and other anorectic cues and they modulate dopamine or local LHA orexin neurons implicated in energy balance, they may have important, unappreciated roles for coordinating behaviors necessary for proper body weight. In this study, we genetically ablated or chemogenetically inhibited LHA Nts neurons in adult mice to determine their necessity for control of motivated behaviors and body weight. Genetic ablation of LHA Nts neurons resulted in profoundly increased adiposity compared with mice with intact LHA Nts neurons, as well as diminished locomotor activity, energy expenditure, and water intake. Complete loss of LHA Nts neurons also led to downregulation of orexin, revealing important cross-talk between the LHA Nts and orexin populations in maintenance of behavior and body weight. In contrast, chemogenetic inhibition of intact LHA Nts neurons did not disrupt orexin expression, but it suppressed locomotor activity and the adaptive response to leptin. Taken together, these data reveal the necessity of LHA Nts neurons and their activation for controlling energy balance, and that LHA Nts neurons influence behavior and body weight via orexin-dependent and orexin-independent mechanisms.
Frequency of Operative Anesthesia Care After Traumatic Injury
Authors: Sunshine Jacob E. , Humbert Andrew T. , Booth Benjamin , Bowman Steven M. , Bulger Eileen M. , Sharar Sam R. 
Published: July 2018

BACKGROUND:
Virtually all anesthesiologists care for patients who sustain traumatic injuries; however, the frequency with which operative anesthesia care is provided to this specific patient population is unclear. We sought to better understand the degree to which anesthesia providers participate in operative trauma care and how this differs by trauma center designation (levels I–V), using data from a comprehensive, regional database—the Washington State Trauma Registry (WSTR). We also sought to specifically assess operative anesthesia care frequency vis a vis the American College of Surgeons guidelines for continuous anesthesiology coverage for Level II trauma center accreditation.

METHODS:
We conducted a retrospective analysis measuring the frequency of operative anesthesia care among patients enrolled in the WSTR. Univariate comparisons were made between trauma patients who had surgery during their admission and those who did not (medical management only). In addition, clinical factors associated with surgical intervention were measured. We also measured the average times from hospital admission to surgery and compared these times across trauma centers, grouped level I, II, and III–V.

RESULTS:
From 2004 to 2014, there were approximately 176,000 encounters meeting WSTR inclusion criteria. Approximately 60% of these trauma encounters included exposure to operative anesthesia during the admission. Among all surgical procedures during the trauma admission, approximately 33% occurred within a level I trauma center, 23% occurred within a level II trauma center, and 44% occurred in a trauma center with a III, IV, or V designation. The predominant procedure category during a trauma admission was orthopedic. The presence of hypotension on admission (P < .01), increasing injury severity score (P < .01) and higher emergency department Glasgow Coma Score (P < .01) were all associated with surgical intervention during the trauma hospitalization, after adjustment for potential confounders. In level I trauma centers, for general surgical procedures, the median time to surgery was 2.5 hours; in level II trauma centers, the median time was 1.7 hours.

CONCLUSIONS:
This study highlights the frequent role anesthesiologists play in caring for patients who sustain traumatic injuries, in trauma centers levels I–V. In level II trauma centers, in-house anesthesiology coverage might have benefit for those patients requiring surgery within 1 hour, whereas the former American College of Surgeons requirement of 30-minute response time for out-of-hospital anesthesiology coverage is likely sufficient to provide satisfactory care to patients requiring surgery within 3 hours. Whether the increased cost of such in-house anesthesiology coverage at level II trauma centers is justified by its clinical benefit remains an unanswered question.
“I Am Just aTiçitl”: Decolonizing Central Mexican Nahua Female Healers, 1535–1635
Authors: Polanco Edward Anthony 
Published: July 2018

AbstractSince the sixteenth century, Central Mexican tiçiyotl (Nahua healing knowledge) has been portrayed as a male-dominated system akin to Western medicine. This has made Nahua women invisible in broader discussions of tiçiyotl. Though the historiography acknowledges that women were titiçih (healing ritual specialists), the scholarship has primarily focused on their role in midwifery. This article first uses early modern Spanish dictionaries to underscore discrepancies in the vocabulary used to describe indigenous healers. Then, using evidence from two sixteenth-century proceedings against Nahua women in Central Mexico (in conjunction with other primary sources), this article demonstrates that female titiçih were not analogous to Spanish midwives. Sixteenth- and seventeenth-century female titiçih—like their ancestors—were practitioners of tiçiyotl who gazed into water, hurled corn kernels, applied salubrious materials, and communicated with deities through entheogenic substances to keep their communities whole. Moreover, this article argues that scholarship must decolonize tiçiyotl in order to explore and understand its complexities. This can only be achieved by moving away from Western terms and frameworks that do not adequately describe Nahua ideologies.
A Marcha das Vadias e Seu Feminismo: Práticas, experiências e conflitos de uma geração de jovens feministas
Authors: Vargas Janaína , Brites Jurema 
Published: July 2018

O artigo apresenta uma reflexão acerca das relações geracionais de jovens engajadas na luta feminista. A partir de uma pesquisa etnográfica realizada junto ao Coletivo Marcha das Vadias de Santa Maria, no Rio Grande do Sul, desenvolvemos uma discussão a respeito da articulação dos novos movimentos sociais em sua interface com as dinâmicas de uma prática feminista marcada pela atuação em espaços da internet. As disputas entre diferentes práticas políticas dessas jovens são descritas como parte da configuração de um feminismo contemporâneo, marcado por disputas simbólicas que articulam novas formas de ação política, manifestadas por fragmentação, fluidez, efemeridade e primazia das pautas imateriais.Palavras-chave: Marcha das Vadias. Feminismo. Juventude.
Histórias de cultura. O poder do Storytelling em destinos de Turismo Cultural
Authors: Gonçalves Jose Carlos Póvoas 
Published: July 2018

O turismo cultural no qual faz parte a vertente Storytelling assume cada vez maior relevância nos dias de hoje. Não só por ser um produto único, mas também porque faz a ponte entre residentes e os turistas, aproxima-os uns dos outros de uma maneira que a vertente tradicional do turismo jamais faria. Contudo a informação existente sobre este tema ainda é escassa, especialmente na sua vertente turí­stica. Este trabalho tem como objetivo apresentar dados sobre o subproduto do turismo cultural, o Storytelling, assim como mostrar a sua relevância para a atividade turí­stica.
Este trabalho tem como objetivo apresentar dados sobre o subproduto do turismo cultural, o Storytelling, assim como mostrar a sua relevância para a atividade turí­stica.
Pengaruh Irisan Rimpang Terhadap Berat Kering dan Performa Simplisia Lempuyang Wangi (Zingiber aromaticum Val.) setelah Pengeringan
Authors: Utami Mega Rizqi , Prihastanti Erma , Suedy Sri Widodo Agung 
Published: July 2018

Tanaman obat adalah tanaman yang digunakan sebagai bahan pembuatan obat, umumnya berasal dari Famili Zingiberaceae misalnya lempuyang wangi (Zingiber aromaticum Val.). Simplisia merupakan bahan alamiah sebagai bahan pembuatan obat yang belum mengalami pengolahan. Pengirisan merupakan salah satu tahap penting dalam pembuatan bahan obat karena dapat mempermudah dalam proses pengepakan, penyimpanan dan penggilingan. Pengirisan dapat dilakukan secara melintang atau membujur. Tujuan penelitian ini adalah mengetahui pengaruh arah irisan, tebal irisan, dan kombinasinya terhadap berat kering dan performa simplisia lempuyang wangi setelah pengeringan. Penelitian ini dilaksanakan di Laboratorium BSF Tumbuhan UNDIP. Rancangan yang digunakan adalah Rancangan Acak Lengkap (RAL) dengan perlakuan kombinasi ketebalan (3 mm dan 5 mm) dan arah irisan (membujur dan melintang). Parameter penelitian meliputi berat kering dan performa simplisia yang meliputi warna, kekerasan, dan aroma pada simplisia kering. Analisis data menggunakan Anova dengan taraf kepercayaan 95%. Hasil penelitian menunjukkan arah irisan berpengaruh terhadap berat kering simplisia, sedangkan interaksi antara tebal dan arah irisan tidak berpengaruh terhadap berat kering simplisia lempuyang wangi. Kata kunci: simplisia, lempuyang wangi, pengirisan, berat kering, performa
Perbedaan Kadar Glukosa, Karotenoid dan Biomassa Alang-Alang (Imperata cylindrica L. Beauv) yang Tumbuh di Daerah Ternaungi di Kec. Kunduran Blora dan Ungaran Timur Semarang
Authors: Martha Dhitya Arlan Bayu , Prihastanti Erma , Haryanti Sri 
Published: July 2018

Tanaman alang-alang banyak dimanfaatkan sebagai bahan baku industri jamu dan obat terutama rhizomenya. Kualitas rhizome tanaman alang-alang dipengaruhi oleh berbagai faktor salah satunya adalah lingkungan tumbuhnya. Tujuan penelitian ini untuk mengetahui perbedaan kadar glukosa, karotenoid dan biomassa tanaman alang-alang yang tumbuh pada daerah ternaungi di Kabupaten Blora dan Kabupaten Semarang. Sampel tanaman diambil dari lokasi di daerah Kabupaten Blora dan Semarang dengan 10 ulangan. Metode pengukuran kadar glukosa dan karotenoid dilakukan dengan menggunakan alat UV-Spektrofotometer. Pengukuran Biomassa tanaman alang-alang meliputi berat basah dan berat kering tanaman. Analisis data menggunakan Independent T – Test pada taraf kepercayaan 95 % dengan software SPSS versi 16. Kadar karotenoid dan glukosa pada rhizome tanaman alang-alang yang berasal dari Kabupaten Blora yaitu 0,8817 ppm dan 2,871 ppm dan biomassa (berat basah 10,98 gram dan berat kering 2,81 gram di Semarang. Kadar Karotenoid dan glukosa pada rhizome tanaman alang-alang yang berasal dari Kabupaten Semarang yaitu 0,7966 ppm dan 2,0686 ppm. Hasil Penelitian menunjukkan bahwa kadar glukosa dan karotenoid tanaman alang-alang dari Kabupaten Blora dan Semarang tidak berbeda secara signifikan namun Biomassa tanaman alang-alang berbeda secara signifikan. Kata kunci : Tanaman alang-alang, karotenoid, glukosa, biomassa