bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting the effectiveness of quality control circles in a hospital using a combination of fuzzy VIKOR and Grey Relational Analysis
Authors: Bahadori Mohammadkarim , Teymourzadeh Ehsan , Faizy Bagejan Foad , Ravangard Ramin , Raadabadi Mehdi , Hosseini Seyed Mojtaba 
Published: February 2018

Background: One of the techniques used to achieve productivity, employees’ job satisfaction and higher quality goods and services, as well as to solve the problems by using a team, is the formation of quality control circles. Quality control circles enable managers to meet the organization’s and employees’ needs through making effective use of resources and facilities. On the other hand, the quality of services is always affected by uncertainty and ambiguous and implicit judgments, which make its measurement uncertain. Aim: The present study aimed to identify important factors affecting the effectiveness of quality control circles in a hospital, as well as rank them using a combination of fuzzy VIKOR and Grey Relational Analysis (GRA). Methodology: This was an applied, cross-sectional and descriptive–analytical study conducted in 2016. The study population consisted of five academic members and five experts in the field of nursing working in a hospital, who were selected using a purposive sampling method. Also, a sample of 107 nurses was selected through a simple random sampling method using their employee codes and the random-number table. The required data were collected using a researcher-made questionnaire which consisted of 12 factors. The validity of this questionnaire was confirmed through giving the opinions of experts and academic members who participated in the present study, as well as performing confirmatory factor analysis. Its reliability also was verified (α=0.796). The collected data were analyzed using SPSS 22.0 and LISREL 8.8, as well as VIKOR–GRA and IPA methods. Results: The results of ranking the factors affecting the effectiveness of quality control circles showed that the highest and lowest ranks were related to ‘Managers’ and supervisors’ support’ (Š = 6.80, [Formula: see text] = 0.36) and ‘Group leadership’ (Š = 2.63, [Formula: see text] = 0.98). Also, the highest hospital performance was for factors such as ‘Clear goals and objectives’ and ‘Group cohesiveness and homogeneity’, and the lowest for ‘Reward system’ and ‘Feedback system’, respectively. Conclusion: The results showed that although ‘Training the members’, ‘Using the right tools’ and ‘Reward system’ were factors that were of great importance, the organization’s performance for these factors was poor. Therefore, these factors should be paid more attention by the studied hospital managers and should be improved as soon as possible. Applying quality control circles in any organization is very helpful and provides opportunities for maximum use of employees’ creativity, initiative and skills in reaching their and their organization’s goals and objectives, and prepares favorable working conditions for the employees’ optimal performance through increasing the managers’ sense of responsibility and commitment.
Practice Patterns in the Treatment and Monitoring of Acute T Cell–Mediated Kidney Graft Rejection in Canada
Authors: Leblanc Julie , Subrt Peter , Paré Michèle , Hartell David , Sénécal Lynne , Blydt-Hansen Tom , Cardinal Héloïse 
Published: February 2018

Background: One of the goals of the Canadian National Transplant Research Program (CNTRP) is to develop novel therapies for acute rejection that could positively affect graft outcomes with greater efficacy or less toxicity. To develop innovative management strategies for kidney graft rejection, new modalities need to be compared with current clinical practices. However, there are no standardized practices concerning the management of acute T cell–mediated rejection (TCMR). Objectives: To describe clinicians’ practice patterns in the diagnosis, treatment, and monitoring of acute TCMR in Canada. Design: Survey. Setting, Patients/Participants: Canadian transplant nephrologists and transplant surgeons involved in the management of acute TCMR. Methods and Measurements: We developed an anonymous, web-based survey consisting of questions related to the diagnosis, treatment, and monitoring of TCMR. The survey was disseminated on 3 occasions between June and October 2016 through the Canadian Society of Transplantation (CST) kidney group electronic mailing list. Results: Forty-seven respondents, mostly transplant nephrologists (97%), originating from at least 18 of the 25 Canadian centers offering adult or pediatric kidney transplantation, participated in the study. Surveillance biopsies were used by 28% of respondents to screen for kidney graft rejection. High-dose steroids were used by most of the respondents to treat clinical and subclinical Banff grade 1A and 1B rejections. Nine percent (95% confidence interval [CI]: 1-17) of practitioners used lymphocyte-depleting agents as the first-line approach for the treatment of Banff grade 1B acute rejection. Eighteen percent (95% CI: 7-29) and 36% (95% CI: 8-65) of respondents reported that they would not use high-dose steroids for treating clinical and subclinical borderline rejections, respectively. Seventy percent (95% CI: 54-83) of respondents answered that there was no indication to assess histological response to treatment independent of the change in kidney function. Limitations: The limitations of this study are its limited sample size and the low representation of pediatric specialists. Conclusions: There is heterogeneity regarding the use of surveillance biopsies, treatment of borderline rejection, and modalities to monitor treatment response among transplant physicians. Our results illustrate the current state of practice patterns across Canada and can be used to inform the design of future trials.
Ulnar Collateral Ligament Reconstruction Versus Repair With Internal Bracing: Comparison of Cyclic Fatigue Mechanics
Authors: Jones Christopher M. , Beason David P. , Dugas Jeffrey R. 
Published: February 2018

Background: Ulnar collateral ligament (UCL) injuries have increased significantly in recent years, and reconstruction has become the preferred treatment for UCL injury over ligament repair. In a recent study, UCL repair with internal bracing demonstrated significantly greater resistance to gap formation in biomechanical tests, even at low cycles of valgus loading. Purpose/Hypothesis: The purpose of this study was to compare the fatigue and failure mechanics of traditional UCL reconstruction with UCL repair and internal bracing. We hypothesized that repaired specimens would have less gap formation, closer return to native gap formation, and greater maximum torque to failure versus traditionally reconstructed specimens. Study Design: Controlled laboratory study. Methods: Ten matched pairs of cadaveric elbows were positioned at 90° of flexion and the native UCL subjected to 500 cycles of subfailure valgus loading. A simulated tear was created, and the 10 cycles were repeated. Each pair of specimens was next given repair with internal bracing on 1 side and a modified Jobe reconstruction on the contralateral side, followed by 100 manual cycles of flexion-extension, 500 cycles of valgus rotation, and, finally, rotation to failure. Results: The specimens that received the repair unexpectedly experienced significantly less gapping in the torn state than did those in the reconstruction group. At the 10th cycle, repaired UCL injuries had significantly less gap formation than the reconstructed UCLs. At the 100th and 500th cycles, repaired UCL injuries continued to experience significantly less gap formation as compared with the reconstructed injuries. Conclusion: When compared with the gold standard reconstruction technique, UCL repair with internal bracing is more resistant to gap formation under fatigue loading. However, the unexpected early difference between the torn states may have confounded this finding. Time-zero failure properties of this repair technique are on par with those of traditional reconstruction, even after 500 cycles of valgus loading. Clinical Relevance: UCL reconstruction has become a common procedure among adolescent and elite-level throwers. Recent data suggest that UCL repair may be a viable option for younger athletes with acute proximal or distal UCL tears, allowing a faster return to play.
Mouse and human HSPC immobilization in liquid culture by CD43- or CD44-antibody coating
Authors: Loeffler Dirk , Wang Weijia , Hopf Alois , Hilsenbeck Oliver , Bourgine Paul E. , Rudolf Fabian , Martin Ivan , Schroeder Timm 
Published: February 2018

Key Points
Anti-CD43– and anti-CD44–antibody coating immobilizes live mouse and human HSPCs. This enables 2D colony formation, medium exchange without cell-identification loss, and increased throughput of time-lapse imaging.
LSD1 inhibition exerts its antileukemic effect by recommissioning PU.1- and C/EBPα-dependent enhancers in AML
Authors: Cusan Monica , Cai Sheng F. , Mohammad Helai P. , Krivtsov Andrei , Chramiec Alan , Loizou Evangelia , Witkin Matthew D. , Smitheman Kimberly N. , Tenen Daniel G. , Ye Min , Will Britta , Steidl Ulrich , Kruger Ryan G. , Levine Ross L. , Rienhoff Hugh Y. , Koche Richard P. , Armstrong Scott A. 
Published: February 2018

Key Points
LSD1 inhibition induces a global increase in chromatin accessibility, whereas DOT1L inhibition induces global decreases in accessibility. Perturbation of PU.1 and C/EBPα expression renders AML cells more resistant to LSD1 inhibition.
Young and middle-aged adults with airflow limitation according to lower limit of normal but not fixed ratio have high morbidity and poor survival: a population-based prospective cohort study
Authors: Çolak Yunus , Afzal Shoaib , Nordestgaard Børge G. , Vestbo Jørgen , Lange Peter 
Published: February 2018

A presumed consequence of using a fixed ratio for the definition of airflow limitation (AFL) has been overdiagnosis among older individuals and underdiagnosis among younger individuals. However, the prognosis of younger individuals with potentially underdiagnosed AFL is poorly described. We hypothesised that potential underdiagnosis of AFL at a younger age is associated with poor prognosis.We assigned 95 288 participants aged 20–100 years from the Copenhagen General Population Study into the following groups: individuals without AFL with forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.70 and ≥lower limit of normal (LLN) (n=78 779, 83%); individuals with potentially underdiagnosed AFL with FEV1/FVC ≥0.70 and <LLN (n=1056, 1%); individuals with potentially overdiagnosed AFL with FEV1/FVC <0.70 and ≥LLN (n=3088, 3%); and individuals with AFL with FEV1/FVC <0.70 and <LLN (n=12 365, 13%). We assessed risk of exacerbations, pneumonias, ischaemic heart disease, heart failure and all-cause mortality. Median follow-up was 6.0 years (range: 2 days–11 years).Compared to individuals without AFL, individuals with potentially underdiagnosed AFL had an increased risk of morbidity and mortality with age- and sex-adjusted hazard ratios (HR) of 2.7 (95% CI: 1.7–4.5) for pneumonias, 2.3 (95% CI: 1.2–4.5) for heart failure, and 3.1 (95% CI: 2.1–4.6) for all-cause mortality.Young and middle-aged adults with AFL according to LLN but not fixed ratio experience increased respiratory and cardiovascular morbidity and early death.
Predictive painting across faults
Authors: Xue Zhiguang , Wu Xinming , Fomel Sergey 
Published: February 2018

Predictive painting can effectively spread information in 3D volumes following the local structures (dips) of seismic events. However, it has trouble spreading information across faults with significant displacement. To address this problem, we incorporate fault-slip information into predictive painting to correctly spread information across faults. The fault slip is obtained using a local similarity scan to measure local shifts of the different sides of a fault. We have developed three methods to use the fault-slip information: (1) the area partition method, which uses the fault slip to correct the painting result after predictive painting in each divided area; (2) the fault-zone replacement method, which replaces fault zones with smooth transitions calculated with the fault slip information to avoid sharp jumps; and (3) the unfaulting method, in which we use the fault slip information to unfault the volume, perform predictive painting in the unfaulted domain, and then map the painting result back to the original space. Our methods are tested in application of predictive painting to horizon picking. Numerical examples demonstrate that predictive painting after incorporating fault slip information can correctly spread information across faults, which makes the proposed three approaches of using fault-slip information effective and applicable.
Combined Colloid Preload and Crystalloid Coload Versus Crystalloid Coload During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial
Authors: Tawfik Mohamed Mohamed , Tarbay Amany Ismail , Elaidy Ahmed Mohamed , Awad Karim Ali , Ezz Hanaa Mohamed , Tolba Mohamed Ahmed 
Published: February 2018

BACKGROUND:
The optimal strategy of fluid administration during spinal anesthesia for cesarean delivery is still unclear. Ultrasonography of the inferior vena cava (IVC) has been recently used to assess the volume status and predict fluid responsiveness. In this double-blind, randomized controlled study, we compared maternal hemodynamics using a combination of 500-mL colloid preload and 500-mL crystalloid coload versus 1000-mL crystalloid coload. We assessed the IVC at baseline and at subsequent time points after spinal anesthesia.

METHODS:
Two hundred American Society of Anesthesiologists physical status II parturients with full-term singleton pregnancies scheduled for elective cesarean delivery under spinal anesthesia were randomly allocated to receive either 500-mL colloid preload followed by 500-mL crystalloid coload (combination group) or 1000-mL crystalloid coload (crystalloid coload group) administered using a pressurizer. Ephedrine 3, 5, and 10 mg boluses were administered when the systolic blood pressure decreased below 90%, 80% (hypotension), and 70% (severe hypotension) of the baseline value, respectively. The IVC was assessed using the subcostal long-axis view at baseline, at 1 and 5 minutes after intrathecal injection, and immediately after delivery; the maximum and minimum IVC diameters were measured, and the IVC collapsibility index (CI) was calculated using the formula: IVC-CI = (maximum IVC diameter – minimum IVC diameter)/maximum IVC diameter. The primary outcome was the total ephedrine dose.

RESULTS:
Data from 198 patients (99 patients in each group) were analyzed. The median (range) of the total ephedrine dose was 11 (0–60) mg in the combination group and 13 (0–61) mg in the crystalloid coload group; the median of the difference (95% nonparametric confidence interval) was −2 (−5 to 0.00005) mg, P = .22. There were no significant differences between the 2 groups in the number of patients requiring ephedrine, the incidence of hypotension and severe hypotension, the time to the first ephedrine dose, and neonatal Apgar scores at 1 and 5 minutes. The maximum and minimum IVC diameters in each group increased after spinal anesthesia and after delivery, and they were larger in the combination group. The IVC-CI after delivery was higher in the crystalloid coload group.

CONCLUSIONS:
The combination of 500-mL colloid preload and 500-mL crystalloid coload did not reduce the total ephedrine dose or improve other maternal outcomes compared with 1000-mL crystalloid coload. The IVC was reliably viewed before and during cesarean delivery, and its diameters significantly changed over time and differed between the 2 groups.
Exercise Training in “At-Risk” Black and White Women: A Comparative Cohort Analyses
Authors: BOWDON MEGAN , MARCOVITZ PAMELA , JAIN SUSANNA K. , BOURA JUDITH , LIROFF KAITLIN G. , FRANKLIN BARRY A. 
Published: February 2018

ABSTRACT

Purpose
Few data on the effect of exercise interventions in black women at risk for cardiovascular disease are available.

Methods
Women ≥18 yr of age without known cardiovascular disease with ≥1 coronary risk factor were enrolled in a community-based exercise program ≥3 d·wk−1 for ≥30 min per session for 6 months. Exercise training intensity ~50% to 80% of functional capacity, using heart rate (HR) and/or rating of perceived exertion (RPE) as the primary intensity modulators. Preconditioning versus postconditioning quality of life assessments (depression and level of daytime sleepiness), dietary fat intake, Duke Activity Status Index score, changes in cardiovascular efficiency (systolic/diastolic blood pressure (SBP/DBP), HR, RPE during a standardized submaximal workload), and anthropometric measures, including body weight, body mass index, and waist circumference, were evaluated.

Results
Of 556 volunteers, 143 were excluded, leaving 413 women (222 white, 191 black; mean ± SD age, 61 ± 9 yr) who met compliance criteria. Both groups demonstrated significant (P < 0.05) postconditioning decreases in body mass index, waist circumference, resting SBP/DBP, and total and LDL cholesterol, and reductions in HR, SBP/DBP, and RPE at a fixed submaximal workload, and in fat screener, depression, and sleep scores. Duke Activity Status Index scores increased significantly (P < 0.0001) for both groups, signifying increases in self-reported functional capacity. Although 87 women (21%) experienced a musculoskeletal injury/discomfort during the program, there were no exercise-related cardiovascular events.

Conclusions
A progressive moderate-to-vigorous exercise intervention without preliminary exercise testing elicited comparable improvements in coronary risk factors, anthropometric and quality of life measures, and cardiovascular efficiency in “at-risk” black and white women. These adaptations were achieved at exercise levels below those recommended in contemporary physical activity guidelines.
Predicting Diaphyseal Cortical Bone Status Using Measures of Muscle Force Capacity
Authors: HIGGINS SIMON , SOKOLOWSKI CHESTER M. , VISHWANATHAN MEGHA , ANDERSON JESSICA G. , SCHMIDT MICHAEL D. , LEWIS RICHARD D. , EVANS ELLEN M. 
Published: February 2018

ABSTRACT

Purpose
Muscle cross-sectional area (MCSA) is often used as a surrogate for the forces applied to bones during physical activity. Although MCSA is a strong predictor of cortical bone status, its use makes assumptions about the relationship between muscle size and force that are inaccurate. Furthermore, to measure MCSA and other muscle force surrogates typically requires expensive and/or radiative laboratory equipment. Thus, this study aimed to determine whether clinical laboratory– and field-based methodologies for measuring muscular force capacity accounted for similar variance in diaphyseal cortical bone status as a commonly used muscular force surrogate, MCSA, at the midtibia in young men and women.

Methods
Healthy young adults (n = 142, 19.7 ± 0.7 yr old, 52.8% female) were assessed via peripheral quantitative computed tomography at the midtibia for cortical bone status and MCSA. Muscle force capacity was measured via Biodex dynamometer, Nottingham leg extensor power rig, and Vertec vertical jump. Regression analysis compared the independent variance predicted by each muscle force measure with that of MCSA, accounting for relevant confounders.

Results
MCSA, knee extension peak torque, and peak anaerobic power from vertical jump were independent predictors of select cortical structural outcomes (cortical thickness and area, periosteal and endosteal circumference, and estimated strength) accounting for up to 78.4% of the variance explained (all P < 0.05). However, cortical volumetric bone mineral density was unrelated to any measure or surrogate of muscle force capacity.

Conclusions
MCSA is a strong independent predictor of cortical bone structure; however, both laboratory- and field-based measures of peak torque and/or peak anaerobic power are promising alternatives, explaining similar and sometimes greater variance than MCSA.
Progress and challenges in TB vaccine development
Authors: Voss Gerald , Casimiro Danilo , Neyrolles Olivier , Williams Ann , Kaufmann Stefan H.E. , McShane Helen , Hatherill Mark , Fletcher Helen A 
Published: February 2018

The Bacille Calmette Guerin (BCG) vaccine can provide decades of protection against tuberculosis (TB) disease, and although imperfect, BCG is proof that vaccine mediated protection against TB is a possibility. A new TB vaccine is, therefore, an inevitability; the question is how long will it take us to get there? We have made substantial progress in the development of vaccine platforms, in the identification of antigens and of immune correlates of risk of TB disease. We have also standardized animal models to enable head-to-head comparison and selection of candidate TB vaccines for further development. To extend our understanding of the safety and immunogenicity of TB vaccines we have performed experimental medicine studies to explore route of administration and have begun to develop controlled human infection models. Driven by a desire to reduce the length and cost of human efficacy trials we have applied novel approaches to later stage clinical development, exploring alternative clinical endpoints to prevention of disease outcomes. Here, global leaders in TB vaccine development discuss the progress made and the challenges that remain. What emerges is that, despite scientific progress, few vaccine candidates have entered clinical trials in the last 5 years and few vaccines in clinical trials have progressed to efficacy trials. Crucially, we have undervalued the knowledge gained from our “failed” trials and fostered a culture of risk aversion that has limited new funding for clinical TB vaccine development. The unintended consequence of this abundance of caution is lack of diversity of new TB vaccine candidates and stagnation of the clinical pipeline. We have a variety of new vaccine platform technologies, mycobacterial antigens and animal and human models. However, we will not encourage progression of vaccine candidates into clinical trials unless we evaluate and embrace risk in pursuit of vaccine development.
Case Report: Tibial and fibular osteochondroma as an unusual cause of popliteal artery entrapment syndrome
Authors: Mariúba Jamil Victor de Oliveira , Sobreira Marcone Lima , Yoshida Winston Bonetti , de Oliveira Mariúba Eduardo Savio , Rollo Hamilton de Almeida , Moura Regina , Bertanha Matheus , Jaldin Rodrigo Gibin , Pimenta Rafael Elias Farres , de Camargo Paula Angeleli Bueno , Secondo Mariana Thais Silva 
Published: February 2018

Background: Osteochondroma, or osteocartilaginous exostosis, is the most common benign neoplasm of bone, and accounts for 20-50% of all benign tumors. Vascular complications associated with osteochondromas are rare, and include pseudoaneurysm formation, vessel occlusion and vessel displacement. To date, only two cases of popliteal artery entrapment syndrome (PAES) caused by an isolated fibular osteochondroma have been reported. Case Report: This report describes a unique case of PAES. A 33-year-old woman had a history of multiple osteochondroma, including of the proximal tibia and fibula on the left, diagnosed at age two years and monitored clinically by an orthopedist. The patient presented at our facility with a one-year history of a progressive intermittent claudication, left-sided toe pain and pallor in cold weather. After a complete evaluation, we diagnosed an arterial occlusion of the left popliteal artery. We tried several attempts of revascularization, by different forms, without success. The case went to amputation surgery. Conclusion: We consider this an important case because, although the association of osteochondroma and PAES is rare, physicians should consider it early to avoid acute vascular complications. Moreover, to date, we believe this is the first description of a PAES related with multiple osteochondroma.