bluuebunny/crossref_metadata_2025_split huggingface dataset:
Naming Institutionalized Racism in the Public Health Literature: A Systematic Literature Review
Authors: Hardeman Rachel R. , Murphy Katy A. , Karbeah J’Mag , Kozhimannil Katy Backes 
Published: April 2018

Objectives: Although a range of factors shapes health and well-being, institutionalized racism (societal allocation of privilege based on race) plays an important role in generating inequities by race. The goal of this analysis was to review the contemporary peer-reviewed public health literature from 2002-2015 to determine whether the concept of institutionalized racism was named (ie, explicitly mentioned) and whether it was a core concept in the article. Methods: We used a systematic literature review methodology to find articles from the top 50 highest-impact journals in each of 6 categories (249 journals in total) that most closely represented the public health field, were published during 2002-2015, were US focused, were indexed in PubMed/MEDLINE and/or Ovid/MEDLINE, and mentioned terms relating to institutionalized racism in their titles or abstracts. We analyzed the content of these articles for the use of related terms and concepts. Results: We found only 25 articles that named institutionalized racism in the title or abstract among all articles published in the public health literature during 2002-2015 in the 50 highest-impact journals and 6 categories representing the public health field in the United States. Institutionalized racism was a core concept in 16 of the 25 articles. Conclusions: Although institutionalized racism is recognized as a fundamental cause of health inequities, it was not often explicitly named in the titles or abstracts of articles published in the public health literature during 2002-2015. Our results highlight the need to explicitly name institutionalized racism in articles in the public health literature and to make it a central concept in inequities research. More public health research on institutionalized racism could help efforts to overcome its substantial, longstanding effects on health and well-being.
Predictors of Complications in Patients Receiving Head and Neck Free Flap Reconstructive Procedures
Authors: Eskander Antoine , Kang Stephen , Tweel Ben , Sitapara Jigar , Old Matthew , Ozer Enver , Agrawal Amit , Carrau Ricardo , Rocco James W. , Teknos Theodoros N. 
Published: April 2018

ObjectiveTo (1) determine the overall complication rate, wound healing, and wound infection complications and (2) identify preoperative, intraoperative, and postoperative predictors of these complications.Study DesignCase series with chart review.SettingTertiary academic cancer hospital.Subjects and MethodsAll head and neck free flap patients at The Ohio State University (2006‐2012) were assessed. Multivariable logistic regression assessed the impact of patient factors, flap and wound factors, and intraoperative factors on the aforementioned quality metric outcomes.ResultsOf the 515 patients identified, 54% had a complication predicted by longer operating room (OR) time, higher comorbidity index, and oral cavity and pharyngeal tumor sites. Predictors of wound‐healing complications (15%) were longer OR time, volume of crystalloid given intraoperatively, and oral cavity and pharyngeal tumor sites. Predictors of wound infection (12%) were younger age, diabetes mellitus, and malnutrition.ConclusionsWound healing and infectious complications account for most complications in patients with head and neck cancer undergoing free flap reconstruction. Clean contaminated wounds are a significant predictor of wound complications. Advanced OR time, advanced age, and comorbidity status, including diabetes mellitus and malnutrition, are other important predictors. Crystalloid administration is also an important predictor of wound‐healing complications, and this warrants further study.
Impact of HPV Status on the Prognostic Potential of the AJCC Staging System for Larynx Cancer
Authors: Davidson Stacey M. , Ko Huasing C. , Harari Paul M. , Wieland Aaron M. , Chen Shuai , Baschnagel Andrew M. , Kimple Randall J. , Witek Matthew E. 
Published: April 2018

ObjectiveWe evaluated the ability of the American Joint Committee on Cancer (AJCC) seventh edition staging system to prognosticate the overall survival of patients with human papillomavirus (HPV)–positive laryngeal squamous cell carcinoma.Study DesignRetrospective analysis.SettingNational Cancer Database.Subjects and MethodsPatients diagnosed with laryngeal squamous cell carcinoma who were treated with curative intent were identified in the National Cancer Database. Multivariate analysis was utilized to determine factors correlated with overall survival in the HPV‐negative and HPV‐positive cohorts. Unadjusted and propensity score–weighted Kaplan‐Meier estimation was used to determine overall survival of HPV‐negative and HPV‐positive patients across AJCC stage groupings.ResultsWe identified 3238 patients with laryngeal squamous cell carcinoma, of which 2812 were HPV negative and 426 were HPV positive. Overall survival adjusted for age, sex, and comorbidity status confirmed significant differences among all consecutive stage groupings (I vs II, P <. 001; II vs III, P <. 05; III vs IVA, P <. 001; IVA vs IVB, P <. 05) in the HPV‐negative cohort, whereas only stages IVAs and IVB (P <. 01) exhibited a significant difference in overall survival for HPV‐positive patients.ConclusionThe current AJCC staging system does not accurately distinguish risk of mortality for patients with HPV‐positive disease. These data support the consideration of HPV status in estimating prognosis as well as clinical trial design and clinical decision making for patients with laryngeal squamous cell carcinoma.
Incidence of Osteochondritis Dissecans in Adults
Authors: Weiss Jennifer M. , Shea Kevin G. , Jacobs John C. , Cannamela Peter C. , Becker Ian , Portman Mark , Kessler Jeffrey I. 
Published: April 2018

Background: Osteochondritis dissecans (OCD) has frequently been described in children and adolescents, but cases of OCD in adults are certainly encountered. Little has been published on the epidemiology of OCD in adult patients. Purpose: To assess the frequency of OCD lesions in adults and assess the risk by age, sex, and ethnicity. Study Design: Descriptive epidemiology study. Methods: The authors assessed all patients aged 20 to 45 years from the entire database of patients enrolled as members of Kaiser Permanente Southern California from January 2011 until December 2013. Kaiser Southern California is an integrated health care system serving a racially, ethnically, and socioeconomically diverse population of >3.5 million patients. A retrospective chart review was done on OCD during this period. Inclusion criteria included OCD of any joint. Exclusion criteria included traumatic osteochondral fractures and coexistence of intra-articular lesions other than OCD. Joint involvement/location, laterality, and all patient demographics were recorded. Results: Among 122 patients, a total of 124 OCD lesions were found. The majority of lesions were in the ankle (n = 76) and knee (n = 43), with 3 foot lesions and 2 elbow lesions identified. OCD lesions were identified in 75 men (62%) and 47 women (38%). Overall incidence rates per 100,000 person-years were 3.42 for all OCD, 2.08 for ankle OCD, and 1.21 for knee OCD. The relative risk of adult OCD for men was twice that of women. The relative risk of adult OCD for white patients was 2.3 that of Asians and 1.7 that of Hispanics. Risk of knee OCD was 3.6 times higher for men than women. As compared with women, men had a higher risk for lateral femoral condyle OCD lesions versus the medial femoral condyle ( P = .05; odds ratio [OR], 5.19). Conclusion: This large cohort study of Southern California adults with OCD demonstrated an increased OR for men (vs women) of OCD in all joints. The majority of symptomatic lesions were present in the ankle rather than the knee, as previously found in children. White and black patients had the highest OR of OCD; men had a significantly greater OR of lateral femoral condyle knee lesions as compared with women.
Development of a Novel Large Animal Model of Ischemic Heart Failure Using Autologous Platelet Aggregates
Authors: Kwiatkowski Pawel , Sai-Sudhakar Chittoor , Philips Angela , Parthasarathy Sampath , Sun Benjamin 
Published: April 2018

Background Current animal models of heart failure lack the biomass of thrombus that occurs in patients undergoing myocardial infarction. We propose a novel animal model of ischemic cardiomyopathy developed by sequential direct injections of autologous platelet aggregates into the coronary circulation resulting in development of ischemic cardiac insufficiency. Methods Autologous platelets from adult sheep were isolated and aggregated. Aggregated platelets were then injected into the coronary circulation of anesthetized animals under fluoroscopic guidance. Troponin I levels were monitored for first three days after embolization to validate cardiac tissue injury. Progression of heart failure was corroborated by monitoring changes in echo-based assessment of ejection fraction and left ventricular end-systolic and end-diastolic dimensions. Thrombus-based obstruction of coronary artery was confirmed with histopathology review by mepacrine labeling of pre-aggregated platelets. Results All experimental animals developed heart failure-like cardiac insufficiency confirmed by elevated levels of troponin I and associated with significant drop in the ejection fraction. Conclusions Sequential injections of aggregated platelets into coronary circulation lead to progressive development of ischemic cardiac insufficiency. This phenomenon seems to mimic development of ischemic heart failure seen in human patients and opens multiple research opportunities to fill the existing gap between basic research and clinical practice.
Crush Syndrome after the Wenchuan Earthquake: New Experience with Regional Citrate Anticoagulation Continuous Veno-Venous Hemofiltration
Authors: Xie Hong-Lang , Ji Da-Xi , Hu Wei-Xin , Wu Yan , Ge Yong-Chun , Hou Jin-Hua , Li Lei-Shi , Liu Zhi-Hong 
Published: April 2018

Purpose Acute renal failure (ARF) related to crush syndrome is usually treated with hemodialysis. Continuous veno-venous hemofiltration (CVVH) has seldom been adopted in this situation due to the main drawback of continuous anticoagulation. The purpose of this study was to evaluate the effectiveness and safety of regional citrate anticoagulation (RCA)-CVVH in two crush syndrome patients following the Wenchaun earthquake. Methods Two victims from the Wenchuan earthquake in Southwest China were admitted to our hospital on May 23, 2008, 11 days after their injury. The total entrapment time under the rubble was 5.5 and 22.5 hrs respectively. They remained oliguric on admission, in spite of vigorous treatment in the local hospital including aggressive fluid infusion, fasciotomy and intermittent hemodialysis. On admission, their serum myoglobin levels were 765 and 829 ng/mL, respectively. Further debridement and drainage were performed. RCA-CVVH was conducted; the citrate containing substitution fluid was infused in a pre-dilution manner at a rate of 4 l/h; calcium was infused through a separate access to the venous inlet of the double lumen catheter. The infusion rate was adjusted according to the serum ionized calcium and whole blood activated clotting time (WBACT). A low dose of low molecular weight heparin (LMWH) was infused at the rate of 150∼300 U/h simultaneously for anticoagulation after anemia had been corrected and their wounds were stable. RCA-CVVH was substituted by conventional CVVH and LMWH anticoagulation when case 2 complicated with hypoxia. Results RCA-CVVH was well tolerated, hemodynamic status was stable, and no complications related with RCA-CVVH were noted. The body temperature and WBC decreased to normal range, while anemia and hypoalbuminia were corrected. The levels of serum myoglobin and creatine phosphokinase were also decreased to normal range. Their urine volume increased after 20 and 22 days of oliguria and the tubular function of the patients recovered well. Although the second case encountered acute cholecystitis and acute lung injury in the hospital, both the patients recuperated and neither of them underwent amputation. Conclusions The present two crush patients have been successfully treated, but due to the limits of the small sample, it is difficult to generalize whether RCA-CVVH is safe enough for crush syndrome with a high risk of bleeding diathesis. Additional investigation with a larger number of patients is required. Fluid equilibrium, nutritional support, prevention of bleeding and infection are fundamental in this situation.
A New Prognostic Index for One-Year Survival in Incident Hemodialysis Patients
Authors: Marinovich Sergio , Lavorato Carlos , Moriñigo Claudio , Celia Eduardo , Bisignano Liliana , Soratti Mariano , Hansen-Krogh Daniela 
Published: April 2018

Purpose Although scoring comorbidities for patients beginning chronic hemodialysis has proved significant and has led researchers to develop several indexes, none of them has been extensively accepted. The aim of this study was to: 1) develop a prognostic index for patients entering renal replacement therapy; and 2) identify which one of the available scores better predicts one-year survival. Methods Records from 5,360 incident dialysis-requiring ESRD individuals were studied and a novel comorbidity index (NI) was developed. The agreement of this NI with the Charlson age-comorbidity, Kahn-Wright, ACPI, and Hemmelgarn indexes was assessed to identify which one better predicts one-year survival. The Cox proportional hazard regression with time-dependent covariates was used to analyze survival and the area under the receiver operating characteristic (ROC) curve was calculated to assess the ability of this score to discriminate between prognoses and to compare this NI with indexes already in use. Results 16 of the original 19 predictor variables displayed hazard ratios ≥1.2. Although the area under the ROC curves for all the indexes compared were significantly different from 0.5, the NI showed better performance characteristics (0.74 vs. 0.70 for Charlson's, 0.68 for ACPI, 0.67 for Khan-Wright's and 0.63 for Hemmelgarn's). Compared with the Charlson score, the z statistic was 7.78 (p<0.001). One-year survival estimate for the high-risk group was 43% with the NI and ranged from 66% to 72% when assessed through other indexes. Conclusions We recommend the use of this NI because it better predicts the one-year survival probability of incident hemodialysis-requiring ESRD individuals.
Study of Mechanical Properties of Engineered Cartilage in an in Vivo Culture for Design of a Biodegradable Scaffold
Authors: Komura Makoto , Komura Hiroko , Kanamori Yutaka , Tanaka Yujirou , Ohatani Yoshiyuki , Ishimaru Tetuya , Sugiyama Masahiko , Hoshi Kazuto , Iwanaka Tadashi 
Published: April 2018

Introduction An engineered trachea with an absorbable scaffold should be used to augment the repair of a stenotic tracheal section in infants and children because this type of engineered airway structure can grow as the child grows. Our strategy for relief of tracheal stenosis is tracheoplasty by engineered cartilage implantation in accordance with the concept of costal cartilage grafting to enlarge the lumen. This study investigated the mechanical properties of regenerative cartilage with a biodegradable scaffold, Neoveil®, to aid in design of a composite scaffold that maintained semi-rigid properties until cartilage could be generated. Materials and methods New Zealand White rabbit (n=3) chondrocytes were isolated from auricular cartilage with collagenase type 2 digestion. Then 10×106/cm3 chondrocytes in atelocollagen solution were seeded onto polyglycolic acid (PGA) mesh. A total of 36 constructs, 12 from each rabbit, were implanted into athymic mice (3 constructs/mouse). Constructs were retrieved after 8 weeks and evaluated by measurements of mechanical and biochemical properties as well as histological examination. Thirty-six PGA mesh sheets of the same size but without cells were implanted in control mice. Results After 6 weeks of implantation, staining of sections with Safranin O revealed cartilage accumulation. Glycosaminoglycan was gradually produced from chondrocytes in the engineered constructs, correlating with the duration of implantation. Mechanical parameters had the same values as those for rabbit tracheal cartilage 8 weeks after implantation. Conclusions Biodegradable Neoveil® had good biocompatibility and was able to support extracellular matrix formation in engineered cartilage in an animal model.
Internal Hemodiafiltration versus Low-Flux Bicarbonate Dialysis: Results from a Long-Term Prospective Study
Authors: Righetti Marco , Filiberti Oliviero , Ranghino Andrea , Ferrario Gianmichele , Milani Silvana , Serbelloni Paola , Guida Gian Enrico , Tommasi Adalberto 
Published: April 2018

Introduction About ten years ago it was discovered that changes in filter design which increase passive filtration improved dialysis efficiency. Later, these modified membranes showed similar intradialytic efficiency when used in on-line hemodiafiltration or in bicarbonate dialysis, called internal hemodiafiltration. Aim and Methods On the basis of these previous results, we studied the long-term effects of internal hemodiafiltration, in comparison with low-flux bicarbonate dialysis. The pre-dialysis beta2-microglobulin level was chosen as the primary outcome variable. A prospective multicenter study with a cross-over scheme, 2 treatments and 3 periods, was designed. Twenty-four patients, followed in two dialysis centers, were enrolled. Many other parameters were measured every month at the first dialysis session of the week. The intra-dialytic removal of urea, beta2-microglobulin and homocysteine was also calculated. Results The removal of uremic toxins was significantly higher in internal hemodiafiltration than in low-flux bicarbonate dialysis. The pre-dialysis value of urea, phosphorus, beta2-microglobulin and homocysteine was lower during internal hemodiafiltration as compared with low-flux bicarbonate dialysis. The mean pre-dialysis value of hemoglobin was significantly higher during internal hemodiafiltration than low-flux bicarbonate dialysis, with a trend towards a significantly lower consumption of erythropoiesis stimulating agents during internal hemodiafiltration as compared with low-flux bicarbonate dialysis. Conclusions Long-term treatment with internal hemodiafiltration improves the removal of small molecules and stops the continuous increase of middle molecules as seen in low-flux bicarbonate dialysis. Internal hemodiafiltration may substitute low-flux bicarbonate dialysis, but we need new prospective studies about long-term hard end-points.
Left Ventricular Assist Improves Autonomic Imbalance in Patients with Persistent Myocardial Dysfunction
Authors: Gardiwal Ajmal , Roentgen Philipp , Luesebrink Ulrich , Koenig Thorben , Klein Gunnar , Oswald Hanno 
Published: April 2018

Background Left ventricular assist devices (LVAD) are an effective therapeutic option for end-stage heart failure (HF). Reduced heart rate variability (HRV) as a result of autonomic derangement is evident in chronic heart failure and several studies have established the independent prognostic value of HRV in chronic heart failure. Objective In the present study we investigated whether autonomic function is restored in patients after LVAD implantation with persistent, severely depressed left ventricular function. Methods Ambulatory Holter ECG recordings were collected in heart failure patients with an LVAD (n=8) und age-matched heart failure patients without an LVAD (n=7) both on optimal medical therapy. Cardiac dimensions and function were assessed by echocardiography or angiography. Results Analysis for heart rate variability revealed reduced SDNN (67±4ms), SDANN (56±4ms) and triangular index (18±1) in heart failure patients on optimal medical therapy. However patients with LVAD demonstrated a restoration in heart rate variability with normal SDNN (108±9ms), SDANN (103±8ms) and triangular index (29±2). Compared to patients without LVAD this difference was statistically significant (p<0.01). Conclusions In end-stage heart failure patients autonomic imbalance indicated by severely reduced heart rate variability is restored after LVAD implantation with unloading of the failing heart.
Salivary Cortisol Rhythms in Children With Cleft Lip and/or Palate
Authors: Sundell Anna Lena , Marcusson Agneta , Törnhage Carl-Johan 
Published: April 2018

Objective: Knowledge about the stress response in children with cleft lip and/or palate (CL/P) is sparse and the association between the stress response and health-related quality of life (HRQoL) is unknown. Consequently, investigations on the influence of CL/P on the stress response alone and its association with HRQoL are of importance. The purpose was to determine whether salivary cortisol concentration in children with CL/P differs from that in children without clefts (controls) and whether there are any differences in salivary cortisol concentrations between ages, gender, and type of cleft. Furthermore, the final aim was to determine the correlation between salivary cortisol concentration and HRQoL. Design: The study used a cross-sectional case-control design. Participants: Ninety-one 5- and 10-year-old children with CL/P and 180 age-matched controls. Main Outcome Measures: Salivary samples were collected on 2 mornings and 1 evening for each child. Samples were analyzed using a commercial competitive radioimmunoassay and HRQoL was assessed using the KIDSCREEN-52. Results: Salivary cortisol concentrations were similar in children with CL/P and controls. There was no difference in salivary cortisol concentrations between children with different types of cleft. There was no correlation between cortisol concentration and HRQoL. Conclusion: Five- and 10-year-old children with corrected CL/P seemed not to be more stressed than controls, and there were no correlation to HRQoL. The HRQoL levels - were comparable to that of a European norm population.
Relationships Between Glycemic Control and Cardiovascular Fitness
Authors: Moxley Elizabeth W. , Smith Donald , Quinn Lauretta , Park Chang 
Published: April 2018

Introduction: Diabetes is a serious health problem affecting approximately 29.1 million individuals in the United States. Another 86 million have prediabetes. The development and implementation of lifestyle modifications such as physical activity for these persons are among the most effective methods for prevention and treatment. Objective: The aim of this study was to examine relationships between glycemic control (HbA1c) and cardiovascular fitness (peak maximal oxygen uptake [VO2 peak] and ventilatory threshold [VT]) in overweight/obese subjects with and without type 2 diabetes (T2DM). In addition, the influences of body mass index (BMI) and insulin sensitivity (homeostasis model assessment [HOMA %S]) on the relationship between glycemic control and cardiovascular fitness were explored. Method: Data were abstracted from a completed study that included 51 overweight or obese subjects with T2DM ( n = 18), impaired glucose tolerance ( n = 8), or normal glucose tolerance ( n = 25). Relationships between glycemic control (HbA1c) and cardiovascular fitness (VO2 peak and VT) were determined using correlational analysis and multiple linear regression analyses. Results: A statistically significant relationship was observed between HbA1c and cardiovascular fitness. However, BMI and HOMA %S did not influence the relationship between glycemic control and cardiovascular fitness. Discussion: HbA1c contributes to VO2 peak and VT in obese and overweight subjects across glucose tolerance categories. Significant results were achieved despite the fact that there was a limited range of HbA1c based on the study inclusion criteria. This finding suggests that even a mild decrease in glycemic control can negatively influence cardiovascular fitness.