bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative Lymphatic Leakage in Oncosurgical Patients
Authors: Yarema I. V. , Fatuev O. E. , Kozlov N. S. , Tagirova A. G. , Vagabova I. M. , Hasan A. Sh. , Simanin R. A. , Korolyuk G. M. , Safronova V. V. 
Published: May 2019

Purpose: to evaluate the influence of postoperative lymphatic leakage volume and duration on homokinesis and incidence of postoperative complications in oncosurgury patients underwent different operative interventions.Material and methods. The results of treatment of 310 patients subjected to standard elective surgical intervention for a malignant pathology of different organs with regional lymph node dissection were evaluated. The selection criterion was prolonged (more than 7 days) and prominent (over 50 ml a day) lymphatic leakage during the postoperative period. The fluid discharged during the postoperative period was identified as a lymph by cytology. The diagnosis of a malignant pathology was verified in all patients after histological examination and patients were distributed according to established diagnosis.Results. The duration of lymphatic leakage including the outpatient treatment stage varied from 9 days to 1 year and 2 months depending on the type of surgery. The longest lymphatic leakage occurred in 2 patients after radical mastectomy. During the 1st week of observation in patients with daily lymph losses up to 100 ml, no changes in the blood composition were noted. Prolonged lymphatic leakage (1–2 weeks after operation) in a volume over 100 ml a day resulted in reduced protein content in blood plasma, severe lymphocytopenia, increased platelet count. During the postoperative period, complications were detected in 31 patients; at that, during the 1st week of observation, 27 patients experienced initial lymphatic leakage over 100 ml a day. Analysis of fatal outcomes (7 patients) showed that in all patients the lymphatic leakage exceeded 150 ml a day and lasted 1 to 2 weeks. The longest inpatient time was typical for patients after Wertheim's hysterectomy and cystectomy, whereas the longest outpatient treatment was experienced by patients after radical mastectomy and inguinofemoral lymph node dissection.Conclusion. In case of lymphatic leakage over 100 ml a day in oncosurgury patients, it was necessary to make up protein losses and after 7 days of persistent lymphatic leakage it became necessary to consider use of active surgical tactics aimed at liquidation of lymph losses.
La contribución de Rudolph Otto a la ética
Authors: Crespo Mariano 
Published: May 2019

R. Otto (1869-1937) es conocido por su trabajo en filosofía de la religión. El artículo presenta sus principales contribuciones, centrando la atención en los Aufsätze zur Ethik y en su conexión con Lo santo. Contra la idea de que Otto no puede desarro- llar una ética sin renunciar a posiciones fundamentales de Lo santo, se sostiene una consonancia con sus escritos éticos, según la tesis de que no todo lo que sabemos es una forma de saber (wissen), en el sentido de representación intelectual.
Addition of Adductor Canal Block to Periarticular Injection for Total Knee Replacement
Authors: Goytizolo Enrique A. , Lin Yi , Kim David H. , Ranawat Amar S. , Westrich Geoffrey H. , Mayman David J. , Su Edwin P. , Padgett Douglas E. , Alexiades Michael M. , Soeters Rupali , Mac Phuong Dinh , Fields Kara G. , YaDeau Jacques T. 
Published: May 2019

Background:
Periarticular injection is a popular method to control postoperative pain after total knee replacement. An adductor canal block is a sensory block that can also help to alleviate pain after total knee replacement. We hypothesized that the combination of adductor canal block and periarticular injection would allow patients to reach discharge criteria 0.5 day faster than with periarticular injection alone.

Methods:
This prospective trial enrolled 56 patients to receive a periarticular injection and 55 patients to receive an adductor canal block and periarticular injection. Both groups received intraoperative neuraxial anesthesia and multiple different types of pharmaceutical analgesics. The primary outcome was time to reach discharge criteria. Secondary outcomes, collected on postoperative days 1 and 2, included numeric rating scale pain scores, the PAIN OUT questionnaire, opioid consumption, and opioid-related side effects.

Results:
There was no difference in time to reach discharge criteria between the groups with and without an adductor canal block. The Wilcoxon-Mann-Whitney odds ratio was 0.87 (95% confidence interval [CI], 0.55 to 1.33; p = 0.518). The median time to achieve discharge criteria (and interquartile range) was 25.8 hours (23.4 hours, 44.3 hours) in the adductor canal block and periarticular injection group compared with 26.4 hours (22.9 hours, 46.2 hours) in the periarticular injection group. Patients who received an adductor canal block and periarticular injection reported lower worst pain (difference in means, −1.4 [99% CI, −2.7 to 0]; adjusted p = 0.041) and more pain relief (difference in means, 12% [99% CI, 0% to 24%]; adjusted p = 0.048) at 24 hours after anesthesia. There was no difference in any other secondary outcome measure (e.g., opioid consumption, opioid-related side effects, numeric rating scale pain scores).

Conclusions:
The time to meet the discharge criteria was not significantly different between the groups. In the adductor canal block and periarticular injection group, the patients had lower worst pain and greater pain relief at 24 hours after anesthesia. No difference was noted in any other secondary outcome measure (e.g., opioid consumption, opioid-related side effects, numeric rating scale pain scores).

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Volar Plate Fixation Versus Plaster Immobilization in Acceptably Reduced Extra-Articular Distal Radial Fractures
Authors: Mulders Marjolein A.M. , Walenkamp Monique M.J. , van Dieren Susan , Goslings J. Carel , Schep Niels W.L. ,   on behalf of the VIPER Trial Collaborators
Published: May 2019

Background:
There is no consensus as to whether displaced extra-articular distal radial fractures should be treated operatively or nonoperatively. We compared the outcomes of open reduction and volar plate fixation with closed reduction and plaster immobilization in adults with an acceptably reduced extra-articular distal radial fracture.

Methods:
In this multicenter randomized controlled trial, patients 18 to 75 years old with an acceptably reduced extra-articular distal radial fracture were randomly assigned to open reduction and volar plate fixation or plaster immobilization. The primary outcome was function as measured with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire after 12 months. Follow-up was conducted at 1, 3, and 6 weeks and at 3, 6, and 12 months. Analyses were performed according to the intention-to-treat principle.

Results:
Ninety-two patients were randomized, 48 to open reduction and volar plate fixation and 44 to plaster immobilization; 1 patient in each group was excluded for withdrawing informed consent. At all follow-up time points, operatively treated patients had significantly better functional outcomes, as indicated by significantly lower DASH scores, than patients treated nonoperatively (all p values < 0.05). Twelve nonoperatively managed patients (28%) had fracture redisplacement within 6 weeks and underwent subsequent open reduction and internal fixation, and 6 patients (14%) had a symptomatic malunion treated with corrective osteotomy.

Conclusions:
Patients with an acceptably reduced extra-articular distal radial fracture treated with open reduction and volar plate fixation have better functional outcomes after 12 months compared with nonoperatively managed patients. Additionally, 42% of nonoperatively managed patients had a subsequent surgical procedure. Open reduction and volar plate fixation should be considered for patients who experience this common injury.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Treatment of Partial Traumatic Hemipelvectomy
Authors: He Yu , Qiu Daodi , Zhou Dongsheng , Li Lianxin , Wang Bomin , Wang Lubo 
Published: May 2019

Background:
Partial traumatic hemipelvectomy (THP) is a catastrophic and life-threatening injury caused by high-energy impact. With advances in prehospital resuscitative techniques, more patients now survive this disastrous injury; however, the management of partial THP still lacks well-established therapeutic protocols. The purpose of this study was to present our experience in managing partial THP in a level-I trauma center.

Methods:
We retrospectively reviewed the medical records of 21 consecutive patients with partial THP. The key points of successful treatment are hemorrhage control, proper decision-making regarding amputation, treatment of associated injuries, and infection control. Data on patient demographics, injury characteristics, surgical management, and outcomes were recorded and analyzed.

Results:
Eight female and 13 male patients with a mean age of 31.3 years met the diagnostic criteria. The mean follow-up was 51.9 months. Of 17 surviving patients, 7 underwent primary amputation; limbs were successfully preserved in 4; and 6 patients underwent secondary amputation because of infection, organ dysfunction, and limb necrosis. Two patients died during resuscitation, and 2 patients died after amputation. Phantom limb pain, infection, and skin flap necrosis were the major postoperative complications.

Conclusions:
THP requires cooperative multidisciplinary emergency diagnosis and treatment, early surgical intervention, and definitive treatment. Rapid resuscitation, adequate hemostasis, early amputation, and repeated debridement may improve survival.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Ten-Year Outcomes of Selective Fusions for Adolescent Idiopathic Scoliosis
Authors: Louer Craig , Yaszay Burt , Cross Madeline , Bartley Carrie E. , Bastrom Tracey P. , Shah Suken A. , Lonner Baron , Cahill Patrick J. , Samdani Amer , Upasani Vidyadhar V. , Newton Peter O. 
Published: May 2019

Background:
Selective fusions of the structural curve remain a common treatment strategy for adolescent idiopathic scoliosis, yet long-term outcomes are not well-understood. The purpose of this study was to report 10-year prospective radiographic and patient-rated outcomes of selective fusions of the main thoracic (MT) or thoracolumbar/lumbar (TL/L) curve, with particular attention to the behavior of the uninstrumented, compensatory curve.

Methods:
A prospectively collected multicenter database was used to identify patients who had been followed regularly for least 10 years after a selective MT or TL/L fusion for adolescent idiopathic scoliosis. Interval radiographs were evaluated for coronal and sagittal Cobb angles as well as overall coronal balance. Scores on the Scoliosis Research Society Questionnaire (SRS-24) were catalogued and evaluated. Radiographic outcomes and SRS-24 scores were compared between preoperative and postoperative time points using repeated-measures analysis of variance. Individual patient records were screened for recent curve progression of >5°, and these cases were methodically evaluated.

Results:
Fifty-one patients with selective fusions (21 MT and 30 TL/L) for adolescent idiopathic scoliosis who had been followed for at least 10 years were identified. The instrumented MT and TL/L curves were corrected by an average of 51% and 60%, respectively, at 10 years. The uninstrumented, compensatory curves had gradual spontaneous correction that approached the magnitude of the fused curve at 5 years postoperatively, with the correction maintained at 10 years. This led to excellent coronal balance. A subgroup of patients had recent progression of the primary curve adjacent to the prior fusion or within the instrumented segments, resulting in a compensatory progression of the uninstrumented curve. On the whole, SRS scores did not decrease during follow-up, and no patient had secondary operations.

Conclusions:
Selective fusion of a primary thoracic or lumbar curve in properly selected patients with adolescent idiopathic scoliosis will result in spontaneous correction of the uninstrumented curve and a durable result for at least 10 years.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Pelatihan Pembuatan Alat Permainan Edukatif (APE) Playdough Sebagai Sumber Belajar
Authors: Sahjat Sumarni , Samad Farida 
Published: May 2019

<em>Minimnya kemampuan, kreativitas dan pengalaman guru PAUD dalam memanfaatkan alat dan bahan yang tersedia walaupun secara sederhana dalam pembelajaran di kelas merupakan salah satu alasan diadakan kegiatan Program Pengabdian Masyarakat (PPM) tentang Alat Permainan Edukatif (APE) yakni playdough di gugus PAUD Kota Ternate khususnya di gugus PAUD Ternate Tengah. Adapun tujuan kegiatan PPM ini adalah untuk memberikan pengetahuan/pemahaman tentang APE playdough kepada guru-guru PAUD di gugus Ternate Tengah untuk meningkatkan kemampuan motorik halus, memberikan keterampilan kepada guru PAUD tentang APE playdough sebagai salah sumber belajar di lingkungan sekolah. APE merupakan bagian yang tidak terpisahkan dalam pembelajaran anak di TK karena alat permainan tersebut akan menunjang kegiatan pembelajaran anak secara efektif dan menyenangkan serta mengembangkan berbagai potensi yang dimiliki anak secara optimal. Dalam pelaksanaan kegiatan pengabdian ini guru PAUD gugus Ternate Tengah diberikan pelatihan pembuatan APE playdough berupa tanya jawab, demonstrasi ,diskusi dan evaluasi kegiatan. Luaran yang dicapai yaitu meningkatkan pengetahuan, kemampuan, pengalaman dan kreatifitas guru-guru PAUD se-gugus Kota Ternate dalam memanfaatkan playdough sederhana menjadi alat permainan edukatif (APE), terjalinnya kerjasama guru-guru PAUD terkait dan institusi Universitas dalam upaya peningkatan kualitas pembelajaran bagi anak usia dini, publikasi jurnal dan publikasi media massa.</em>
ANALISIS QoS (Quality of Service) JARINGAN UNBK DENGAN MENGGUNAKAN MICROTIC ROUTER (Studi Kasus : Jaringan UNBK SMAN 1 Jakenan Pati)
Authors: Nindyasari Ratih , Murti Alif Catur , Ghozali Muhammad Imam 
Published: May 2019

<p align="justify"><em>Kebutuhan akan ketersediannya layanan jaringan yang cepat, kestabilan jaringan, dan kesesuaian dengan teknologi yang digunakan menjadi kebutuhan primer bagi masyarakat. Penggunaan teknologi pada zaman sekarang sudah menyentuh semua aspek kehidupan. Aspek pendidikan merupakan salah satu yang terkena dampak dari perkembangan teknologi, khususnya internet. Bentuk nyata dari dampak yang muncul adalah Prosedur Operasional Standar (POS) yang dikeluarkan Badan Standar Nasional Pendidikan (BNSP) di tahun 2017 untuk diadakannya Ujian Nasional Berbasis Komputer (UNBK). Kondisi tersebut membuat beberapa sekolah yang menjadi percontohan mempersiapkan diri dengan mulai membangun ruang ujian yang didesain dengan perangkat komputer dan jaringan internet. Penambahan router pada node awal dan menggunakan manajemen switch mengakibatkan adanya perbedaan dalam pengujian QoS. Dengan adanya penambahan router pada topologi jaringan UNBK ini menjadikan tidak adanya packet loss ketika dilakukan pengujian seperti pada desain topologi jaringan tanpa menggunakan router. Penggunaan server lokal dalam setiap lab memungkinan untuk membackup server yang ada di lab lain ketika terjadi kondisi server down. Sehingga desain topologi jaringan dengan menggunakan router ini dapat diimplementasikan dalam jaringan UNBK pada SMAN 1 Jakenan Pati. </em><em></em></p><p align="justify"> </p><p><strong><em>Kata kunci : Topologi Jaringan, Quality of Service, UNBK, Router Mikrotik, Packet Loss.</em></strong></p>
Efficacy and safety of Tetramethylpyrazine (TMP) Phosphate on Pulmonary Hypertension: study protocol for a randomized controlled trial
Authors: Wang Jian , Chen Yuqin , He Wenjun , Ouyang Haiping , Liu Chunli , Hong Cheng , Wang Tao , Yang Kai , Lu Wenju 
Published: May 2019

Abstract
Background: Tetramethylpyrazine (TMP), an active ingredient in the traditional Chinese herbal medicine Rhizoma Chuanxiong, has been used clinically for the prevention and treatment of cardiovascular disease. The benefits of TMP are largely attributed to its anti-oxidative and vasodilative properties. However, the efficacy of TMP in the treatment of pulmonary hypertension (PH) is unknown. We hypothesized that TMP may have a therapeutic effect in patients with PH.Methods:A randomized, single-blinded, clinical study with a TMP treatment group and a control group will be conducted to evaluate the efficacy and safety of TMP intervention in patients with PH. The recruitment target is 120 subjects meeting the following criteria: (i) At rest and at sea level, mean pulmonary artery pressure above 20 mmHg and pulmonary capillary wedge pressure below 15 mmHg; (ii) Type 1 or 4 PH in the stable phase; (iii) age 15–70 years; (iv) 6-minute walk distance between 100 and 450 meters; (v) lung function at level II, III, or IV according to WHO classification. Subjects will be assigned randomly into two groups at a ratio of 1:2 (control:TMP). Both groups will receive routine treatment, and the treatment group will also receive oral TMP (100 mg) three times a day for 16 weeks. All patients will be followed up for 4, 8, 12, and 16 weeks, and symptoms and patient compliance will be recorded.Discussion:We aim to determine the efficacy and safety of TMP for the treatment of PH.Study registration:ChiCTR1800018664, http://www.chictr.org.cn/edit.aspx?pid=31565&htm=4 (registered on 2 October 2018).
Pyogenic Vertebral Osteomyelitis in Adults: Ten-year Experience in Two Italian Hospitals
Authors: Zoboli Fabio , Ripamonti Diego , Carretta Anna , Bombana Enrico , Ravasio Veronica , Santantonio Teresa Antonia , Rizzi Marco 
Published: May 2019

Abstract
Background: The incidence of pyogenic vertebral osteomyelitis (PVO) is increasing, but optimal diagnostic strategy and medical management remain controversial.

Methods: We conducted a retrospective study of PVO in two Italian hospitals, including all the adults admitted from January 2007 to December 2016. PVO was defined probable or definite according to clinical, radiological and microbiological criteria. The main exposures of interest were investigation strategy and antibiotic treatment. The outcome measures were cure rate, mortality during index admission and recurrence rate.

Results: Most cases were diagnosed with MRI. Biopsy was performed in 47% of patients and was successful only in 49% of them. The microbiological diagnosis (mostly Gram-positive agents) was obtained in 111 patients (62%). Treatment duration did not differ between patients with definite or probable diagnosis (108 and 112 days, respectively). Among the 100 patients (56%) with at least 1-year follow-up, the cure rate, the failure rate and the mortality were 88%, 12% and 3%, respectively. Relapses were uncommon (4%) among patients who completed the follow-up. Among the patients who recovered completely, 47 (59%) had a microbiological diagnosis. Among the 111 patients with a definite diagnosis and 68 with a probable diagnosis, 42% and 49% achieved a full recovery, respectively.

Conclusions: Despite influencing the antibiotic selection, the etiological diagnosis did not impact the cure rate and/or duration of treatment. Some open questions remain with regard to the optimal starting regimen, the duration of treatment and the time to switch to oral therapy.
Prevalence of hepatitis C virus infection and risk factor analysis in Changsha, central China, about population undergoing routine check-up, 2013–2015
Authors: Liu Shaohui , Zeng Chang , Kang Xintong , Tan Ying , Zhou Wei , xiao meifang 
Published: May 2019

Abstract
Background

Currently, Hepatitis C virus (HCV) infection remains a major public health problem. The aim of current study wanted to determine the prevalence of HCV virus infections, and to explore the risk factors for HCV infection in the general adult population undergoing routine check-ups in Changsha City.

Methods

We collected 59688 blood samples from the adult population undergoing routine check-ups in 2013–2015 and obtained relevant information using a standardized questionnaire. We then conducted association and logistic regression analyses. We used the enzyme immunoassay method to test for anti-HCV antibodies in the serum samples.

Results

The positivity rate of anti-HCV was about 0.57% (340/59688) in the general population. Participants from rural areas showed significantly higher HCV seroprevalence rates than did those from the urban area (0.83% vs 0.19%, p < 0.001). HCV seropositivity increased progressively with age, peaking at 55–64 years (1.23%), and decreasing in participants aged 65 and older. The positivity rate of anti-HCV for males was slightly higher than that of females (0.67% vs 0.48%, p = 0.002). The results of multiple logistic regression showed that history of blood transfusion, surgery, living in rural areas, and transmission in families were the main risk factors for HCV infection. Conclusions: The prevalence of HCV infection is low in the general population in Changsha. This information vital for healthcare settings and health education entities in public, especially in rural areas.
Integrating Cultural Practices with Herbicides Augments Weed Management in Flax
Authors: Kurtenbach Moria E. , Johnson Eric N. , Gulden Robert H. , Duguid Scott , Dyck Miles F. , Willenborg Christian J. 
Published: May 2019

Core Ideas
Current weed management strategies in flax are limited.A multi‐factor weed management system is needed to control herbicide‐resistant weeds.Combining several factors has a greater impact on crop‐weed competition than any factor alone.The best combination is a competitive cultivar, seed early, high seeding rate, and use an in‐crop herbicide.
Flax (Linum usitatissimum L.) is an important crop with value in both food and industrial markets. However, flax competes poorly with weeds and as a result, flax yield can be severely inhibited by weed competition. Factors that favor crop competitive ability will have great value in improving weed management in flax. This research sought to identify different combinations of seeding date (early vs. late May), seeding rate (400 vs. 800 seeds m−2), cultivar height (short vs. tall), and herbicide (present vs. absent) that could improve the competitive ability of flax. Field studies were conducted across western Canada over 3 yr from 2014 to 2016. Results showed that seeding a tall cultivar at a high seeding rate in early May combined with an in‐crop herbicide application increased crop establishment by 210 plants m−2. This in turn increased aboveground crop biomass and seed yield by as much as 549 and 617 kg ha−1, respectively. This combination of factors significantly reduced aboveground weed biomass by 50 kg ha−1, although no single factor or combination of factors affected weed seed fecundity. By seeding competitive flax cultivars at higher rates earlier in the growing season, and by combining this with an in‐crop herbicide, producers can develop sound cropping systems that provide more competitive flax crops and another profitable cropping option.