bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of comorbid conditions on outcomes of hip and knee replacement surgery: a systematic review and meta-analysis
Authors: Podmore Bélène , Hutchings Andrew , van der Meulen Jan , Aggarwal Ajay , Konan Sujith 
Published: July 2018

ObjectiveTo systematically perform a meta-analysis of the association between different comorbid conditions on safety (short-term outcomes) and effectiveness (long-term outcomes) in patients undergoing hip and knee replacement surgery.DesignSystematic review and meta-analysis.MethodsMedline, Embase and CINAHL Plus were searched up to May 2017. We included all studies that reported data to allow the calculation of a pooled OR for the impact of 11 comorbid conditions on 10 outcomes (including surgical complications, readmissions, mortality, function, health-related quality of life, pain and revision surgery). The quality of included studies was assessed using a modified Newcastle-Ottawa Scale. Continuous outcomes were converted to ORs using the Hasselblad and Hedges approach. Results were combined using a random-effects meta-analysis.OutcomesThe primary outcome was the adjusted OR for the impact of each 11 comorbid condition on each of the 10 outcomes compared with patients without the comorbid condition. Where the adjusted OR was not available the secondary outcome was the crude OR.Results70 studies were included with 16 (23%) reporting on at least 100 000 patients and 9 (13%) were of high quality. We found that comorbidities increased the short-term risk of hospital readmissions (8 of 11 conditions) and mortality (8 of 11 conditions). The impact on surgical complications was inconsistent across comorbid conditions. In the long term, comorbid conditions increased the risk of revision surgery (6 of 11 conditions) and long-term mortality (7 of 11 conditions). The long-term impact on function, quality of life and pain varied across comorbid conditions.ConclusionsThis systematic review shows that comorbidities predominantly have an impact on the safety of hip and knee replacement surgery but little impact on its effectiveness. There is a need for high-quality studies also considering the severity of comorbid conditions.
Revascularisation of left main stem disease: a prospective analysis of modern practice and outcomes in a non-surgical centre
Authors: Coughlan J J , Blake Nial , Chongprasertpon Napohn , Ibrahim Munir , Arnous Samer , Kiernan Thomas John 
Published: July 2018

PurposeIn this study, we sought to prospectively analyse the management and long term outcomes associated with revascularisation of left main stem disease via percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in our centre.MethodsThis prospective study enrolled all patients with unprotected left main stem disease undergoing revascularisation from January 2013 to June 2014. Baseline characteristics, hospital presentation and hospital stay length were collected. Patients were followed up at 1, 2 and 3 years. Primary outcomes of Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) were defined as death, Q wave myocardial infarction, stroke, repeat revascularisation and readmission within 30 days.Results56 patients with significant left main stem coronary artery disease were identified from the clinical registry. 27 patients underwent PCI (median age 67.7) and 29 CABG (median age 68.6). PCI patients had a higher surgical risk as measured by mean euroSCORE (4.95±5.8 vs 3.11±3.85). At 3 years, total MACCE occurred in 29.6% of the PCI cohort and 27.5% of the CABG cohort. Death occurred in three patients in the PCI group within the first 6 months. Death occurred in one patient in the CABG group over 2 years postprocedure. Two patients in the CABG cohort presented with Transient Ischemic Attacks (TIAs) at 2-year follow-up. At 3 years, revascularisation occurred in three patients in the PCI cohort. There were no revascularisation events in the CABG cohort.ConclusionsPCI with modern drug eluting stents is a reasonable treatment option for unprotected left main stem disease in a non surgical centre.
Low-Density Lipoprotein-Reactive T Cells Regulate Plasma Cholesterol Levels and Development of Atherosclerosis in Humanized Hypercholesterolemic Mice
Authors: Gisterå Anton , Klement Maria L. , Polyzos Konstantinos A. , Mailer Reiner K.W. , Duhlin Amanda , Karlsson Mikael C.I. , Ketelhuth Daniel F.J. , Hansson Göran K. 
Published: July 2018

Background:

Atherosclerotic cardiovascular disease is a chronic inflammatory process initiated when cholesterol-carrying low-density lipoprotein (LDL) is retained in the arterial wall. CD4
+
T cells, some of which recognize peptide components of LDL as antigen, are recruited to the forming lesion, resulting in T-cell activation. Although these T cells are thought to be proatherogenic, LDL immunization reduces disease in experimental animals. These seemingly contradictory findings have hampered the development of immune-based cardiovascular therapy. The present study was designed to clarify how activation of LDL-reactive T cells impacts on metabolism and vascular pathobiology.

Methods:
We have developed a T-cell receptor–transgenic mouse model to characterize the effects of immune reactions against LDL. Through adoptive cell transfers and cross-breeding to hypercholesterolemic mice expressing the antigenic human LDL protein apolipoprotein B-100, we evaluate the effects on atherosclerosis.

Results:
A subpopulation of LDL-reactive T cells survived clonal selection in the thymus, developed into T follicular helper cells in lymphoid tissues on antigen recognition, and promoted B-cell activation. This led to production of anti-LDL immunoglobulin G antibodies that enhanced LDL clearance through immune complex formation. Furthermore, the cellular immune response to LDL was associated with increased cholesterol excretion in feces and with reduced vascular inflammation.

Conclusions:
These data show that anti-LDL immunoreactivity evokes 3 atheroprotective mechanisms: antibody-dependent LDL clearance, increased cholesterol excretion, and reduced vascular inflammation.
How Much Purer is the Synopsis Purioris Theologiae (1625)?
Authors: Stanglin Keith D. 
Published: July 2018

Abstract
The claim implicit in the title of the Synopsis purioris theologiae is that there is a difference between the theological disputations at Leiden conducted before the Synod of Dordt and those conducted after it. This essay examines various possibilities for the nature and extent of this difference. After comparing the disputations with regard to large thematic elements, overall structure, and specific theological topics, it appears that the differences between the two sets of disputations are not as great as might be expected. One must go to hotly debated topics to find differences in the disputations. The Leiden theological handbooks that resulted from the cycles of disputations could, before Dordt, be inconsistent or even incoherent due to the theological diversity within the faculty. What was “purer” after Dordt was a faculty that, on the contested questions of the synod, was uniform in its teaching, a consistency reflected in its theological handbook.
Little lifesavers: Can we start first aid education in kindergarten? – A longitudinal cohort study
Authors: Bánfai Bálint , Pandur Attila , Schiszler Bence , Pék Emese , Radnai Balázs , Bánfai-Csonka Henrietta , Betlehem József 
Published: July 2018

Objectives: First aid programmes should include not only the transfer of knowledge and skills but also improve participants’ helping attitudes. The aim of this study was to evalute the immediate and long-term effects of a 3-day first aid programme for kindergarten children. Methods: One hundred and eighteen kindergarten children (5–7 years old) from an inner-city kindergarten located in Pécs, Hungary, were involved in this study between January 2016 and June 2017. Training consisted of three 45-minute sessions involving the transfer of theoretical knowledge and practical skills about first aid. Knowledge, skills and attitudes were assessed by means of a questionnaire developed for the study and through observation. Participants were tested before and immediately after the programme and at 4 and 15 months. Results: The majority of children had no prior knowledge in first aid. Knowledge and skills significantly improved immediately after training and remained significantly higher at 4 and 15 months when compared to baseline – calling the ambulance ( p < 0.01), performing cardiopulmonary resuscitation (CPR; p < .01), using an automated external defibrillator (AED; p < .01), handling an unconscious patient ( p < .01) and managing bleeding ( p < .01). Attitudes towards first aid improved significantly after the programme ( p < .01) and remained improved after 4 and 15 months when compared to baseline ( p < .01). Conclusion: Beginning first aid education in kindergarten can be useful. Children cannot become professional bystanders immediately following training, but the programme can offer an introduction of first aid. However, the results decreased substantially after 15 months so regular refreshing training should be recommended.
Digital Images in Academic Plastic Surgery: A Novel and Secure Methodology for Use in Clinical Practice and Research
Authors: Hallac Rami R. , Dumas Blaike M. , Seaward James R. , Herrera Royiel , Menzies Christopher , Kane Alex A. 
Published: July 2018

Background: Digital photographs have become an integral part in plastic and reconstructive surgery. They are significant in clinical research and outcome evaluation. There is a need for effective and secure methods to store, search, and retrieve those photographs. We developed a Health Insurance Portability and Accountability Act compliant searchable database to archive and index clinical information for clinical and research purposes. Methods: At our craniofacial clinic, digital media (2-D, 3-D, and 4-D photographs) are obtained on a regular basis to evaluate and document treatment outcomes. In addition, patients are asked to enroll in our institutional review board (IRB)-approved imaging database. Daily, we link all digital photographs to the patient encounter through EPIC’s Media Manager. This allows us to automatically identify and extract new digital media, patient demographics, diagnosis codes, relevant providers, and the text of the clinic notes to our digital database. To search our extensive database, we employed the VIEW search engine. Results: To date, our database contains more than 277 000 images of 11 000 patients where more than 1900 patients are enrolled in the IRB study. This search engine allows full-text search with query response time between 2 and 5 seconds. The search engine displays the returned through a web page interface, which includes image thumbnails and the relevant part of the clinic note. In addition, a patient-specific chart allows the user to examine all patient notes and photographs. Conclusion: Our solution allows providers and researchers to retrieve all digital media securely and efficiently.
High-risk chronic lymphocytic leukemia in the era of pathway inhibitors: integrating molecular and cellular therapies
Authors: Dreger Peter , Ghia Paolo , Schetelig Johannes , van Gelder Michel , Kimby Eva , Michallet Mauricette , Moreno Carol , Robak Tadeusz , Stilgenbauer Stephan , Montserrat Emili 
Published: July 2018

AbstractHigh-risk chronic lymphocytic leukemia (CLL) has been defined by clinical and/or genetic resistance (TP53 abnormalities) to treatment with chemoimmunotherapy (CIT). With the availability of pathway inhibitors (PIs), such as kinase inhibitors and BCL2 antagonists, the outlook of CIT-resistant patients has dramatically improved. Here, we propose a revision of the concept of high-risk CLL, driven by TP53 abnormalities and response to treatment with PI. CLL high-risk-I, CIT-resistant is defined by clinically CIT-resistant disease with TP53 aberrations, but fully responsive to PI. This category is largely the domain of PI-based therapy, and cellular therapy (ie, allogeneic hematopoietic cell transplantation) remains an option only in selected patients with low individual procedure-related risk. In CLL high-risk-II, CIT- and PI-resistant, characterized by increasing exhaustion of pharmacological treatment possibilities, cellular therapies (including chimeric antigen receptor-engineered T cells) should be considered in patients eligible for these procedures. Moreover, molecular and cellular therapies are not mutually exclusive and could be used synergistically to exploit their full potential.
Reduced-intensity conditioning for hematopoietic cell transplant for HLH and primary immune deficiencies
Authors: Allen Carl E. , Marsh Rebecca , Dawson Peter , Bollard Catherine M. , Shenoy Shalini , Roehrs Philip , Hanna Rabi , Burroughs Lauri , Kean Leslie , Talano Julie-An , Schultz Kirk R. , Pai Sung-Yun , Baker K. Scott , Andolina Jeffrey R. , Stenger Elizabeth O. , Connelly James , Ramirez Alyssa , Bryant Christopher , Eapen Mary , Pulsipher Michael A. 
Published: July 2018

Key PointsA prospective reduced-intensity HCT trial for HLH/primary immunodeficiency resulted in low early mortality and 1-year OS of 80%. Conditioning with fludarabine, melphalan, and alemtuzumab was associated with high rates of mixed chimerism and graft failure.
Noninvasive ventilation in acute respiratory failure: which recipe for success?
Authors: Scala Raffaele , Pisani Lara 
Published: July 2018

Noninvasive positive-pressure ventilation (NPPV) to treat acute respiratory failure has expanded tremendously over the world in terms of the spectrum of diseases that can be successfully managed, the locations of its application and achievable goals.The turning point for the successful expansion of NPPV is its ability to achieve the same physiological effects as invasive mechanical ventilation with the avoidance of the life-threatening risks correlated with the use of an artificial airway.Cardiorespiratory arrest, extreme psychomotor agitation, severe haemodynamic instability, nonhypercapnic coma and multiple organ failure are absolute contraindications for NPPV. Moreover, pitfalls of NPPV reduce its rate of success; consistently, a clear plan of what to do in case of NPPV failure should be considered, especially for patients managed in unprotected setting. NPPV failure is likely to be reduced by the application of integrated therapeutic tools in selected patients handled by expert teams.In conclusion, NPPV has to be considered as a rational art and not just as an application of science, which requires the ability of clinicians to both choose case-by-case the best “ingredients” for a “successful recipe” (i.e.patient selection, interface, ventilator, interface,etc.) and to avoid a delayed intubation if the ventilation attempt fails.
High efficacy of artemether–lumefantrine and dihydroartemisinin–piperaquine for the treatment of uncomplicated falciparum malaria in Muheza and Kigoma Districts, Tanzania
Authors: Mandara Celine I. , Kavishe Reginald A. , Gesase Samuel , Mghamba Janneth , Ngadaya Esther , Mmbuji Peter , Mkude Sigsbert , Mandike Renata , Njau Ritha , Mohamed Ally , Lemnge Martha M. , Warsame Marian , Ishengoma Deus S. 
Published: July 2018

AbstractBackgroundArtemether–lumefantrine (AL) is the recommended first-line artemisinin-based combination therapy (ACT) for the treatment of uncomplicated falciparum malaria in most of the malaria-endemic countries, including Tanzania. Recently, dihydroartemisinin–piperaquine (DP) has been recommended as the alternative anti-malarial to ensure effective case management in Tanzania. This study assessed the parasite clearance rate and efficacy of AL and DP among patients aged 6 months to 10 years with uncomplicated falciparum malaria in two sites with different malaria transmission intensity.MethodsThis was an open-label, randomized trial that was conducted at two sites of Muheza Designated District Hospital and Ujiji Health Centre in Tanga and Kigoma regions, respectively. Patients meeting inclusion criteria were enrolled, treated with either AL or DP and followed up for 28 (extended to 42) and 42 (63) days for AL and DP, respectively. Parasite clearance time was monitored in the first 72 h post treatment and the clearance rate constant and half-life were calculated using an established parasite clearance estimator. The primary outcome was parasitological cure on days 28 and 42 for AL and DP, respectively, while secondary outcome was extended parasitological cure on days 42 and 63 for AL and DP, respectively.ResultsOf the 509 children enrolled (192 at Muheza and 317 at Ujiji), there was no early treatment failure and PCR uncorrected cure rates on day 28 in the AL group were 77.2 and 71.2% at Muheza and Ujiji, respectively. In the DP arm, the PCR uncorrected cure rate on day 42 was 73.6% at Muheza and 72.5% at Ujiji. With extended follow-up (to day 42 for AL and 63 for DP) cure rates were lower at Ujiji compared to Muheza (AL: 60.2 and 46.1%, p = 0.063; DP: 57.6 and 40.3% in Muheza and Ujiji, respectively, p = 0.021). The PCR corrected cure rate ranged from 94.6 to 100% for all the treatment groups at both sites. Parasite clearance rate constant was similar in the two groups and at both sites (< 0.28/h); the slope half-life was < 3.0 h and all but only one patient cleared parasites by 72 h.ConclusionThese findings confirm high efficacy of the first- and the newly recommended alternative ACT for treatments for uncomplicated falciparum malaria in Tanzania. The high parasite clearance rate suggests absence of suspected artemisinin resistance, defined as delayed parasite clearance.Trial registrationThis trial is registered at ClinicalTrials.gov under registration number NCT02590627
Retention of Knowledge Levels of Health Care Providers in Cancer Screening Through Telementoring
Authors: Hariprasad Roopa , Arora Sanjeev , Babu Roshani , Sriram Latha , Sardana Sarita , Hanumappa Sudarshan , Mehrotra Ravi 
Published: July 2018

Purpose Every year > 450,000 individuals are diagnosed with cancer and approximately 350,000 die of it in India. The Ministry of Health and Family Welfare has released an Operational Framework for the Management of Common Cancers that highlights population-based cancer screening programs in primary health care facilities by health care providers (HCPs) and capacity building of HCPs. The purpose of this study is to present a low-cost training model that is highly suitable for resource-deficient settings, such as those found in India, through Extension for Community Health Outcome (ECHO), a knowledge-sharing tool, to enable high-quality training of HCPs. Materials and Methods An in-person, 3-day training program was conducted for 27 HCPs in the tribal primary health care center of Gumballi in Karnataka, India, to teach the basics of cancer screening in oral, breast, and cervical cancer. The training of HCPs was done using the ECHO platform while they implemented the cancer screening, thus enabling them to build the much needed knowledge and skill set to conduct cancer screening in their respective communities. Results The knowledge level of the HCPs was tracked before the intervention, immediately after the 3-day training program, and 6 months after the ECHO intervention, which clearly showed progressive acquisition and retention of knowledge. A marked improvement in knowledge level score from an average of 6.3 to 13.7 on a 15-point scale was noticed after the initial in-person training. The average knowledge further increased to a score of 14.4 after 6 months as a result of training using the ECHO platform. Conclusion ECHO is an affordable and effective model to train HCPs in cancer screening in a resource-constrained setting.
The Long Program for Ethics in Ethnobiology
Authors: Fowler Cynthia T. , Herron Scott 
Published: July 2018

Ethics is a core interest of practicing ethnobiologists and a function of healthy relationships between individuals, cultures, researchers, and the foci of study. Changing times and cultural identities require clear reflections among scientists and responsive interactions with the individuals and cultures who work with ethnobiologists. This Ethnobiology Letters special issue, “Ethics in Ethnobiology,” explores the diverse ways in which intentional conversations about ethics guide us as we encounter unforeseen circumstances and witness changing values in ourselves as well as our collaborators. Moreover, by integrating the ethics of diverse interlocutors into their own research endeavors, these authors illustrate how ethnobiologists listen deeply to the values of their research collaborators.
Patrząc na Wschód: Unia Europejska wobec niestabilnego wschodniego sąsiedztwa
Authors: STĘPNIEWSKI TOMASZ 
Published: July 2018

Niniejszy artykuł – w sposób bardzo skrótowy – analizuje politykę Unii Europejskiej wobec wschodnich sąsiadów. W pierwszej kolejności ukazano sytuację UE (kryzysy, z jakimi boryka się Wspólnota), a następnie zaprezentowano sytuację państw wschodniego sąsiedztwa (przez pryzmat polityki Partnerstwa Wschodniego), z położeniem nacisku na tzw. kryzys ukraiński. Kryzys ukraiński, de facto trwający konflikt zbrojny Rosji z Ukrainą, powoduje, że zmianie uległa nie tylko sytuacja geopolityczna Europy Wschodniej, ale również warunki, w jakich realizowana jest polityka wschodnia Unii Europejskiej. Inaczej mówiąc, agresja Rosji na Ukrainę spowodowała, że UE znalazła się w bardzo trudnej sytuacji i zmuszona została do zmiany swej polityki względem Rosji. Projekt Partnerstwa Wschodniego Unii Europejskiej jest projektem długoterminowym i w takich kategoriach powinien być postrzegany. Należy również pamiętać, że wśród państw członkowskich Unii Europejskiej występują państwa przeciwne, obojętne lub sojusznicze w odniesieniu do polityki wschodniej Unii Europejskiej, w tym do inicjatywy Partnerstwa Wschodniego.
A Resistivity Survey of Phosphate Nodules in Oshoshun, Southwestern Nigeria
Authors: Sanuade Oluseun Adetola , Olaojo Abayomi Adesola , Akanji Adesoji Olumayowa , Oladunjoye Michael Adeyinka , Omolaiye Gabriel E. 
Published: July 2018

Abstract
This geophysical study was carried out to determine the occurrence of phosphate nodules in the Oshoshun Formation of the Dahomey Basin, Southwestern Nigeria. The electrical resistivity method, comprising 1D vertical electrical sounding (VES; using Schlumberger array) and 2D geoelectrical imaging (using Wenner array), was used to determine the nature and depth of occurrence of the phosphate nodules. Six profile lines were established within the study area, and inverted sections were generated from the apparent resistivity data using DIPRO inversion algorithm. Five VES points were also acquired in the study area, and Win- Resist programme was used to process and interpret the field resistivity data. Four pits were dug along the profiles to verify the interpreted results. The results obtained by both techniques reveal similar geoelectric units: the top soil, clay, clayey sand and clay at different depths. These layers host pockets of phosphate nodules (78-≥651 Ωm) with varying thicknesses. The strong correlation between the lithology profiles obtained from the pits and the interpreted results of the inverted apparent resistivity sections demonstrates the efficacy of the electrical resistivity method in characterising phosphate occurrence within the formation.