bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishing an ECMO program in a developing country: challenges and lessons learned
Authors: Assy Jana , Skouri Hadi , Charafeddine Lama , Majdalani Marianne , Younes Khaled , Bulbul Ziad , Sfeir Pierre , Bourgi Jamil , Hallal Ali , Rifai Khaled , Zaatari Rafika , Bitar Fadi , Rassi Issam El 
Published: March 2019

Aim: The ECMO (extracorporeal membrane oxygenation) Program at the American University of Beirut Medical Center was established in November 2015 as the first program serving adult and pediatric population in a low-resource setting. The aim of the study is to describe the challenges faced during the establishment of the program and factors leading to its success. Methods: The program establishment is described. The preparation phase, included the strategic, financial, and clinical planning by administration, nursing, and a multidisciplinary team of physicians. The training and education phase included all the involved nurses, perfusionists, and physicians. Concerns were heard from various stakeholders, and the challenges were analyzed and discussed. Results: The preparation committee chose the adequate equipment, responded to the concerns, defined roles and responsibilities through credentialing and privileging, wrote policies and protocols, and established a strategy to decide for the ECMO indication. Selected team of nurses, physicians, and perfusionists are identified and trained locally, and abroad. A full-time ECMO physician was recruited to launch the program. Twelve patients (6 adults, 3 children, and 3 neonates) were supported by ECMO, for cardiac and respiratory indications. Eleven patients were supported by veno-arterial ECMO, and 1 patient (a neonate) with veno-venous ECMO. Overall, 75% survived to decannulation and 41% survived to discharge. Conclusion: With limited human and financial resources, new ECMO centers need to carefully establish selection criteria that may differ from those used in developed countries. Indications should be discussed on a case by case basis, taking into account clinical, social, and financial issues. This experience might help other institutions in developing countries to build their own program despite financial and human limitations.
In Vivo Glenoid Track Width Can Be Better Predicted With the Use of Shoulder Horizontal Extension Angle
Authors: Kawakami Jun , Yamamoto Nobuyuki , Etoh Toshimitsu , Hatta Taku , Mineta Mitsuyoshi , Itoi Eiji , Isawa Ryohei 
Published: March 2019

Background: The glenoid track concept has been widely used to assess the risk of instability caused by a bipolar lesion. The mean glenoid track width is reported to be 83% of the glenoid width. However, this width seems to be affected by the range of motion of the shoulder. By clarifying the relationship between the range of shoulder motion and the glenoid track width, a more precise determination of the glenoid track width for each individual could be possible. Purpose: To determine the relationship between the glenoid track width and the range of motion of healthy volunteers. Study Design: Descriptive laboratory study. Methods: Magnetic resonance imaging was taken in 41 shoulders of 21 healthy volunteers (mean age, 32 years) with the arm in maximum horizontal extension, with the arm kept in 90° of abduction and 90° of external rotation. Three-dimensional surface bone models of the glenoid and the humerus were created with image analysis software. The distance from the anterior rim of the glenoid to the medial margin of the footprint of the rotator cuff tendon was defined as the glenoid track width. Active and passive ranges of shoulder motion were measured in the supine and sitting positions. The correlations between the glenoid track width and the ranges of shoulder motion were investigated with Pearson correlation coefficients. Intra- and interobserver reliabilities based on the intraclass correlation coefficient were also analyzed to assess the reliability of the glenoid track measurement. Results: The intra- and interobserver reliabilities for the glenoid track measurement were excellent (0.988 and 0.988, respectively). Among all the measurements, the glenoid track width and the active range of motion in horizontal extension in the sitting position showed the greatest correlation coefficient ( r = −0.623, P < .0001). A correlation between the glenoid track width and this angle was expressed as Y = −0.49 X + 90, where X is the horizontal extension angle (degrees) and Y is the glenoid track width (percentage of glenoid width). Conclusion: The present data demonstrate that the greater the horizontal extension angle in abduction and external rotation, the smaller the glenoid track width. An individualized glenoid track width can be obtained by measuring the active horizontal extension angle with the arm in abduction and external rotation in the sitting position. Clinical Relevance: An individualized glenoid track width enables selection of a more precise surgical option by the on-track/off-track concept.
The impact of warmed and humidified CO2 insufflation during robotic radical prostatectomy: Results of a randomized controlled trial
Authors: Oderda Marco , Cerutti Elisabetta , Gontero Paolo , Manetta Tilde , Mengozzi Giulio , Meyer Nicolas , Munegato Stefania , Noll Eric , Rampa Paola , Piéchaud Thierry , Diemunsch Pierre 
Published: March 2019

Background: Cool and dry gas insufflation during laparoscopy induces hypothermia and cytokine increase, with significant perioperative morbidity. Our aim was to assess if warmed and humidified CO2 insufflation with HumiGard™ device can achieve significant benefits over standard insufflation in terms of risk of hypothermia, cytokine response, blood gases, and intra- and postoperative parameters, in the setting of robot-assisted radical prostatectomy (RARP). Methods: This was a prospective, randomized controlled clinical trial. Sixty-four patients with prostate cancer undergoing RARP were randomized to receive warmed and humidified CO2 insufflation with HumiGard device, plus hot air warming blanket (treatment group, H + WB), or standard CO2 insufflation, plus hot air warming blanket (control group, WB). Body core temperature (BCT), plasma levels of IL-6 and TNF-α, pain scores, and intraoperative parameters were recorded. The data were analyzed according to the Bayesian paradigm. Results: Intraoperative BCT increased in both groups during surgery, with a statistically significant difference favoring group H + WB, ending at 0.2°C higher on average than group WB. No difference across groups was shown for cytokine levels. Blood gas parameters were not affected by warmed CO2 insufflation. No statistical differences were noted for pain scores and the other intra- and postoperative parameters. Conclusions: During RARP, warm and humidified CO2 insufflation with the HumiGard device was more effective than the standard CO2 insufflation in maintaining the patient’s heat homeostasis, even if the difference was minimal. No imbalances were detected on blood gas analyses. No benefit could be shown in terms of cytokine levels and pain scores.
Measurement of Preconception Health Knowledge: A Systematic Review
Authors: Cairncross Zoe F. , Ravindran Saranyah , Yoganathan Shaira , Dennis Cindy-Lee , Enders Joanne , Graves Lisa , Mill Catriona , Telner Deanna , Brown Hilary K. 
Published: March 2019

Objective:Preconception health is an important determinant of maternal, paternal, and infant outcomes. Knowledge is commonly used to evaluate the effectiveness of interventions to promote preconception health. Our objective was to examine how preconception health knowledge has been measured in the existing literature and to identify measurement gaps, biases, and logistical challenges.Data Source:MEDLINE, EMBASE, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, and gray literature were searched from database inception to January 2018.Study Inclusion and Exclusion Criteria:Studies were included if they measured preconception or interconception health knowledge and included reproductive-aged women and/or men.Data Extraction:Two independent reviewers completed data extraction and quality appraisal using standardized instruments.Data Synthesis:Due to measurement heterogeneity, a narrative synthesis was performed.Results:The review included 34 studies from 14 countries with data collected in 2000 to 2017. Most studies used cross-sectional (n = 24) or prepost designs (n = 7). Studies primarily sampled women (n = 25), and methodological quality was rated largely as weak (n = 18) or moderate (n = 14). Preconception health knowledge tools focused on fertility, folic acid, and alcohol, with few questions pertaining to men’s health, mental health, or the interconception period. Only 19 (56%) studies reported psychometric properties of their knowledge tools.Conclusions:This systematic review revealed the need for a valid and reliable knowledge tool that reflects a holistic conceptualization of preconception health.
Adverse Events and Their Risk Factors Following Intra-articular Corticosteroid Injections of the Ankle or Subtalar Joint
Authors: Anderson Sophia E. , Lubberts Bart , Strong Anne D. , Guss Daniel , Johnson A. Holly , DiGiovanni Christopher W. 
Published: March 2019

Background: Little data exists regarding the incidence of adverse events and their associated risk factors following intra-articular corticosteroid injection of the ankle and subtalar joint. The aim of this study was to determine the complication rate associated with such injections and to identify any predictive risk factors. Methods: Adult patients who had received an intra-articular ankle or subtalar joint injection between January 2000 and April 2016 at one of 3 regional hospitals (2 level 1 trauma centers and 1 community hospital) were included. Patients with prior intra-articular injection of corticosteroid into the ankle or subtalar joint were excluded. Explanatory variables were sex, age, race, body mass index, diabetes status, tobacco use, presence of fluoroscopic guidance, location of intra-articular injection, and administering physician’s years of experience. Results: Of the 1708 patients included in the final cohort, 99 patients (5.8%) had a total of 104 adverse events within 90 days postinjection. The most prevalent types of adverse events were postinjection flare in 78 patients (4.6% of total cohort, 75% of adverse events) followed by skin reaction in 10 patients (0.6% of total cohort, 9% of adverse events). No infections were noted. Multivariable logistic regression analysis found that intra-articular injection in the subtalar ( P = .004) was independently associated with development of an adverse event. Fluoroscopic guidance was not found to be protective of an adverse event compared to nonguided injections ( P = .476). Conclusion: The adverse event rate following intra-articular ankle or subtalar joint corticosteroid injection was 5.8%, with postinjection flare being the most common complication. Infections following injection were not reported. Injection into the subtalar joint was independently associated with the development of an adverse event after intra-articular corticosteroid injection, and this was not mitigated by the use of fluoroscopic guidance. Level of Evidence: Level III, retrospective comparative study.
Identifying Mobile Applications Aimed at Self-Management in People With Chronic Kidney Disease
Authors: Lewis Rachel A. , Lunney Meaghan , Chong Christy , Tonelli Marcello 
Published: March 2019

Background: A growing number of mobile applications (apps) target people with chronic illness as the primary user. There is increasing evidence that digital technology can improve health outcomes for users but the sheer number of apps available is likely to overwhelm many potential users. Objective: The purpose of this study was to systematically search for apps aimed at people with chronic kidney disease. An important secondary objective was to develop a search strategy that could be used to identify similar apps in the future. Design: A systematic review of the scientific and gray literature including app stores, clearinghouses, and Google. Setting/patients: The focus of this research was the identification of apps that may be of use to people interested in self-management of chronic kidney disease. Methods: Three reviewers independently searched app stores, websites, and databases to identify apps of potential interest and any information related to the function and efficacy of these. Apps that met the inclusion criteria were short-listed, reviewed in more detail, and cross-referenced with other sources such as clearinghouses, Google, and kidney care organizations. A population, intervention, comparison, outcome, and design framework was used to search selected databases. Results: Of the 1464 apps purporting to be for chronic kidney disease, only 15 were eligible for inclusion. Searching the 2 major app stores (iOS and Android) appeared to be the most productive way of identifying apps of potential interest. An increasing number of public and private clearinghouses have been established to assist users with finding apps. Privacy and security of user information is a particular and valid concern of health care professionals and organizations. Limitations: The breadth and depth of information relating to each app varied and made it difficult to systematize the evaluation of apps. Due to the large number of health care apps and the challenges to searching app stores and websites, it is possible that some apps were missed during our searches. Similarly, while there are many kidney care–related websites that contain useful information, these were not captured by our study. Conclusion: There are very few available apps aimed specifically at people with chronic kidney disease; those that are available are best identified by manually searching the 2 major app stores. Privacy and confidentiality of user information when using the apps is a concern among health care providers in particular.
“Come and live with my feet and you'll understand” – a qualitative study exploring the experiences of retail footwear in women with rheumatoid arthritis
Authors: Tehan Peta Ellen , Morpeth Trish , Williams Anita Ellen , Dalbeth Nicola , Rome Keith 
Published: March 2019

AbstractBackgroundFoot pain and deformity are common in people with rheumatoid arthritis (RA). Previous research has identified that women with RA seek retail footwear to alleviate their foot problems. The specific footwear features that women with RA require, and what would help them to find shoes that meet these requirements, are unknown. This study aimed to determine the factors that influence the choice of appropriate retail footwear by women with RA.MethodAn overarching qualitative approach was taken, using reflexive thematic analysis of conversational style interviews. The interviews explored experiences and use of retail footwear in 20 women with RA. The interviews were digitally recorded transcribed verbatim and analysed using a reflexive thematic framework.ResultsWomen with RA sought retail footwear which had adequate cushioning, width, a flexible sole, lightweight, were made from breathable materials and were easy to put on and take off. However, this choice was driven by the need for comfort, cost and usability, with aesthetics being less of a priority. Despite having opinions on what criteria they felt that they needed, these women did not feel empowered to make good choices about purchasing retail footwear for symptomatic relief. Furthermore, they did not receive the necessary support from podiatrists and shoe shop staff.ConclusionWomen with RA have clear ideas about what features a retail shoe should have to achieve comfort. There is a constant compromise between achieving comfort and their feelings about their appearance and how they feel others perceive them. Women with RA describe negative experiences with shoe shop assistants and podiatrists leading to poor footwear choices. Both retail staff and podiatrists need increased understanding about the particular problems that women with RA experience.
Geriatric Assessment Predicts Hospitalization Frequency and Long-Term Care Use in Older Adult Cancer Survivors
Authors: Williams Grant R. , Dunham Lisette , Chang YunKyung , Deal Allison M. , Pergolotti Mackenzi , Lund Jennifer L. , Guerard Emily , Kenzik Kelly , Muss Hyman B. , Sanoff Hanna K. 
Published: March 2019

PURPOSE: The association between geriatric assessment (GA)–identified impairments and long-term health care use in older cancer survivors remains unknown. Our objective was to evaluate whether a GA performed at cancer diagnosis was predictive of hospitalizations and long-term care (LTC) use in older adult cancer survivors. METHODS: Older adults with GA performed between 3 months before through 6 months after diagnosis were included (N = 125). Patients with Medicare Parts A and B coverage and no managed care were identified. Hospitalizations and LTC use (skilled nursing or assisted living) were assessed up to 5 years postdiagnosis. GA risk measures were evaluated in separate Poisson models estimating the relative risk (RR) for hospital and LTC visits, adjusting for age and Charlson comorbidity score. RESULTS: The mean age of patients was 74 years, and the majority were female (80%) and white (90%). Breast cancer (64%) and early-stage disease (stages 0 to III, 77%) were common. Prefrail/frail status (RR, 2.5; P < .001), instrumental activities of daily living impairment (RR, 5.47; P < .001), and limitations in climbing stairs (RR, 2.94; P < .001) were associated with increased hospitalizations. Prefrail/frail status (RR, 1.86; P < .007), instrumental activities of daily living impairment (RR, 4.58; P < .001), presence of falls (RR, 6.73; P < .001), prolonged Timed Up and Go (RR, 5.45; P < .001), and limitations in climbing stairs (RR, 1.89; P < .005) were associated with LTC use. CONCLUSION: GA-identified impairments were associated with increased hospitalizations and LTC use among older adults with cancer. GA-focused interventions should be targeted toward high-risk patients to reduce long-term adverse health care use in this vulnerable population.
Seaweeds to the rescue of forgotten diseases: a review
Authors: Freile-Pelegrín Yolanda , Tasdemir Deniz 
Published: March 2019

Abstract
Neglected tropical diseases (NTDs) are a group of diseases that are predominant in the poorest parts of the world affecting 1.4 billion people. The development of new drugs is urgently needed in order to combat these forgotten diseases. Natural products from marine organisms have been widely explored as a source of new bioactive molecules. However, despite their enormous potential in drug discovery, not even one seaweed-based molecule has entered pre-clinical testing for NTDs. This review gives an overview of the current status of algal natural products against NTDs. The list of compounds is by no means exhaustive, but covers the most important classes of active substances in marine algae against the most studied NTDs.
A question of audience: Laonikos Chalkokondyles’ Hellenism
Authors: Akışık-Karakullukçu Aslıhan 
Published: March 2019

Abstract
By focusing on the known details of Laonikos Chalkokondyles’ biography, on his relation to Byzantine historiographical tradition, by comparing his historical work to that of contemporary intellectuals living under the Ottomans as well as those in the west, examining his portrayal of Mehmed II, his adoption of a Herodotean model, the revival of Herodotus in the Renaissance more generally, and the reception of the ᾿Aπόδειξις in the fifteenth and sixteenth centuries, I argue that Laonikos was writing for an elite circle of Byzantine émigrés and other intellectuals with access to classical Greek in the west, rather than for the post- Byzantine intellectuals associated with the Ottoman court.
Local Level Decentralization in Ethiopia: Case Study of Tigray Regional State
Authors: Fiseha Assefa 
Published: March 2019

AbstractBased on the literature on decentralization, this article investigates the institutional arrangement and autonomy of local governments in Tigray Regional state. It is based on two rounds of field work covering nine districts. At a formal level, local governments are autonomous units with some defined mandates including power to decide on policy issues. In reality however, local governments in the study area act more as deconcentrated than as autonomous units since their autonomy is curtailed by higher level governments and party structures. Local governments are thus extension arms of the regional state with little autonomy of their own. Institutions such as elected councils, mayors and the executive exist at the local level but there is more vertical than horizontal accountability. As a result, local Councils have not been able to ensure accountability. Thus decentralization has not resulted in popular control of local governance and local-level development as interests of the party and the local political elite prevail over popular interests. The article calls for rethinking the design of local government that would constitute a local government deal that shifts decision-making away from higher level institutions to the local level, constituting multi-stake holders having control over the affairs of local government.
Application of Y.S. Lee’s General Theory of Law and Development to Botswana
Authors: Ghebremusse Sara 
Published: March 2019

Abstract
Botswana has achieved significant socio-economic development despite its low-income status in 1966 when colonial rule ended, earning it the status of an “African success story” and “African miracle”. Botswana’s development was achieved in great part to its abundance of natural resources (diamonds), in contrast to other African countries that displayed conditions affiliated with the “resource curse”: corruption, rent-seeking behaviour by the ruling class, Dutch disease, declining terms of trade, the absence of economic diversification, and even civil conflict. Despite its extensive coverage in political economy and development studies literature, Botswana’s socio-economic development has yet to be interrogated through a law and development lens. Yong-Shik Lee offers a theoretical framework to conduct such an analysis in his article, General Theory of Law and Development, which proposes that law directly impacts development through three categorical Regulatory Impact Mechanisms: regulatory design; regulatory compliance; and quality of implementation. This article applies Lee’s theory to Botswana, making it one of the first applications of Lee’s theory to an African case study.