bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prothrombin Complex Concentrate Reversal of Coagulopathy in Emergency General Surgery Patients
Authors: Younis Moustafa , Ray‐Zack Mohamed , Haddad Nadeem N. , Choudhry Asad , Hernandez Matthew C. , Wise Kevin , Zielinski Martin D. 
Published: February 2018

AbstractBackgroundCoagulopathy can delay or complicate surgical diseases that require emergent surgical treatment. Prothrombin complex concentrates (PCC) provide concentrated coagulation factors which may reverse coagulopathy more quickly than plasma (FFP) alone. We aimed to determine the time to operative intervention in coagulopathic emergency general surgery patients receiving either PCC or FFP. We hypothesize that PCC administration more rapidly normalizes coagulopathy and that the time to operation is diminished compared to FFP alone.MethodsSingle institution retrospective review was performed for coagulopathic EGS patients during 2/1/2008 to 8/1/2016. Patients were divided into three groups (1) PCC alone (2) FFP alone and (3) PCC and FFP. The primary outcome was the duration from clinical decision to operate to the time of incision. Summary and univariate analyses were performed.ResultsCoagulopathic EGS patients (n = 183) received the following blood products: PCC (n = 20, 11%), FFP alone (n = 119, 65%) and PCC/FFP (n = 44, 24%). The mean (± SD) patient age was 71 ± 13 years; 60% were male. The median (IQR) Charlson comorbidity index was similar in all three groups (PCC = 5(4–6), FFP = 5(4–7), PCC/FFP = 5(4–6), p = 0.33). The mean (± SD) dose of PCC administered was similar in the PCC/FFP group and the PCC alone group (2539 ± 1454 units vs. 3232 ± 1684, p =. 09). The mean (±SD) time to incision in the PCC alone group was significantly lower than the FFP alone group (6.0 ± 3.6 vs. 8.8 ± 5.0 h, p = 0.01). The mean time to incision in the PCC + FFP group was also significantly lower than the FFP alone group (7.1 ± 3.6 vs. 8.8 ± 5.0, p = 0.03). The incidence of thromboembolic complications was similar in all three groups.ConclusionsPCC, alone or in combination with FFP, reduced INR and time to surgery effectively and safely in coagulopathic EGS patients without an apparent increased risk of thromboembolic events, when compared to FFP use alone.Level of evidenceIV single institutional retrospective review.
Transplantation as disease modifying therapy in adults with inherited metabolic disorders
Authors: Sirrs Sandra , Hannah‐Shmouni Fady , Nantel Stephen , Neuberger James , Yoshida Eric M. 
Published: February 2018

AbstractTransplantation is an established disease modifying therapy in selected children with certain inherited metabolic diseases (IMDs). Transplantation of hematopoietic stem cells or solid organs can be used to partially correct the underlying metabolic defect, address life threatening disease manifestations (such as neutropenia) or correct organ failure caused by the disease process. Much less information is available on the use of transplantation in adults with IMDs. Transplantation is indicated for the same IMDs in adults as in children. Despite similar disease specific indications, the actual spectrum of diseases for which transplantation is used differs between these age groups and this is partly related to the natural history of disease. There are diseases (such as urea cycle defects and X‐linked adrenoleukodystrophy) for which transplantation is recommended for selected symptomatic patients as a treatment strategy in both adults and children. In those diseases, the frequency with which transplantation is used in adults is lower than in children and this may be related in part to a reduced awareness of transplantation as a treatment strategy amongst adult clinicians as well as limited donor availability and allocation policies which may disadvantage adult patients with IMDs. Risks of transplantation and disease‐specific prognostic factors influencing outcomes also differ with age. We review the use of transplantation as a disease modifying strategy in adults focusing on how this differs from use in children to highlight areas for future research.
Financial Impact of PEVAR Compared with Standard Endovascular Repair in Canadian Hospitals
Authors: Roche-Nagle Graham , Hazel Maureen , Rajan Dheeraj K. 
Published: February 2018

Objectives The percutaneous endovascular abdominal aortic repair (PEVAR) approach is a minimally invasive technique that has demonstrated clinical benefit over traditional surgical cut down associated with standard endovascular abdominal aortic aneurysm (AAA) repair (EVAR). The objective of our study was to evaluate the budget impact to a Canadian hospital of changing the technique for AAA repair from the EVAR approach to the PEVAR approach. Methods We examined the budget impact of replacing the EVAR approach with the PEVAR approach in a Canadian hospital that performs 100 endovascular AAA repairs annually. The model incorporates the costs associated with surgery, length of stay, and postoperative complications occurring within 30 days. Results The use of PEVAR in AAA repair is associated with increased access device costs when compared with the EVAR approach (CAD$1000 vs CAD$400). However, AAA repair completed with the PEVAR approach demonstrates reduced operating time (101 minutes vs 133 minutes), length of stay (2.2 days vs 3.5 days), time in the recovery room (174 minutes vs 193 minutes), and postoperative complications (6% vs 30%), which offset the increased device costs. The model establishes that switching to the PEVAR approach in a Canadian hospital performing 100 AAA repairs annually would result in a potential cost avoidance of CAD$245,120. Conclusions A change in AAA repair technique from EVAR to PEVAR can be a cost-effective solution for Canadian hospitals.
Coagulopathic side effect of L-asparaginase on fibrinogen level in childhood acute lymphoblastic leukemia during induction phase
Authors: Alqasim Alauldeen Mudhafar Zubair , Al-Hadithi Raji Hussein , Al-Khalidi Aseel Nashaat 
Published: February 2018

Background:
L-asparaginase is chemotherapeutic agent commonly used in treatment of Acute Lymphoblastic Leukemia. Thromboembolic and to a lesser extent bleeding events are serious complications associated with administration of this drug during the induction phase in ALL especially in children resulting from reduced synthesis of proteins such as Antithrombin & fibrinogen.

Objective:
Evaluation of the coagulopathic side effect of L-asparaginase during the induction phase in treatment of ALL in children by measuring fibrinogen levels before & after administration of this drug.

Subjects & method:
An interventional prospective study was performed on 30 newly diagnosed children with ALL, all of them received 9 cycles of L-asparaginase during the induction phase according to UKALL 2003 Protocol. Fibrinogen was measured before & after treatment with L-asparaginase and the results are compared to a control group of 30 healthy children age & sex matched.

Results:
Reduced fibrinogen level is observed in 13 out of 30 patients (43.3%) after treatment with L-asparaginase ranging from 25 to 110 mg/dl with means fibrinogen before & after treatment of 252 ± 16.40 mg/dl & 158.97 ± 17.88 mg/dl respectively (p < .0001).

Conclusion:
Significant reduction in fibrinogen level occurred in childhood ALL patients after treatment with L-asparaginase.
Ignorance Is Not Bliss: If We Don’t Understand Hypoactive Sexual Desire Disorder, How Can Flibanserin Treat It? Commentary
Authors: Anderson Ryan , Moffatt Claire E. 
Published: February 2018

Abstract

Background
Female sexual dysfunction (FSD) affects as many as 1 in every 3 women, with a significant portion of these with hypoactive sexual desire disorder (HSDD). These figures alone present significant psychological and pharmacologic challenges. Partly in response to this situation, in 2015 the US Food and Drug Administration approved flibanserin for the treatment of HSDD. This approval has drawn criticism on the grounds of efficacy and necessity.

Aim
To better inform potential consumers about FSD, flibanserin and other interventions for the treatment of HSDD, the importance of understanding the mechanism of FSD, and the efficacy of flibanserin and to review existing relevant knowledge.

Methods
A literature review of extant clinic studies and theoretical discussion articles was performed.

Outcomes
Efficacy of flibanserin for addressing symptoms associated with HSDD in premenopausal women.

Results
Extant literature and empirical evidence suggest that the efficacy of flibanserin for the treatment of HSDD in premenopausal women is at least questionable.

Clinical Translation
Clinicians considering the prescription of flibanserin would be well advised to appreciate some of the controversies concerning the efficacy of the drug.

Strengths and Limitations
The prohibitive usage guidelines, tenuous risk-benefit profile, and considerable cost of use of flibanserin are each worthy of consideration. Flibanserin thus far has been trialed in only a narrow patient range: premenopausal women in long-term relationships with acquired or generalized HSDD.

Conclusions
Although we acknowledge that the discovery and use of flibanserin constitute a compelling narrative, we conclude by questioning the specific efficacy and necessity of flibanserin in providing a treatment for HSDD in women.
Dose‐Response Effects of Tai Chi and Physical Therapy Exercise Interventions in Symptomatic Knee Osteoarthritis
Authors: Lee Augustine C. , Harvey William F. , Price Lori Lyn , Han Xingyi , Driban Jeffrey B. , Iversen Maura D. , Desai Sima A. , Knopp Hans E. , Wang Chenchen 
Published: February 2018

AbstractBackgroundTherapeutic exercise is a currently recommended nonpharmacological treatment for knee osteoarthritis (KOA). The optimal treatment dose (frequency or duration) has not been determined.ObjectiveTo examine dose‐response relationships, minimal effective dose, and baseline factors associated with the timing of response from 2 exercise interventions in KOA.DesignSecondary analysis of a single‐blind, randomized trial comparing 12‐week Tai Chi and physical therapy exercise programs (Trial Registry #NCT01258985).SettingUrban tertiary care academic hospitalParticipantsA total of 182 participants with symptomatic KOA (mean age 61 years; BMI 32 kg/m2, 70% female; 55% white).MethodsWe defined dose as cumulative attendance‐weeks of intervention, and treatment response as ≥20% and ≥50% improvement in pain and function. Using log‐rank tests, we compared time‐to‐response between interventions, and used Cox regression to examine baseline factors associated with timing of response, including physical and psychosocial health, physical performance, outcome expectations, self‐efficacy, and biomechanical factors.Main Outcome MeasuresWeekly Western Ontario and McMasters Osteoarthritis Index (WOMAC) pain (0‐500) and function (0‐1700) scores.ResultsBoth interventions had an approximately linear dose‐response effect resulting in a 9‐ to 11‐point reduction in WOMAC pain and a 32‐ to 41‐point improvement in function per attendance‐week. There was no significant difference in overall time‐to‐response for pain and function between treatment groups. Median time‐to‐response for ≥20% improvement in pain and function was 2 attendance‐weeks and for ≥50% improvement was 4‐5 attendance‐weeks. On multivariable models, outcome expectations were independently associated with incident function response (hazard ratio = 1.47, 95% confidence interval 1.004‐2.14).ConclusionsBoth interventions have approximately linear dose‐dependent effects on pain and function; their minimum effective doses range from 2‐5 weeks; and patient perceived benefits of exercise influence the timing of response in KOA. These results may help clinicians to optimize patient‐centered exercise treatments and better manage patient expectations.Level of EvidenceII
The Normative Justification of Integrative Stakeholder Engagement: A Habermasian View on Responsible Leadership
Authors: Patzer Moritz , Voegtlin Christian , Scherer Andreas Georg 
Published: February 2018

ABSTRACT:The transition from modern to postmodern society leads to changing expectations about the purpose and responsibility of leadership. Habermas’s social theory provides a useful analytical tool for understanding current societal transition processes and exploring their implications for the responsibility of business vis-à-vis society. We argue that integrative responsible leadership, in particular, can contribute to the reconciliation of business with societal goals. Integrative responsible leadership understood in a Habermasian way is not only a strategic endeavor but also a communicative endeavor. An essential part of integrative responsible leadership in light of the current societal transformation processes is the facilitation of discourses about a shared base of norms and values. This is exemplified alongside current societal developments like the European migration crisis or the emerging nationalist and fundamentalist movements in some countries. We specify how and when leadership should resort to communicative action and discuss the implications for leadership.
Capacity development and Indigenous social enterprise: The case of the Rirratjingu clan in northeast Arnhem Land
Authors: Spencer Rochelle , Brueckner Martin , Wise Gareth , Marika Bundak 
Published: February 2018

AbstractWith the widespread shift from models of welfare to business-led development, capacity development offers a useful lens from which to consider the emergence of Indigenous social enterprise as a business-led development approach. We explore capacity development from the international development literature and identify capacity development principles in the context of an Indigenous social enterprise in remote northeast Arnhem Land. Here, Aboriginal Australians continue to experience poverty and marginalisation. This paper provides an ethnographic example of the relationship between Indigenous social enterprise and capacity development. Identifying principles of capacity development in this rich context reveals the remit of the Indigenous social enterprise privileges environmental stewardship and cultural maintenance.
Current levels of gonorrhoea screening in MSM in Belgium may have little effect on prevalence: a modelling study
Authors: Buyze J. , Vanden Berghe W. , Hens N. , Kenyon C. 
Published: February 2018

AbstractThere is considerable uncertainty as to the effectiveness of Neisseria gonorrhoeae (NG) screening in men who have sex with men. It is important to ensure that screening has benefits that outweigh the risks of increased antibiotics resistance. We develop a mathematical model to estimate the effectiveness of screening on prevalence. Separable Temporal Exponential family Random Graph Models are used to model the sexual relationships network, both with main and casual partners. Next, the transmission of Gonorrhoea is simulated on this network. The models are implemented using the R package ‘statnet’, which we adapted among other things to incorporate infection status at the pharynx, urethra and rectum separately and to distinguish between anal sex, oral sex and rimming. The different screening programmes compared are no screening, 3.5% of the population screened, 32% screened and 50% screened. The model simulates day-by-day evolution for 10 years of a population of 10 000. If half of the population would be screened, the prevalence in the pharynx decreases from 11.9% to 10.2%. We conclude that the limited impact of screening on NG prevalence may not outweigh the increased risk of antibiotic resistance.
Short periods of darkness fail to restore visual or neural plasticity in adult cats
Authors: HOLMAN KAITLYN D. , DUFFY KEVIN R. , MITCHELL DONALD E. 
Published: February 2018

AbstractIt has been shown that the visual acuity loss experienced by the deprived eye of kittens following an early period of monocular deprivation (MD) can be alleviated rapidly following 10 days of complete darkness when imposed even as late as 14 weeks of age. To examine whether 10 days of darkness conferred benefits at any age, we measured the extent of recovery of the visual acuity of the deprived eye following the darkness imposed on adult cats that had received the same early period of MD as used in prior experiments conducted on kittens. Parallel studies conducted on different animals examined the extent to which darkness changed the magnitude of the MD-induced laminar differences of the cell soma size and immunoreactivity for the neurofilament (NF) protein in the dorsal lateral geniculate nucleus (dLGN). The results indicated that 10 days of darkness imposed at one year of age neither alleviated the acuity loss of the deprived eye induced by an earlier period of MD nor did it decrease the concurrent lamina differences of the soma size or NF loss in the dLGN.
Melanopsin expression in the cornea
Authors: DELWIG ANTON , CHANEY SHAWNTA Y. , BERTKE ANDREA S. , VERWEIJ JAN , QUIRCE SUSANA , LARSEN DELAINE D. , YANG CINDY , BUHR ETHAN , VAN GELDER RUSSELL , GALLAR JUANA , MARGOLIS TODD , COPENHAGEN DAVID R. 
Published: February 2018

AbstractA unique class of intrinsically photosensitive retinal ganglion cells in mammalian retinae has been recently discovered and characterized. These neurons can generate visual signals in the absence of inputs from rods and cones, the conventional photoreceptors in the visual system. These light sensitive ganglion cells (mRGCs) express the non-rod, non-cone photopigment melanopsin and play well documented roles in modulating pupil responses to light, photoentrainment of circadian rhythms, mood, sleep and other adaptive light functions. While most research efforts in mammals have focused on mRGCs in retina, recent studies reveal that melanopsin is expressed in non-retinal tissues. For example, light-evoked melanopsin activation in extra retinal tissue regulates pupil constriction in the iris and vasodilation in the vasculature of the heart and tail. As another example of nonretinal melanopsin expression we report here the previously unrecognized localization of this photopigment in nerve fibers within the cornea. Surprisingly, we were unable to detect light responses in the melanopsin-expressing corneal fibers in spite of our histological evidence based on genetically driven markers and antibody staining. We tested further for melanopsin localization in cell bodies of the trigeminal ganglia (TG), the principal nuclei of the peripheral nervous system that project sensory fibers to the cornea, and found expression of melanopsin mRNA in a subset of TG neurons. However, neither electrophysiological recordings nor calcium imaging revealed any light responsiveness in the melanopsin positive TG neurons. Given that we found no light-evoked activation of melanopsin-expressing fibers in cornea or in cell bodies in the TG, we propose that melanopsin protein might serve other sensory functions in the cornea. One justification for this idea is that melanopsin expressed inDrosophilaphotoreceptors can serve as a temperature sensor.
Conservation implications of spatial genetic structure in two species of oribatid mites from the Antarctic Peninsula and the Scotia Arc
Authors: van Vuuren Bettine Jansen , Lee Jennifer E. , Convey Peter , Chown Steven L. 
Published: February 2018

AbstractMitochondrial and nuclear sequence data from two Antarctic ameronothroid mites, Halozetes belgicae and Alaskozetes antarcticus, were used to address three key questions important for understanding both the evolution of biodiversity and its future conservation in the Antarctic Peninsula Region: i) Do populations of mites across the Antarctic Peninsula and Scotia Arc constitute distinct genetic lineages? ii) What implications does the spatial genetic structure in these species have for current understanding of the region’s glacial history? iii) What are the conservation implications of these findings? Our results indicate that both mite species have been present in the Antarctic since at least the Pliocene. At the regional scale, both species are comprised of a number of divergent, but sympatric, lineages that are genetically as distinct as some species within the genera Halozetes and Alaskozetes. At the local scale, complex structure suggests limited and stochastic post-Holocene dispersal. For both species, considerable spatial genetic structure exists across the region, similar to that found in other terrestrial invertebrates. These results support the implementation of stringent biosecurity measures for moving between the Scotia Arc islands and the Antarctic Peninsula, and throughout the latter, to conserve both evolutionary history and future evolutionary trajectories.
Towns in Victorian England and Wales: a new classification
Authors: SMITH HARRY , BENNETT ROBERT J. , RADICIC DRAGANA 
Published: February 2018

ABSTRACT:This article describes the creation of a new urban classification based on the 1891 census of England and Wales. It is the first attempt to use the recently available electronic version of the census (I-CeM) to classify all large towns in late Victorian England and Wales on their economic structure. Where previous scholars were restricted by the form of occupation data contained in the published census reports, I-CeM allows manipulation of the data in order to aggregate urban units and examine their occupational structures in great detail. The classification is then used to compare key socio-economic characteristics of different towns.
Chronic disease burden predicts food insecurity among older adults
Authors: Jih Jane , Stijacic-Cenzer Irena , Seligman Hilary K , Boscardin W John , Nguyen Tung T , Ritchie Christine S 
Published: February 2018

AbstractObjectiveIncreased out-of-pocket health-care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of the present study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity.DesignSecondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Study (HCNS) linked to the 2012 nationally representative HRS.SettingUSA.SubjectsRespondents of the 2013 HRS HCNS with household incomes <300 % of the federal poverty line (n 3552). Chronic disease burden was categorized by number of concurrent chronic conditions (0–1, 2–4, ≥5 conditions), with multiple chronic conditions (MCC) defined as ≥2 conditions.ResultsThe prevalence of food insecurity was 27·8 %. Compared with those having 0–1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2–4 conditions being 2·12 (95 % CI 1·45, 3·09) and for those with ≥5 conditions being 3·64 (95 % CI 2·47, 5·37).ConclusionsA heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.