bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Various Cycling Regimens on Phosphorus Removal in Chronic Peritoneal Dialysis Patients
Authors: Juergensen P. , Eras J. , Mcclure B. , Kliger A.S. , Finkelstein F.O. 
Published: January 2018

Background The National Kidney Foundation Dialysis Outcome Quality Initiative clinical practice guidelines have suggested that serum phosphate levels be maintained at ≤ 5.5 mg/dL in patients maintained on dialysis. Over 45% of anuric patients maintained on CAPD have serum phosphate levels > 5.5 mg/dL. The present study was designed to address the question whether phosphate removal could be enhanced by increasing the dialysate volume during cycler peritoneal dialysis therapy. Methods Medically stable patients maintained on chronic peritoneal dialysis therapy, who were high or high-average transporters and had serum phosphate levels ≥ 5.5 mg/dL, were invited to participate in the study. The protocol involved measuring phosphate and creatinine clearances at weekly intervals on three different cycler prescriptions consisting of 7 and 12 full cycles or 24 cycles with 50% tidal PD (TPD) over 9 hours. Ten patients agreed to participate. Those patients (n=7) with a BMI > 22 had 2 liter (L) fill volumes and 14 L of total dialysate (7 cycles of 2 L) or 24 L total dialysate (12 cycles of 2 L or 50% TPD with 24 cycles). The patients (n=3) with a BMI & 20 had 1.2 L fill volumes and 8.4 L total dialysate (7 cycles) or 14.4 L total dialysate (12 cycles of 1.2 L or 50% TPD with 24 cycles). Results The mean age (± SD) of the study patients was 50.8 (± 9.3) years. There were 6 females, 6 Caucasians and 4 African-Americans. The mean weight of the patients was 71.5 (± 24.2) kg and mean height 1.65 (+ 7.6) meters. The mean BMI was 18.3 (± 1.27) in the < 20 BMI group and 30.3 (± 6.6) in the > 22 BMI group. The mean phosphate clearance (L/night/1.73m2) increased from 3.96 (± 1.16) with 7 cycles to 4.71 (+ 1.81) with 12 cycles and 4.51 (± 1.61) with 50% TPD. Creatinine clearance (L/night/1.73m2) was 4.74 (± 1.74) with 7 cycles, 6.06 (± 2.04) with 12 cycles and 5.61 (± 2.01) with TPD. Conclusion The present study indicates that there is a significant, 19% (P & 0.005) rise in phosphate clearance by increasing dialysate volume 71% from 7 cycles to 14 cycles compared to a 27% increase in creatinine clearance. With tidal PD, phosphate clearance increased by 12% (p=NS) and creatinine clearance increased 18 % (p, 0.02). This increase in phosphate clearance translates into & 50 mg net phosphate removal in 9 hours, assuming a serum phosphate of 6 mg/%. Thus, increasing dialysis cycles and volume results in only a minimal increase in net phosphate removal.
Imaging Work-Up for Peritoneal Access Care and Peritoneal Dialysis Complications
Authors: Scanziani R. , Pozzi M. , Pisano L. , Barbone G. Santagostino , Dozio B. , Rovere G. , Gabella P. , Magrì F. 
Published: January 2018

Peritoneal dialysis (PD) represents a treatment opportunity for patients with end-stage renal failure, but it has particular complications that sometimes force cessation of this procedure (1–9). These complications are due to the presence of the peritoneal catheter and of dialysis solution within the peritoneal cavity. Infections are the most common complications of PD, followed by mechanical complications. Diagnostic imaging of the complications of PD is important because such an evaluation can aid in the diagnosis and in the decision making process about the treatment. In this review we present the main radiologic investigations employed: plain radiograph, US, peritoneography, computed tomography peritoneography, magnetic resonance peritoneography, peritoneal scintigraphy. To diagnose catheter-related problems plain radiograph, ultrasonography and peritoneography can be useful. US is useful in diagnosing and following-up exit-site and tunnel infections. Peritoneography and C T-peritoneography, alone or in combination, can be recommended as gold standard investigation to assess mechanical peritoneal dialysis complications, such as catheter malfunction, leaks, hernias and sclerosing peritonitis. Newer methods, such as MR peritoneography or scintigraphy could be useful in selected patients, on center-based experience. An appropriate use of radiology may significantly improve technique survival, morbidity and mortality of patients treated with PD.
Molecular Adsorbent Recirculating System (MARS) Application in Liver Failure: Clinical and Hemodepurative Results in 22 Patients
Authors: Stefoni S. , Colì L. , Bolondi L. , Donati G. , Ruggeri G. , Feliciangeli G. , Piscaglia F. , Silvagni E. , Sirri M. , Donati G. , Baraldi O. , Soverini M.L. , Cianciolo G. , Boni P. , Patrono D. , Ramazzotti E. , Motta R. , Roda A. , Simoni P. , Magliulo M. , Borgnino L.C. , Ricci D. , Mezzopane D. , Cappuccilli M.L. 
Published: January 2018

Purpose Acute liver failure (ALF) and acute on chronic liver failure (ACLF) still show a poor prognosis. MARS was used in 22 patients with ALF or ACLF to prolong patient survival for liver function recovery or as a bridge to transplantation. Design Evaluation of depurative efficiency, biocompatibility, hemodynamics, encephalopathy (HE) and clinical outcome. Procedures During 71 five-hour sessions we evaluated (0′, 60′, 120′, 180′, 240′, 300′): bilirubin, ammonia, cholic acid (CCA), chenodeoxycholic acid (CCDCA), leukocytes, platelets, hemoglobin and mean arterial pressure (MAP). Serum creatinine, electrolytes, cardiac output, cardiac index (bioimpedence) and HE (West Haven Criteria score) were evaluated at 0' and 300′. Statistical methods and outcome measures: Student's t-test for pre- vs. end-session values was used. For bilirubin and ammonia the correlation test was made between pre- and end-session values and between pre-session values and removal rates (RRS). Main Findings Survival was 90.9% at 7 days, 40.9% at 30 days. Pre- vs. end-session: bilirubin from 37.2±12.5 mg/dL to 24.9±8.9 mg/dL (p<0.01), ammonia from 88.0±60.4 μmol/L to 43.6±32.9 μmol/L (p<0.01), CCA from 42.8±21.0 μmol/L 18.2±9.8 μmol/L (p<0.01), CCDCA from 26.3±6.3 μmol/L to 15.7±7.6 μmol/L (p<0.01). The correlation test between pre-session values of bilirubin and ammonia vs. RRS was respectively 0.32 (p=0.01) and 0.30 (p=0.04). Leukocytes, platelets and hemoglobin remained stable. MAP increased from 82.0±12.0 mmHg to 87.0±13.0 mmHg (p<0.05), West Haven Criteria score decreased from 2.7±0.7 to 0.7±0.7 (p<0.001). Conclusion MARS treatment led in all patients to an improvement of clinical, hemodynamic and neurological conditions, with significant reduction in the hepatic toxins blood level. Treatment biocompatibility and tolerance were satisfactory
Model Based Study on Monitoring Ketone Bodies to Improve Safety in Intensive Insulin Therapy
Authors: Fabietti P.G. , Canonico V. , Orsini Federici M. , Sarti E. , Massi Benedetti M. 
Published: January 2018

Aim The present study explores new signals (capillary 3βhydroxybutyrate - 3 βOHB) for improving the safety of a closed loop insulin infusion system (external wearable artificial pancreas). Methods Data collected during a clinical trial on diabetic subjects including a period of insulin deprivation were interpreted through mathematical models to simulate the effect of monitoring ketone bodies (capillary 3βOHB, KB) compared to blood glucose in subjects on Continuous Subcutaneous Insulin Infusion (CSII) treatment. Results The estimation of model coefficients satisfactorily fits experimental data. The evaluation of dynamic changes of capillary 3βOHB levels showed a more rapid response than blood glucose. Conclusions The effect of the combination of monitoring of glucose and ketone bodies can consistently improve the safety and efficacy of the use of a closed loop system for glycemic control in dangerous situations like ketoacidosis. If a subcutaneous glucose-ketone bodies sensor were to become available in the near future it would be a key component of an external artificial pancreas.
Uremic Pruritus
Authors: Kosmadakis G.C. , Zerefos N. 
Published: January 2018

Renal itch is a localized or generalized itch, affecting patients with chronic renal failure, where there is no primary skin disease and no systemic or psychological dysfunction that might cause pruritus. Uremic pruritus (UP) is an unpleasant sensation, rarely appearing in earlier stages of chronic kidney disease. Renal transplantation is the definite solution for that problem. The prevalence of UP has been reduced during the last years, possibly, due to a more efficient dialysis, with more biocompatible filters. During the last decades a big number of substances were considered to be etiologic factors of UP, and an even bigger number of therapeutic substances appeared with promising potentials and conflicting results in the course of their use. The main reason for this disorientation is the lack of sound evidence on the pathogenetic mechanisms that may potentiate UP. ‘Inflammatory’ and ‘opioid’ hypothesis are the best studied and the reduction of UP is a fact. Nevertheless the mechanisms of the pathogenesis of UP are still under investigation and a long way has to be done in order to achieve more definite results.
Influence of Different Growth Factors on Chondrogenic Differentiation of Adipose-Derived Stem Cells in Polyurethane-Fibrin Composites
Authors: Froelich Katrin , Setiawan Lydia E. , Technau Antje , Ramos Tirado Mario , Hackenberg Stephan , Hagen Rudolf , Staudenmaier Rainer , Kleinsasser Norbert H. 
Published: January 2018

Introduction Chondrogenic differentiation of adipose-derived stem cells (ASCs) has proven to be feasible. To compensate for laryngeal palsy or cartilage defects after surgery or trauma using tissue engineering, a formable and stable scaffold material is mandatory. Methods ASCs were seeded in fibrin-polyurethane scaffolds and cultured in chondrogenic differentiation medium adding the growth factors TGF-□1, TGF-□3, and BMP-2 for up to 35 days. Results Histological examination showed acid glycosaminoglycans in the extracellular matrix in all groups. Immunofluorescence presented positive staining for collagen II, aggrecan, and SOX-9 in the TGF-□1–, TGF-□3–, and BMP-2-group. With Real-time PCR analyses, chondrogenic differentiation became apparent by the expression of the specific genes COL2A1 (collagen II), AGC 1 (aggrecan), and SOX-9, whereas collagen II expression was low in all groups compared to bone marrow-derived stem cells (BMSC) due to reduced chondrogenic ability. Conclusions These findings demonstrate the general ability of ASCs to differentiate into matrix-producing chondrocytes in fibrin-polyurethane scaffolds. However, further experiments are necessary to enhance this chondrogenic potential of ASCs seeded in fibrin-polyurethane scaffolds in order to produce a suitable regeneration method for treating cartilage defects or an implantable medialization material for vocal cord palsy.
Economic evaluation of R&D investment in natural resource management
Authors: Chudleigh Peter , Simpson Sarah , Schofield Nick 
Published: January 2018

An approach is presented for evaluating in economic terms the investment made by a publicly funded natural resource management research and development (R&D) funding organisation (Land & Water Australia) over its 16-year life. The approach combines qualitative methods to describe research investments and their outputs, outcomes and benefits with conventional cost-benefit analyses that produce measures of the worth of the investment. While the major driver of such an approach is the need for accountability to the Australian Government, co-funders and the public, a number of other objectives are being met also. Benefits to the organisation are accruing, including a better understanding of the factors that contribute to a successful investment and how to communicate the benefits of research to stakeholders. One of the important strengths of the process is the consistency of application of a standardised approach to cost-benefit analyses and the transparency of the analyses that have now addressed 28 separate case studies. The approach is flexible, is conducive to updating information over time, and recognises many of the difficulties involved in applying investment analysis to R&D investment. The development of the process has adopted a continuous improvement philosophy.
Youth participation in evaluation
Authors: Leger Pam St , Bell Catherine 
Published: January 2018

This study reports on the evaluation of two Australian educational initiatives that involved a high degree of youth participation in the evaluation process. Both evaluations involved capturing youth perspectives through photographic portfolios as one of the data collection methods, in order to portray young people's understandings of the relationship between leadership and the potential to create change in their communities. The article describes two initiatives: r.u.MAD?, a youth philanthropic program, and the Glenormiston Leadership Pilot Program for Year 9 students, and provides a brief overview of the evaluation findings in relation to each initiative. The main findings of the r.u.MAD? evaluation were that students and their teachers believed that the r.u.MAD framework had enabled them to make significant differences in their school environments or local communities and that links with local communities were strengthened. Students also reported that their experiences in r.u.MAD? projects had given them increased organisational and leadership skills. The main findings of the evaluation of the Glenormiston Leadership Pilot Program were that the rural setting and proximity to the sea provided a rich site for leadership program for Year 9 students, particularly those who had grown up in Melbourne. The evaluation also found that the program model was effective in terms of developing skills in leadership and independent learning. The article also explores some of the issues and challenges that surround youth participation in the evaluation of educational programs that have a strong leadership and empowerment focus. In addition, some comments are made about the use of photographs as an evaluation strategy.
Challenges Faced when Evaluating the Jalaris Kids Future Club
Authors: Haviland Maya , Pillsbury With James 
Published: January 2018

Jalaris Aboriginal Corporation in Western Australia was established in 1994 to look after the needs of an Aboriginal community. The organisation's most recent project is the ‘Kids Future Club’, an after-school activities program. Jalaris has a history of evaluating their work using a participatory action research approach, but decided to approach evaluation of the Kids Future Club in a slightly different way. This article discusses the reasons for the changed approach, the efforts made to develop culturally appropriate tools for data collection, and the challenges encountered in undertaking evaluation of outcomes for individual children in the context of Jalaris and their Aboriginal community. The tensions between ethical approaches to working within the Aboriginal kinship network and undertaking evaluation that required detailed observation and data collection of individuals proved to be irreconcilable for Jalaris. Lessons learnt from this evaluation process may inform future efforts to evaluate Aboriginal community initiatives.
Why We Should Focus on Understanding the Individual in Evaluation
Authors: Kushner Saville 
Published: January 2018

This article1 is drawn from the work of Barry MacDonald and is written as a tribute to him. It addresses an issue he raised some while ago whose relevance intensifies today in a world seeing the demise of independent professional practice and public sector ethos. The ‘portrayal of persons’ relates to a paper MacDonald wrote in 1976 (MacDonald 1976), at a time when the discipline and the practice of evaluation was in rapid emergence and development. He was arguing forcefully that to understand innovation we have to understand innovators. This was not a new message. It had been enunciated elsewhere, including by Schwab (1978) and Schön (1971) whose work revealed individualism, values and exchange as key elements of innovation. But what MacDonald added was a political dimension: using the portrayal of persons to share control of the evaluation by passing responsibilities for interpretation (generalisation) to the evaluand; and by empowering the organisation by enhancing knowledge of itself (for example, against attempts to enforce external values on professional action through external accountability). The rationale was the same as that for case study evaluation: to ground generalisations in the experience of the practitioners and to shape evaluation around issues and dilemmas encountered in their practices. This inevitably leads to working with small samples (cases) but not losing the aim of deriving broad generalisation. This was the key methodological principle that provoked and continues to provoke reaction from those who believe in a quantity theory of generalisation—that systems are made up of patterns of action and phenomena, and that we need sufficiently broad ranges of data to ensure that we have captured the full extension of a pattern. Case theorists argue that even where this is true, it is more important to capture the inherent qualities of the patterning and its contingent relationships with context. MacDonald sought to show, as I do in this article, that it is possible to arrive at important and generalisable (provisional) insights from a sample of one.
Evaluation from inside Out: The Experience of Using Local Knowledge and Practices to Evaluate a Program for Adolescent Girls in India through the Lens of Gender and Equity
Authors: Nandi Rajib , Nanda Rituu B , Jugran Tanisha 
Published: January 2018

This article describes an interesting approach where the evaluators recognised the value of using local community knowledge and experience in evaluating a Government of India program for the development and empowerment of adolescent girls. The evaluators tried to integrate participatory and appreciative approaches and looked at the evaluation process through a gender and equity lens. The evaluators went beyond the mandate of evaluation and focused on building evaluation capacity by fostering ownership of the program among stakeholders and encouraging the community to be the active agents of change. Instead of traditional evaluation where evaluators are outsiders, we engaged the stakeholders in the evaluation. All the stakeholders, including the funding agency, a non-government organisation (NGO), the adolescent girls and the wider community were engaged in varying degrees—from defining the objectives, designing questions, data collection and data analysis in the context of their aspirations and expectations, so that it could be an occasion for recognition and celebration of their strengths. The local project implementers and the adolescent girls themselves re-evaluated their own responses and used them in a particular context to further empower themselves. We used principles of the strength-based approach and framed appreciative questions, which recognised the strengths of the community and NGO staff. This created a non-threatening environment, which stimulated open sharing of experiences. Further, this resulted in reinforcing the evaluation process by improving the quality and richness of data that the community produced itself, which would not have been the case in a traditional evaluation. Additionally, a gender and equity lens was used to conduct the evaluation in six multi-ethnic districts, populated with religious and linguistic minorities, and an indigenous population. The gender and equity lens allows recognising the systematic discrimination based on gender, caste and class. The evaluation was able to probe whether the program assessed time, mobility, poverty and accessibility constraints of girls, and accounted for intersectional discrimination.
A new perspective for mixed-methods evaluations
Authors: Elahi Sha'ban , Kalantari Nadia , Hassanzadeh Mohammad , Azar Adel 
Published: January 2018

Evaluation is a broad and multifaceted area of study for researchers that requires the use of a combination of research methods—subsequently providing a challenging agenda for policy-makers. The multifaceted nature of the field indicates an urgent need for a comprehensive framework that includes guidelines for researchers and practitioners. There are several important factors in the selection of method(s) for evaluations including an evaluation's paradigm, approach and purpose; this article aims to address each of these and propose a new perspective for evaluations using a mixed-methods approach. Specifically, the article aims to inform a framework to help evaluators select appropriate methods, with special emphasis on the structural components of the working methodologies. Given the significance of the theoretical background of evaluation, a literature review was carried out with the purpose of informing the development of a new perspective for mixed-methods evaluations using a meta-synthesis approach. All related literature including books and papers published in peer-reviewed journals was extracted, studied and analysed via open coding. Thus, the new perspective presented in this article is based on rich and reliable literature and is helpful for evaluators who are interested in using a mixed-methods approach.
Building evaluation capacity in micro community organisations—more burden than benefit?
Authors: Doherty Bridget , Eccleston Richard , Hansen Emily , Natalier Kristin , Churchill Brendan 
Published: January 2018

Building evaluation capacity in community organisations is promoted as a key means of creating an evaluation culture that will reorient organisations towards identifying and measuring outcomes, demonstrating achievements and enhancing accountability. Building evaluation capacity presents a number of challenges for micro-organisations, including limited resources for evaluation, a low existing evaluation skills base, and, an organisational culture and practice that does not align well with evaluation tools and techniques typically used to demonstrate program outcomes. The implementation of the Thriving Communities Healthy Families pilot project in Tasmania, a place-based health promotion intervention delivered through Neighbourhood Houses (NH), included an evaluation capacity building (ECB) component. The pilot project is used in this article as a case study to illustrate the tensions that arose for community development workers in the NH as they implemented a new program, and contended with the demands of developing their evaluation capacity. We found that while community development workers value evaluation and the importance of demonstrating program outcomes, the model of building evaluation capacity of the workers themselves was burdensome. Further, some workers perceived that evaluation activities impacted negatively on their primary role of supporting vulnerable community members. We conclude that, in very small community sector organisations, ECB requires an ongoing mentoring/relationship-building approach, rather than a traditional training approach. This has implications for how to fund ECB and raises questions on where best to focus ECB in these micro-organisations.