bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma Filtration Adsorption Dialysis (PFAD): A New Technology for Blood Purification
Authors: Nalesso F. 
Published: January 2018

Severe sepsis is one of the most significant challenges in critical care. Despite all the developments achieved in infectious diseases and critical care, along with numerous attempts to develop treatments, the mortality rate of severe sepsis and septic shock remains unacceptably high. The pathophysiology of severe sepsis and septic shock is only partially understood. Circulating pro-inflammatory and anti-inflammatory mediators appear to participate in the complex cascade of events which leads to deranged microcirculatory function, as we know from the peak concentration hypothesis. Therapeutic trials targeting single pro-inflammatory and anti-inflammatory mediators failed to demonstrate any benefit, suggesting that the unselective removal of different mediators may be a more appropriate approach. In severe sepsis several blood purification techniques, such as continuous hemofiltration (CVVH), high volume hemofiltration (HVHF), pulse high volume hemofiltration (HVHF), plasma filtration, plasma adsorption, coupled plasma filtration adsorption (CPFA), have been proposed but such techniques appear to have both theorical as well as practical limitations. Plasma Filtration Adsorption Dialysis (PFAD) is a new extracorporeal treatment which combines different principles of blood purification in a single device. The core of this technique is a new dialyzer composed by three suitable compartments that provide specific functions. The association of multiple principles permits specific removal of molecules implicated in the pathophysiology of patient's disease and re-establishment of hydro-electrolyte, acid-base equilibrium, if renal dysfunction-failure is present. The final target of PFAD is to obtain complete purification by combining principles of physics and chemistry to remove hydrophilic and hydrophobic molecules with a very wide range of weights.
Head to head comparison of adverse effects and efficacy between high dose deflazacort and high dose prednisolone in systemic lupus erythematosus: a prospective cohort study
Authors: Ganapati A , Ravindran R , David T , Yadav B , Jeyaseelan V , Jeyaseelan L , Danda D 
Published: January 2018

Background Deflazacort (DFZ), an oxazoline derivative of prednisolone (PDN), has a dose equivalence of 1.2:1 (mg) to PDN. No study to date has compared adverse effects and efficacy of high doses of DFZ as against high-dose PDN in systemic lupus erythematosus (SLE). Objectives To compare adverse effects of high dose DFZ and PDN in SLE patients, especially in terms of cushingoid features and gain in body weight, 3 and 6 months after initiation of these agents. Methods In both the steroid arms, the following outcome parameters were assessed at 3 and 6 months: (a) cushingoid features by Cushing's Severity Index (CSI) (b) hirsutism by modified Ferriman Gallwey score (c) weight gain by difference (Δ, delta) of weight (in kilograms). Results Patients on PDN had 1.6 kg (3.2%) and 2 kg (5.1%) higher median weight gain as compared to those on DFZ at 3 and 6 months respectively (  p = 0.012 and 0.001). PDN caused 10% and 22.2% higher increment in median hirsutism scores as compared to DFZ at 3 months and 6 months follow-up, respectively (  p = 0.004 and 0.002). PDN caused 100% higher increase in median CSI scores than DFZ at 6 months (  p = 0.03). There was no significant difference by generalized estimation equation between the groups with respect to changes in SLEDAI, renal SLEDAI, anti-dsDNA titres and C3/C4 levels. There were two serious infections (requiring hospitalization/intravenous antibiotics) in the PDN group, while none in the DFZ group. Conclusion Comparable intake and tapering of high dose DFZ and PDN in active SLE revealed 2-fold less weight gain, 2.5-fold less hirsutism and 1.5-fold lower cushingoid severity index as well as lower glycaemic elevation in the DFZ group as compared to PDN group. Both had similar efficacy.
The Socioeconomic Dimensions for the Management of Haemophilia in India
Authors: Gupta Hemant , Dutta Ujjal Protim , Sengupta Partha Pratim 
Published: January 2018

Purpose: Haemophilia is an X-lined recessive disorder of coagulation that can affect any section of the society. Haemophilia is incurable and expensive lifelong disease; hence, the patient always brings in a financial crisis to manage its medication. In developing country like India the per capita health expenditure is 58 USD/year in 2012. The AHF therapy has been negligibly used in critical conditions of the disease. This study was undertaken to identify the social and economic dimensions that can influence the attitude of the medical practitioners for the choice of treatment therapy for a patient with haemophilia (PwH) in India. Design/methodology/approach: A cross-sectional study was conducted by collecting the primary data from the randomly selected 50 medical practitioners who were having at least one PwH on weekly basis. The EFA method was applied to determine the major socioeconomic dimensions of the choice of therapy. Findings: Four major dimensions were explored in the study that have significant impact on the attitude of medical practitioners. The availability of the AHF therapy is the most important dimension for consideration of a therapy for PwH in India. Moreover, the patient safety profile, patient affordability profile, and the experience of medical practitioners are three more dimensions that established the positive impact on attitude. Research limitations/implications: The methodology has socioeconomic tools for analysis and applied instrument has only 15 items for factor analysis. Practical implications: Governing bodies to rectify the policies on rare diseases because of inadequate supply of medicines. Academics would also benefit greatly since it will add value to existing body of literature on haemophilia in Indian context.
It’s All About Communication: A Mixed-Methods Approach to Collaboration Between Volunteers and Staff in Pediatric Palliative Care
Authors: Meyer Dorothee , Schmidt Pia , Zernikow Boris , Wager Julia 
Published: January 2018

Background: Multidisciplinary teamwork is considered central to pediatric palliative care. Although different studies state that volunteers play an essential role in palliative care, little is known about the collaboration between volunteers and staff. Aim: This study aims to explore and compare the perspectives of volunteers and staff regarding collaboration in a pediatric palliative care unit. Design: A mixed-methods approach was chosen to appropriately reflect the complex aspects of collaboration. Setting/Participants: Both face-to-face interviews with staff who work together with volunteers and a group discussion with all volunteers were conducted. These were supplemented by 2 questionnaires designed for this study that examined participants’ characteristics and their estimation of what information volunteers need before they meet a patient. Results: Nine staff members and 7 volunteers participated in this study. Their ideas of collaboration could be grouped into 3 categories: (i) factual level of collaboration, (ii) relationship level of collaboration, and (iii) overall appraisal of collaboration (suggestions for improvement). Conclusion: Communication can be considered a key factor in successful collaboration between volunteers and staff. Because many patients in pediatric palliative care units are not able to communicate verbally, good information flow between volunteers and staff is crucial for ensuring quality patient care. Moreover, communication is the key to establishing a team philosophy by clarifying roles and building relationships between volunteers and staff.
Five-Year Experience of an Inpatient Palliative Care Unit at an Academic Referral Center
Authors: Shinall Myrick C. , Martin Sara F. , Nelson Jill , Miller Richard S. , Semler Matthew W. , Zimmerman Eli E. , Noblit Christy C. , Ely E. Wesley , Karlekar Mohana 
Published: January 2018

Background: Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center. Methods: We retrospectively reviewed a prospectively collected database of all admissions to the PCU at Vanderbilt University Medical Center in the first 5 years of its existence, from 2012 through 2017. Results: Over these 5 years, there were 3321 admissions to the PCU. No single underlying disease process accounted for the majority of the patients, but the largest single category of patients were those with malignancy, who accounted for 38% of admissions. Transfers from the intensive care unit accounted for 50% of admissions, with 43% of admissions from a hospital floor and 7% coming from the emergency department or a clinic. Median length of stay in the PCU was 3 days. In hospital deaths occurred for 50% of admitted patients, while 38% of patients were discharged from the PCU to hospice. Conclusion: These data show that a successful PCU is enabled by buy in from a wide variety of referring specialists and by a multidisciplinary palliative care team focused on care of the actively dying patient as well as pain and symptom management, advance care planning, and hospice referral since a large proportion of referred patients do not die in house.
Syme Amputation: A Systematic Review
Authors: Braaksma Rudwina , Dijkstra Pieter U. , Geertzen Jan H. B. 
Published: January 2018

Background: In the decision-making process toward an amputation of the lower extremity, knowledge about patient-related outcomes after amputation and rehabilitation is important. We have not found a systematic review that provides this knowledge for Syme amputation. The aim of this study was to present an overview of outcomes after a Syme amputation grouped according to the International Classification of Functioning, Disability and Health (ICF) model, focusing on body structures and functions, activities, and participation. Methods: A systematic literature search was performed. Included studies went through 2 selection procedures by 2 independent assessors. Included were all studies concerning Syme amputation with patient-related outcomes. Results: Thirty-six studies were included for data extraction, concerning 1056 patients (238 children and 818 adults). Heel pad migration was reported in 49 of 176 (28%), skin problems in 23 of 128 (18%), and bone problems in 42 of 145 (29%) children. No reamputations were reported. All children were fitted with a prosthesis, and 62 of 90 (69%) children participated in sports. Skin problems were reported in 35 of 195 (18%), ulceration or infection in 120 of 512 (23%), residual limb pain in 46 of 181 (25%), and reamputations in 180 of 919 (20%) adults. In total, 247 of 363 (68%) adults were fitted with a prosthesis. Walking aids were used by 45 of 135 (33%) adults. Employment status was unchanged in 147 of 209 (72%) adults. Conclusion: In children, no reamputations were necessary and few complications were reported, with good participation in daily life in the majority of children. In adults, more complications and reamputations were reported; nevertheless, most adult amputees became successful prosthesis users. Level of Evidence: Therapeutic Level III, systematic review containing retrospective cohort studies.
Impact of 3 Tesla MRI on interobserver agreement in clinically isolated syndrome: A MAGNIMS multicentre study
Authors: Hagens Marloes HJ , Burggraaff Jessica , Kilsdonk Iris D , Ruggieri Serena , Collorone Sara , Cortese Rosa , Cawley Niamh , Sbardella Emilia , Andelova Michaela , Amann Michael , Lieb Johanna M , Pantano Patrizia , Lissenberg-Witte Birgit I , Killestein Joep , Oreja-Guevara Celia , Wuerfel Jens , Ciccarelli Olga , Gasperini Claudio , Lukas Carsten , Rovira Alex , Barkhof Frederik , Wattjes Mike P ,   For the MAGNIMS Study Group
Published: January 2018

Background: Compared to 1.5 T, 3 T magnetic resonance imaging (MRI) increases signal-to-noise ratio leading to improved image quality. However, its clinical relevance in clinically isolated syndrome suggestive of multiple sclerosis remains uncertain. Objectives: The purpose of this study was to investigate how 3 T MRI affects the agreement between raters on lesion detection and diagnosis. Methods: We selected 30 patients and 10 healthy controls from our ongoing prospective multicentre cohort. All subjects received baseline 1.5 and 3 T brain and spinal cord MRI. Patients also received follow-up brain MRI at 3–6 months. Four experienced neuroradiologists and four less-experienced raters scored the number of lesions per anatomical region and determined dissemination in space and time (McDonald 2010). Results: In controls, the mean number of lesions per rater was 0.16 at 1.5 T and 0.38 at 3 T ( p = 0.005). For patients, this was 4.18 and 4.40, respectively ( p = 0.657). Inter-rater agreement on involvement per anatomical region and dissemination in space and time was moderate to good for both field strengths. 3 T slightly improved agreement between experienced raters, but slightly decreased agreement between less-experienced raters. Conclusion: Overall, the interobserver agreement was moderate to good. 3 T appears to improve the reading for experienced readers, underlining the benefit of additional training.
Cognate facilitation priming effect is modulated by writing system: Evidence from Chinese-English bilinguals
Authors: Zhang Juan , Wu Chenggang , Zhou Tiemin , Meng Yaxuan 
Published: January 2018

Aims: The present study aims to examine the cross-script cognate facilitation effect that cognates have processing advantages over non-cognates and this effect is strong evidence supporting the non-selective access hypothesis for bilinguals. Methodology: By adopting a masked translation priming paradigm, Experiment 1 used 48 Chinese–English cognates (Chinese words) and 48 non-cognates (Chinese words) as primes and their English translation equivalences as targets. Chinese–English bilinguals were instructed to judge whether the target stimuli were real words or not. In Experiment 2, another group of participants took the same lexical decision task as in Experiment 1, except that English–Chinese cognates and non-cognates (English words) served as primes and their Chinese translation equivalences were targets. Data and analysis: Response latency and accuracy data were submitted to a repeated-measures analysis of variance. Findings/conclusions: Experiment 1 showed that Chinese–English cognates (Chinese words) and non-cognates (Chinese words) produced similar priming effect, while Experiment 2 revealed that English–Chinese cognates (English words) generated a significant priming effect, whereas non-cognates (English words) failed to induce any priming effect. Overall, Chinese words did not show cognate advantage, while English words produced a significant cognate facilitation effect. These results might be attributed to different mappings from orthography to phonology in English and Chinese. Opaque mapping from orthography to phonology in Chinese hindered phonological activation and reduced Chinese–English cognate phonological priming effect. However, English–Chinese cognates benefited from transparent mapping from sound to print and thus generated a significant phonological priming effect. Implications of the current findings for bilingual word recognition models were discussed. Originality: The present study is the first to investigate the cross-script cognate facilitation effect by ensuring both the heterogeneity of primes and targets (English and Chinese) and the homogeneity of primes (Chinese or English). The results indicated that the writing systems of the primes constrained the cross-script cognate priming effect.
Risk of Erectile Dysfunction After Traumatic Brain Injury: A Nationwide Population-Based Cohort study in Taiwan
Authors: Yang Yun-Ju , Chien Wu-Chien , Chung Chi-Hsiang , Hong Kun-Ting , Yu Yi-Lin , Hueng Dueng-Yuan , Chen Yuan-Hao , Ma Hsin-I , Chang Hsin-An , Kao Yu-Chen , Yeh Hui-Wen , Tzeng Nian-Sheng 
Published: January 2018

Introduction: In our study, we aimed to investigate the association between a traumatic brain injury (TBI) and subsequent erectile dysfunction (ED). This is a population-based study using the claims dataset from The National Health Insurance Research Database. Methods: We included 72,642 patients with TBI aged over 20 years, retrospectively, selected from the longitudinal health insurance database during 2000–2010, according to the ICD-9-CM. The control group consisted of 217,872 patients without TBI that were randomly chosen from the database at a ratio of 1:3, with age- and index year matched. Cox proportional hazards analysis was used to estimate the association between the TBI and subsequent ED. Results: After a 10-year follow-up, the incidence rate of ED was higher in the TBI patients when compared with the non-TBI control group (24.66 and 19.07 per 100,000, respectively). Patients with TBI had a higher risk of developing ED than the non-TBI cohort after the adjustment of the confounding factors, such as age, comorbidity, residence of urbanization and locations, seasons, level of care, and insured premiums (adjusted hazard ratio (HR) = 2.569, 95% CI [1.890, 3.492], p < .001). Conclusion: This is the first study using a comprehensive nationwide database to analyze the association of ED and TBI in the Asian population. After adjusted the confounding factors, patients with TBI have a significantly higher risk of developing ED, especially organic ED, than the general population. This finding might remind clinicians that it’s crucial in early identification and treatment of ED in post-TBI patients.
Cost-efficient designs for three-arm trials with treatment delivered by health professionals: Sample sizes for a combination of nested and crossed designs
Authors: Moerbeek Mirjam 
Published: January 2018

Background This article studies the design of trials that compare three treatment conditions that are delivered by two types of health professionals. The one type of health professional delivers one treatment, and the other type delivers two treatments, hence, this design is a combination of a nested and crossed design. As each health professional treats multiple patients, the data have a nested structure. This nested structure has thus far been ignored in the design of such trials, which may result in an underestimate of the required sample size. In the design stage, the sample sizes should be determined such that a desired power is achieved for each of the three pairwise comparisons, while keeping costs or sample size at a minimum. Methods The statistical model that relates outcome to treatment condition and explicitly takes the nested data structure into account is presented. Mathematical expressions that relate sample size to power are derived for each of the three pairwise comparisons on the basis of this model. The cost-efficient design achieves sufficient power for each pairwise comparison at lowest costs. Alternatively, one may minimize the total number of patients. The sample sizes are found numerically and an Internet application is available for this purpose. The design is also compared to a nested design in which each health professional delivers just one treatment. Results Mathematical expressions show that this design is more efficient than the nested design. For each pairwise comparison, power increases with the number of health professionals and the number of patients per health professional. The methodology of finding a cost-efficient design is illustrated using a trial that compares treatments for social phobia. The optimal sample sizes reflect the costs for training and supervising psychologists and psychiatrists, and the patient-level costs in the three treatment conditions. Conclusion This article provides the methodology for designing trials that compare three treatment conditions while taking the nesting of patients within health professionals into account. As such, it helps to avoid underpowered trials. To use the methodology, a priori estimates of the total outcome variances and intraclass correlation coefficients must be obtained from experts’ opinions or findings in the literature.
Physical and anthropometrical attributes of Australian youth soccer players
Authors: Keller Brad S , Raynor Annette J , Bruce Lyndell , Iredale Fiona 
Published: January 2018

Objectives To determine whether Australian youth soccer players of varying levels could be distinguished based on their anthropometrical and physical attributes. Design A cross-sectional observational design was used, involving six anthropometrical and physical tests for each player. Methods Participants represented three youth levels of competition, namely national elite (n = 18), state elite (n = 22) and sub-elite (n = 22). Anthropometrical and physical tests included standing height; body mass; 5, 10, 30 m sprint and 20 m ‘flying start’ sprint; zig-zag agility test; vertical jump and Yo-Yo Intermittent Recovery test level 1. A multiple analysis of variance for the main effect of cohort, with a follow-up ANOVA and Tukey's Honest Significant Difference were used to discern which attributes differed between each cohort. Receiver operating characteristic curves were calculated, providing cut-off values between cohorts. Results The national elite cohort was significantly taller than the state elite cohort (ES = 0.94) and faster than the sub-elite athletes across 30 m (ES = 0.79) and 20 m with a flying start (ES = 0.77) (P < 0.05). The national elite cohort had a significantly higher level of intermittent endurance, compared to the state elite athletes who also performed better than the sub-elite cohort. The discrepancy between groups in the Yo-Yo Intermittent Recovery test level 1 was exemplified by the receiver operating characteristic with 94.1% of national elite players running further than 1980 m, while 95.7% of state elite and 100% of sub-elite players failed to reach this distance (ES = 0.88–1.77). Conclusions It is evident that anthropometrical and physical attributes differ between youth cohorts, particularly intermittent endurance. It is important to use this knowledge to enhance the current processes used to identify future talent for success in Australian soccer.