bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical and psychiatric profile of patients who self-harm by burning in a regional burn unit over an 11-year period
Authors: Conlin Samantha , Littlechild Joseph , Aditya Hosakere , Bahia Hilal 
Published: June 2016

Introduction Patients admitted to hospital for deliberate self-harm by burning (DSHB) provide a challenge for medical, surgical and psychological management. We retrospectively reviewed all the patients admitted to a Scottish regional burn unit with DSHB over an 11-year period to assess demographics and outcome. Methods Ward admission data were used to identify DSHB patients admitted to the South East Scotland regional burn unit in Livingston, UK between 2002 and 2012, as well as a control group of accidental burn patients. Data were extracted concerning burn injury, psychiatric history and inpatient management. Results A total of 53 DSHB patients with 58 attendances over the 11-year period were compared to 49 accidental burns patients. Compared to controls, DSHB patients were more likely to be unemployed, live alone and have a previous psychiatric diagnosis ( p < 0.01). DSHB patients had more severe burns, a longer hospital stay and were more likely to undergo surgery ( p < 0.01). DSHB patients with previous self-harm, suicide attempts and diagnoses of personality and eating disorder all had significantly less severe burns than DSHB patients without these risk factors ( p < 0.05). Conclusions In our experience, DSHB patients have more severe burn injuries and require longer, resource-intensive hospital stays. Burn units should have an appropriate specialist psychologist/psychiatrist who works within the Burn multi-disciplinary team to help manage this complex group of patients’ healthcare needs and reduce their risk of further self-harm.
Parathyroid 4D‐CT
Authors: Hoang Jenny K. , Williams Katherine , Gaillard Frank , Dixon Andrew , Sosa Julie A. 
Published: June 2016

Four‐dimensional computed tomography (4D‐CT) is a new modality for preoperative localization of parathyroid adenomas. We performed a survey study to describe the role and trends in the utilization of 4D‐CT. Of 361 radiologists, 200 (55%) reported that 4D‐CT was used in their practices. Nineteen (10%) used 4D‐CT as the first‐line imaging study; 155 (76%) reported that 4D‐CT played a secondary role; and 26 (13%) reported that it is performed routinely in combination with ultrasound and scintigraphy. Early adopters of 4D‐CT (use for >3 years) were 3 times more likely to use 4D‐CT in a first‐line role (18%) when compared with radiologists who used 4D‐CT for ≤3 years (6%; P <. 05). In conclusion, more than half of radiologists perform 4D‐CT, and a majority reported that 4D‐CT plays a secondary role. However, this role may change, as utilization is increasing and radiologists may follow early adopters, who are more likely to use it as a first‐line study.
Use of Lean and CAHPS Surgical Care Survey to Improve Patients’ Experiences with Surgical Care
Authors: Jiang Nancy , Malkin Benjamin D. 
Published: June 2016

Objectives(1) Measure patients’ experiences with surgical care using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Surgical Care Survey. (2) Use lean thinking to analyze and improve quality of patient care.Study DesignA prospective quality improvement study.SettingHospital‐based otolaryngology clinic.Subjects and MethodsThe CAHPS Surgical Care Survey was distributed to 17 surgical patients to determine their perception of the current state of care. Survey results were analyzed with lean thinking, and changes were made to improve critical areas. A second set of surveys was distributed to 10 patients to assess the success of the interventions immediately and 2 months later. The data were analyzed with the Mann‐Whitney U test.ResultsSeventeen patients completed the CAHPS Surgical Care Survey to determine the initial state. A3 Thinking was used to analyze the results and design an improvement. Overall positive patient experience was 57% at the postoperative visit with 3 key aspects of care: time spent during visit, encouragement to ask questions, show of respect to the patient. Two causes were postulated; then, solution approaches were developed and tested in a series of rapid experiments. Two groups of 10 patients completed the CAHPS Surgical Care Survey to determine the postintervention state. Overall positive patient experience significantly improved to 93% (U = 474, P <. 001) and 83% (U = 546, P =. 009) immediately and 2 months later, respectively.ConclusionLean thinking helps to eliminate defects by breaking down complex problem solving into a scientific process. When combined with the CAHPS Surgical Care Survey, it can be successfully used to improve patients’ surgical experiences.
Complementary Feeding Diets Made of Local Foods Can Be Optimized, but Additional Interventions Will Be Needed to Meet Iron and Zinc Requirements in 6- to 23-Month-Old Children in Low- and Middle-Income Countries
Authors: Osendarp Saskia J. M. , Broersen Britt , van Liere Marti J. , De-Regil Luz M. , Bahirathan Lavannya , Klassen Eva , Neufeld Lynnette M. 
Published: June 2016

Background: The question whether diets composed of local foods can meet recommended nutrient intakes in children aged 6 to 23 months living in low- and middle-income countries is contested. Objective: To review evidence of studies evaluating whether (1) macro- and micronutrient requirements of children aged 6 to 23 months from low- and middle-income countries are met by the consumption of locally available foods (“observed intake”) and (2) nutrient requirements can be met when the use of local foods is optimized, using modeling techniques (“modeled intake”). Methods: Twenty-three articles were included after conducting a systematic literature search. To allow for comparisons between studies, findings of 15 observed intake studies were compared against their contribution to a standardized recommended nutrient intake from complementary foods. For studies with data on intake distribution, %< estimated average requirements were calculated. Results: Data from the observed intake studies indicate that children aged 6 to 23 months meet requirements of protein, while diets are inadequate in calcium, iron, and zinc. Also for energy, vitamin A, thiamin, riboflavin, niacin, folate, and vitamin C, children did not always fulfill their requirements. Very few studies reported on vitamin B6, B12, and magnesium, and no conclusions can be drawn for these nutrients. When diets are optimized using modeling techniques, most of these nutrient requirements can be met, with the exception of iron and zinc and in some settings calcium, folate, and B vitamins. Conclusion: Our findings suggest that optimizing the use of local foods in diets of children aged 6 to 23 months can improve nutrient intakes; however, additional cost-effective strategies are needed to ensure adequate intakes of iron and zinc.
Single-center experience with simultaneous thoracic endovascular aortic repair and abdominal endovascular aneurysm repair
Authors: Zeng Qinglong , Guo Xi , Huang Lianjun , Sun Lizhong 
Published: June 2016

Objective To evaluate the efficacy and outcomes of simultaneous thoracic endovascular aortic repair (TEVAR) and abdominal endovascular aneurysm repair (EVAR). Methods A total of 21 patients (20 men; mean 65 ± 7 years, range 54–77) underwent simultaneous TEVAR and EVAR between September 2010 and June 2015 at a single center were retrospectively reviewed. All patients had concomitant thoracic pathologies (aneurysm, penetrating aortic ulcer, intramural hematoma, or dissection) and abdominal aortic aneurysm. The abdominal aneurysms diameters ranged from 5.9 cm to 10 cm. Thoracic lesions in 17 patients were complicated with acute aortic syndrome, and the remainders had indications for simultaneous repair. All patients were followed up postoperative at 1 month, 6 months, and yearly thereafter. Technique success, procedure-related complications were evaluated. Results All patients received local anesthesia, perioperative relative high arterial pressure (above 130/80 mmHg) maintenance, and prophylactic high-dose corticosteroid. The technical success rate was 100%. Average procedural time was 157.6 ± 45.6 min. The length of thoracic coverage was 20.4 ± 4.7 cm (range 15–27). Two patients required left subclavian artery coverage during TEVAR and two patients required lowest renal artery coverage during EVAR. Chimney stents were deployed simultaneously. Patients were followed between 2 and 59 months postoperatively. No patients developed acute cardiopulmonary complications and contrast-induced nephropathy. Two patients developed transient lower extremity weakness that resolved with blood pressure elevation, cerebrospinal fluid drainage, and intravenous drips of high-dose corticosteroid. The average hospital stay was 10.7 ± 7.9 days (range 4–30). During follow-up, one patient died of aneurysm rupture at postoperative 6 months, two patients developed type Ib endoleak at 9 months and 48 months respectively, one was successfully sealed with iliac stent-graft extension, the other received conservative treatment and is symptom free till now. Conclusion Combined TEVAR and EVAR can be performed safely with minimal morbidity and mortality. When anatomically feasible, simultaneous TEVAR and EVAR can be considered as an acceptable alternative for multilevel aortic diseases.
Efficacy and safety of rVIII-SingleChain: results of a phase 1/3 multicenter clinical trial in severe hemophilia A
Authors: Mahlangu Johnny , Kuliczkowski Kazimierz , Karim Faraizah Abdul , Stasyshyn Oleksandra , Kosinova Marina V. , Lepatan Lynda Mae , Skotnicki Aleksander , Boggio Lisa N. , Klamroth Robert , Oldenburg Johannes , Hellmann Andrzej , Santagostino Elena , Baker Ross I. , Fischer Kathelijn , Gill Joan C. , P’Ng Stephanie , Chowdary Pratima , Escobar Miguel A. , Khayat Claudia Djambas , Rusen Luminita , Bensen-Kennedy Debra , Blackman Nicole , Limsakun Tharin , Veldman Alex , St. Ledger Katie , Pabinger Ingrid ,   for the AFFINITY Investigators
Published: June 2016

Key Points
rVIII-SingleChain is a novel rFVIII, designed to have high stability and high binding affinity for VWF. In severe hemophilia A patients, rVIII-SingleChain was well tolerated and resulted in low bleeding rates, when dosed twice per week.
Researchers’ perspectives on pediatric obesity research participant recruitment
Authors: Parikh Yasha , Mason Maryann , Williams Karen 
Published: June 2016

AbstractBackgroundChildhood obesity prevalence has tripled over the last three decades. Pediatric obesity has important implications for both adult health as well as the United States economy. In order to combat pediatric obesity, exploratory studies are necessary to create effective interventions. Recruitment is an essential part of any study, and it has been challenging for all studies, especially pediatric obesity studies. The objective of this study was to understand barriers to pediatric obesity study recruitment and review facilitators to overcome recruitment difficulties.MethodsTwenty four childhood obesity researchers were contacted. Complete data for 11 researchers were obtained. Interviews were transcribed and analyzed using content analysis. Grounded Theory methodological approach was used, as this was an exploratory study. Investigators YP and MM coded the interviews using 28 codes.ResultsBarriers to recruitment included: family and study logistics, family economics, lack of provider interest, invasive protocols, stigma, time restraints of clinicians, lack of patient motivation/interest, groupthink of students in a classroom, and participants who do not accept his or her own weight status. Facilitators to enhance recruitment practices included accommodating participants outside of regular clinic hours, incentivizing participants, cultivating relationships with communities, schools and clinics prior to study recruitment, emphasizing benefits of a study for the patient, and shifting language to focus on health rather than obesity.ConclusionsPediatric obesity researchers face many standard and some unique challenges to recruitment, reflecting challenges common to clinical research as well as some specific to pediatrics and some specific to obesity research. Both pediatric studies as well as obesity studies are an added challenge to the already‐difficult task of general study recruitment. Our findings can be used to make researchers more aware of potential difficulties, approaches and on‐going needs for enhancing recruitment and enrollment practices, and in turn if applied, may result in increased study efficiency.
Mental disorders in new parents before and after birth: a population-based cohort study
Authors: Xu Fenglian , Sullivan Elizabeth , Binns Colin , Homer Caroline S. E. 
Published: June 2016

BackgroundMental disorders of women during the postnatal period are a major public health problem. Compared with women's mental disorders, much less attention has been paid to men's mental disorders in the perinatal period. To date, there have been no reports in the literature describing secular changes of both maternal and paternal hospital admissions for mental disorders over the period covering the year before pregnancy (non-parents), during pregnancy (expectant parents) and up to the first year after birth (parents) based on linked parental data. The co-occurrences of couples' hospital admissions for mental disorders have not previously been investigated.AimsTo describe maternal and paternal hospital admissions for mental disorders before and after birth. To compare the co-occurrences of parents' hospital admissions for mental disorder in the perinatal period.MethodThis is a cohort study using paired parents' population data from the New South Wales (NSW) Perinatal Data Collection (PDC), Registry of Births, Deaths and Marriages (RBDM) and Admitted Patients Data Collection (APDC). The study included all parents (n=196 669 couples) who gave birth to their first child in NSW between 1 January 2003 and 31 December 2009.ResultsThe hospital admission rate for women with a principal mental disorder diagnosis in the period between the year before pregnancy and the first year after birth was significantly higher than that for men. Parents' mental disorders influenced each other. If a man was admitted to hospital with a principal mental disorder diagnosis, his wife or partner was more likely to be admitted to hospital with a principal mental disorder diagnosis compared with women whose partner had not had a hospital admission, andvice versa.ConclusionsMothers' mental disorders after birth increased more significantly than fathers. However, fathers' mental disorders significantly impacted the co-occurrence of mothers' mental disorders.
Rivaroxaban: An Affordable and Effective Alternative in Cancer-Related Thrombosis?
Authors: Xavier Flávia Dias , Hoff Paulo Marcelo Gehm , Braghiroli Maria Ignez , Paterlini Ana Carolina Carvalho Rocha , Souza Karla Teixeira , Faria Luiza Dib Batista Bugiato , Ferreira Fernando Sergio Blumm , Machado Karime Kalil , Fernandes Gustavo dos Santos 
Published: June 2016

Background Venous thromboembolic events (VTEs) are common and potentially fatal complications in cancer patients, and they are responsible for the second most common cause of death. Low molecular weight heparin (LMWH) is the gold-standard treatment, but the costs involved limit its use, especially in developing countries. Recently, the oral anticoagulant rivaroxaban, which directly inhibits factor Xa, was approved for VTE treatment. Methods We conducted a retrospective analysis from January 2009 to February 2014 with patients who had cancer and VTE who were receiving rivaroxaban. We compared the efficacy, safety, and cost of rivaroxaban and low molecular weight heparin (LMWH) alone or followed by vitamin K antagonists. Results Forty-one patients were identified, with a median age of 62.5 years. The most frequent tumor histology was adenocarcinoma (78%), which was most often found in the colon (26.8%). Most participants had advanced disease and an implanted central venous catheter. Patients’ VTE risk-assessment scores were low (12.5%), intermediate (50%), and high (35.5%). Pulmonary thromboembolism was reported in 41.4% of patients, but inferior limb thrombosis was reported only in 14.6%; 43.9% of patients received enoxaparin before starting rivaroxaban. Rivaroxaban was used for a median time of 5.5 months. Nonmajor bleeding was reported in 12.2% of patients, and rethrombosis was reported in 12.2%. In our study, rivaroxaban was as safe and effective as enoxaparin/vitamin K antagonists ( P = .54 and P = .25, respectively) or LMWH ( P = .46 and P = .29, respectively). Conclusion Although our study was a retrospective analysis, our results suggest that in this cohort of oncologic patients, rivaroxaban was safe and effective. Its oral route and lower cost make it an attractive alternative to LMWH, improving management of patients with cancer in low-income countries. Additional studies are necessary to confirm our data.
Risk Factors for Spontaneously Self-Reported Postprandial Hypoglycemia After Bariatric Surgery
Authors: Nannipieri Monica , Belligoli Anna , Guarino Daniela , Busetto Luca , Moriconi Diego , Fabris Roberto , Mari Andrea , Baldi Simona , Anselmino Marco , Foletto Mirto , Vettor Roberto , Ferrannini Ele 
Published: June 2016

Context:
Postprandial hypoglycemia (PPHG) is a recognized complication of Roux-en-Y gastric bypass (RYGB) surgery. Data on PPHG after laparoscopic sleeve gastrectomy (LSG) are scant.

Objective:
The objective of the study was to identify preoperative predictors of PPHG in subjects spontaneously self-reporting PPHG after RYGB or LSG.

Patients, Setting, and Intervention:
Nondiabetic patients spontaneously self-reporting symptoms/signs of PPHG (PPHG group, 21 RYGB and 11 LSG) were compared in a case-control design with subjects who never experienced spontaneous or oral glucose tolerance test (OGTT)-induced hypoglycemia over 24 months after surgery (No-PPHG group, 13 RYGB and 40 LSG). Paired pre- and postoperative 3-hour OGTTs were analyzed in all participants.

Main Outcome Measures:
Insulin sensitivity was assessed by the oral glucose insulin sensitivity index and β-cell function by mathematical modeling of the C-peptide response to glucose.

Results:
Before surgery, the body mass index was lower in PPHG than No-PPHG patients in the RYGB (P = .002) and trended similarly in the LSG group (P = .08). Fasting glycemia and the glucose-OGTT nadir were lower in the PPHG than the No-PPHG subjects in both surgery groups. Before surgery, insulin sensitivity was higher in PPHG than No-PPHG in the RYGB (393 ± 55 vs 325 ± 44 mL/min−1 · m−2, P = .001) and LSG groups (380 ± 48 vs 339 ± 60 mL/min−1 · m−2, P = .05) and improved to a similar extent in all groups after surgery. Before surgery, β-cell glucose sensitivity was higher in PPHG than No-PPHG in both RYGB (118 ± 67 vs 65 ± 24 pmol/min−1 · m2 · mM−1) and LSG patients (114 ± 32 vs 86 ± 33) (both P = .02) and improved in all subjects after surgery.

Conclusions:
In subjects self-reporting PPHG after surgery, lower presurgery plasma glucose concentrations, higher insulin sensitivity, and better β-cell glucose sensitivity are significant predictors of PPHG after both RYGB and LSG.
Impact of On-Bypass Red Blood Cell Transfusion on Severe Postoperative Morbidity or Mortality in Children
Authors: Willems Ariane , Datoussaid Dounia , Tucci Marisa , Sanchez Torres Cristel , De Villé Andrée , Fils Jean-François , Van der Linden Philippe 
Published: June 2016

BACKGROUND:Children undergoing cardiac surgery are frequently exposed to red blood cell (RBC) transfusions mainly in the case of hemorrhage or low oxygen transport. However, in this population, RBCs are sometimes added to the cardiopulmonary bypass (CPB) priming solution to maintain a predefined hematocrit on bypass. In this study, we investigated the impact of RBCs added to the CPB on severe postoperative morbidity or mortality.METHODS:This retrospective cohort study was conducted between 2006 and 2012 in a tertiary care level, children’s hospital. Children receiving red cells only to prime the CPB (CPB transfusion) were compared with those receiving no RBCs during their entire hospital stay. The primary outcome was severe postoperative morbidity or mortality. Studied secondary outcomes were neurologic deficit, infection, length of mechanical ventilation, pediatric intensive care unit and hospital length of stay, and mortality. Both groups were compared with propensity score analysis where patients were matched via a genetic matching algorithm. In all analyses, applying a Bonferroni correction, aPvalue <.05/8 = .00625, was considered statistically significant.RESULTS:Among the 854 patients retained for this study, 439 (51.4%) received no RBC transfusion during their entire hospital stay and 415 (49.6%) received a CPB transfusion. Thirty-five (8.0%) patients in the no-transfusion group and 110 (26.5%) patients in the CPB transfusion group developed severe postoperative morbidity or died. This difference was statistically significant using univariate analysis (P< .001). Propensity score analysis showed that 79 (19.55%) patients developed severe postoperative morbidity or died in the no-transfusion group compared with 103 (25.50%) patients in the CPB transfusion group (P= .043). The relative risk and its Bonferroni-corrected confidence interval was 0.77 (0.53–1.10). All secondary outcomes were not significantly different between both groups, except the number of patients who developed infections (P< .001).CONCLUSIONS:In the condition of our study, adding RBCs to the CPB priming to maintain a predefined hematocrit does not seem to impact markedly severe postoperative morbidity or mortality in children undergoing cardiac surgery. Only the risk of infection was increased in the CPB transfusion group. Further studies are warranted to better understand the complex interaction among severity of illness, anemia, RBCs transfusion, and outcome in children undergoing cardiac surgery.
Metabolic cost of osmoregulation in a hypertonic environment in the invasive African clawed frogXenopus laevis
Authors: Peña-Villalobos Isaac , Narváez Cristóbal , Sabat Pablo 
Published: June 2016

ABSTRACTStudies of aquatic invertebrates reveal that salinity affects feeding and growth rates, reproduction, survival, and diversity. Little is known, however, about how salinity impacts the energy budget of vertebrates and amphibians in particular. The few studies focused on this topic in vertebrates suggest that the ingestion of salts and the resulting osmoregulatory activity is energetically expensive. We analyzed the effect of saline acclimation on standard metabolic rates (SMR) and the activities of metabolic enzymes of internal organs and osmoregulatory variables (plasma osmolality and urea plasma level) in females of Xenopus laevis by means of acclimating individuals to an isosmotic (235 mOsm NaCl; ISO group) and hyper-osmotic (340 mOsm NaCl; HYP group) environment for 40 days. After acclimation, we found that total and mass-specific SMR was approximately 80% higher in the HYP group than those found in the ISO group. These changes were accompanied by higher citrate synthase activities in liver and heart in the HYP group than in the ISO group. Furthermore, we found a significant and positive correlation between metabolic rates and plasma urea, and citrate synthase activity in liver and heart. These results support the notion that the cost of osmoregulation is probably common in most animal species and suggest the existence of a functional association between metabolic rates and the adjustments in osmoregulatory physiology, such as blood distribution and urea synthesis.