bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous Infusion Nonsteroidal Anti-Inflammatory Drugs for Perioperative Pain Management
Authors: Howard Meredith L. , Isaacs Alex N. , Nisly Sarah A. 
Published: September 2016

Purpose: To review the use of continuous infusion (CI) nonsteroidal anti-inflammatory drugs (NSAIDs) as an alternative modality for pain control in surgical patient populations. Methods: A PubMed and MEDLINE search was conducted from 1964 through February 2016 using the following search terms alone or in combinations: continuous, infusion, nonsteroidal anti-inflammatory drug, diclofenac, ibuprofen, indomethacin, ketoprofen, ketorolac, and surgery. All English-language, prospective and retrospective, adult and pediatric studies evaluating intravenous or intramuscular CI NSAIDs for surgical pain were evaluated for inclusion in this review. Results: Twenty four prospective and retrospective publications evaluating CI NSAIDs were identified: 12 in abdominal surgery, 7 in orthopedic surgery, and 5 in pediatric surgery. Specific CI NSAIDs utilized included diclofenac, indomethacin, ketoprofen, and ketorolac. Most studies compared the CI NSAID to placebo or an alternative analgesic and evaluated pain control, supplemental opioid use, and related adverse effects. In these surgical populations, CI NSAIDs decreased opioid consumption, alongside provision of adequate pain control. While long-term adverse effects were rarely collected, a decrease in nausea and sedation was often seen with the CI NSAID groups. Conclusions: In the abdominal, orthopedic, and pediatric surgical populations, CI NSAIDs represent a feasible alternative modality for perioperative pain control.
Clinical Predictive Value of Cystatin C in Pediatric Sickle Cell Disease: A Marker of Disease Severity and Subclinical Cardiovascular Dysfunction
Authors: Tantawy Azza Abdel Gawad , Adly Amira Abdel Moneam , Ismail Eman Abdel Rahman , Abdelazeem Mai 
Published: September 2016

Background: Patients with sickle cell disease (SCD) are at high risk of renal dysfunction and cardiovascular morbidity. The association between cystatin C and renal function is well known, however, cystatin C has recently emerged as a strong predictor of cardiovascular events and adverse outcomes in patients with and without kidney disease, mostly related to both inflammation and atherosclerosis. Aim: To determine cystatin C levels in 53 children and adolescents with SCD compared to 40 age- and sex-matched healthy controls and assess its relation to markers of hemolysis, iron overload, sickle vasculopathy, and carotid intima–media thickness (CIMT). Methods: Patients with SCD in steady state were studied, focusing on hydroxyurea therapy, hematological profile, serum ferritin, high-sensitivity C-reactive protein (hs-CRP), urinary albumin–creatinine ratio (UACR), and serum cystatin C. Echocardiography and CIMT were assessed using high-resolution ultrasound. Heart disease was defined by systolic left ventricle dysfunction (shortening fraction <30% or ejection fraction <55%). Results: Carotid IMT was significantly higher in patients with SCD compared to controls ( P < .001). Patients with SCD having nephropathy, heart disease, or history of frequent sickling crisis (≥3 attacks/y) had significantly higher cystatin C levels than those without ( P < .05). Patients with SCD treated with hydroxyurea had lower cystatin C levels than untreated patients ( P = .039). High-sensitivity C-reactive protein, UACR, ejection fraction, and CIMT were independently related to cystatin C in multiple regression analysis. The cutoff values of cystatin C for detection of renal or cardiovascular complications were determined. Conclusion: Cystatin C may be considered a biological marker for vascular dysfunction and subclinical atherosclerosis in SCD.
Pediatric Acquired von Willebrand Disease With Berlin Heart Excor Ventricular Assist Device Support
Authors: Gossai Nathan , Brown Nicholas M. , Ameduri Rebecca , Zantek Nicole D. , Louis James St. , Steiner Marie E. 
Published: September 2016

Background: The balance of hemostasis and anticoagulation is a concern for patients dependent upon ventricular assist devices (VADs). Bleeding is a common complication with both short- and long-term use of these devices. A better understanding of the risk factors and etiologies of bleeding associated with these devices is needed and could improve the overall results. We sought to determine the relationship of mechanical circulatory assist device use with acquired von Willebrand disease (avWD) in children. Methods: Data were analyzed retrospectively via review of the medical record of 19 consecutive patients who were supported with the Berlin EXCOR VAD for greater than 24 hours. Laboratory testing for avWD was performed at the discretion of the clinical team, often in association with clinical bleeding. Results: Of 19 pediatric patients, 10 (52.6%) had laboratory testing consistent with avWD. Median time to detection of avWD was 35 days postimplantation of device (range 0-310 days). Both minor mucosal bleeding and bleeding requiring intervention were highly prevalent in patients in whom avWD was identified (10/10 [100%] and 7/10 [70%]). The mean age of all patients was 3.3 years, but patients found to have avWD tended to be older (mean 5.3 years) and supported with larger volume VADs. Conclusions: This experience demonstrates a high prevalence of avWD following EXCOR implantation. Bleeding, older age, and larger VAD size may be associated with avWD. These results should stimulate critical evaluation of individualized anticoagulation regimens in pediatric VAD patients.
Twenty Years of Adult Congenital Heart Surgery
Authors: Long Michael A. , Smit Francis E. , Brown Stephen C. 
Published: September 2016

Background: Lack of data exists on the surgical management of adult congenital heart disease on the African continent. This study was undertaken to describe the clinical profile and surgical outcome of adult patients with congenital heart disease undergoing surgery in a single-center African study population. Methods: A retrospective medical chart review of consecutive adult patients (≥18 years) undergoing congenital heart surgery between October 1995 and December 2015 at our institution was undertaken. We described cardiac diagnosis, diagnostic complexity, risk profile, and surgical morbidity and mortality. Results: Data were collected of 233 surgical procedures performed in 219 patients (45.6% males). The most common diagnostic category was septal defects (41.2%), followed by right heart lesions (17.2%), left heart lesions (12.4%), thoracic arteries (9.0%), and conduit failure (6.9%). Twenty-four percent of patients presented in functional class III or IV, and 46% of patients met the criteria for the simple Bethesda diagnostic class. Preoperative risk factors were identified in 19.8% of patients. Corrective surgery was performed in 71.7% of cases, reoperative surgery in 27.6%, and palliative surgery in 0.8%. Right ventricle to pulmonary artery conduit placement comprised 53.1% of reoperations. The overall hospital mortality was 1.7%. Postoperative complications occurred in 26.3% of cases. Conclusions: This study presents a detailed description of this emerging population in a developing world context. Our outcomes data suggest that adult congenital heart disease surgery is feasible in a Southern African tertiary referral center with low operative mortality and acceptable morbidity.
Variation in Perfusion Strategies for Neonatal and Infant Aortic Arch Repair
Authors: Meyer David B. , Jacobs Jeffrey P. , Hill Kevin , Wallace Amelia S. , Bateson Brian , Jacobs Marshall L. 
Published: September 2016

Background: Regional cerebral perfusion (RCP) is used as an adjunct or alternative to deep hypothermic circulatory arrest (DHCA) for neonates and infants undergoing aortic arch repair. Clinical studies have not demonstrated clear superiority of either strategy, and multicenter data regarding current use of these strategies are lacking. We sought to describe the variability in contemporary practice patterns for use of these techniques. Methods: The Society of Thoracic Surgeons Congenital Heart Surgery Database (2010-2013) was queried to identify neonates and infants whose index operation involved aortic arch repair with cardiopulmonary bypass. Perfusion strategy was classified as isolated DHCA, RCP (with less than or equal to ten minutes of DHCA), or mixed (RCP with more than ten minutes of DHCA). Data were analyzed for the entire cohort and stratified by operation subgroups. Results: Overall, 4,523 patients (105 centers) were identified; median age seven days (interquartile range: 5.0-13.0). The most prevalent perfusion strategy was RCP (43%). Deep hypothermic circulatory arrest and mixed perfusion accounted for 32% and 16% of cases, respectively. In all, 59% of operations involved some period of RCP. Regional cerebral perfusion was the most prevalent perfusion strategy for each operation subgroup. Neither age nor weight was associated with perfusion strategy, but reoperations were less likely to use RCP (31% vs 45%, P < .001). The combined duration of RCP and DHCA in the RCP group was longer than the DHCA time in the DHCA group (45 vs 36 minutes, P < .001). Conclusion: There is considerable variability in practice regarding perfusion strategies for arch repair in neonates and infants. In contemporary practice, RCP is the most prevalent perfusion strategy for these procedures. Use of DHCA is also common. Further investigation is warranted to ascertain possible relative merits of the various perfusion techniques.
Perturbed hematopoiesis in mice lacking ATMIN
Authors: Anjos-Afonso Fernando , Loizou Joanna I. , Bradburn Amy , Kanu Nnennaya , Purewal Sukhveer , Da Costa Clive , Bonnet Dominique , Behrens Axel 
Published: September 2016

Key Points
ATMIN deletion using Vav-Cre causes chronic leukopenia, with fewer B cells and common myeloid progenitors. Long-term HSCs in ATMIN-deficient mice show increased cell cycling and are more prone to exhaustion under stress.
Respiratory clinical guidelines inform ward-based nurses’ clinical skills and knowledge required for evidence-based care
Authors: Johnson Alisha M. , Smith Sheree M.S. 
Published: September 2016

Respiratory clinical guidelines provide clinicians with evidence-based guidance for practice. Clinical guidelines also provide an opportunity to identify the knowledge and technical and non-technical skills required by respiratory ward-based registered nurses. The aim of this review was to use a systematic process to establish the core technical and non-technical skills and knowledge identified in evidence-based clinical guidelines that enable the care of hospitalised adult respiratory patients.17 guidelines were identified in our systematic review. The quality assessment demonstrated variability in these guidelines. Common core knowledge and technical and non-technical skills were identified. These include pathophysiology, understanding of physiological measurements and monitoring, education, counselling, and ward and patient management.The knowledge and skills extracted from respiratory clinical guidelines may inform a curriculum for ward-based respiratory nursing to ensure optimal care of adult patients.
Overview of Results Presented in "Trends in Logic XIII"
Authors: Klonowski Mateusz 
Published: September 2016

Book Reviews: Andrzej Indrzejczak, Janusz Kaczmarek, and Michał Zawidzki (editors), “Trends in Logic XIII. Gentzen’s and Jaśkowski’s Heritage. 80 Years of Natural Deduction and Sequent Calculi”, Wydawnictwo UŁ, Łódź (Poland), 2014, 269 pages, ISBN 978-83-7969-161-6.
Selling Out: The Inauthenticity Discount in the Craft Beer Industry
Authors: Frake Justin 
Published: September 2016

This paper investigates why audiences devalue organizations that behave inauthentically. One explanation is that inauthenticity leads to lower perceptions of product quality. This stems from the audience’s doubt of an inauthentic actor’s capability and commitment to produce high-quality goods. Another explanation is that audiences discount the symbolic value—or what the object represents—of products from inauthentic organizations. I empirically test each of these mechanisms in the craft beer industry. First, I exploit exogenous variation in consumers’ knowledge of craft brewers’ inauthentic identity (whether they are owned by a corporate brewer) to empirically demonstrate an inauthenticity discount. Next, I decompose audience evaluations to show that knowledge of a producer’s inauthenticity does not have a statistically significant impact on evaluators’ sensory experience of the product—its taste, smell, appearance, or mouthfeel—but that it does affect audience evaluations of the product’s symbolic value. This paper was accepted by Olav Sorenson, organizations.
Primary production calculations for sea ice from bio-optical observations in the Baltic Sea
Authors: Müller Susann , Vähätalo Anssi V. , Uusikivi Jari , Majaneva Markus , Majaneva Sanna , Autio Riitta , Rintala Janne-Markus 
Published: September 2016

Abstract
Bio-optics is a powerful approach for estimating photosynthesis rates, but has seldom been applied to sea ice, where measuring photosynthesis is a challenge. We measured absorption coefficients of chromophoric dissolved organic matter (CDOM), algae, and non-algal particles along with solar radiation, albedo and transmittance at four sea-ice stations in the Gulf of Finland, Baltic Sea. This unique compilation of optical and biological data for Baltic Sea ice was used to build a radiative transfer model describing the light field and the light absorption by algae in 1-cm increments. The maximum quantum yields and photoadaptation of photosynthesis were determined from 14C-incorporation in photosynthetic-irradiance experiments using melted ice. The quantum yields were applied to the radiative transfer model estimating the rate of photosynthesis based on incident solar irradiance measured at 1-min intervals. The calculated depth-integrated mean primary production was 5 mg C m–2 d–1 for the surface layer (0–20 cm ice depth) at Station 3 (fast ice) and 0.5 mg C m–2 d–1 for the bottom layer (20–57 cm ice depth). Additional calculations were performed for typical sea ice in the area in March using all ice types and a typical light spectrum, resulting in depth-integrated mean primary production rates of 34 and 5.6 mg C m–2 d–1 in surface ice and bottom ice, respectively. These calculated rates were compared to rates determined from 14C incorporation experiments with melted ice incubated in situ. The rate of the calculated photosynthesis and the rates measured in situ at Station 3 were lower than those calculated by the bio-optical algorithm for typical conditions in March in the Gulf of Finland by the bio-optical algorithm. Nevertheless, our study shows the applicability of bio-optics for estimating the photosynthesis of sea-ice algae.
Estimating Arctic sea-ice freeze-up and break-up from the satellite record: A comparison of different approaches in the Chukchi and Beaufort Seas
Authors: Johnson Mark , Eicken Hajo 
Published: September 2016

1. Abstract
The recognized importance of the annual cycle of sea ice in the Arctic to heat budgets, human behavior, and ecosystem functions, requires consistent definitions of such key events in the ice cycle as break-up and freeze-up. An internally consistent and reproducible approach to characterize the timing of these events in the annual sea-ice cycle is described. An algorithm was developed to calculate the start and end dates of freeze-up and break-up and applied to time series of satellite-derived sea-ice concentration from 1979 to 2013. Our approach builds from discussions with sea-ice experts having experience observing and working on the sea ice in the Bering, Chukchi and Beaufort Seas. Applying the algorithm to the 1979–2013 satellite data reveals that freeze-up is delayed by two weeks per decade for the Chukchi coast and one week per decade for the Beaufort coast. For both regions, break-up start is arriving earlier by 5–7 days per decade and break-up end is arriving earlier by 10–12 days per decade. In the Chukchi Sea, “early” break-up is arriving earlier by one month over the 34-year period and alternates with a “late” break-up. The calculated freeze-up and break-up dates provide information helpful to understanding the dynamics of the annual sea-ice cycle and identifying the drivers that modify this cycle. The algorithm presented here, and potential refinements, can help guide future work on changes in the seasonal cycle of sea ice. The sea-ice phenology of freeze-up and break-up that results from our approach is consistent with observations of sea-ice use. It may be applied to advancing our understanding and prediction of the timing of seasonal navigation, availability of ice as a biological habitat, and assessment of numerical models.
A prospective randomised controlled trial of the fibular nailversusstandard open reduction and internal fixation for fixation of ankle fractures in elderly patients
Authors: White T. O. , Bugler K. E. , Appleton P. , Will† E. , McQueen M. M. , Court-Brown C. M. 
Published: September 2016

AimsThe fundamental concept of open reduction and internal fixation (ORIF) of ankle fractures has not changed appreciably since the 1960s and, whilst widely used, is associated with complications including wound dehiscence and infection, prominent hardware and failure. Closed reduction and intramedullary fixation (CRIF) using a fibular nail, wires or screws is biomechanically stronger, requires minimal incisions, and has low-profile hardware. We hypothesised that fibular nailing in the elderly would have similar functional outcomes to standard fixation, with a reduced rate of wound and hardware problems.Patients and MethodsA total of 100 patients (25 men, 75 women) over the age of 65 years with unstable ankle fractures were randomised to undergo standard ORIF or fibular nailing (11 men and 39 women in the ORIF group, 14 men and 36 women in the fibular nail group). The mean age was 74 years (65 to 93) and all patients had at least one medical comorbidity. Complications, patient related outcome measures and cost-effectiveness were assessed over 12 months.ResultsSignificantly fewer wound infections occurred in the fibular nail group (p = 0.002). At one year, there was no evidence of difference in mean functional scores (Olerud and Molander Scores 63; 30 to 85, versus 61; 10 to 35, p = 0.61) or scar satisfaction. The overall cost of treatment in the fibular nail group was £91 less than in the ORIF group despite the higher initial cost of the implant.ConclusionWe conclude that the fibular nail allows accurate reduction and secure fixation of ankle fractures, with a significantly lower rate of soft-tissue complications, and is more cost-effective than ORIF. Cite this article: Bone Joint J 2016;98-B:1248–52.
The anatomical reduction of a moderate or severe stable slipped capital femoral epiphysis by modified Dunn subcapital osteotomy using the Ganz approach
Authors: Abdelazeem A. H. , Beder F. K. , Abdel Karim M. M. , Abdelazeem H. , Abdel-Ghani H. 
Published: September 2016

Aims This study analysed the clinical and radiological outcome of anatomical reduction of a moderate or severe stable slipped capital femoral epiphysis (SCFE) treated by subcapital osteotomy (a modified Dunn osteotomy) through the surgical approach described by Ganz. Patients and Methods We prospectively studied 31 patients (32 hips; 16 females and five males; mean age 14.3 years) with SCFE. On the Southwick classification, ten were of moderate severity (head-shaft angle > 30° to 60°) and 22 were severe (head-shaft angle > 60°). Each underwent open reduction and internal fixation using an intracapsular osteotomy through the physeal growth plate after safe surgical hip dislocation. Unlike the conventional procedure, 25 hips did not need an osteotomy of the apophysis of the great trochanter and were managed using an extended retinacular posterior flap. Results Clinical outcome was assessed using the range of movement and the Harris Hip (HHS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC), and Merle d’Aubigné scores, while radiological measurements included slip and alpha angles. The mean duration of follow-up was 24.1 months (12 to 40). There was a significant improvement in all clinical and radiological measurements after treatment (p < 0.001). Post-operative major complications were one deep infection and one case of femoral head collapse. Conclusion These findings suggest that a modified Dunn osteotomy carried out through Ganz approach is a safe and effective method of treating the stable SCFE with a high degree of slip. Cite this article: Bone Joint J 2016;98-B:1283–8.
Does laminar flow ventilation reduce the rate of infection?
Authors: Pinder E. M. , Bottle A. , Aylin P. , Loeffler M. D. 
Published: September 2016

Aims To determine whether there is any difference in infection rate at 90 days between trauma operations performed in laminar flow and plenum ventilation, and whether infection risk is altered following the installation of laminar flow (LF). Patients and Methods We assessed the impact of plenum ventilation (PV) and LF on the rate of infection for patients undergoing orthopaedic trauma operations. All NHS hospitals in England with a trauma theatre(s) were contacted to identify the ventilation system which was used between April 2008 and March 2013 in the following categories: always LF, never LF, installed LF during study period (subdivided: before, during and after installation) and unknown. For each operation, age, gender, comorbidity, socio-economic deprivation, number of previous trauma operations and surgical site infection within 90 days (SSI90) were extracted from England’s national hospital administrative Hospital Episode Statistics database. Crude and adjusted odds ratios (OR) were used to compare ventilation groups using hierarchical logistic regression. Subanalysis was performed for hip hemiarthroplasties. Results A total of 803 065 trauma operations were performed during this time; 19 hospitals installed LF, 124 already had LF, 13 had PV and the type of ventilation was unknown in 28. Patient characteristics were similar between the groups. The rate of SSI90 was similar for always LF and PV (2.7% and 2.4%). For hemiarthroplasties of the hip, the rates of SSI90 were significantly higher for LF compared with PV (3.8% and 2.6%, OR 1.45, p = 0·001). Hospitals installing LF did not see any statistically significant change in the rate of SSI90. Conclusion The results of this observational study imply that infection rate is similar when orthopaedic trauma surgery is performed in LF and PV, and is unchanged by installing LF in a previously PV theatre. Cite this article: Bone Joint J 2016;98-B:1262–9.