bluuebunny/crossref_metadata_2025_split huggingface dataset:
Targeted antenatal anti‐D prophylaxis program for RhD‐negative pregnant women – outcome of the first two years of a national program in Finland
Authors: Haimila Katri , Sulin Kati , Kuosmanen Malla , Sareneva Inna , Korhonen Anu , Natunen Suvi , Tuimala Jarno , Sainio Susanna 
Published: July 2017

AbstractIntroductionThe aim of this study was to assess the accuracy of the non‐invasive fetal RHD test at 24–26 weeks of gestation as part of the national antenatal screening program to target routine antenatal anti‐D prophylaxis (RAADP) at 28–30 weeks at women carrying an RhD‐positive fetus.Material and methodsA prospective cohort study involving all maternity care centers and delivery hospitals in Finland between February 2014 and January 2016. Fetal RHD genotyping using cell‐free fetal DNA in maternal plasma was performed with real‐time polymerase chain reaction in a centralized setting. The results were systematically compared with the serological newborn RhD typing. The main outcome measure was the accuracy of the fetal RHD assay; the secondary variable was compliance with the newly introduced RAADP program.ResultsFetal RHD was screened from 10 814 women. For the detection of fetal RHD, sensitivity was 99.99% [95% confidence interval (CI) 99.92–99.99] and specificity 99.81% (95% CI 99.60–99.92). One false‐negative and seven false‐positive results were reported by the delivery hospitals in two years. The negative predictive value of the test was 99.97% (95% CI 99.81–99.99). At the end of the study period, over 98% of the RhD‐negative women participated in the new screening program.ConclusionsThe targeted RAAPD program was implemented effectively in the national maternity care program in Finland. An accurate fetal RHD screening test allows discontinuation of newborn testing without risking the postnatal prophylaxis program. In the future, the main area to investigate will be the clinical effect of RAADP on subsequent pregnancies.
Self‐management of stress urinary incontinence via a mobile app: two‐year follow‐up of a randomized controlled trial
Authors: Hoffman Victoria , Söderström Lars , Samuelsson Eva 
Published: July 2017

AbstractIntroductionWe investigated the long‐term effects of using a mobile app to treat stress urinary incontinence with a focus on pelvic floor muscle training.Material and methodsA previous randomized controlled trial of 123 women aged 27–72 years found that three months of self‐managing stress urinary incontinence with support from the Tät® app was effective. We followed up the women in the app group (n = 62) two years after the initial trial with the same primary outcomes for symptom severity (International Consultation on Incontinence Questionnaire Short Form) and condition‐specific quality of life (ICIQ‐Lower Urinary Tract Symptom Quality of Life) and compared the scores with those at baseline.ResultsOf the 62 women, 61 and 46 (75.4%), respectively, participated in three‐month and two‐year follow‐ups. Baseline data did not differ between responders and non‐responders at follow‐up. The mean decreases in International Consultation on Incontinence Questionnaire Short Form and ICIQ‐Lower Urinary Tract Symptom Quality of Life scores after two years were 3.1 (95% confidence interval 2.0–4.2) and 4.0 (95% confidence interval 2.1–5.9), respectively. Of the 46 women, four (8.7%) rated themselves as very much better, nine (19.6%) as much better, and 16 (34.8%) as a little better. The use of incontinence protection products decreased significantly (p = 0.04), and the proportion of women who felt they could contract their pelvic muscles correctly increased from 14/46 (30.4%) at baseline to 31/46 (67.4%) at follow‐up (p < 0.001).ConclusionsSelf‐management of stress urinary incontinence with support from the Tät® app had significant and clinically relevant long‐term effects and may serve as first‐line treatment.
Is there a revision needed of the current FIGO staging system?
Authors: Menczer Joseph 
Published: July 2017

AbstractThe FIGO staging system has undergone many modifications since it first appeared in about the middle of the previous century. Due to the use of modern diagnostic tools, namely computed tomography, magnetic resonance imaging, positron emission tomography, sentinel lymph node biopsy and neoadjuvant chemotherapy, certain gynecological cancer cases cannot be allocated to a specific stage if one wishes to adhere strictly to FIGO requirements. In these circumstances such cases actually remain unstaged. This should prompt appropriate modifications of the current FIGO staging system so that it fulfills its aims.
Veno‐Arterial Extracorporeal Membrane Oxygenation Support in Patients Undergoing Aortic Surgery
Authors: Zhong Zhaopeng , Jiang Chunjing , Yang Feng , Hao Xing , Xing Jialin , Wang Hong , Hou Xiaotong 
Published: July 2017

AbstractVeno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) is an option for mechanical support for patients with postcardiotomy cardiogenic shock (PCS). However, the use of VA‐ECMO in patients suffering from aortic disease with PCS has not been greatly reported. This is a retrospective review of adult patients undergoing aortic surgery who received VA‐ECMO support to treat refractory PCS from August 2009 to May 2016. A total of 36 patients who underwent aortic surgery with VA‐ECMO support for refractory PCS were included. Preoperative, perioperative, and postoperative variables were assessed and analyzed for possible correlation with in‐hospital mortality. After a mean duration of 3.6 ± 2.9 days, 24 patients (67%) were weaned off VA‐ECMO, and 18 patients (50%) were discharged from the hospital. The overall in‐hospital mortality was 50%. The main cause of death was multiple organ dysfunction. The survivors had a lower level of preoperative creatine kinase‐MB (CK‐MB), a higher rate of antegrade cannulation, and a lower lactate level at 12 h, respectively. Relevant factors for in‐hospital mortality were retrograde‐flow cannulation (odds ratio [OR], 2.49), peak lactate levels greater than 20 mmol/L (OR, 5.0), and preoperative CK‐MB greater than 100 IU/L (OR, 6.40). Antegrade cannulation may provide better perfusion and should be emphasized to improve outcomes. Additionally, levels of peak serum lactate and preoperative CK‐MB may be relevant factors for in‐hospital mortality in aortic patients with PCS.
Learning curve for the thoracoscopic repair of esophageal atresia with tracheoesophageal fistula
Authors: Okuyama Hiroomi , Tazuke Yuko , Ueno Takehisa , Yamanaka Hiroaki , Takama Yuichi , Saka Ryuta , Usui Noriaki , Soh Hideki , Yonekura Takeo 
Published: July 2017

AbstractAimThoracoscopic repair (TR) of esophageal atresia with tracheoesophageal fistula (EA/TEF) remains a considerable challenge, even for the most experienced pediatric surgeons. The aim of this study is to report the outcomes of our experience with TR of EA/TEF and to determine the learning curve for this procedure.MethodsEleven consecutive cases that had undergone TR of EA/TEF at our institutes were included in this study. The medical charts were reviewed retrospectively. To determine the learning curve for TR of EA/TEF, a logarithmic curve‐fitting analysis was performed. The data were expressed as medians with ranges.ResultsThe median age and birth weight were 1 day (range, 1–3 days) and 2.8 kg (range, 2.5–3.7 kg), respectively. TR was completed in all cases without any complications. The median operative time was 230 min (range, 164–383 min). There were no cases of anastomotic leakage. One patient with a long gap required repeated balloon dilatation for refractory anastomotic stricture. No mortality or recurrence of tracheoesophageal fistula occurred. The operative time was significantly longer in patients with a long gap (>20 mm) than in those with a shorter gap. Once the three cases with a long gap had been excluded, the operative time decreased as the number of treated cases increased. The relationship between the operative time and case number fit a logarithmic function curve well (operative time in minutes = 300 – 62 × log (case number), R2 = 0.8359, P = 0.0015).ConclusionsOur results suggest that TR of EA/TEF is a safe procedure. It has a considerable learning curve, but requires advanced endoscopic surgical skills.
Mental capacity to consent to research? Experiences of consenting adults with intellectual disabilities and/or autism to research
Authors: Hamilton Jahnese , Ingham Barry , McKinnon Iain , Parr Jeremy R. , Tam Louise Yuen‐Chong , Le Couteur Ann 
Published: July 2017

Accessible Summary

The NHS Constitution states that all patients should have opportunity to take part in approved research
This study asked clinical researchers how they include people with intellectual disabilities and/or autism in research
Many barriers were identified that relate to making mental capacity judgements
Many researchers agreed new resources that support consent and capacity judgements for research would be helpful and gave some ideas about what could help
.AbstractBackgroundAdults with intellectual disabilities and/or autism are often excluded from participating in health and healthcare research. Understanding study information, which is an important aspect of demonstrating capacity to give informed consent, can be a particular challenge. This study surveyed clinical researchers to discover: (i) their experiences of assessing mental capacity for research; (ii) what methods they used to facilitate the inclusion of adults with intellectual disabilities and/or autism; and (iii) their views about a proposal to develop new resources to facilitate mental capacity judgements with adults with intellectual disabilities and/or autism for informed consent for research.MethodsClinical researchers in North East England who conduct research with NHS patients with intellectual disabilities and/or autism were invited to participate in a 22‐item self‐completed semi‐structured questionnaire survey, either online or on paper.ResultsTwenty‐one clinicians completed the survey (response rate 30.4%). Participants reported on 18 research studies which included people with intellectual disabilities and/or autism. In many studies people who lacked capacity to give informed consent were excluded, and often shortcuts were taken in judging capacity. Limited adaptations to support capacity were used. Respondents welcomed the proposal of developing assistive resources that could support capacity judgements and informed consent to research.ConclusionsTo improve access to research for people with intellectual disabilities and/or autism, researchers need robust methods to facilitate informed consent and mental capacity judgements. Future research should determine which assistive resources show potential to support informed consent and capacity decisions, and whether such resources could improve inclusion in research.
Child understandings of the causation of childhood burn injuries: Child activity, parental domestic demands, and impoverished settings
Authors: Titi N. , van Niekerk A. , Ahmed R. 
Published: July 2017

AbstractBackgroundBurns are a global public health problem. In South Africa, the rate of paediatric burn deaths is 5 times higher than other upper middle‐income countries, with concentrations in impoverished settings. Globally, the majority of research focuses on expert and caregiver descriptions of burn occurrence, causation, and prevention, with limited consideration of children's perspectives. This study investigated children's understanding of the causation and prevention of childhood burns.MethodsData were collected from eighteen 10‐ to 11‐year‐old children living in selected impoverished, fire‐affected neighbourhoods in Cape Town, through 3 isiXhosa focus groups. All focus groups were transcribed, coded, and analysed for emerging themes through thematic analysis.ResultsThemes regarding burn causation and risks centred around 4 themes: (a) developmental limits in context; (b) domestic chores, child capacity, and inability to say “no”; (c) inadequate supervision and compromised caregiving; and (d) unsafe structures. Child accounts of prevention pertained to (e) burn injury prevention activities in comprised environments and emphasized child agency, and upgrading the physical environment.ConclusionThe children in this study ascribed burn injuries as the consequence of their developmental limits in the context of poverty, constraints on parental supervision, and unsafe environments. The children recommended safety education and upgrading their physical environments as part of burns injury prevention. The child accounts offer useful insights to inform safety interventions in impoverished settings.
Radiofrequency ablation for the management of thyroid nodules: A critical appraisal of the literature
Authors: Cesareo Roberto , Palermo Andrea , Pasqualini Valerio , Cianni Roberto , Gaspa Gianluigi , Manfrini Silvia , Pacella Claudio Maurizio 
Published: July 2017

SummaryThe majority of benign thyroid nodules are asymptomatic, remain stable in size and do not require treatment. However, a minority of patients with growing nodules may have local symptoms or cosmetic concerns, and thus demand surgical therapy. The timely use of ultrasound‐guided, minimally invasive thermal therapies has changed the natural history of benign, enlarging thyroid nodules (TNs). These procedures produce persistent shrinkage of TNs and an improvement of local symptoms. Among the various procedures, percutaneous ethanol injection represents the first‐line treatment for thyroid cysts, while in solid cold nodules, laser and radiofrequency ablation (RFA) have proven to be very effective and safe techniques in producing significant volume reduction that remains stable over several years. In particular, RFA seems to be suited for the management of small and medium nodules, while larger nodules may require repeated RFA treatments, and could be difficult to treat if they extend into the chest. RFA is performed in outpatient clinics and has a lower risk of complications compared to surgery. However, to date, there is still no unanimous consensus on the percutaneous treatment of benign nodules using such minimally invasive thermal techniques. In this review, we critically revise the literature to identify patients who are more likely to benefit from RFA treatment as an alternative to surgery.
Consumption Structure of Migrant Worker Families in China
Authors: Cao Guangzhong , Li Kai , Wang Ruimin , Liu Tao 
Published: July 2017

AbstractThis study draws on a survey of migrants in 12 cities across four major urbanizing areas in China and investigates the structure of migrant worker families' urban and rural consumption. The results show that the structure of migrant worker families' consumption has been dominated by survival consumption. These families tend to live frugally in cities while engaging in conspicuous consumption in their rural hometowns. The structure of migrant worker families' consumption is mainly shaped by their income stability and wealth levels rather than their current income level. Moreover, migrant worker families with high educational levels and those who intend to settle permanently in cities are likely to allocate substantial expenditure to status and hedonic consumption and to upgrade their urban consumption structure.
China's Internet Finance: A Critical Review
Authors: Xu Jianguo 
Published: July 2017

AbstractChina's Internet finance industry developed explosively from 2012 to 2015. Undersupply of financial services, progress of information technology and accommodative regulations for Internet finance jointly explain the explosive development. Regulation tightened after the small‐scale P2P lending crisis in 2015. The present paper discusses the role of information technology and mega data analysis in financial services, with particular attention paid to some popular misconceptions. The paper predicts that large financial institutions and information technology companies will play a dominant role in the future development of Internet finance.
The fine needle aspiration of translocation sarcomas
Authors: VandenBussche C. J. , Adams C. L. , McDonald O. G. , Whitworth S. A. , Ali S. Z. 
Published: July 2017

IntroductionSoft tissue sarcomas comprise a heterogeneous group of clinically aggressive cancers that are often hard to classify on limited cytological samples. “Translocation sarcomas” (TS) are a diverse subset of such cancers, different from pleomorphic sarcomas, and characterised by unique single chromosomal translocations in each sarcoma subtype. Interestingly, despite their high‐grade biological behaviour, TS have deceptively monotonous and bland cytomorphology, therefore creating diagnostic issues on limited samples.Materials and methodsA retrospective search was conducted of the cytopathology archives of The Johns Hopkins Hospital revealing 147 translocation sarcoma cases over a 25‐year period.ResultsThe common morphological denominators for most translocation sarcomas were: hypercellularity, cellular monotony, mostly discohesive and single cells, round‐to‐oval or short spindled cells and a lack of necrosis. The exceptions were an inflammatory myofibroblastic tumour, in which cellular monotony was not present owing to the prominence of lymphocytes and plasma cells, and low‐grade fibromyxoid sarcoma, in which the specimens were generally hypocellular. Ancillary testing, especially immunoperoxidase staining, was often required for primary lesions.ConclusionDistinct morphological clues and subsequent ancillary testing (particularly immunoperoxidase staining) provide an accurate diagnosis on cytological interpretation of both, primary and recurrent/metastatic lesions.
Associations between drugs and small‐bowel mucosal bleeding: Multicenter capsule‐endoscopy study
Authors: Niikura Ryota , Yamada Atsuo , Maki Koutarou , Nakamura Masanao , Watabe Hirotsugu , Fujishiro Mitsuhiro , Oka Shiro , Esaki Motohiro , Fujimori Shunji , Nakajima Atsushi , Ohmiya Naoki , Matsumoto Takayuki , Tanaka Shinji , Koike Kazuhiko , Sakamoto Choitsu 
Published: July 2017

Background and AimAlthough several drugs may induce small‐bowel mucosal injuries, it is unclear whether these injuries contribute to overt small‐bowel bleeding. This study was designed to evaluate the associations between drug use and small‐bowel mucosal injury and between these mucosal injuries and overt bleeding in a disease‐relevant population.MethodsWe retrospectively studied patients with suspected small‐bowel diseases who underwent capsule endoscopy between 2010 and 2013. Drug exposure, Charlson Comorbidity Index, smoking, and alcohol consumption were assessed before capsule endoscopy. Adjusted odds ratios (AOR) and confidence intervals (CI) were estimated for small‐bowel mucosal injury and small‐bowel overt bleeding.ResultsIn total, 850 patients were analyzed during the study period. Median age was 64 years, and 544 patients (64.0%) were men. Among the patients with small‐bowel mucosal injury (n = 60) and without mucosal injury (n = 705), use of non‐steroidal anti‐inflammatory drugs (NSAIDs) (AOR 1.8, 95% CI 1.01–3.31) was significantly associated with an increased risk of small‐bowel mucosal injury compared with non‐use. Patients with small‐bowel mucosal injury with overt bleeding (n = 85) and without overt bleeding (n = 60) were compared, and no significant difference between the groups in the usage rates for NSAIDs, thienopyridine, other antiplatelets, anticoagulants, acetaminophen, tramadol hydrochloride, or steroids was revealed, even after adjusting for confounders.ConclusionAlthough the use of NSAIDs was significantly associated with an increased risk of small‐bowel mucosal injury, no significant associations were observed between the use of such drugs and small‐bowel overt bleeding.
Comparative efficacy and safety of gemigliptin versus linagliptin in type 2 diabetes patients with renal impairment: A 40‐week extension of the GUARD randomized study
Authors: Han Sang Youb , Yoon Sun Ae , Han Byoung Geun , Kim Sung Gyun , Jo Young‐Il , Jeong Kyung Hwan , Oh Kook‐Hwan , Park Hyeong Cheon , Park Sun‐Hee , Kang Shin‐Wook , Na Ki‐Ryang , Kang Sun Woo , Kim Nam‐Ho , Jang Younghwan , Kim Bogyeong , Shin Seonghye , Cha Dae Ryong 
Published: July 2017

AimsThe long‐term safety and efficacy of gemigliptin was evaluated in the present extension study after a 12‐week study during a 40‐week follow‐up period.MethodsThe main study was a randomized, placebo‐controlled, double‐blinded, phase IIIb study in which 50 mg of gemigliptin (N = 66) or placebo (N = 66) was administered to patients with type 2 diabetes mellitus (T2DM) and moderate or severe renal impairment over a 12‐week period. Patients with a glycated haemoglobin (HbA1c) level of 7% to 11% and an estimated glomerular filtration rate (eGFR) of 15 to 59 mL/min/1.73 m2 were enrolled in the main study. After 12 weeks, patients in the gemigliptin group continued to receive gemigliptin (N = 50), whereas patients in the placebo group were transitioned from placebo to linagliptin (N = 52). Each group received the indicated treatment over the subsequent 40‐week period. A total of 102 patients consented to participate in the extension study, and 79 patients ultimately completed the study.ResultsThe HbA1c levels of both groups were significantly reduced at week 52 compared with baseline. Specifically, the adjusted mean change ± standard error in HbA1c level in the gemigliptin and placebo/linagliptin groups was 1.00% ± 0.21% and 0.65% ± 0.22% lower at week 52 than at baseline (P < .001 and P = .003), respectively. No significant difference in the change in HbA1c level was found between the 2 groups (P = .148). Trends in fasting plasma glucose, fructosamine and glycated albumin levels in the 2 groups were similar to trends in HbA1c levels. The eGFR of both groups was also significantly lower at week 52 than at baseline, and no significant difference in change in eGFR was found between the 2 groups. In contrast, both drugs had little effect on urinary albumin excretion, although both drugs significantly reduced the urinary type IV collagen level. The overall rates of adverse events were similar between the 2 groups.ConclusionsGemigliptin and linagliptin did not differ with respect to safety and efficacy in patients with T2DM and renal impairment. The 2 drugs had similar glucose‐lowering effects, and the changes in eGFR and albuminuria were also similar. Additionally, the risk of side effects, including hypoglycaemia, was similar between the 2 groups.