bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lessons Learned From 35 Cases of Laryngeal Foreign Bodies Undergoing Misdiagnosis in Pediatric Population
Authors: Chen Qingguo , Chu Hanqi , Tao Yanling , Huang Hongyan , Peng Liyan 
Published: December 2016

Objectives: To present 35 cases of laryngeal foreign bodies (FBs) in pediatric population undergoing misdiagnosis so as to draw on our lessons to improve early diagnosis. Methods: A retrospective analysis over 15 years was conducted of 35 cases of laryngeal FBs undergoing misdiagnosis in children. Meanwhile, a control group, including 42 cases of laryngeal FBs without misdiagnosis in children, was set. These patients’ clinical data were collected and analyzed to identify the risk factors for misdiagnosis. Results: The results of chi-square test and univariate analysis both showed a significant difference in time elapsed between discomforts and admission, witnessed foreign body (FB) aspiration history, biphasic stridor, aphonia, roentgenologic findings, and type and size of FBs between the misdiagnosed group and control group. Multivariate analysis further identified delayed doctor visits, unwitnessed FB aspiration history, nonspecific symptoms, and negative roentgenologic manifestations as independent risk factors for misdiagnosis. Conclusions: Diagnosis of laryngeal FBs, especially small, thin, and radiolucent FBs, remains a challenge. We emphasized the importance of timely doctor visits, careful clinical history inquisition, and prompt performance of radiographic or endoscopic examinations for diagnosis.
HPV-Positive Oropharyngeal Cancer Via p16 Immunohistochemistry in Japan
Authors: Toman Julia , Von Larson Scott , Umeno Hirohito , Kurita Takashi , Furusaka Tohru , Hasegawa Hisashi , Prasad Manju L. , Sasaki Clarence T. 
Published: December 2016

Objectives: Human papillomavirus (HPV) has emerged as a driving cause of head and neck cancer, but investigations outside the West are limited. A p16 immunohistochemistry is a commonly used biomarker for HPV cancers. We sought to investigate the pathology and rates of HPV head and neck oropharyngeal cancer in Japan via p16 immunohistochemistry at 2 institutions in Japan. Methods: Fifty-nine oropharyngeal specimens from 2 university hospitals in Japan were examined for morphology and p16 immunohistochemistry. The rate of p16 positivity was then determined, and the 2 groups were compared for differences in age, smoking history, gender, and stage of presentation and mortality. Results: The rate of p16 positivity among the oropharyngeal specimens was 29.5%. There were important differences in the pathology compared to morphology usually seen in the US. The patients with p16+ cancer tended to be younger. There was no significant difference in smoking status. Patients with p16+ cancers trended toward better survival. Conclusion: There appears to be a geographical difference in HPV rates of oropharyngeal cancers with persistently lower rates in Asian countries when compared to Western Europe and the US. Conclusions about HPV head and neck squamous cell carcinoma (HNSCC) in Western countries may not be generalizable across the globe at this time.
Responding to challenges for people with psychotic illness: Updated evidence from the Survey of High Impact Psychosis
Authors: Morgan Vera A , Waterreus Anna , Carr Vaughan , Castle David , Cohen Martin , Harvey Carol , Galletly Cherrie , Mackinnon Andrew , McGorry Patrick , McGrath John J , Neil Amanda L , Saw Suzy , Badcock Johanna C , Foley Debra L , Waghorn Geoff , Coker Sarah , Jablensky Assen 
Published: December 2016

Objective: The objective is to summarise recent findings from the 2010 Australian Survey of High Impact Psychosis (SHIP) and examine their implications for future policy and planning to improve mental health, physical health and other circumstances of people with a psychotic disorder. Methods: Survey of High Impact Psychosis collected nationally representative data on 1825 people with psychotic illness. Over 60 papers have been published covering key challenges reported by participants: financial problems, loneliness and social isolation, unemployment, poor physical health, uncontrolled symptoms of mental illness, and lack of stable, suitable housing. Findings are summarised under the rubric of participant-ranked top challenges. Results: The main income source for the majority (85%) of participants was a government benefit. Only one-third was employed, and the most appropriate employment services for this group were under-utilised. High rates of loneliness and social isolation impacted mental and physical health. The rate of cardiometabolic disease was well above the general population rate, and associated risk factors were present from a very young age. Childhood abuse (30.6%), adult violent victimisation (16.4%) and alcohol and substance abuse/dependence (lifetime rates of 50.5% and 54.5%, respectively) complicated the clinical profile. Treatment with medication was suboptimal, with physical health conditions undertreated, a high rate of psychotropic polypharmacy and underutilisation of clozapine in chronic persistent psychotic illness. Only 38.6% received evidence-based psychosocial therapies. In the previous year, 27.4% had changed housing and 12.8% had been homeless, on average for 155 days. Conclusion: Money, social engagement and employment are the most important challenges for people with psychotic illness, as well as good physical and mental health. An integrated approach to recovery is needed to optimise service delivery and augment evidence-based clinical practice with measures to improve physical health and social circumstances. Meeting these challenges has the potential to reduce costs to government and society, as well as promote recovery.
Inter-laboratory proficiency tests in measuring thermal insulation and evaporative resistance of clothing using the Newton-type thermal manikin
Authors: Młynarczyk Magdalena , Havenith George , Léonard Jean , Martins Rui , Hodder Simon 
Published: December 2016

Clothing acts as an important barrier for heat and vapor transfer between the human body and the environment. Parameters that could describe that transfer include, inter alia, thermal insulation (the so-called dry heat exchange) and evaporative resistance (the so-called wet heat exchange). Once the above-mentioned parameters are determined, it is possible to consciously adapt clothing ensembles to the existing thermal environment in the workplace. In order to validate the mentioned method of thermal insulation and evaporative resistance measurements, proficiency tests (PTs) were organized. The main goal of the PT was to compare thermal insulation and evaporative resistance for one set of clothing using the Newton-type thermal manikin. In total, four laboratories participated in the PT study. The reference value of the thermal insulation ( It) and evaporative resistance ( Ret) were calculated as the mean of all the results. The assessment criteria included permissible errors for thermal insulation and evaporative resistance measurements, which were 4% and 10%, respectively. Calculations included, inter alia, z-scores and indicators, such as the inter-laboratory coefficient of variation or the reproducibility limit. The results contribute to the worldwide discussion on standardized studies of evaporative resistance of clothing.
Effects of pumping station configuration on the energy performance of district cooling systems
Authors: Lo Anthony CW , Jones Phil , Yik Francis WH 
Published: December 2016

In this paper, a hypothetical district representing the typical urban districts in Hong Kong was considered and a district cooling system model was designed for this district. Mathematical models were tailor-designed for all the major district cooling system equipment to simulate the effects of changing the pumping station’s configuration on the energy performance of the district cooling system. The measures included the use of multiple pumping stations and an unequal number of pumps in each station. In view of the vast number of pumping station combinations possible for analysis, a hydraulic gradient evaluation method was adopted to assist a quick assessment and exploration of those combinations that would be technically feasible. Furthermore, the energy performance of all these technically feasible combinations was evaluated to identify an optimum design that would lead to the lowest electricity consumption. Practical application: In a district cooling system where there is only one main pumping station for distributing chilled water to all the buildings in the district, the chilled water flow rate and pressure head are very high. Adding booster pumping stations can help to reduce pressure head, pump size and hence power demand of the main pumping station. In this paper, the effects of different pumping station configurations on the energy performance of a district cooling system were investigated. The configuration that could mitigate the impacts of a low delta-T on the energy performance of the district cooling system was also identified.
Extracorporeal membrane oxygenation in transcatheter aortic valve replacement
Authors: Dolmatova Elena , Moazzami Kasra , Cocke Thomas P , Elmann Elie , Vaidya Pranay , Ng Arthur F , Satya Kumar , Narayan Rajeev L 
Published: December 2016

Background Patients undergoing transcatheter aortic valve replacement can experience severe perioperative complications leading to hemodynamic instability and death. Venoarterial extracorporeal membrane oxygenation can be used to provide cardiorespiratory support during this time. Methods From 2012 to 2015, of 247 patients who underwent transcatheter aortic valve replacement, 6 (2.42%) required extracorporeal membrane oxygenation support. Their mean age was 82 ± 7.4 years, mean Society of Thoracic Surgeons score was 9.4 ± 6.6, and mean aortic gradient was 28.3 ± 12 mm Hg. Rescue extracorporeal membrane oxygenation was required for hemodynamic instability due to ventricular fibrillation ( n = 1), respiratory failure ( n = 1), left ventricular wall rupture ( n = 2), and aortic annulus rupture ( n = 1). In one patient, prophylactic extracorporeal membrane oxygenation was required due to advanced heart failure. Additional procedures included valve-in-valve implantation ( n = 1), conversion to an open procedure ( n = 3), and intraaortic balloon pump insertion ( n = 1). Results The median hospital stay was 20 days. There were 2 hospital deaths in patients whose hospital course was complicated by left ventricular wall rupture or aortic annulus rupture with resulting tamponade. Among the 4 survivors, one required continuous ventilator support following discharge, and 3 experienced no major complications during the first month after discharge. Conclusions Extracorporeal membrane oxygenation can be considered a viable option for high-risk patients undergoing transcatheter aortic valve replacement and those who develop cardiac complications following this procedure and require cardiorespiratory support.
Preoperative pulmonary rehabilitation for marginal-function lung cancer patients
Authors: Hashmi Asra , Baciewicz Frank A , Soubani Ayman O , Gadgeel Shirish M 
Published: December 2016

Background This study aimed to evaluate the impact of preoperative pulmonary rehabilitation in lung cancer patients undergoing pulmonary resection surgery with marginal lung function. Methods Short-term outcomes of 42 patients with forced expiratory volume in 1 s < 1.6 L who underwent lung resection between 01/2006 and 12/2010 were reviewed retrospectively. They were divided into group A (no preoperative pulmonary rehabilitation) and group B (receiving pulmonary rehabilitation). In group B, a second set of pulmonary function tests was obtained. Results There were no significant differences in terms of sex, age, race, pathologic stage, operative procedure, or smoking years. Mean forced expiratory volume in 1 s and diffusing capacity for carbon monoxide in group A was 1.40 ± 0.22 L and 10.28 ± 2.64 g∙dL−1 vs. 1.39 ± 0.13 L and 10.75 ± 2.08 g∙dL−1 in group B. Group B showed significant improvement in forced expiratory volume in 1 s from 1.39 ± 0.13 to 1.55 ± 0.06 L ( p = 0.02). Mean intensive care unit stay was 6 ± 5 days in group A vs. 9 ± 9 days in group B ( p = 0.22). Mean hospital stay was 10 ± 4 days in group A vs. 14 ± 9 days in group B ( p = 0.31). There was no significant difference in morbidity or mortality between groups. Conclusion Preoperative pulmonary rehabilitation can significantly improve forced expiratory volume in 1 s in some marginal patients undergoing lung cancer resection. However, it does not improve length of stay, morbidity, or mortality.
Additional effects of topical tranexamic acid in on-pump cardiac surgery
Authors: Taksaudom Noppon , Siwachat Sophon , Tantraworasin Apichat 
Published: December 2016

Objective Postoperative bleeding after cardiac surgery is commonly associated with hyperfibrinolysis. This study was designed to evaluate the efficacy of topical tranexamic acid in addition to intravenous tranexamic acid in reducing bleeding in cardiac surgery cases. Methods From July 1, 2014 to September 30, 2015, 82 patients who underwent elective on-pump cardiac surgery were randomized into a tranexamic acid group and a placebo group. In the tranexamic acid group, 1 g of tranexamic acid dissolved in 100 mL of normal saline solution was poured into the pericardium during sternal closure; the placebo group had 100 mL of saline only. Two patients were excluded from the study due to obvious surgical bleeding. The primary endpoint was total blood loss 24 h after surgery. Repeated measures with mixed models was used to analyze bleeding over time. Results There was no significant difference in demographic and intraoperative data except for a significantly lower platelet count preoperatively in the tranexamic acid group ( p = 0.030). There was no significant difference in postoperative drainage volumes at 8, 16, and 24 h, postoperative bleeding over time (coefficient = 0.713, p = 0.709), or blood product transfusion between the groups. There were no serious complications. Conclusions Topical tranexamic acid is safe but it adds no additional efficacy to the intravenous application in reducing postoperative blood loss. Intravenous tranexamic acid administration alone is sufficient antifibrinolytic treatment to enhance the hemostatic effects during on-pump cardiac surgery.
The short-term efficacy of vena cava filters for the prevention of pulmonary embolism in patients with venous thromboembolism receiving anticoagulation: Meta-analysis of randomized controlled trials
Authors: Jiang Jun , Jiao Yuanyong , Zhang Xiwei 
Published: December 2016

Objectives To perform a meta-analysis of randomized controlled trials assessing the effectiveness of inferior vena cava filters in patients with deep vein thrombosis for preventing pulmonary embolism. Method Relevant randomized controlled trials of inferior vena cava filters for the prevention of pulmonary embolism were identified by searching electronic databases updated in February 2016. Relative risks of recurrent pulmonary embolism, recurrent deep vein thrombosis, and mortality at three months were analyzed. Results Three published randomized controlled trials were included involving a total of 863 deep vein thrombosis patients. No significant differences were detected with inferior vena cava filters placement with regard to the incidence of recurrent pulmonary embolism or fatal pulmonary embolism. There were also no significant differences in the incidence of recurrent deep vein thrombosis or mortality with inferior vena cava filters placement at three months. Conclusions Inferior vena cava filter in addition to anticoagulation was not associated with a reduction in the incidence of recurrent pulmonary embolism as compared with anticoagulation alone in patients with deep vein thrombosis in the short term.
Clinicopathological significance of oestrogen receptor expression in non-small cell lung cancer
Authors: Chen Xiang-Qi , Zheng Li-Xian , Li Zhi-Ying , Lin Ting-Yan 
Published: December 2016

Objective To investigate the expression and clinicopathological significance of the oestrogen receptor (ER) in non-small cell lung cancer (NSCLC). Methods ER expression was examined by immunohistochemical staining of tumour tissue and adjacent normal lung tissue from 67 NSCLC patients. The relationships between ER expression and clinicopathological features were analysed. Results A higher percentage of NSCLC tissues (28/67, 41.79%) than adjacent normal lung tissues (10/55, 18.18%) were ER positive. ER expression correlated with tumour differentiation but not with gender, age, tumour histological type, tumour size, lymph node metastasis, or clinical TNM staging. The median survival times of patients with ER-positive ( n = 28) and -negative ( n = 39) tumours were 36 and 27 months, respectively. The 1-, 3-, and 5-year survival rates were higher for patients with ER-positive tumours than for patients with ER-negative tumours. Conclusion ER expression could be a useful prognostic biomarker and therapeutic target for patients with NSCLC.
The association of uric acid with leukoaraiosis
Authors: Li Jun-Jing , Huang Yin-Hui , Lin You-Yu , Li Mi-Mi , Chen Ya-Fang , Cai Ruo-Wei 
Published: December 2016

Objective To explore the possible correlation between uric acid levels and leukoaraiosis (LA). Methods This cross-sectional study enrolled patients who presented with some neurological discomfort (e.g. dizziness, headache, mild cognitive impairment). Potential demographic and clinical risk factors associated with LA, including sex, age, hypertension, diabetes mellitus, smoking, alcohol consumption, dyslipidaemia, plasma fibrinogen, D-dimer, uric acid, and homocysteine, were investigated using univariate and multivariate logistic regression analyses. Results A total of 268 patients were enrolled in the study and divided into the LA group ( n = 164) and the non-LA group ( n = 104). Compared with the non-LA group, uric acid was significantly higher in the LA group (mean ± SD: 356.49 ± 121.85 µmol/l versus 289.96 ± 102.98 µmol/l). Multivariate logistic regression analyses showed that uric acid was an independent risk factor for LA (odds ratio 1.285; 95% confidence interval 1.062, 1.556). Conclusion Hyperuricaemia was an independent risk factor for leukoaraiosis in Chinese patients.
Effects of atorvastatin on ADP-, arachidonic acid-, collagen-, and epinephrine-induced platelet aggregation
Authors: Zhao Lei , Liu Demin , Liu Bin , Hu Haijuan , Cui Wei 
Published: December 2016

Objective Atorvastatin reduces the incidence of cardiovascular events. However, the effects of atorvastatin on platelet aggregation are unknown. Methods Blood samples were obtained from 126 healthy volunteers. Prepared isolated platelet suspensions were adjusted with saline to three different concentrations of 100 × 109, 300 × 109, and 600 × 109 platelets/L. Platelet samples were incubated with atorvastatin (10−7 mol/L, 10−6 mol/L or 10−5 mol/L), and stimulated with ADP (10 µmol/L), arachidonic acid (0.5 mmol/L), collagen (2 µg/mL), and epinephrine (1 mg/mL). The maximal amplitude of aggregation and the curve slope were measured by electric impedance aggregometry. Results Atorvastatin inhibited platelet aggregation at moderate (300 × 109/L) and high (600 × 109/L) concentrations. However, an inhibitory effect of atorvastatin at low concentrations (100 × 109/L) was not observed. Conclusions The study shows that atorvastatin inhibits platelet aggregation in vitro, and this inhibitory effect is related to platelet concentrations.
Strategic Workforce Planning for Health Human Resources
Authors: Baumann Andrea , Crea-Arsenio Mary , Akhtar-Danesh Noori , Fleming-Carroll Bonnie , Hunsberger Mabel , Keatings Margaret , Elfassy Michael David , Kratina Sarah 
Published: December 2016

Background Health-care organizations provide services in a challenging environment, making the introduction of health human resources initiatives especially critical for safe patient care. Purpose To demonstrate how one specialty hospital in Ontario, Canada, leveraged an employment policy to stabilize its nursing workforce over a six-year period (2007 to 2012). Methods An observational cross-sectional study was conducted in which administrative data were analyzed to compare full-time status and retention of new nurses prepolicy and during the policy. The Professionalism and Environmental Factors in the Workplace Questionnaire® was used to compare new nurses hired into the study hospital with new nurses hired in other health-care settings. Results There was a significant increase in full-time employment and a decrease in part-time employment in the study hospital nursing workforce. On average, 26% of prepolicy new hires left the study hospital within one year of employment compared to 5% of new hires during policy implementation. The hospital nurses scored significantly higher than nurses employed in other health-care settings on 5 out of 13 subscales of professionalism. Conclusions Decision makers can use these findings to develop comprehensive health human resources guidelines and mechanisms that support strategic workforce planning to sustain and strengthen the health-care system.
Role of B-Type Natriuretic Peptide in Predicting In-Hospital Outcomes in Acute Exacerbation of Chronic Obstructive Pulmonary Disease With Preserved Left Ventricular Function: A 5-Year Retrospective Analysis
Authors: Vallabhajosyula Saraschandra , Haddad Toufik Mahfood , Sundaragiri Pranathi R. , Ahmed Anas A. , Nawaz Muhammad Sarfraz , Rayes Hamza A. A. , Devineni Harish C. , Kanmanthareddy Arun , McCann Dustin A. , Wichman Christopher S. , Modrykamien Ariel M. , Morrow Lee E. 
Published: December 2016

Background: The role of B-type natriuretic peptide (BNP) is less understood in the risk stratification of patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), especially in patients with normal left ventricular ejection fraction (LVEF). Methods: This retrospective study from 2008 to 2012 evaluated all adult patients with AECOPD having BNP levels and available echocardiographic data demonstrating LVEF ≥40%. The patients were divided into groups 1, 2, and 3 with BNP ≤ 100, 101 to 500, and ≥501 pg/mL, respectively. A subgroup analysis was performed for patients without renal dysfunction. Outcomes included need for and duration of noninvasive ventilation (NIV) and mechanical ventilation (MV), NIV failure, reintubation at 48 hours, intensive care unit (ICU) and total length of stay (LOS), and in-hospital mortality. Two-tailed P < .05 was considered statistically significant. Results: Of the total 1145 patients, 550 (48.0%) met our inclusion criteria (age 65.1 ± 12.2 years; 271 [49.3%] males). Groups 1, 2, and 3 had 214, 216, and 120 patients each, respectively, with higher comorbidities and worse biventricular function in higher categories. Higher BNP values were associated with higher MV use, NIV failure, MV duration, and ICU and total LOS. On multivariate analysis, BNP was an independent predictor of higher NIV and MV use, NIV failure, NIV and MV duration, and total LOS in groups 2 and 3 compared to group 1. B-type natriuretic peptide continued to demonstrate positive correlation with NIV and MV duration and ICU and total LOS independent of renal function in a subgroup analysis. Conclusion: Elevated admission BNP in patients with AECOPD and normal LVEF is associated with worse in-hospital outcomes and can be used to risk-stratify these patients.