bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Feeding Neonates With Cardiac Disease
Authors: Scahill Carly J. , Graham Eric M. , Atz Andrew M. , Bradley Scott M. , Kavarana Minoo N. , Zyblewski Sinai C. 
Published: January 2017

Background: The potential for necrotizing enterocolitis (NEC) in neonates requiring cardiac surgery has contributed largely to wide feeding practice variations and a hesitation to initiate enteral feeding during the preoperative period, specifically those patients with hypoplastic left heart syndrome. Methods: A retrospective chart review of neonates undergoing cardiac surgery at a single institution between July 2011 and July 2013 was performed. The primary objective of this study was to determine if preoperative feeding was associated with NEC in neonates requiring cardiac surgery. Univariable and multivariable analyses were performed to evaluate the relationship between preoperative feeding and NEC. Secondary outcomes including growth failure, total ventilator days, total length of stay, and tube-assisted feeds at discharge were analyzed. Results: One hundred thirty consecutive neonates who required cardiac surgery were included in the analysis. Preoperative feeding occurred in 61% (n = 79). The overall prevalence of NEC was 9% (12/130), including three neonates with surgical NEC. There was no difference in the prevalence of NEC between the preoperative feeding and nil per os (NPO) groups. Preoperative NPO status was associated with longer ventilator-dependent days ( P = .01) but was not associated with worsened growth failure, longer length of stay, or increased prevalence of tube-assisted feeds at discharge. Conclusion: In this study cohort, preoperative feeding was associated with a low prevalence of NEC. Larger prospective studies evaluating the safety and benefits of preoperative feeding in cardiac neonates are warranted.
Short-Term Results of Sinus of Valsalva Aneurysm Repair
Authors: Abralov Khakimjon , Alimov Amonjon 
Published: January 2017

Background: We retrospectively analyzed 65 patients who underwent surgical repair of sinus of Valsalva aneurysm over the last 27 years. Methods: From January 1, 1988, to October 1, 2015, a total of 65 patients with sinus of Valsalva aneurysm underwent surgical repair in our hospital. There were 41 males (63%) and 24 females (37%), and their age ranged from 5 to 50 years (mean 23 ± 10 years, median 21 years). Out of the 65 patients, 45 (69%) had ruptured sinus of Valsalva aneurysm, 46 (70%) had a ventricular septal defect, and 22 (34%) had aortic valve insufficiency. The ruptured sinus of Valsalva was repaired with patch in 12 cases and direct suturing in 33 cases. The aortic valve was replaced in five patients and the aortic root was replaced in five patients. Results: Sixty patients (92%) survived the 30-day operative interval. At one year follow-up, only two patients had complications: infective endocarditis and sepsis, which lead to septic shock (n = 1) and paraprosthetic leakage and mitral valve regurgitation (n = 1). All the other patients were well and in New York Heart Association functional class I or II. Conclusion: In this relatively high-risk population, repair of SVA can be achieved with satisfactory early results.
Effects of Exercise Restriction on Patients With Anomalous Aortic Origin of a Coronary Artery
Authors: Elias Matthew D. , Meza James , McCrindle Brian W. , Brothers Julie A. , Paridon Stephen , Cohen Meryl S. 
Published: January 2017

Background: Management of young patients with anomalous aortic origin of a coronary artery (AAOCA) may involve exercise restriction. We sought to identify the association of exercise restriction with changes over time in body mass index (BMI) and exercise capacity in this cohort. Methods: We performed a retrospective review of patients with AAOCA seen at The Children’s Hospital of Philadelphia between January 1, 1998, and August 31, 2014. Linear mixed model repeated-measures analysis assessed changes in BMI and exercise capacity. Results: We included 72 patients with a median age at presentation of 12.6 years (interquartile range: 10.1-15.8) and mean follow-up of 3.6 ± 3.0 years. The majority had an anomalous right coronary artery (71%) and interarterial ± intramural coronary course (90%). Surgery was performed in 54%, more often in those with interarterial/intramural course ( P < .001) and symptoms ( P = .003). Most patients (82%) were exercise-restricted on presentation, and restricted patients were older than those who were not restricted ( P = .01). There was no significant difference between restricted and nonrestricted patients in initial BMI z scores, percentage of patients with BMI over 85th percentile (26%) or exercise capacity variables. In univariable analysis, exercise restriction over time was not associated with change in BMI z score ( P = .25) or change in exercise variables. Restriction was not associated with significant change in these variables in multivariable analysis. Conclusions: Although further investigation is warranted to determine the degree of adherence to exercise restriction, the recommendation of restriction alone is not associated with increasing BMI or decreasing exercise performance in the short-term.
Surgical Site Infection After Pediatric Cardiothoracic Surgery
Authors: Sochet Anthony A. , Cartron Alexander M. , Nyhan Aoibhinn , Spaeder Michael C. , Song Xiaoyan , Brown Anna T. , Klugman Darren 
Published: January 2017

Background: Surgical site infection (SSI) occurs in 0.25% to 6% of children after cardiothoracic surgery (CTS). There are no published data regarding the financial impact of SSI after pediatric CTS. We sought to determine the attributable hospital cost and length of stay associated with SSI in children after CTS. Methods: We performed a retrospective, matched cohort study in a 26-bed cardiac intensive care unit (CICU) from January 2010 through December 2013. Cases with SSI were identified retrospectively and individually matched to controls 2:1 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery category, and primary cardiac diagnosis and procedure. Results: Of the 981 cases performed during the study period, 12 with SSI were identified. There were no differences in demographics, clinical characteristics, or intraoperative data. Median total hospital costs were higher in participants with SSI as compared to controls (US$219,573 vs US$82,623, P < .01). Children with SSI had longer median CICU length of stay (9 vs 3 days, P < .01), hospital length of stay (18 vs 8.5 days, P < .01), and duration of mechanical ventilation (2 vs 1 day, P < .01) and vasoactive administration (4.5 vs 1 day, P < .01). Conclusions: Children with SSI after CTS have an associated increase in hospital costs of US$136,950/case and hospital length of stay of 9.5 days/case. The economic burden posed by SSI stress the importance of infection control surveillance, exhaustive preventative measures, and identification of modifiable risk factors.
Rehabilitation's Contribution to Industrial Health
Authors: McCahan J. F. 
Published: January 2017

During the past few years there has been increasing interest in rehabilitation, but rarely do we find the various aspects fitted properly into the total picture. The glamorous, more dramatic, orthopedic conditions, the situations of which headlines and heart warming human interest stories are made, receive the major share of attention. The amputee, the paraplegic, these are synonymous with the problem of rehabilitation in the minds of many. The “unglamorous light work” placements, accomplished daily within industry to help an employee partially disabled by illness or injury do not reach the headlines, but they are undoubtedly of tremendous importance in the total problem of rehabilitation; probably far more so than the glamor cases. Fundamentally, rehabilitation means assisting an individual to return to as great a degree of social and economic self-sufficiency as he is able to achieve. Thus the worker who sustains a fractured wrist and is temporarily assigned work that he can do with his uninjured hand is part of today's rehabilitation effort. The employee who returns after eight weeks absence due to a coronary attack, is rehabilitated by permanent assignment to a less arduous job. These cases do not make the headlines. They are part of the daily, unobtrusive, but very important contribution that an effective in-plant medical program makes to the problem of rehabilitation. It is relatively unsung but it is a vitally significant part of the rehabilitation needs in this country.
Mean Glenoid Defect Size and Location Associated With Anterior Shoulder Instability
Authors: Gottschalk Lionel J. , Bois Aaron J. , Shelby Marcus A. , Miniaci Anthony , Jones Morgan H. 
Published: January 2017

Background: There is a strong correlation between glenoid defect size and recurrent anterior shoulder instability. A better understanding of glenoid defects could lead to improved treatments and outcomes. Purpose: To (1) determine the rate of reporting numeric measurements for glenoid defect size, (2) determine the consistency of glenoid defect size and location reported within the literature, (3) define the typical size and location of glenoid defects, and (4) determine whether a correlation exists between defect size and treatment outcome. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, Ovid, and Cochrane databases were searched for clinical studies measuring glenoid defect size or location. We excluded studies with defect size requirements or pathology other than anterior instability and studies that included patients with known prior surgery. Our search produced 83 studies; 38 studies provided numeric measurements for glenoid defect size and 2 for defect location. Results: From 1981 to 2000, a total of 5.6% (1 of 18) of the studies reported numeric measurements for glenoid defect size; from 2001 to 2014, the rate of reporting glenoid defects increased to 58.7% (37 of 63). Fourteen studies (n = 1363 shoulders) reported defect size ranges for percentage loss of glenoid width, and 9 studies (n = 570 shoulders) reported defect size ranges for percentage loss of glenoid surface area. According to 2 studies, the mean glenoid defect orientation was pointing toward the 3:01 and 3:20 positions on the glenoid clock face. Conclusion: Since 2001, the rate of reporting numeric measurements for glenoid defect size was only 58.7%. Among studies reporting the percentage loss of glenoid width, 23.6% of shoulders had a defect between 10% and 25%, and among studies reporting the percentage loss of glenoid surface area, 44.7% of shoulders had a defect between 5% and 20%. There is significant variability in the way glenoid bone loss is measured, calculated, and reported.
Effects of Sex and Fatigue on Biomechanical Measures During the Drop-Jump Task in Children
Authors: Briem Kristín , Jónsdóttir Kolbrún Vala , Árnason Árni , Sveinsson Þórarinn 
Published: January 2017

Background: Female athletes have a higher rate of anterior cruciate ligament (ACL) injury than males from adolescence and into maturity, which is suggested to result from sex-specific changes in dynamic movement patterns with maturation. Few studies have studied movement strategies and response to fatigue in children. Purpose: To evaluate the effect of fatigue on biomechanical variables associated with increased risk for ACL injury during a drop-jump (DJ) performance in children. Study Design: Controlled laboratory study. Methods: A total of 116 children (mean age, 10.4 years) were recruited from local sports clubs and performed 5 repetitions of a DJ task before and after a fatigue protocol. Kinematic and kinetic data from initial contact (IC) to the first peak vertical ground reaction force (vGRF) were analyzed for both limbs, including limb and fatigue as within-subject factors for analyses between boys and girls. Pearson correlation coefficients were calculated to identify associations between variables of interest. Results: Girls demonstrated greater peak vGRF values than boys (by 8.1%; P < .05), there were greater peak vGRF values for the right limb than the left (by 6.2%; P < .001), and fatigue led to slightly greater values ( P < .05). Although weak, the correlation between peak vGRF values and knee flexion excursion was stronger for girls ( r = –0.20) than boys ( r = –0.08) ( P < .006). Fatigue resulted in greater knee flexion angles at IC and less excursion during landing, more so for girls (by 6.1° vs 1.4°; interaction, P < .001), although the knee flexion moment was generally lowered by fatigue ( P < .001). Limb asymmetry in knee flexion moments was more pronounced for boys than for girls (interaction, P < .05), contrary to that seen in frontal plane knee moments, where asymmetry was much greater in girls than boys (interaction, P < .001). Conclusion: Even as young athletes, girls and boys seem to adopt dissimilar movement strategies and are differently affected by fatigue. Clinical Relevance: Injury prevention programs should be considered at an earlier age in an effort to lower the risk of ACL injury in athletes.
Are There Barriers for Professional Development of Women Dentists? A Qualitative Study in Saudi Arabia
Authors: Rajeh M. , Nicolau B. , Pluye P. , Qutob A. , Esfandiari S. 
Published: January 2017

Globally, there is an upward trend in the number of women applying to dental schools and entering the profession of dentistry. Women dentists aim to advance their careers; however, differences exist between men and women dentists regarding leadership positions and work titles. For example, in Saudi Arabia, women usually occupy lower ranked positions than men in the Saudi public sector, and they are, therefore, paid less than their male counterparts. This study aimed to explore the possible barriers to Saudi women dentists’ professional advancement using a qualitative descriptive study design. Specifically, semistructured in-depth interviews were conducted with 13 women practicing dentistry in the Makkah region of Saudi Arabia. The interviews were audio-recorded and transcribed verbatim, and the data were interpreted using qualitative content analysis (NVivo 11; QRS International). The results revealed 4 challenges that might delay the participants’ career development. These include family-related challenges, sociocultural challenges, workplace challenges, and transportation issues. From this perspective, some perceived barriers to the professional development of women dentists were found that might not be unique to Saudi Arabia, and the article’s suggestions and recommendations aim to minimize the effects of these barriers impeding women’s advancement in dentistry in Saudi Arabia. Knowledge Transfer Statement: This study makes an important contribution to knowledge on this topic. These results will aid policy makers’ efforts to create supportive work environments through gender-specific incentives that meet the current professional and family needs of women dentists, particularly those in Saudi Arabia.
Complete genome sequence of Lutibacter profundi LP1T isolated from an Arctic deep-sea hydrothermal vent system
Authors: Wissuwa Juliane , Bauer Sven Le Moine , Steen Ida Helene , Stokke Runar 
Published: January 2017

AbstractLutibacter profundi LP1T within the family Flavobacteriaceae was isolated from a biofilm growing on the surface of a black smoker chimney at the Loki’s Castle vent field, located on the Arctic Mid-Ocean Ridge. The complete genome of L. profundi LP1T is the first genome to be published within the genus Lutibacter. L. profundi LP1T consists of a single 2,966,978 bp circular chromosome with a GC content of 29.8%. The genome comprises 2,537 protein-coding genes, 40 tRNA species and 2 rRNA operons. The microaerophilic, organotrophic isolate contains genes for all central carbohydrate metabolic pathways. However, genes for the oxidative branch of the pentose-phosphate-pathway, the glyoxylate shunt of the tricarboxylic acid cycle and the ATP citrate lyase for reverse TCA are not present. L. profundi LP1T utilizes starch, sucrose and diverse proteinous carbon sources. In accordance, the genome harbours 130 proteases and 104 carbohydrate-active enzymes, indicating a specialization in degrading organic matter. Among a small arsenal of 24 glycosyl hydrolases, which offer the possibility to hydrolyse diverse poly- and oligosaccharides, a starch utilization cluster was identified. Furthermore, a variety of enzymes may be secreted via T9SS and contribute to the hydrolytic variety of the microorganism. Genes for gliding motility are present, which may enable the bacteria to move within the biofilm. A substantial number of genes encoding for extracellular polysaccharide synthesis pathways, curli fibres and attachment to surfaces could mediate adhesion in the biofilm and may contribute to the biofilm formation. In addition to aerobic respiration, the complete denitrification pathway and genes for sulphide oxidation e.g. sulphide:quinone reductase are present in the genome. sulphide:quinone reductase and denitrification may serve as detoxification systems allowing L. profundi LP1T to thrive in a sulphide and nitrate enriched environment. The information gained from the genome gives a greater insight in the functional role of L. profundi LP1T in the biofilm and its adaption strategy in an extreme environment.
Fresh-Frozen Plasma: Ordering Patterns and Utilization in the Operating Rooms of a Tertiary Referral Hospital
Authors: Meyer Matthew J. , Dzik Walter H. , Levine Wilton C. 
Published: January 2017

BACKGROUND:
Blood product transfusion is the most commonly performed hospital procedure. Intraoperative blood product utilization varies between institutions and anesthesiologists. In the United States in 2011, nearly 4 million plasma units were transfused.

METHODS:
A retrospective analysis of intraoperative plasma ordering patterns and utilization (thawing and transfusing) was performed at a tertiary, academic hospital between January 2015 and March 2016.

RESULTS:
Over 15 months, 46,002 operative procedures were performed. In 1540 of them, plasma was thawed or transfused: 8297 plasma units were thawed and 3306 of those units were transfused. These 3306 plasma units were transfused in 749 cases with a median of 2 plasma units (interquartile range, 2–4) transfused. The percentage of average monthly procedures with plasma thawed and none transfused was 51.3% (confidence interval, 49.0%–53.6%). The cardiac surgery service requested the greatest number of plasma units to be thawed (2143) but only transfused 712 (33.2%) of them. Of all plasma units not transfused, 45% were generated by procedures with 1 to 4 units of plasma thawed; 95.7% of these units were thawed as even integers (ie, 2, 4).

CONCLUSIONS:
For operative procedures, far more plasma was thawed than was transfused and this practice occurred across surgical specialties and anesthesiologists. Considering the plasma that was not transfused, 45% occurred in procedures with 4 or fewer units of plasma requested suggesting these low-volume requests were a primary source of potential waste. Further studies are needed to examine associations between plasma utilization and clinical outcomes.
Economic Evaluation of Pharmacologic Pre- and Postconditioning With Sevoflurane Compared With Total Intravenous Anesthesia in Liver Surgery: A Cost Analysis
Authors: Eichler Klaus , Urner Martin , Twerenbold Claudia , Kern Sabine , Brügger Urs , Spahn Donat R. , Beck-Schimmer Beatrice , Ganter Michael T. 
Published: January 2017

BACKGROUND:
Pharmacologic pre- and postconditioning with sevoflurane compared with total IV anesthesia in patients undergoing liver surgery reduced complication rates as shown in 2 recent randomized controlled trials. However, the potential health economic consequences of these different anesthesia regimens have not yet been assessed.

METHODS:
An expostcost analysis of these 2 trials in 129 patients treated between 2006 and 2010 was performed. We analyzed direct medical costs for in-hospital stay and compared pharmacologic pre- and postconditioning with sevoflurane (intervention) with total IV anesthesia (control) from the perspective of a Swiss university hospital. Year 2015 costs, converted to US dollars, were derived from hospital cost accounting data and compared with a multivariable regression analysis adjusting for relevant covariables. Costs with negative prefix indicate savings and costs with positive prefix represent higher spending in our analysis.

RESULTS:
Treatment-related costs per patient showed a nonsignificant change by −12,697 US dollars (95% confidence interval [CI], 10,956 to −36,352; P = .29) with preconditioning and by −6139 US dollars (95% CI, 6723 to −19,000; P = .35) with postconditioning compared with the control group. Results were robust in our sensitivity analysis. For both procedures (control and intervention) together, major complications led to a significant increase in costs by 86,018 US dollars (95% CI, 13,839-158,198; P = .02) per patient compared with patients with no major complications.

CONCLUSIONS:
In this cost analysis, reduced in-hospital costs by pharmacologic conditioning with sevoflurane in patients undergoing liver surgery are suggested. This possible difference in costs compared with total IV anesthesia is the result of reduced complication rates with pharmacologic conditioning, because major complications have significant cost implications.
Novel swine model of ricin-induced acute respiratory distress syndrome
Authors: Katalan Shahaf , Falach Reut , Rosner Amir , Goldvaser Michael , Brosh-Nissimov Tal , Dvir Ayana , Mizrachi Avi , Goren Orr , Cohen Barak , Gal Yoav , Sapoznikov Anita , Ehrlich Sharon , Sabo Tamar , Kronman Chanoch 
Published: January 2017

Pulmonary exposure to the plant toxin ricin, leads to respiratory insufficiency and death. To date, in-depth study of the functional disorders ensuing pulmonary intoxication, a prerequisite for establishing a clinically-relevant therapeutic protocol, is hampered by the lack of an appropriate animal model. To this end, we set up the pig, as a large animal model for the comprehensive study of the multifarious clinical manifestations of pulmonary ricinosis.
Here we report for the first time, the monitoring of barometric whole body plethysmography for pulmonary function tests in non-anesthetized ricin-intoxicated pigs. Up to 30 hours post-exposure, as a result of progressing hypoxemia and to prevent carbon dioxide retention, animals exhibited a compensatory response of elevation in Minute Volume, attributed mainly to a robust elevation in respiratory rate with minimal response in tidal volume. This response was followed by decompensation, manifested by a descent in Minute Volume and severe hypoxemia, refractory to oxygen treatment. Radiological evaluation revealed evidence of early diffuse bi-lateral pulmonary infiltrates while hemodynamic parameters remained unchanged, excluding cardiac failure as an explanation for respiratory insufficiency. Ricin-intoxicated pigs suffered from increased lung permeability accompanied by cytokine storming while histological studies revealed lung tissue insults accumulating over time, up to the development of diffuse alveolar damage. Charting the decline in PaO2/FiO2 ratio in a mechanically-ventilated pig, confirmed that ricin-induced respiratory damage complies with the accepted diagnostic criteria for Acute Respiratory Distress Syndrome. The establishment of this animal model of pulmonary ricinosis, should assist us in our pursuit of efficient medical countermeasures, specifically-tailored to deal with the respiratory deficiencies stemming from ricin-induced Acute Respiratory Distress Syndrome.