bluuebunny/crossref_metadata_2025_split huggingface dataset:
Platelet Counts, Acute Kidney Injury, and Mortality after Coronary Artery Bypass Grafting Surgery
Authors: Kertai Miklos D. , Zhou Shan , Karhausen Jörn A. , Cooter Mary , Jooste Edmund , Li Yi-Ju , White William D. , Aronson Solomon , Podgoreanu Mihai V. , Gaca Jeffrey , Welsby Ian J. , Levy Jerrold H. , Stafford-Smith Mark , Mathew Joseph P. , Fontes Manuel L. 
Published: November 2015

AbstractAbstract
The authors performed a retrospective observational study of the association between postoperative nadir platelet counts, acute kidney injury, and mortality in coronary artery bypass grafting (CABG) surgery. The authors found a significant independent association between postoperative nadir platelet counts, acute kidney injury, and mortality after CABG surgery. The work suggests that the potential platelet-related ischemic events during the CABG surgery warrant further investigation.
Supplemental Digital Content is available in the text.

Background
Cardiac surgery requiring cardiopulmonary bypass is associated with platelet activation. Because platelets are increasingly recognized as important effectors of ischemia and end-organ inflammatory injury, the authors explored whether postoperative nadir platelet counts are associated with acute kidney injury (AKI) and mortality after coronary artery bypass grafting (CABG) surgery.

Methods
The authors evaluated 4,217 adult patients who underwent CABG surgery. Postoperative nadir platelet counts were defined as the lowest in-hospital values and were used as a continuous predictor of postoperative AKI and mortality. Nadir values in the lowest 10th percentile were also used as a categorical predictor. Multivariable logistic regression and Cox proportional hazard models examined the association between postoperative platelet counts, postoperative AKI, and mortality.

Results
The median postoperative nadir platelet count was 121 × 109/l. The incidence of postoperative AKI was 54%, including 9.5% (215 patients) and 3.4% (76 patients) who experienced stages II and III AKI, respectively. For every 30 × 109/l decrease in platelet counts, the risk for postoperative AKI increased by 14% (adjusted odds ratio, 1.14; 95% CI, 1.09 to 1.20; P < 0.0001). Patients with platelet counts in the lowest 10th percentile were three times more likely to progress to a higher severity of postoperative AKI (adjusted proportional odds ratio, 3.04; 95% CI, 2.26 to 4.07; P < 0.0001) and had associated increased risk for mortality immediately after surgery (adjusted hazard ratio, 5.46; 95% CI, 3.79 to 7.89; P < 0.0001).

Conclusion
The authors found a significant association between postoperative nadir platelet counts and AKI and short-term mortality after CABG surgery.
Case Scenario: Perioperative Management of a Young Woman with Fontan Repair for Major Gynecologic Surgery
Authors: Dell’Anna Antonio Maria , Grieco Domenico Luca , Russo Andrea , Marana Elisabetta , Antonelli Massimo 
Published: November 2015

Abstract
Effective treatment for many congenital heart diseases diagnosed before birth has become available since the last three decades. Continuous improvements in surgical knowledge and techniques have allowed patients born with severe heart defects to survive through adulthood. However, palliative surgery often implies profound modifications of classical circulatory physiology, which must be taken into account particularly when general anesthesia is needed for major noncardiac surgery. Among the palliative surgeries, Fontan repair is an intervention aiming at excluding the right heart chambers with a total cavopulmonary conduit, which directs blood flow from both inferior and superior vena cavae directly to the right pulmonary artery. In such condition, patients are very sensitive to both preload reduction and pulmonary vascular resistances increase, so that a careful monitoring during anesthesia is required. Unfortunately, standard monitoring with a pulmonary artery catheter is not possible because of altered anatomy of right sections. In this case scenario, the authors report the perioperative management of a young woman who underwent major gynecologic surgery, who was managed using a transpulmonary thermodilution technique that was deemed more accurate than noncalibrated pulse-contour method and also able to provide more information regarding preload status. The authors adopted an integrated approach merging together hemodynamic and functional data (ScvO2 and venoarterial CO2 difference) to assess the appropriateness of hemodynamic management. The authors describe also pathophysiologic changes during such condition and also potential drawbacks of chosen technique.
Allograft Bone Use in Pediatric Subaxial Cervical Spine Fusions
Authors: Murphy Robert F. , Glotzbecker Michael P. , Hresko Michael T. , Hedequist Daniel 
Published: November 2015

Background:
The use of freeze-dried allograft as a bone graft substitute for pediatric spine surgery is safe and efficacious in the thoracic and lumbar spines. Allograft bone use in segmental instrumented fusions in the subaxial cervical spine has not been well reported in the literature. We sought to describe our experience with allograft bone in this patient cohort, and to compare union rates to patients treated with autograft.

Methods:
Medical records were queried over a 10-year time period (2004 to 2014). Inclusion criteria were all pediatric patients (18 y old and below) who underwent subaxial cervical spine fusion with minimum follow-up of 24 months. Variables queried included demographics, type of graft material used, diagnosis, approach (anterior, posterior, combined), levels instrumented, placement of postoperative halo, surgical-related complications, and achievement of fusion.

Results:
A total of 26 patients qualified for inclusion (18 allograft, 8 autograft). No differences existed between the 2 groups regarding age, sex, or number of fused levels. In the allograft cohort, average age at initial surgery was 13.3 years (range, 5 to 18 y). The most common reasons for surgery included trauma (6), tumor (3), and syndrome-associated kyphosis (3). The average number of instrumented levels was 4 (range, 2 to 13). Four patients (22%) developed a postoperative surgical complication. There were 2 asymptomatic pseudarthroses not requiring revision. At a minimum of 24-month follow-up (average, 45 mo; range, 24 to 121 mo), the allograft group demonstrated a fusion rate of 88%, which was comparable with a fusion rate of 87% in the autograft group.

Conclusions:
The use of allograft bone for pediatric subaxial instrumented cervical spine fusions is safe in a variety of conditions, with the same rate of fusion as autograft. Rates of complications are acceptable. To avoid donor-site morbidity from autogenous graft harvest, we recommend considering allograft bone in subaxial cervical spine fusions with modern segmental instrumentation.

Level of Evidence:
Level IV—case series; therapeutic.
Long-term Results of Combined Epiphysiodesis and Imhauser Intertrochanteric Osteotomy in SCFE: A Retrospective Study on 53 Hips
Authors: Trisolino Giovanni , Pagliazzi Gherardo , Di Gennaro Giovanni L. , Stilli Stefano 
Published: November 2015

Background:
The management of moderate and severe slipped capital femoral epiphysis is still an issue. The main concern is represented by the choice of an intra-articular or an extra-articular osteotomy to correct the deformity. Theoretically, the intra-articular osteotomy allows the best correction, but it is technically demanding and involves a higher risk of avascular necrosis (AVN); conversely, an extra-articular intertrochanteric osteotomy (ITO) is easier and involves a lower risk of early complications, but may lead to femoroacetabular impingement, resulting in early osteoarthritis and the need for total hip replacement (THR).
The aim of this study was to analyze the long-term survivorship free from THR after combined epiphysiodesis and Imhauser ITO.

Methods:
From 1975 to 2000, 45 patients (53 hips) underwent a combined epiphysiodesis and Imhauser ITO. There were 27 male and 18 female patients with an average age of 12.8±1.9 years. All cases showed a posterior sloping angle >40 degrees (mean, 69±16 degrees). The cumulative survivorship was determined according to Kaplan and Meier, with the end point defined as conversion to THR.

Results:
A total of 6 patients (6 hips; 11%) had a follow-up <2 years. Among them, no postoperative complications occurred. For the remaining 39 patients (47 hips, 89%), the mean follow-up was 21±11 years. Four early postoperative complications were reported (2 AVN, 2 chondrolysis). The cumulative 39 years’ survivorship free from THR was 68.5% (95% confidence interval, 42.4%-84.7%). The age at surgery (hazard ratio=1.849 per year older, P=0.017) and the postoperative onset of AVN or chondrolysis (hazard ratio=10.146, P=0.010) affected the long-term prognosis significantly.

Conclusions:
The combined epiphysiodesis and Imhauser ITO is a valid surgical option in moderate to severe slipped capital femoral epiphysis, preserving the natural hip for at least 39 years in the majority of the patients. Care must be taken to avoid AVN or chondrolysis. The age at surgery affects the prognosis negatively.

Level of Evidence:
Level III—a retrospective study.
Comparison of Surgical Outcomes, Narcotics Utilization, and Costs After an Anterior Cervical Discectomy and Fusion
Authors: Tabaraee Ehsan , Ahn Junyoung , Bohl Daniel D. , Collins Michael J. , Massel Dustin H. , Aboushaala Khaled , Singh Kern 
Published: November 2015

Study Design:
Retrospective cohort analysis of a prospectively maintained registry.

Objective:
To compare the surgical outcomes, narcotic utilization, and costs between a stand-alone (SA) cage and anterior plating (AP) with an interbody device for 1-level anterior cervical discectomy and fusion (ACDF).

Background Data:
ACDF with a SA cage has gained popularity as a potential alternative to anterior cervical plating. Few studies have compared the surgical outcomes, narcotic utilization, and costs of ACDF utilizing a SA cage versus AP with an interbody device.

Methods:
Patients who underwent a primary 1-level ACDF for degenerative spinal pathology between 2010 and 2013 were analyzed. Patients were stratified on the basis of the type of implant system (SA cage vs. AP) and assessed with regard to demographics, comorbidities, smoking, visual analogue scale (VAS) scores (preoperative/postoperative), procedural time, estimated blood loss (EBL), length of hospitalization, complications, reoperations, narcotic consumption, and total costs. Statistical analysis was performed with independent sample T tests for continuous variables and χ2 analysis for categorical data. An α level of <0.05 denoted statistical significance.

Results:
Of the 93 patients included, 52 (55.9%) underwent an ACDF with a SA cage system. Patient demographics, comorbidity burden, body mass index, smoking status, and preoperative VAS score were similar between cohorts. The SA cohort incurred a significantly lower EBL (P<0.001) than the AP cohort. However, none required a transfusion and the procedural time, length of hospitalization, postoperative VAS score, complication rates, 1-year arthrodesis rate, and reoperation rates were similar between cohorts. Postoperative narcotics consumption and total costs were also similar between groups.

Conclusions:
Our findings suggest that the SA cage may be associated with a significantly lower EBL, which may not be clinically relevant. Perioperative outcomes, complications, reoperation rates, narcotics consumption in the immediate postoperative period, and total costs may be similar regardless of the instrumentation utilized in a 1-level ACDF.
Insulin Resistance Predicts Virological Response to Interferon-α in Chronic Hepatitis B Patients
Authors: Wang Xin , Zhao Ying-Ren , Liu Hong-Li , Ma Xiao-Hua , Zhang Yu , Yi Rui-Tian 
Published: November 2015

Goals:
To elucidate impact of insulin resistance (IR) on the response to interferon-α (IFN-α) therapy in chronic hepatitis B (CHB) patients.

Background:
Metabolic factors influencing the virological response of CHB patients on IFN-α treatment are still unexplored.

Study:
Eighty CHB patients were treated with IFN-α for 48 weeks. The IR was evaluated by homeostasis model assessment of IR (HOMA-IR) before treatment. Viral load and biochemical parameters were measured at 12, 24, and 48 weeks after starting treatment, and then 24 weeks after the end of treatment. IFN-γ and tumor necrosis factor-α were tested at baseline and 12 weeks of treatment.

Results:
Pretreatment HOMA-IR proved to be the only independent predictor of primary nonresponse, as well as the pretreatment HOMA-IR, viral load and primary nonresponse were independently associated with virological response at 24, 48 weeks of treatment and at the follow-up endpoint. The significant higher virological relapse rate in patients with IR was observed in patients with virological response at 48 weeks of treatment. The mean HOMA-IR was significantly lower in virological responders than in virological nonresponders. The secretion of IFN-γ and tumor necrosis factor-α was not induced in patients with IR at 12 weeks after IFN-α treatment.

Conclusions:
Our data suggest that IR is strongly associated with virological response, thus reflecting the important role played by metabolic factors in the viral kinetics during IFN-α treatment. These findings suggested clinical application of pretreatment HOMA-IR could enable treatment outcome to be predicted and treatment regimens to be determined.
A Short Screening Tool to Identify Victims of Child Sex Trafficking in the Health Care Setting
Authors: Greenbaum V. Jordan , Dodd Martha , McCracken Courtney 
Published: November 2015

Objectives
The aim of this study was to describe characteristics of commercial sexual exploitation of children/child sex trafficking (CSEC/CST) victims and to develop a screening tool to identify victims among a high-risk adolescent population.

Methods
In this cross-sectional study, patients aged 12 to 18 years who presented to 1 of 3 metropolitan pediatric emergency departments or 1 child protection clinic and who were identified as victims of CSEC/CST were compared with similar-aged patients with allegations of acute sexual assault/sexual abuse (ASA) without evidence of CSEC/CST. The 2 groups were compared on variables related to medical and reproductive history, high-risk behavior, mental health symptoms, and injury history. After univariate analysis, a subset of candidate variables was subjected to multivariable logistic regression to identify an optimum set of 5 to 7 screening items.

Results
Of 108 study participants, 25 comprised the CSEC/CST group, and 83 comprised the ASA group. Average (SD) age was 15.4 (1.8) years for CSEC/CST patients and 14.8 (1.6) years for ASA patients; 100% of the CSEC/CST and 95% of the ASA patients were female. The 2 groups differed significantly on 16 variables involving reproductive history, high-risk behavior, sexually transmitted infections, and previous experience with violence. A 6-item screen was constructed, and a cutoff score of 2 positive answers had a sensitivity of 92%, specificity of 73%, positive predictive value of 51%, and negative predictive value of 97%.

Conclusions
Adolescent CSEC/CST victims differ from ASA victims without evidence of CSEC/CST across several domains. A 6-item screen effectively identifies CSEC/CST victims in a high-risk adolescent population.
Dynamics of scene representations in the human brain revealed by magnetoencephalography and deep neural networks
Authors: Cichy Radoslaw Martin , Khosla Aditya , Pantazis Dimitrios , Oliva Aude 
Published: November 2015

ABSTRACTHuman scene recognition is a rapid multistep process evolving over time from single scene image to spatial layout processing. We used multivariate pattern analyses on magnetoencephalography (MEG) data to unravel the time course of this cortical process. Following an early signal for lower-level visual analysis of single scenes at ~100ms, we found a marker of real-world scene size, i.e. spatial layout processing, at ~250ms indexing neural representations robust to changes in unrelated scene properties and viewing conditions. For a quantitative explanation that captures the complexity of scene recognition, we compared MEG data to a deep neural network model trained on scene classification. Representations of scene size emerged intrinsically in the model, and resolved emerging neural scene size representation. Together our data provide a first description of an electrophysiological signal for layout processing in humans, and a novel quantitative model of how spatial layout representations may emerge in the human brain.
Expression weighted cell type enrichments reveal genetic and cellular nature of major brain disorders
Authors: Skene Nathan G. , Grant Seth G.N. 
Published: November 2015

AbstractThe cell types that trigger the primary pathology in many brain diseases remain largely unknown. One route to understanding the primary pathological cell type for a particular disease is to identify the cells expressing susceptibility genes. Although this is straightforward for monogenic conditions where the causative mutation may alter expression of a cell type specific marker, methods are required for the common polygenic disorders. We developed the Expression Weighted Cell Type Enrichment (EWCE) method that uses single cell transcriptomes to generate the probability distribution associated with a gene list having an average level of expression within a cell type. Following validation, we applied EWCE to human genetic data from cases of epilepsy, Schizophrenia, Autism, Intellectual Disability, Alzheimer’s disease, Multiple Sclerosis and anxiety disorders. Genetic susceptibility primarily affected microglia in Alzheimer’s and Multiple Sclerosis; was shared between interneurons and pyramidal neurons in Autism and Schizophrenia; while intellectual disabilities and epilepsy were attributable to a range of cell-types, with the strongest enrichment in interneurons. We hypothesized that the primary cell type pathology could trigger secondary changes in other cell types and these could be detected by applying EWCE to transcriptome data from diseased tissue. In Autism, Schizophrenia and Alzheimer’s disease we find evidence of pathological changes in all of the major brain cell types. These findings give novel insight into the cellular origins and progression in common brain disorders. The methods can be applied to any tissue and disorder and have applications in validating mouse models.
Effect of hydrothermal processing on the proximate composition and organoleptic characteristics of dehulledMoringa oleiferaseeds
Authors: Ogunsina Babatunde Sunday , Olumakaiye Motunrayo Funke , Chinma Chiemela Eyinnaya , Akomolafe Opeyemi Paul 
Published: November 2015

Purpose– This paper aims to investigate the effect of hydrothermal treatment by conventional, microwave and pressure cooking on the cooking properties, proximate composition and organoleptic characteristics of dehulledMoringa oleiferaseeds.Design/methodology/approach– Samples ofMoringa oleiferaseeds were subjected to cooking for the minimum time by each of the methods under study. Cooking properties, proximate composition and organoleptic characteristics were determined following standard analytical procedures.Findings– The results showed that the average cooking time were 25, 30 and 40 mins for conventionally, pressure- and microwave-cooked moringa kernels, respectively. There was no significant difference in cooking weight, moisture absorbed and water uptake ratio of conventionally and pressure-cooked samples. The protein content of moringa kernel reduced from 41.9 for raw kernels to 40.2, 41.2 and 36.9 per cent for conventionally, pressure- and microwave-cooked samples, respectively. Pressure and microwave cooking indicated 40.1 and 39.3 g/100g of crude fat, whereas raw kernels indicated 37.1 g/100g. Conventionally and pressure-cooked kernels had lower fibre content than the raw kernels, but there was no significant difference in the ash contents of the samples. Cooking influenced the proximate composition and colour of moringa kernels. Microwave cooking indicated higher values of cookability than other cooking methods considered in this study, but no significant difference was observed in the organoleptic characteristics of moringa kernels due to the cooking methods.Practical implications– Given the high protein and vital nutrients content which are seldom found in daily diets, moringa kernels may be considered by processors of edible nuts and kernels for food-based applications such as cooked, roasted, mixed or spiced kernels.Originality/value– This work is perhaps the first to document moringa seeds processing by hydrothermal treatment.
Anti‐biofilm and bactericidal effects of magnolia bark‐derived magnolol and honokiol on Streptococcus mutans
Authors: Sakaue Yuuki , Domon Hisanori , Oda Masataka , Takenaka Shoji , Kubo Miwa , Fukuyama Yoshiyasu , Okiji Takashi , Terao Yutaka 
Published: November 2015

ABSTRACTDental caries affects people of all ages and is a worldwide health concern. Streptococcus mutans is a major cariogenic bacterium because of its ability to form biofilm and induce an acidic environment. In this study, the antibacterial activities of magnolol and honokiol, the main constituents of the bark of magnolia plants, toward planktonic cell and biofilm of S. mutans were examined and compared with those of chlorhexidine. The minimal inhibitory concentrations of magnolol, honokiol and chlorhexidine for S. mutans were 10, 10 and 0.25 µg/mL, respectively. In addition, each agent showed bactericidal activity against S. mutans planktonic cells and inhibited biofilm formation in a dose‐ and time‐dependent manner. Magnolol (50 µg/mL) had greater bactericidal activity against S. mutans biofilm than honokiol (50 µg/mL) and chlorhexidine (500 µg/mL) at 5 min after exposure, while all showed scant activity against biofilm at 30 s. Furthermore; chlorhexidine (0.5–500 µg/mL) exhibited high cellular toxicity for the gingival epithelial cell line Ca9‐22 at 1 hr, whereas magnolol (50 µg/mL) and honokiol (50 µg/mL) did not. Thus; it was found that magnolol has antimicrobial activities against planktonic and biofilm cells of S. mutans. Magnolol may be a candidate for prevention and management of dental caries.
Con‐forming bodies: the interplay of machines and bodies and the implications of agency in medical imaging
Authors: Wood Lisa A. 
Published: November 2015

AbstractAttending to the material discursive constructions of the patient body within cone beam computed tomography (CBCT) imaging in radiotherapy treatments, in this paper I describe how bodies and machines co‐create images. Using an analytical framework inspired by Science and Technology Studies and Feminist Technoscience, I describe the interplay between machines and bodies and the implications of materialities and agency. I argue that patients’ bodies play a part in producing scans within acceptable limits of machines as set out through organisational arrangements. In doing so I argue that bodies are fabricated into the order of work prescribed and embedded within and around the CBCT system, becoming, not only the subject of resulting images, but part of that image. The scan is not therefore a representation of a passive subject (a body) but co‐produced by the work of practitioners and patients who actively control (and contort) and discipline their body according to protocols and instructions and the CBCT system. In this way I suggest they are ‘con‐forming’ the CBCT image. A Virtual Abstract of this paper can be found at: https://youtu.be/qysCcBGuNSM.