bluuebunny/crossref_metadata_2025_split huggingface dataset:
L’ossuaire de Douaumont dans des quotidiens français : de l’idée à l’inauguration
Authors: Walter Jacques 
Published: September 2015

L’ossuaire de Douaumont sort de terre en une dizaine d’années. Cette émergence peut être scandée en plusieurs étapes : formulation publique de l’idée, pose de la première pierre, concours d’architecture, inauguration partielle, inauguration finale. Pourquoi s’intéresser à leur traitement par des quotidiens de l’époque ? Pas tant pour constater que la surface éditoriale qui leur est consacrée est inégale suivant les journaux et les moments que pour analyser les évolutions des sens attribués au monument, ainsi que les façons dont celui-ci est investi par plusieurs catégories d’acteurs ne partageant pas tous le même engouement commémoratif. Si le religieux est un facteur important dans la construction de l’ossuaire, le politique et le médiatique le sont tout autant. En interaction, ils se livrent à un incessant travail de réélaboration du passé dans le présent.
A Pictorial Mobile Application for Improving Communication Skills in Non-Verbal Autism
Authors: Abou El-Seoud Samir , Karkar AbdelGhani , Al Ja'am Jihad , Karam Omar 
Published: September 2015

It is estimated that as many as 25 percent of individuals living with autism spectrum disorders are non-verbal. That is, they cannot functionally communicate with others using their voice. Despite that substantial fraction, we still know very little about these individuals, their abilities, and their needs. "We still know very little about the cognitive capabilities of nonverbal people with autism, and how best to help them learn to communicate," said Geri Dawson, Ph.D., Autism Speaks chief science officer.
Non-verbal people with autism are usually unable to communicate normally using natural languages. They can, however, learn to communicate through specific symbols and images. Special education instructors have adopted this method of communication to teach non-verbal people with autism. They introduce the symbols and images to them through different methodologies. This learning process appeared to be effective but it is very long. The process is carried out manually and requires a lots of times, dedication, and resources. The instructors should find the materials in different formats and circumstances. They should repeat the lessons several times and normally in a face-to-face framework. We propose in this paper a mobile-based application that allows non- verbal people with autism to learn and communicate with their surroundings using a smart device. They can then be taught to use specific symbols and images through the smart mobile phones. They can form simple words and sentences to express their feelings and needs. The application is flexible and allows the addition of new contents very easily. To assess the progress of the users, different exercises and puzzles are proposed. These allow the users to improve their skills and to continue learning outside the classrooms.
PD-L1 Gene Polymorphism and High Level of Plasma Soluble Pd-L1 Protein may be aSsociated with Non-Small Cell Lung Cancer
Authors: Cheng Sensen , Zheng Jinsong , Zhu Jingyan , Xie Chao , Zhang Xia , Han Xiao , Song Bao , Ma Yuan , Liu Jie 
Published: September 2015

Background PD-1 and its ligand PD-L1 belong to the co-inhibition molecules, which can downregulate immune responses. The PD-L1 polymorphism and the level of soluble PD-L1 (sPD-L1) were investigated in non-small cell lung cancer (NSCLC). Methods A total of 288 NSCLC patients and 300 controls were enrolled. An A/C polymorphism at position 8923 in the PD-L1 gene was genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. Results The prevalence of the 8923C allele was significantly higher in NSCLC patients than controls (10.2% versus 5.3%, p = 0.002, odds ratio 2.03, 95% confidence interval 1.30-3.17; data were adjusted for age and sex). NSCLC patients also showed increased plasma levels of sPD-L1 compared to controls (1.92 ng/mL versus 0.91 ng/mL, p<0.001). Furthermore, lung adenocarcinoma patients had higher sPD-L1 levels than patients with squamous cell carcinoma (p<0.01). However, no association was observed between the different genetic variants and plasma concentrations of sPD-L1. Conclusions The PD-L1 8923A/C polymorphism could be associated with increased susceptibility to NSCLC. Plasma levels of sPD-L1 are significantly increased in NSCLC patients, especially those with adenocarcinoma.
An Affordable and Easily Constructed Model for Training in Ultrasound-guided Vascular Access
Authors: Rippey James C.R. , Blanco Pablo , Carr Peter J. 
Published: September 2015

Purpose This paper describes a simple and inexpensive method to make high-fidelity simulators for use in ultrasound-guided vascular access teaching. The phantoms can be created to reflect the ultrasound appearance and feel of central or peripheral arteries and veins. Different clinical states such as hypovolaemia may be readily displayed using the phantoms. Methods The article and associated videos describe the production, appearance and use of phantoms for central vascular access, for peripheral venous access and for peripheral arterial access. Key ingredients are readily accessible and include chicken breasts, modelling balloons and thin walled latex or silicone tubing. Results The phantoms are easily and rapidly constructed and may be used repeatedly in a training session. As the needle passes through the phantom and vessel wall, the ultrasound appearance and tactile sensation is very similar to that of human tissue and vessels. Conclusions Using this method, simple and inexpensive phantoms can be created. These are ideal for use in training for ultrasound-guided vascular access. Links to videos describing the phantom construction process, their appearance and the teaching techniques utilised by the authors are found in the text.
Evaluation of Sterilization using the MEH200® (Cotton Pack) in Vascular Access Puncture
Authors: Ueda Yuka , Tsuchida Kenji , Okada Daigo , Muromiya Yasuto , Suenaga Takehiro , Yokota Narushi , Kawahara Kana , Nagai Kojiro , Kanayama Hiro-omi , Minakuchi Jun 
Published: September 2015

Background In recent years, chlorhexidine-alcohol has been attracting increasing attention for its role in skin antisepsis. There have been few reports on the infection frequency associated with vascular access and no reports on the infection frequency associated with antiseptics. Aims We investigated skin disinfection during vascular access puncture in patients on chronic hemodialysis (HD). Methods We analyzed patients on chronic HD with arteriovenous fistula (AVF) and arteriovenous graft (AVG) between January 2006 and December 2010. Results The MEH200® (cotton pack including alcohol and chlorhexidine gluconate) was used in 97% of patients. A total of 1130 patients were analyzed, including 911 with AVF and 219 with AVG. Of these, seven with AVF had an infection attributed to the insertion site, which represented a rate of 0.008% of patients per year. Twenty patients with AVG had an infection attributed to the insertion site, which represented a rate of 9.1% of patients per year. The frequency was not higher than that previously reported. Conclusions In HD patients, the MEH200® may be effective for the prevention of bacteremia.
Outcomes of Blood Flow Suppression Methods of Treating High Flow Access in Hemodialysis Patients with Arteriovenous Fistula
Authors: Kanno Taro , Kamijo Yuji , Hashimoto Koji , Kanno Yutaka 
Published: September 2015

Purpose A high flow access (HFA) may cause heart failure in patients with an arteriovenous fistula (AVF) undergoing hemodialysis (HD) and is associated with poor prognosis. There are a variety of blood flow suppression techniques for treating HFA; however, the therapeutic outcome is still unclear. Methods The following three different blood flow suppression methods were performed on 74 patients with HFA: proximal artery banding with distal artery ligation (A-ban with A-lig: 12 cases); shunt vein banding (V-ban: 37 cases); and anastoplasty (Ana: 25 cases). Results There were no differences in the sex or mean age or duration of HD between the treatment groups. The A-ban with A-lig method was mainly selected for patients with a distal AVF and the anastoplasty method was selected most often for patients with a cubital AVF. The techniques were equally effective in reducing flow volume (FV) and the FV/cardiac output ratio (Flow/CO) to target levels, and clinical symptoms improved in all patients. The rates of HFA recurrence and AVF occlusion were significantly higher in the V-ban group (18.9% and 24.3%, respectively). A small proportion of patients in each treatment group developed a postoperative infection. Conclusions Each method proved to be an effective means of treating HFA. The choice of surgical method should be informed by the type of vascular access; however, the A-ban with A-lig and Ana methods appear to achieve clinically significant reductions in FV and have lower rates of HFA recurrence and AVF occlusion.
Vascular Access Intervention by a Nephrologist in Hiroshima
Authors: Doi Shigehiro , Masaki Takao 
Published: September 2015

Background Vascular access intervention (VAI) is a procedure essential to the maintenance of patency in vascular access and has become indispensable to nephrologists. This procedure has changed nephrology to a more exciting field. Concept This report describes the VAI technique which is based on 15 years of treatment experience of the author of this report and which the author has taught to young nephrologists in Hiroshima.
Is Bypass Graft Technique Effective in Arteriovenous Graft?
Authors: Noguchi Tomonaga , Miyamoto Masahito , Kataoka Kazuyoshi , Sato Kazuhiro , Nihei Hiroshi , Takeda Isao , Inoue Keiji , Sasagawa Naru , Chiba Tetsuo 
Published: September 2015

Background Arteriovenous graft (AVG) requires percutaneous transluminal angioplasty (PTA) to maintain its patency; however, bypass graft technique is often chosen in cases requiring PTA again within 3 months. We retrospectively examined whether bypass graft technique is effective for AVG. Methods The sample patient population consisted of 50 patients who underwent bypass graft technique on the venous side of the AVG between April 2012 and March 2014. The primary and assisted patencies of the technique were calculated, and compared by the type and length of the bypass graft. Kaplan-Meier method and log-rank test were used for the calculation and comparison of the patency, respectively. p<0.05 was considered statistically significant. Results The reasons for surgery were thrombotic occlusion (27 cases), frequent PTA (15 cases) and others (8 cases). Frequent PTA was conducted within 3 months in 22 of 27 thrombotic occlusion cases (making 37/50, or 74%). Moreover, thrombectomy was required in 34 cases (68%). The 1-year primary and 1-year assisted patencies of the technique were 6.5% and 72.6%, respectively. When the endpoint was frequent PTA within 3 months after the technique, 1-year primary patency was 45.9%. Conclusions The 1-year primary patency of the technique was poor, and patency was hard to maintain without the assistance of PTA. Given that frequent PTA was conducted in 74% of patients, it may be a cause for the poor patency. Many cases required thrombectomies, which have the disadvantage of being more invasive than PTA. We concluded that bypass graft technique is not valuable for cases that received frequent PTA.
Reduction or Discontinuation of Antibiotic Prophylaxis in Vascular Access Surgery, Tendon Sheath Incision and PD Catheter Placement
Authors: Nagai Kojiro , Tsuchida Kenji , Sasada Maki , Yokota Narushi , Nishitani Masaaki , Kanayama Hiro-omi , Minakuchi Jun 
Published: September 2015

Purpose Immune response in dialysis patients is suppressed and these patients are susceptible to bacterial infections. Therefore, minimal use of antibiotics in dialysis patients is recommended to avoid generating drug-resistant bacteria. However, minor surgeries including vascular access surgery, tendon sheath incision and peritoneal dialysis (PD) catheter placement are inevitable in dialysis patients and evidence-based recommendations on the judicious use of antibiotics are not currently available for these procedures. In this study, the optimal antibiotic prophylaxis for minor surgeries was evaluated. Methods This is a retrospective study. In dialysis patients at Kawashima Hospital, a three-step reduction of antibiotic use was performed in 651 cases of arteriovenous fistula (AVF) and tendon sheath incision surgeries from July 2009 through October 2012. Moreover, general surgical guidelines-recommended dose of preoperative antibiotics only were used in 532 cases of arteriovenous graft (AVG) and PD catheter placement from January 2010 through October 2012. The surgical site was observed for 2 weeks after the surgery. Results In only one case of AVF surgery, redness of the skin around the stitches was noticed 5 days after the surgery, which was healed with antibiotics taken orally for 3 days. Neither AVG nor PD catheter placement demonstrated any infection at the surgical site during the 2-week observation period. Conclusions Even in dialysis patients, neither pre- nor postoperative antibiotics are necessary for AVF and tendon sheath incision surgeries. AVG and PD catheter placement surgeries require only a small amount of antibiotics preoperatively.
Percutaneous Transluminal Angioplasty in Japan: Five-Center Investigation
Authors: Murakami Masaaki , Miyamoto Masahito , Suemitsu Kotaro 
Published: September 2015

Purpose Percutaneous transluminal angioplasty (PTA) is the first-line treatment for vascular access stenosis. To our knowledge, multicenter clinical research of PTA has not been reported in Japan. We examined the efficacy and safety of PTA for arteriovenous fistula (AVF) and arteriovenous graft (AVG) in five centers of Japan. Methods Three hundred cases of angioplasty for AVF and 300 for AVG were examined in three centers each. A hundred consecutive patients from each center who underwent PTA for AVG or AVF prior to March 2014 and met the inclusion criteria were searched retrospectively. Primary patency rates were estimated using the Kaplan-Meier method. Results The mean age was 69.3 ± 11.2 years in the AVF group and 70.2 ± 11.9 years in the AVG group. The anatomical success rates were 51.7% (155 of 300) in the AVF group and 72.0% (216 of 300) in the AVG group. The clinical success rates were 99.7% (299 of 300) in the AVF group and 100% (300 of 300) in the AVG group. A total of 25 complications (4.17%) were encountered in both groups including one major complication (0.17%). The primary patency was 99.0% at 1 month, 87.9% at 3 months and 51.7% at 6 months in the AVF group, and 96.0% at 1 month, 64.8% at 3 months and 20.4% at 6 months in the AVG group. Conclusions The clinical success rate of PTA in five centers was relatively high and a major complication rate was only 0.17%. However, anatomical success rates were low comparing with the previous studies and the primary patency rates were inferior to the past data.
Vascular access in super-aged patients
Authors: Kawanishi Hideki , Shintaku Sadanori , Moriishi Misaki 
Published: September 2015

Purpose In developed countries, dialysis patients are aging along with the general population. The choice of vascular access (VA) is a more complex decision among elderly patients and is not specifically addressed by clinical practice guidelines. We investigated the relationship between the VA type at dialysis initiation in elderly patients and their prognosis, as well as the selection of the optimal VA type. Methods We conducted a retrospective observational cohort study of consecutive adult patients (age ≥18 years) as their first form of renal replacement therapy (RRT) between January 1, 2003, and December 31, 2010. For this study, VA included both arteriovenous fistula (AVF) and temporary central venous catheter (CVC). Results A total of 402 patients were included in this study. The percentage of patients who started dialysis with CVC increased with age, and 63% of those were over 80 years. The survival rate in the group of elderly patients (≥70 years) using CVC at dialysis initiation was significantly lower. In contrast, the survival rates were comparable between nonelderly patients (<70 years) using CVC or AVF. One hundred and thirty patients were super-aged (≥80 years). In super-aged patients (≥80 years) and aged patients (70-79 years), dialysis initiation with CVC was correlated with a significantly poorer survival rate than dialysis initiation with AVF. The survival rates were comparable between the low CRP group (<1.8 mg/dL) using CVC or AVF. Conclusions The initiation of dialysis with temporary CVC is not a risk factor of death in nonelderly patients (<70 years). On the other hand, in elderly (≥70 years) and super-aged (≥80 years) patients, dialysis initiation with CVC increased the risk of death, but they had to start dialysis with CVC on an emergency basis because of their clinical condition, that is, inflammations.
Central Venous Access Devices Site Care Practices: An International Survey of 34 Countries
Authors: Broadhurst Daphne , Moureau Nancy , Ullman Amanda J. 
Published: September 2015

Purpose Effective postinsertion management of central venous access devices (CVADs) is important to prevent CVAD-associated complications, including catheter-associated bloodstream infections. Although there is a wealth of evidence-based guidelines available to guide the care of CVADs, applying their recommendations to the clinical setting across variable patient groups, CVAD types and international healthcare settings is challenging. This may result in patients receiving suboptimal care. Methods A cross-sectional descriptive study using an online survey was performed with an aim to determine current CVAD site care practices internationally. The CVAD site care domains included skin antisepsis, dressing selection, frequency of dressing change and device securement practices across impaired and unimpaired CVAD sites. Results Clinicians (n = 1044) residing in 34 countries reported diversity in their practice, with the majority of respondents practicing as nurses (89%) from North America (81%) as vascular access specialists (52%). The respondents’ reported practice was variant, with differing inconsistency to guidelines throughout each of the domains. There was wide variance in the management of CVAD sites with impaired skin integrity, such as rash, skin stripping/adhesive-related injuries and drainage. Vascular access clinicians reported high levels of confidence in managing CVAD sites, including those with impaired skin. Conclusions These inconsistencies are reflective of the complex and heterogeneous populations requiring CVADs, the evidence available to support practice in this area, the skills and knowledge of the clinicians caring for them and the resources of the healthcare setting. Further research and education is necessary to ensure that CVAD site care is undertaken effectively to minimise preventable complications.
The Impact of Tunnelled Vascular Catheters on Time to Arteriovenous Fistula Creation
Authors: Nandakoban Hareeshan , Aravindan Ananthakrishnapuram , Spicer Tim , Narayanan Govind , Gonzalez Noemir , Suranyi Michael , Wong Jeffrey K.W. 
Published: September 2015

Purpose The purpose of this study is to examine the effect of the presence of tunnelled vascular catheter (TVC) on physician referral and surgeon review and operating patterns and ultimately time of creation of permanent haemodialysis (HD) access. Methods A retrospective analysis of TVC and arteriovenous fistulae (AVF) databases in 2010. Physician referral time and surgical time to operation were compared between patients commencing HD with TVC and a control group who commenced HD with AVF. Results The AVF group (n = 27) commenced HD with an AVF and TVC group (n = 49) commenced HD via a TVC. Time from physician referral to surgeon review in the AVF vs. TVC group was 29 vs. 35 days (p = 0.6). Time from surgeon review to access creation was 43 vs. 50 days (p = 0.4). However, in the TVC group, the time from TVC insertion to physician referral to a surgeon was an additional 109 ± 20 days. Subgroup analysis of 11 TVC patients (23%) presenting at end stage without AVF (crash starters) had a TVC to physician referral time of 103 ± 75 days, physician referral to surgeon review of 14.4 ± 4 days and surgeon review to AVF of 67 ± 23 days. Conclusions The presence of a TVC is associated with a significant delay (>3 months) before physicians make a referral for surgeon review. There was no surgeon-related delay to access creation related to the presence of a TVC.
No-Touch Technique for Radiocephalic Arteriovenous Fistula – Surgical Technique and Preliminary Results
Authors: Hörer Tal M. , Skoog Per , Quell Robin , Nilsson Kristofer F. , Larzon Thomas , Souza Domingos R. 
Published: September 2015

Purpose The radiocephalic arteriovenous fistula (RC-AVF) has significant failure rates due to occlusions and failure to mature. The size and quality of the veins are considerable limiting factors for the procedure. The aim of this pilot study was to describe the No-Touch technique (NTT) to create RC-AVF and present the results up to 1 year of follow-up. Methods Thirty-one consecutive patients who were referred for surgery for a RC-AVF were included (17 men, mean age 63 years, range 35-84) and operated by NTT where the vein and artery were dissected with a tissue cushion around it. Twenty-two patients had small veins or arteries (≤2 mm), 12 patients had a small cephalic vein (≤2 mm), and the mean distal cephalic vein diameter was 2.4 mm (range 1.0-4.1 mm). Results Technical surgical success and immediate patency were obtained in all patients. Clinical success was achieved in 23 of the 27 (85%) patients who required hemodialysis. The proportion of primary patency at 30 days and 6 months was 84% and 64%, respectively. Secondary patency at 30 days and 6 months was 97% and 83%, respectively. At 1-year follow-up, primary patency was 54% and secondary patency was 80%. There was no major difference in patency due to preoperative vein diameter. Conclusions The results of this study indicate that NTT can be used for primary radio-cephalic fistula surgery with very good results. This method offers the potential to create a RC-AVF in patients who are not usually considered appropriate for a distal arm fistula due to a small cephalic vein.
Peripherally Inserted Central Catheter-Related Vein Thrombosis in Breast Cancer Patients
Authors: Kang Junren , Sun Wenyan , Li Hailong , Ma Enling , Wang Kai , Chen Wei 
Published: September 2015

Purpose To identify clinical incidence, risk factors and treatment of peripherally inserted central venous catheters (PICCs)-related upper extremity venous thrombosis (UEVT) in breast cancer patients undergoing chemotherapy. Methods We performed a retrospective cohort study of breast cancer patients with PICC insertion undergoing chemotherapy. PICC-related UEVT was diagnosed by ultrasound. Patient-, catheter- and insertion-related factors were analyzed in univariable and multivariable logistic regression to identify significant independent risk factors for PICC-related UEVT. The incidence and treatment of PICC-related UEVT were also analyzed. Results A total of 568 breast cancer patients with PICC undergoing chemotherapy were included, for a total of 54,769 catheter days; 8 patients (1.4%) developed PICC-related UEVT. The median time of developing UEVT was 11 days (range of 3 to 79 days). In multivariable analysis, metastasis (p = 0.002) and malposition (p = 0.013) were shown to be significant risk factors for PICC-related UEVT. All patients were treated with low-molecular-weight heparin (LMWH) and followed until PICCs were removed. None of the patients developed pulmonary embolus. Conclusions Metastasis and malposition were significant risk factors for PICC-related UEVT in breast cancer patients. With early diagnosis and standardized anticoagulant treatment, a better clinical outcome could be achieved. Further prospective and large sample studies are needed.