bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pasteurized Donor Human Milk Maintains Microbiological Purity for 4 Days at 4°C
Authors: Vickers Amy Manning , Starks-Solis Shaina , Hill David R. , Newburg David S. 
Published: March 2015

Background: Most protective components in human milk are stable during prolonged storage at 4ºC; however, pasteurization reduces some microbicidal activities responsible for suppressing microbial growth and protecting against infection. Donor milk used by neonatal intensive care units (NICUs) is frozen pasteurized donor human milk (PDHM) defrosted and stored at 4ºC. Current Human Milk Banking Association of North America (HMBANA) Best Practice guidelines recommend that milk be discarded 24 hours after being thawed, but experimental data on the duration of microbiological purity in thawed PDHM are sparse. Objective: This study evaluates microbiological purity of thawed PDHM during prolonged storage at 4ºC. Methods: A total of 42 independent, randomly selected PDHM samples were thawed at 4ºC. As is typical in NICUs, each bottle was opened at 3-hour intervals and 3 mL was withdrawn with a sterile syringe and transferred into a sterile tube. The 3 mL samples removed at 0, 24, 48, 72, 96 hours, and 9 days were tested for the presence of any microorganisms by a clinical laboratory that routinely screens PDHM for microbes. Results: No evidence of microbial growth was observed in cultured samples taken at 0 to 9 days after thawing of the milk samples. Conclusion: There was no evidence of microbes in PDHM as dispensed by HMBANA milk banks when defrosted and stored at 4ºC for up to 9 days. Extended storage of PDHM in the NICU could reduce waste of donor milk, thereby increasing availability of human milk to vulnerable neonatal patients.
Pedicle ties provide a rapid and safe method for feline ovariohysterectomy
Authors: Miller Kirk P , Rekers Wendy , Ellis Kristi , Ellingsen Kris , Milovancev Milan 
Published: March 2015

Objectives The specific objectives of the present study were to evaluate the rate of hemorrhage-related complications across a large number of feline pedicle tie (PT) procedures, and evaluate for a difference in surgical time between traditional pedicle double ligation (PDL) and PT procedures. Methods In the initial phase of the study, 2136 intact female cats underwent an ovariohysterectomy using the PT technique. Hemorrhagic complications not detected intraoperatively were to be confirmed via exploratory surgery or necropsy. The second phase of the study recorded the duration of surgery for four groups: kittens undergoing PTs (n = 50), kittens undergoing PDL (n = 49), adult cats undergoing PTs (n = 50) and adult cats undergoing PDL (n = 54). Kittens were defined as a cat 4 months old or younger. Statistical comparisons of age, body weight and surgical times between the PT and PDL groups were performed within, but not between, kitten and adult cat categories. Results Six of 2136 (0.281%) cats experienced a hemorrhage-related complication associated with the ovarian pedicle. Five of the six ovarian pedicle hemorrhage-related complications were recognized and corrected intraoperatively, with the remaining hemorrhagic event being detected postoperatively. Surgical times were significantly shorter in PT kittens compared with PDL kittens (4.7 ± 0.1 mins vs 6.7 ± 0.1 mins) and PT adult cats compared with PDL adult cats (5.0 ± 0.2 mins vs 7.0 ± 0.2 mins). Conclusions and relevance This study demonstrates that the PT technique is associated with a very low risk of hemorrhage-related complications and is significantly faster than double ligating the ovarian pedicle in kittens and adult cats. Use of the PT technique has the potential to be of significant economic benefit in institutions performing large numbers of feline ovariohysterectomies.
An experimental and modeling assessment of the HCFC-R123 refrigerant capabilities for lubricating rolling EHD circular contacts
Authors: Vergne Philippe , Fillot N , Bouscharain N , Devaux N , Morales-Espejel GE 
Published: March 2015

This work aims at investigating the capabilities of the hydrochlorofluorocarbon (HCFC)-R123 refrigerant for lubricating rolling elastohydrodynamic circular contacts. The viscosity pressure and temperature dependence of this fluid, used in oil-free compressors, are first studied in its liquid phase. Complementary data like density variations are taken from the thermo-physics literature. Besides, film thickness measurements using a ball-on-disk tribometer equipped with an interferometry facility have been performed under pure rolling conditions. For the same operating conditions, film thickness is then predicted from a numerical elastohydrodynamic model in which the viscosity and density dependencies with pressure and temperature are described using physics-based relationships, allowing a quantitative approach. The results obtained from the full numerical model, from the analytical elastohydrodynamic film-thickness expressions, and from the experiments show an acceptable agreement. They clearly reveal that indeed refrigerants can build up a reasonable film thickness for lubricating elastohydrodynamic rolling point contacts.
Women's empowerment and education: Panchayats and women's Self-help Groups in India
Authors: Ghosh Ratna , Chakravarti Paromita , Mansi Kumari 
Published: March 2015

While women have made many advances, their inferior status to men continues to be a global phenomenon. At a time of unprecedented economic growth, India is experiencing a dramatic intensification of violence against women and the majority of girls are still not getting equal educational opportunity. In one of the most important steps for the empowerment of women, the Indian government gave constitutional status to village-level councils or Panchayati Raj institutions and reserved 33% of the seats in Panchayats for women. In addition, women were organized into Self-help Groups to mark the beginning of a major process of empowering women, although not much attention was paid to women's formal education. Our aim was to explore the impact of these measures on women's empowerment in the states of West Bengal and Mizoram. In general, we found that affirmative action does ensure that larger numbers of women enter politics but it does not ensure that the women participate in politics and function as elected representatives, because of lack of education. Empowerment needs to be seen as a holistic outcome of processes of critical education that enables women to lead autonomous lives and the freedom to act. Both affirmative action and education are necessary to empower women who have suffered discrimination and lack of power always.
Cementless surface replacement hemiarthroplasty for primary glenohumeral osteoarthritis: results of over 5-year follow-up in patients with or without rotator cuff deficiency
Authors: Al-Hadithy Nawfal , Furness Nicholas , Patel Ronak , Jonas Sam , Jobbagy Attila , Lowdon Ian , Woods David 
Published: March 2015

Background Cementless surface replacement hemiarthroplasty (CSRHA) is an established treatment for glenohumeral osteoarthritis; however, studies evaluating its role in arthritis with rotator cuff deficiency are limited. This study reviews the outcomes of CSRHA for glenohumeral osteoarthritis with and without rotator cuff tears. Methods 41 CSRHA (Mark III Copeland prosthesis) were performed for glenohumeral osteoarthritis with intact rotator cuffs ( n = 21) and cuff-deficient shoulders ( n = 20). Patients were assessed using Oxford and Constant questionnaires, patient satisfaction, range of motion measurements and by radiography. Results Mean age and follow-up were 75 years and 5.1 years, respectively. Functional gains were significantly higher in patients with intact rotator cuffs compared to cuff-deficient shoulders, with Oxford Shoulder Score improving from 18 to 37.5 and 15 to 27 and forward flexion improved from 60° to 126° and 44° to 77° in each group, respectively. Two patients with deficient cuffs had deficient subscapularis tendons; one of which was dislocated anteriorly. Conclusions CSRHA provides significant improvements in pain and function in patients with glenohumeral osteoarthritis. In patients with deficient cuffs, functional gains are limited, and should be considered in low-demand patients where pain is the primary problem. Caution should be taken in patients with a deficient subscapularis as a result of the risk of dislocation.
Aseptic non‐touch technique and catheter‐related bloodstream infection in children receiving parenteral nutrition at home
Authors: Mutalib Mohamed , Evans Victoria , Hughes Anna , Hill Susan 
Published: March 2015

ObjectivesParenteral nutrition (PN) at home is an acceptable form of delivering long‐term PN for children with intestinal failure. Catheter‐related bloodstream infection (CRBSI) is one of the serious complications of long‐term PN and can lead to increasing morbidity and mortality. Using aseptic non‐touch technique (ANTT) was proven to decrease the incidence of CRBSI in hospital patients. In this study we aimed to review the incidence of CRBSI in children receiving PN at home in our institution using the ANTT and a simplified training programme for parents and carers.MethodsWe retrospectively collected clinical and microbiological data on all children with intestinal failure (IF) who were on treatment with PN at home under our specialist IF rehabilitation service between November 2012 and November 2013.ResultsThirty‐five children were included, 16 of whom did not have any infection recorded during the study period. The overall CRBSI rate was 1.3 infections per 1000 line‐days, with Staphylococcus being the commonest organism. Twenty‐one children did not require catheter change and the overall catheter changes were 1.8 per 1000 line‐days.ConclusionIn this article, we report a low incidence of CRBSI in a single institution by using the principle of ANTT for accessing central venous catheters combined with a simplified, nurse‐led, two‐week standardised training programme for parents of children going home on PN.
IBD‐related work disability in the community: Prevalence, severity and predictive factors. A cross‐sectional study
Authors: Ramos Alexis , Calvet Xavier , Sicilia Beatriz , Vergara Mercedes , Figuerola Ariadna , Motos Jaume , Sastre Adoración , Villoria Albert , Gomollón Fernando 
Published: March 2015

Background and aimsData on the prevalence of work disability in patients with inflammatory bowel disease (IBD) are heterogeneous. As most studies have been performed in selected, often severe, IBD patients, the true prevalence of disability in the community remains controversial. The aim of this cross‐sectional study was to evaluate the prevalence and severity of disability and its predictive factors in a community‐based IBD population.Patients and methodsPatients recorded in the community‐based IBD register at the Hospital Universitario de Burgos were contacted. After informed consent they completed a set of questionnaires including demographic, clinical, disability and quality of life data. The statistical study was performed using SPSS 21.ResultsA total of 293 patients were included – 151 Crohn's disease (CD), 142 ulcerative colitis (UC), 137 female, mean age: 45 ± 11 years, mean time since diagnosis: 10.6 ± 11 years. Twelve patients (4.1%) had a work‐disability pension. In addition, 93 (32%) of all patients had an officially recognized disability degree, which was generally moderate (n  = 73, 25%) or severe (N  = 16, 5%). Age, time since IBD diagnosis, CD, perianal disease, incontinence, active disease, the need for anti‐TNF or psychological treatment, previous surgeries and the number of diagnostic tests and medical visits in the previous year were predictors of disability. Major predictors of qualifying for a disability pension were age, IBD activity, incontinence, need for biological drugs and ostomy.ConclusionMild to moderate work disability is frequent in IBD. However, only a minority of patients develop severe disability qualifying them for a pension.
The safety of same‐day CT colonography following incomplete colonoscopy with polypectomy
Authors: Lara Luis F , Avalos Danny , Huynh Huan , Jimenez-Cantisano Brenda , Padron Mariann , Pimentel Ronnie , Erim Tolga , Schneider Alison , Ukleja Andrew , Parlade Albert , Castro Fernando 
Published: March 2015

BackgroundConcerns about the risk of bowel perforation for same‐day computed tomography colonography (CTC) following an incomplete colonoscopy with polypectomy may lead to unnecessarily postponing the CTC.ObjectiveThe objective of this article is to describe the complications including colon perforations associated with same‐day CTC in a cohort who had polypectomies but an incomplete colonoscopy.DesignWe conducted a retrospective study.SettingOur study took place in a single, tertiary referral center.PatientsWe studied consecutive patients who had CTC the same day as an incomplete colonoscopy with polypectomy.InterventionsInterventions included optical colonoscopy (OC), endoscopic polypectomies, and same‐day CTC.Main outcome measurements: Our main outcome measurements included perforation rate with long‐term follow‐up.ResultsA total of 3% of patients undergoing colonoscopy from January 2008 to December 2012 had same‐day CTC following incomplete OC, and 72 polypectomies were performed in 34 (or 17%) of these patients. Incomplete colonoscopies were due to colon tortuosity and looping (25), severe angulations (five), colon mass (two), colon stenosis (one), bradycardia (one). Fifty‐three percent of the OCs were screening for colon neoplasia, 29% diagnostic and 18% were surveillance of colon polyps. Most polyps were ≤ 5 mm, and found in the left colon. There were no reported complications or perforations associated with same‐day CTCs during short‐ and long‐term follow‐up.LimitationsLimitations of our analysis included retrospective single‐center design, small number of patients for the occurrence, referral to same‐day CTC was not standardized, inability to establish safety of CTC for specific scenarios such as after complex polypectomies, strictures, or advanced IBD.ConclusionsRadiologists’ apprehension to perform a CTC the same day as an incomplete colonoscopy following polypectomies because of perceived risk of perforation may be unfounded. More data are needed to determine the safety of same‐day CTC in patients with high‐risk findings during colonoscopy such as a stricture, severe IBD, and after complex polypectomies.
Fluid Extravasation Related to Hip Arthroscopy
Authors: Hinzpeter Jaime , Barrientos Cristián , Barahona Maximiliano , Diaz Jorge , Zamorano Alvaro , Salazar Alfonso , Catalan Jaime 
Published: March 2015

Background: Complications related to hip arthroscopy are rare, with a current rate of <2%. Some complications are related to fluid extravasation, which has been associated with life-threatening conditions such as abdominal compartment syndrome, cardiopulmonary arrest, hypothermia, and atelectasis. Purpose: To identify risk factors for fluid volume extravasation in hip arthroscopy and to determine the relationship between anatomical location on computed tomography (CT) and extravasated volume. Study Design: Case series; Level of evidence, 4. Methods: We performed a prospective cohort study of 40 consecutive arthroscopies for femoroacetabular impingement. Patient demographics and procedures performed (ie, acetabuloplasty and its size, femoral osteoplasty, and psoas tenotomy) were recorded. The extravasated volume was estimated by the difference between the infused volume and the intraoperatively collected volume. Within 12 hours after the procedure, the pelvis was scanned by CT. We created a 3-stage radiological classification based on progressive involvement of anatomical structures attributed to liquid extravasation. Statistical analyses were performed with a 95% CI and a significance level of 5%. Results: No relevant clinical symptoms related to fluid extravasation were recorded. The mean extravasated volume was 3.06 L at a rate of 1.05 L/h, corresponding to nearly 10% of the infused volume. There was a trend toward greater extravasated volume with longer operative time and longer time in the peripheral compartment (without axial traction); however, there was no statistical significance. The anatomical classification on CT imaging was directly related to the extravasated volume and compromised the thigh, gluteus, and retroperitoneum and intraperitoneal spaces. There was a 6-fold greater probability of female patients having an advanced stage extravasation on CT classification. Conclusion: In our series, 10% of the infused volume was extravasated in uncomplicated hip arthroscopy. Risk factors for extravasation were related to operative time, particularly during peripheral compartment intervention (ie, without traction). The anatomical classification proposed in this study reflects the progressive involvement of the thigh, gluteus, iliopsoas, and retroperitoneal and intraperitoneal spaces after increase in extravasated volume. Compared with males, females were associated with more severe anatomical compromise for the same extravasated volume.
Haploidentical hematopoietic transplantation from KIR ligand–mismatched donors with activating KIRs reduces nonrelapse mortality
Authors: Mancusi Antonella , Ruggeri Loredana , Urbani Elena , Pierini Antonio , Massei Maria Speranza , Carotti Alessandra , Terenzi Adelmo , Falzetti Franca , Tosti Antonella , Topini Fabiana , Bozza Silvia , Romani Luigina , Tognellini Rita , Stern Martin , Aversa Franco , Martelli Massimo F. , Velardi Andrea 
Published: March 2015

Key Points
Haploidentical transplantation from KIR ligand–mismatched donors with activating KIRs reduces nonrelapse mortality and improves survival. Activating KIR genetics should be considered when selecting donors for T cell–depleted haploidentical hematopoietic transplantation.
Obinutuzumab plus fludarabine/cyclophosphamide or bendamustine in the initial therapy of CLL patients: the phase 1b GALTON trial
Authors: Brown Jennifer R. , O’Brien Susan , Kingsley C. Daniel , Eradat Herbert , Pagel John M. , Lymp James , Hirata Jamie , Kipps Thomas J. 
Published: March 2015

Key Points
In this phase 1b study, obinutuzumab plus FC or B had acceptable safety, with infusion reactions the most common adverse event. Obinutuzumab plus FC or B showed promising clinical activity in the initial treatment of CLL, with no relapses to date.
The effectiveness of a flood protection computer game for disaster education
Authors: Tsai Meng-Han , Chang Yu-Lien , Kao Catherine , Kang Shih-Chung 
Published: March 2015

Abstract

Background
Taiwan experiences typhoons annually and the heavy rain accompanies a typhoon often causes flooding and damage. Local decision-makers invest heavily in flood-prevention measures thus need to allocate resources wisely to minimize the destruction. As floods periodically cause tremendous damage to lives and property, passing on the learning of previous generations becomes important. Disaster education is therefore critical in the region. However, the current disaster education curriculum follows a traditional education methodology focusing on theoretical and conceptual knowledge and teaching. An alternative methodology is needed to motivate students and to deliver practical experience in disaster education.

Method
This study adopted a persuasive technology game-initiated-learning (GIL) and developed a Flood Protection game to understanding the following: (1) students’ motivation for learning, (2) their ability to play the game, and (3) their focus on disaster topics. To evaluate their levels of motivation, students’ reactions were analyzed and categorized into four specific expressions: discussion, question, laughter, and screaming. Students’ game playing ability was analyzed and categorized into four stages: explore, aware, fluent, and known. Finally, the content of students’ discussions and questions were analyzed to assess their interest in disaster education.

Results
Students’ levels of motivation were found to be high (an average of 2.3 instances of discussion, 0.7 instances of question, 1.3 instances of laughter, and 0.8 instances of screaming were observed per minute during the game); their ability to play the game was sufficient (79% of students completed the game having reached the “known” stage); and the content of their discussions and questions was closely related to disaster knowledge (73% of the 256 discussions and questions related closely to flood and disaster knowledge).

Conclusions
From this research, we find that GIL is a persuasive design in flood protection training. Students with low motivation in conventional learning environments were triggered after playing the game. It enhanced students’ motivation to learn more about flooding. In short, the game does benefit flood disaster education, indicating that a well-designed game may promote students’ motivation in disaster education and cause behavior change.
Integrating Patient-Reported Outcomes into Spine Surgical Care through Visual
Dashboards: Lessons Learned from Human-Centered Design
Authors: Hartzler Andrea L. , Chaudhuri Shomir , Fey Brett C. , Flum David R. , Lavallee Danielle 
Published: March 2015

Introduction: The collection of patient-reported outcomes (PROs) draws attention
to issues of importance to patients—physical function and quality of life. The
integration of PRO data into clinical decisions and discussions with patients requires
thoughtful design of user-friendly interfaces that consider user experience and present
data in personalized ways to enhance patient care. Whereas most prior work on PROs
focuses on capturing data from patients, little research details how to design effective
user interfaces that facilitate use of this data in clinical practice. We share lessons
learned from engaging health care professionals to inform design of visual dashboards,
an emerging type of health information technology (HIT).Methods: We employed
human-centered design (HCD) methods to create visual displays of PROs to support patient
care and quality improvement. HCD aims to optimize the design of interactive systems
through iterative input from representative users who are likely to use the system in
the future. Through three major steps, we engaged health care professionals in targeted,
iterative design activities to inform the development of a PRO Dashboard that visually
displays patient-reported pain and disability outcomes following spine
surgery.Findings: Design activities to engage health care administrators, providers, and
staff guided our work from design concept to specifications for dashboard
implementation. Stakeholder feedback from these health care professionals shaped user
interface design features, including predefined overviews that illustrate at-a-glance
trends and quarterly snapshots, granular data filters that enable users to dive into
detailed PRO analytics, and user-defined views to share and reuse. Feedback also
revealed important considerations for quality indicators and privacy-preserving sharing
and use of PROs.Conclusion: Our work illustrates a range of engagement methods guided by
human-centered principles and design recommendations for optimizing PRO Dashboards for
patient care and quality improvement. Engaging health care professionals as stakeholders
is a critical step toward the design of user-friendly HIT that is accepted, usable, and
has the potential to enhance quality of care and patient outcomes.