bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knee flexion contracture treated with botulinum toxin type A in patients with haemophilia (PWH)
Authors: Daffunchio C. , Caviglia H. , Nassif J. , Morettil N. , Galatro G. 
Published: July 2015

IntroductionKnee flexion contracture (KFC) remains a common complication of haemoarthrosis in children and young adults with haemophilia. If the KFC is not treated properly it produces disability, postural and gait abnormalities.ObjectiveEvaluate the effectiveness of conservative treatment of KFC with Botulinum toxin type A (BTX‐A) in PWH.MethodsSeventeen patients were treated, with 21 affected knees. Mean age was 26 years. The mean follow up was 12 months. We evaluated flexion and KFC pretreatment BTX‐A and up to 12 months posttreatment. BTX‐A application was in hamstring and calf muscles. To evaluate the function, a questionnaire about different activities was made, and it was checked 3, 6 and 12 months after BTX‐A. According to the degree of KFC, knees were divided into 3 groups: Group 1: −10° to −30° (n = 10), Group 2: −31° to −45° (n = 6) Group 3: −46° or more (n = 5).ResultsThe average KFC improved from −38° to −24°. The improvement was 14° (P < 0.001). The average KFC improvement was 9° in group 1, 17° in group 2, and 23° in group 3. There was a high correlation between the improvement in KFC and the total score of the questionnaire R = 0.77.ConclusionsTreatment of KFC with BTX‐A improves knee‐related functional activities, with the advantage of being a low‐cost procedure and easy to apply.
Efficacy of interferon‐beta plus ribavirin combination treatment on the development of hepatocellular carcinoma in Japanese patients with chronic hepatitis C
Authors: Ikezaki Hiroaki , Nomura Hideyuki , Furusyo Norihiro , Ogawa Eiichi , Kajiwara Eiji , Takahashi Kazuhiro , Kawano Akira , Maruyama Toshihiro , Tanabe Yuichi , Satoh Takeaki , Nakamuta Makoto , Kotoh Kazuhiro , Azuma Koichi , Dohmen Kazufumi , Shimoda Shinji , Hayashi Jun ,   The Kyushu University Liver Disease Study (KULDS) Group
Published: July 2015

AbstractAimAlthough there is much evidence of an antitumor effect of pegylated interferon (IFN)‐α‐based treatment, limited data is available about that of IFN‐β‐based treatment. Our goal was to evaluate the impact of IFN‐β plus ribavirin (RBV) treatment on the suppression of hepatocellular carcinoma (HCC).MethodsThis retrospective, multicenter study consisted of 124 chronic hepatitis C patients who were treated with IFN‐β plus RBV treatment, including 61 with advanced fibrosis and five with pretreatment HCC. All participants were followed for a median of 2.8 years (range, 2.2–3.2) after the end of their antiviral treatment. The data of 112 patients who finished the treatment were available for analysis. Cox proportional hazard analyses were performed to determine factors significantly associated with HCC development. Cumulative incidence curves for HCC were plotted using the Kaplan–Meier method and differences between groups were assessed using the log–rank test.ResultsThe 2.9% rate of HCC development of patients with sustained virological response (SVR) was significantly lower (P = 0.027) than the 15.9% of non‐SVR patients. Interestingly, no significant difference was observed between the rates of HCC development of patients with and without advanced fibrosis (P = 0.733), even though the SVR rate of patients with advanced fibrosis was significantly lower than that of those without advanced fibrosis (P < 0.001). Stepwise multivariable Cox analysis extracted that only SVR was significantly associated with HCC development (hazard ratio, 0.20; 95% confidence interval, 0.03–0.84, P = 0.027).ConclusionSVR was significantly associated with a lower risk of HCC development after IFN‐β plus RBV treatment.
Efficacy of automated tumor‐feeder detection software using cone‐beam computed tomography technology in transarterial embolization through extrahepatic collateral vessels for malignant hepatic tumors
Authors: Miyayama Shiro , Yamashiro Masashi , Nagai Keiichi , Tohyama Jun , Kawamura Kenshi , Yoshida Miki , Sakuragawa Naoko 
Published: July 2015

AbstractAimWe evaluated the performance of automated tumor‐feeder detection (AFD) software using cone‐beam computed tomography technology in identifying tumor‐feeders of extrahepatic collaterals.MethodsAFD was prospectively used in superselective transarterial chemoembolization (TACE) or embolization (TAE) of extrahepatic collaterals for 29 hepatocellular carcinomas and one liver metastasis (mean tumor diameter ± standard deviation, 28 ± 15.6 mm) in 25 patients. The detectability of extrahepatic tumor‐feeders with non‐selective digital subtraction angiography (DSA) and AFD was evaluated and compared using a χ2‐test. Tumor response of target lesions in each patient at 2–3 months after treatment was evaluated using the modified Response Evaluation Criteria in Solid Tumors. Complications were also evaluated.ResultsOf 46 tumor‐feeders, non‐selective DSA and AFD could identify 26 and 44, respectively (P < 0.001). Regarding the origin of tumor‐feeders, both non‐selective DSA and AFD could identify 14 of 15, six of seven and two of two tumor‐feeders of the right inferior phrenic, omental and right renal capsular artery, respectively. In the cystic and left gastric or right colic artery, AFD could identify 13 of 13 and nine of nine tumor‐feeders but non‐selective DSA could identify only three of 13 and one of nine, respectively (P < 0.001). Complete response was obtained in 15 patients, partial response in six, stable disease in three and progressive disease in one. No severe complications developed except for right pleural effusion after embolization of the right inferior phrenic artery.ConclusionAFD has a sufficient ability to identify extrahepatic tumor‐feeders and may improve the safety and local effects of TACE/TAE of extrahepatic collaterals.
‘I just don't want to get bullied anymore, then I can lead a normal life’; Insights into life as an obese adolescent and their views on obesity treatment
Authors: Reece Lindsey J. , Bissell Paul , Copeland Robert J. 
Published: July 2015

AbstractBackgroundAdolescent obesity is a complex condition involving social, emotional, behavioural and cultural issues.DesignOne‐to‐one interviews and small focus groups with overweight and obese young people were conducted. Qualitative research is an appropriate method to explore the complexity of this issue.Setting and participantsOverweight and obese adolescent's attending a community weight management intervention in South Yorkshire.Main variables studiedInterviews aimed to explore the experiences of obese adolescents and their perspectives towards obesity treatment.ResultsAdolescent's provided detailed accounts of their perspectives on weight gain, alluding to disordered patterns of eating and overeating, reported as being triggered by social and emotional factors, and in particular, bullying. Avoidance of bullying and a desire to integrate socially with peers were key drivers to seek treatment. Young people reported what they should do to lose weight, yet responsibility for successful weight loss and lifestyle change was repeatedly attributed to the treatment received, as opposed to viewing this as a combination of self‐motivation coupled with support provided by friends and family.ConclusionWeight loss programmes need to consider the complex experience of obese young people in their design, focusing on how to implement long‐term lifestyle changes.
A simple self‐reported adherence tool as a predictor of viral rebound in people with viral suppression on antiretroviral therapy
Authors: O'Connor JL , Gardner EM , Esser S , Mannheimer SB , Lifson AR , Telzak EE , Phillips AN ,   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) Strategies for Management of Antiretroviral Therapy (SMART) Study Group
Published: July 2015

ObjectivesThe aim of the study was to investigate the relationship between self‐reported antiretroviral therapy (ART) adherence and virological outcomes in the multinational Strategies for Management of Antiretroviral Therapy (SMART) study.MethodsEligible participants were from the continuous ART arm and had at least one viral load (VL) ≤ 50 HIV‐1 RNA copies/mL and a subsequent VL value (VL pair). Self‐reported adherence was measured at each visit using a five‐point Likert scale which employed a 7‐day recall. High adherence was defined as taking ‘all pills every day’ (level 1) for every regimen component; all others had suboptimal adherence (levels 2 − 5). In individuals with VL suppression (≤ 50 copies/mL), the association between adherence (at the time of VL suppression) and VL rebound (> 200 copies/mL at next visit) was assessed using multivariable logistic regression with generalized estimating equations.ResultsA total of 10 761 sets of VL pairs from 1986 participants were included in the study. For 1220 (11%) VL pairs, adherence was suboptimal. For 507 VL pairs (5%), VL rebound occurred. The risk of rebound generally increased as adherence decreased: 4.2% for level 1, 7.7% for level 2, 16.3% for level 3, 9.4% for level 4 and 12.9% for level 5. In multivariable analysis, suboptimal adherence at the time of suppression was associated with a 50% increased odds of experiencing subsequent VL rebound [odds ratio (OR) 1.51; 95% confidence interval (CI) 1.19–1.92; P = 0.0023], compared with high adherence.ConclusionsSelf‐reported suboptimal adherence in people with VL suppression is associated with an increased risk of VL rebound. Our findings highlight the importance of continued adherence counselling, even in people with VL suppression, and to ensure that people with HIV infection maintain excellent adherence in order to minimize the risk of VL rebound.
Titanium mesh in reconstructive surgery of the nasal pyramid. Follow‐up of our 11 initial cases
Authors: Otero‐Rivas María Mercedes , González‐Sixto Beatriz , Alonso‐Alonso Teresa , Pérez‐Bustillo Alicia , Valladares‐Narganes Luis Miguel , Rodríguez‐Prieto Manuel Ángel 
Published: July 2015

AbstractBackgroundTitanium mesh has been employed in neurosurgery, plastic surgery, and maxillofacial surgery as a bone replacement in diverse conditions. We first reported on its use as a substitute for osteocartilaginous nasal structure with satisfactory functional and aesthetic results in 2009.ObjectivesTo assess the utility and tolerance of titanium mesh as a substitute of the osteocartilaginous portion of the nose.Materials and MethodsEleven patients were identified who had a nasal reconstruction with titanium mesh. We retrospectively searched for infection, extrusion, nasal valve collapse, second surgery, and patient satisfaction in the patients’ records. All patients presented with various types of non‐melanoma skin cancer in the nasal pyramid. In the reconstruction of full‐thickness nasal defects, local flaps were used, employing titanium mesh as a support structure.ResultsNo mesh extrusions, infections, or collapse of the nasal valve were noted in patients with a mean follow‐up of five years. Only one patient needed a second surgery to debulk the flap. Patient satisfaction achieved a mean score of 7.5 out of 9 in 10 patients.ConclusionsAs cartilage grafts need a second surgical site, with consequent morbidity, the use of titanium mesh proves useful and safe in the reconstruction of nasal full‐thickness defects. The results of our series of patients demonstrate the suitability of this material in the repair of nasal osteochondral defects, as well as its low rate of complications.
Inpatient views and experiences before and after implementing a totally smoke‐free policy in the acute psychiatry hospital setting
Authors: Filia Sacha L. , Gurvich Caroline T. , Horvat Anton , Shelton Clare L. , Katona Lynda J , Baker Amanda L. , Stafrace Simon , Keppich‐Arnold Sandra , Kulkarni Jayashri 
Published: July 2015

AbstractIn the present study, we examined the views and experiences of patients admitted to an acute psychiatry unit before and after the implementation of a totally smoke‐free policy. Forty‐six inpatients completed a questionnaire assessing their views before the smoking ban. Another 52 inpatients completed a questionnaire assessing their views and experiences after the smoking ban. Before the totally smoke‐free policy, 69.6% smoked, with 67.7% smoking more when admitted to the psychiatry ward. Before the smoking ban, 54.4% reported that the totally smoke‐free policy would be ‘negative’ or ‘very negative,’ and 30.5% said it would be ‘positive’ or ‘very positive.’ After the totally smoke‐free policy, 57.7% smoked heavily before hospital (mean cigarettes/day = 24.9), with consumption dramatically reducing following admission to a totally smoke‐free psychiatric unit (mean cigarettes/day = 8.3). After the totally smoke‐free policy, 36.5% reported that it was ‘negative’ or ‘very negative,’ and 50% reported that it was ‘positive’ or ‘very positive.’ Overall, inpatients reported improved acceptance of the policy following implementation. Inpatients stated that the most difficult thing about the smoking ban was experiencing increased negative emotions, while the most positive aspect was the improved physical environment of the ward. Inpatients who smoke must be appropriately supported using a range of strategies, and in the present study, we suggest relevant clinical implications.
Reforming against all odds: Multi‐pillar pension systems in the Czech Republic and Romania
Authors: Adascalitei Dragos , Domonkos Stefan 
Published: July 2015

AbstractAttempts to replace pay‐as‐you‐go pension schemes with private funded systems came to a halt in Central and Eastern Europe after 2005. However, more recently, the region has witnessed two belated reformers: the Czech Republic and Romania. Both countries decided to partially privatize pensions despite the rising tide of evidence concerning the challenges associated with the policy. We argue that while part of the domestic political elite remained supportive of private funded pensions, the difficulties experienced by earlier reformers and reduced support from International Financial Institutions led to the adoption of small funded pension pillars. Such cautious attempts at privatization might become more common in the future as large reforms have proven politically unsustainable.
A call for more elaborate and transparent pension data to inform policy‐making: A critical examination of World Bank data for Eastern Europe
Authors: Altiparmakov Nikola 
Published: July 2015

AbstractThis article offers a critical analysis of the methods by means of which data relating to the performance of second pillar pension schemes are collated, compared and reported. This is done with regard to the performance of mandatory private second pillar pension funds in Eastern Europe. By critically examining data published in a number of World Bank studies, and through the identification of data problems and irregularities, the article argues that a much more elaborate and transparent approach to the collation, comparative analysis and reporting of data is needed. Required is the establishment of a consensus regarding what should represent a robust basis for making credible policy recommendations, not least with regard to pension re‐reforms in the countries of Eastern Europe and elsewhere. In the absence of such a consensus, unresolved data problems and irregularities may potentially continue to influence the formulation of incomplete national policy conclusions regarding the performance of second pillar pension funds and, in turn, the ability of policy‐makers to evaluate appropriately the need for, and assess the feasibility of implementing in a sustainable manner, pension re‐reform.
Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus “Dormant Conduction”: Is Adenosine Expendable?
Authors: SCHAEFFER BENJAMIN , WILLEMS STEPHAN , SULTAN ARIAN , HOFFMANN BORIS A. , LÜKER JAKOB , SCHREIBER DOREEN , AKBULAK RUKEN , MOSER JULIA , KUKLIK PAWEL , STEVEN DANIEL 
Published: July 2015

Loss of Pace Capture and Dormant Conduction in PVIIntroductionPermanent pulmonary vein isolation (PVI) remains an essential goal of ablation therapy in patients with atrial fibrillation. Aim of this study was the intraindividual comparison of unexcitability to pacing along the ablation line versus dormant conduction (DC) as additional procedural endpoints.MethodsA total of 58 patients with paroxysmal atrial fibrillation (PAF) underwent PVI by circumferential ablation of ipsilateral pulmonary veins (PVs), followed by testing for DC by adenosine administration. Irrespective of the presence of DC, pacing along the ablation line for left atrium capture was performed and additional radio frequency energy applied if necessary. PVs with initial DC were retested after achieving unexcitability.ResultsPVI was achieved in 224 of 224 PVs. In 33 of 224 PVs (15%) DC was revealed. At 92 of 112 ablation lines (82%) sites of excitability were found. Three (9%) of the initial 33 PVs with DC showed further DC after achieving unexcitability at repeated testing. Thirty‐two of 33 assumed areas of unmasked PV–LA reconduction as revealed by DC‐testing showed a corresponding site of excitability on the ablation line. After a follow‐up of 11.6 ± 3.4 months 79% of patients were free of arrhythmia.ConclusionsPacing for unexcitability can safely identify potential sites of DC and even sites that would have not been detected by testing for DC. Unexcitability, therefore, serves as a suitable and safe procedural endpoint not only for patients with contraindications to adenosine administration. Our data suggest that adenosine may be expendable when achieving unexcitability along the ablation line.
Assessment of fidelity in an educational workshop designed to increase the uptake of a primary care alcohol screening recommendation
Authors: Hanbury Andria , Farley Katherine , Thompson Carl , Wilson Paul M. 
Published: July 2015

AbstractRationale, aims and objectivesEducational workshops are a commonly used quality improvement intervention. Often delivered by credible local health professionals who do not necessarily have skills in pedagogy, it can be challenging to achieve high intervention fidelity. This paper summarizes the fidelity assessment of a workshop designed to increase the uptake of a primary care alcohol screening recommendation.MethodDelivered in a single health region, the workshop comprised separate sessions delivered by three local health professionals, plus two role plays delivered by a commercial company. Sessions were tailored to local barriers. Meetings were held with presenters and an outline of the barriers was provided. Two researchers attended the workshop, rating the number of specified barriers targeted by presenters and their quality of delivery. Participant responsiveness was measured through attendees' feedback and intervention dose was calculated as the proportion of health professionals who attended and proportion of general practices represented.ResultsExposure was low, with 62 of 545 health professionals from 30 of a possible 80 practices attending. Sixty‐five per cent of the specified barriers were targeted. There was variability in quality of delivery and participant responsiveness; challenges included potential mixed messages, overreliance on didactic methods and certain barriers appearing easier to target than others.ConclusionsThe framework provided a rounded assessment of intervention fidelity: intervention coverage was low, adherence was moderate and there was variability in the quality of delivery across presenters. Future studies testing the effectiveness of interventions delivered by local experts with and without brief training in pedagogy/behaviour change would be beneficial.
Quantitative comparison of cerebral artery development in human embryos with other eutherians
Authors: Ashwell Ken W. S. , Shulruf Boaz 
Published: July 2015

AbstractThe embryonic and early fetal human brain is known to undergo extraordinary expansion of its cellular population during embryonic and early fetal life, and is critically dependant on a steady supply of nutrients and oxygen for proper brain development. Quantitative analysis of the internal radius of the aorta and cerebral arteries in a range of eutherian mammals has been used to compare arterial flow to the developing human brain with that to the brains of non‐human eutherians. Human embryos showed a much steeper rise of internal radius of the aorta with increasing body size than the embryos of non‐human eutherians, but the thickness of the aorta rose at the same pace relative to body size in both humans and non‐humans, suggesting that aortic pressure is similar in all eutherian embryos of a similar size. The sums of internal radii of both the internal carotids and vertebral arteries of human embryos raised to the fourth power were much lower at embryonic stages (less than 22 mm body length) than in non‐human eutherians, were similar between humans and non‐humans at 22–30 mm body length, and exceeded the non‐humans at body lengths of more than 30 mm. The relative size of the internal calibre of the cerebral feeder arteries (internal carotid and vertebral) to the aorta did not change between embryonic and fetal sizes in either humans or non‐humans. The findings suggest that the developing human brain may actually receive less blood flow at embryonic sizes (less than 22 mm body length) than do other mammalian embryos of a similar body size, but that internal carotid and vertebral flow is higher in human fetuses (body length greater than 30 mm) than in developing non‐humans of the same body size. Increased flow to the developing human brain relative to non‐humans is achieved by simultaneous increases in both aortic and cerebral feeder artery internal calibre.
Epaxial muscle fiber architecture favors enhanced excursion and power in the leaper Galago senegalensis
Authors: Huq Emranul , Wall Christine E. , Taylor Andrea B. 
Published: July 2015

AbstractGalago senegalensis is a habitual arboreal leaper that engages in rapid spinal extension during push‐off. Large muscle excursions and high contraction velocities are important components of leaping, and experimental studies indicate that during leaping by G. senegalensis, peak power is facilitated by elastic storage of energy. To date, however, little is known about the functional relationship between epaxial muscle fiber architecture and locomotion in leaping primates. Here, fiber architecture of select epaxial muscles is compared between G. senegalensis (n = 4) and the slow arboreal quadruped, Nycticebus coucang (n = 4). The hypothesis is tested that G. senegalensis exhibits architectural features of the epaxial muscles that facilitate rapid and powerful spinal extension during the take‐off phase of leaping. As predicted, G. senegalensis epaxial muscles have relatively longer, less pinnate fibers and higher ratios of tendon length‐to‐fiber length, indicating the capacity for generating relatively larger muscle excursions, higher whole‐muscle contraction velocities, and a greater capacity for elastic energy storage. Thus, the relatively longer fibers and higher tendon length‐to‐fiber length ratios can be functionally linked to leaping performance in G. senegalensis. It is further predicted that G. senegalensis epaxial muscles have relatively smaller physiological cross‐sectional areas (PCSAs) as a consequence of an architectural trade‐off between fiber length (excursion) and PCSA (force). Contrary to this prediction, there are no species differences in relative PCSAs, but the smaller‐bodied G. senegalensis trends towards relatively larger epaxial muscle mass. These findings suggest that relative increase in muscle mass in G. senegalensis is largely attributable to longer fibers. The relative increase in erector spinae muscle mass may facilitate sagittal flexibility during leaping. The similarity between species in relative PCSAs provides empirical support for previous work linking osteological features of the vertebral column in lorisids with axial stability and reduced muscular effort associated with slow, deliberate movements during anti‐pronograde locomotion.