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  • 1
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    Online Resource
    Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
    Oxford University Press (OUP) ; 2019
    In:  British Journal of Surgery Vol. 106, No. 2 ( 2019-01-08), p. e103-e112
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 106, No. 2 ( 2019-01-08), p. e103-e112
    Abstract: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89·6 per cent) compared with that in countries with a middle (753 of 1242, 60·6 per cent; odds ratio (OR) 0·17, 95 per cent c.i. 0·14 to 0·21, P & lt; 0·001) or low (363 of 860, 42·2 per cent; OR 0·08, 0·07 to 0·10, P & lt; 0·001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference −9·4 (95 per cent c.i. −11·9 to −6·9) per cent; P & lt; 0·001), but the relationship was reversed in low-HDI countries (+12·1 (+7·0 to +17·3) per cent; P & lt; 0·001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0·60, 0·50 to 0·73; P & lt; 0·001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1002/bjs.11051
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2006309-X
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  • 2
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    Global variation in anastomosis and end colostomy formation following left‐sided colorectal resection
    Oxford University Press (OUP) ; 2019
    In:  BJS Open Vol. 3, No. 3 ( 2019-06), p. 403-414
    Details
    In: BJS Open, Oxford University Press (OUP), Vol. 3, No. 3 ( 2019-06), p. 403-414
    Type of Medium: Online Resource
    ISSN: 2474-9842 , 2474-9842
    URL: Issue
    URL: Article
    DOI: 10.1002/bjs5.2019.3.issue-3
    DOI: 10.1002/bjs5.50138
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2902033-5
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  • 3
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    Global economic burden of unmet surgical need for appendicitis
    Oxford University Press (OUP) ; 2022
    In:  British Journal of Surgery Vol. 109, No. 10 ( 2022-09-09), p. 995-1003
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. 10 ( 2022-09-09), p. 995-1003
    Abstract: There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and $73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and $75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znac195
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2006309-X
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  • 4
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    NFAT2 Is an essential mediator of orthopedic particle-induced osteoclastogenesis
    Wiley ; 2008
    In:  Journal of Orthopaedic Research Vol. 26, No. 12 ( 2008-12), p. 1577-1584
    Details
    In: Journal of Orthopaedic Research, Wiley, Vol. 26, No. 12 ( 2008-12), p. 1577-1584
    Type of Medium: Online Resource
    ISSN: 0736-0266 , 1554-527X
    URL: Issue
    URL: Article
    DOI: 10.1002/jor.v26:12
    DOI: 10.1002/jor.20714
    Language: English
    Publisher: Wiley
    Publication Date: 2008
    detail.hit.zdb_id: 2050452-4
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  • 5
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    Targeting vascular endothelial growth factor ameliorates PMMA-particles induced inflammatory osteolysis in murine calvaria
    Elsevier BV ; 2019
    In:  Bone Vol. 123 ( 2019-06), p. 86-91
    Details
    In: Bone, Elsevier BV, Vol. 123 ( 2019-06), p. 86-91
    Type of Medium: Online Resource
    ISSN: 8756-3282
    URL: Article
    DOI: 10.1016/j.bone.2019.03.025
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 1496324-3
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  • 6
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    Patients With Symptomatic Sequelae of Slipped Capital Femoral Epiphysis Have Advanced Cartilage Wear at the Time of Surgical Intervention
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of Pediatric Orthopaedics Vol. 41, No. 6 ( 2021-07), p. e398-e403
    Details
    In: Journal of Pediatric Orthopaedics, Ovid Technologies (Wolters Kluwer Health), Vol. 41, No. 6 ( 2021-07), p. e398-e403
    Abstract: Slipped capital femoral epiphysis (SCFE) is a common hip problem in children. The resulting deformity can cause impingement similar to cam-type idiopathic femoroacetabular impingement (FAI). Although there are similarities between FAI and SCFE, deformity patterns, severity, and time of onset of symptoms varies, which may impact management. The purpose of this study was to describe patterns of articular cartilage damage in patients undergoing surgical hip dislocation for sequelae of SCFE in comparison to patients undergoing arthroscopic surgery for primary FAI. Methods: Patients were identified who underwent surgical treatment for hip pain due to primary FAI (cam type) or sequelae of SCFE. Clinical data and radiographic measurements were recorded. Cartilage was assessed intraoperatively. Severity was classified using the modified Beck classification, while location was classified into 6 sectors. Statistical analysis was performed to test for differences in demographic and radiographic characteristics between the SCFE and FAI patients. χ 2 or Fisher exact tests were used to evaluate trends in patterns of acetabular and femoral cartilage wear between SCFE and FAI groups. Results: The SCFE group had 28 hips compared with 304 in the FAI group. SCFE patients were younger (19 vs. 32, P 〈 0.001), had higher body mass index (30±5.9 vs. 24±4.8, P 〈 0.001), and were more often male (61% vs. 27%, P 〈 0.001). Deformity severity based on α-angle was higher in the SCFE group [AP 74 vs. 55 ( P =0.001) and Dunn 72 vs. 58 ( P 〈 0.001)]. There were no significant differences with regards to lateral center edge angle, anterior center edge angle, or Tonnis angle. In both groups the most common locations for cartilage lesions in both groups were the anterior peripheral and superolateral peripheral regions with fewer but more widely distributed femoral head lesions. The SCFE group had higher rates of femoral head and superolateral central cartilage lesions compared with the FAI group. There was no statistical difference between high-grade femoral or acetabular cartilage lesions between groups. Conclusions: Patients with SCFE were younger at the time of surgery and presented with more severe deformity based on radiographic α-angle compared to patients with FAI. Our results suggest higher prevalence of femoral head lesions and more diffuse cartilage injury in patients with SCFE. This study can be used to support early surgical intervention in patients with symptomatic sequelae of SCFE due to risk of premature joint damage. Level of Evidence: Level III—prognostic study.
    Type of Medium: Online Resource
    ISSN: 0271-6798
    URL: Article
    DOI: 10.1097/BPO.0000000000001797
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2049057-4
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  • 7
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    Novel Motion Sickness Minimization Control via Fuzzy-PID Controller for Autonomous Vehicle
    MDPI AG ; 2020
    In:  Applied Sciences Vol. 10, No. 14 ( 2020-07-10), p. 4769-
    Details
    In: Applied Sciences, MDPI AG, Vol. 10, No. 14 ( 2020-07-10), p. 4769-
    Abstract: In terms of vehicle dynamics, motion sickness (MS) occurs because of the large lateral acceleration produced by inappropriate wheel turning. In terms of passenger behavior, subjects experience MS because they normally tilt their heads towards the direction of lateral acceleration. Relating these viewpoints, the increment of MS originates from the large lateral acceleration produced by the inappropriate wheel’s turn, which then causes greater head movement with respect to the lateral acceleration direction. Therefore, this study proposes the utilization of fuzzy-proportional integral derivative (PID) controller for an MS minimization control structure, where the interaction of the lateral acceleration and head tilt concept is adopted to diminish the lateral acceleration. Here, the head movement is used as the controlled variable to compute the corrective wheel angle. The estimation of the head movement is carried out by an estimation model developed by the radial basis function neural network (RBFNN) method. An experiment involving a driving simulator was conducted, to verify the proposed control system’s performance in regard to the autonomous vehicle’s passengers. The results show that the averages of motion sickness incidence (MSI) index can be lowered by 3.95% for single lap and 11.49% for ten laps.
    Type of Medium: Online Resource
    ISSN: 2076-3417
    URL: Article
    DOI: 10.3390/app10144769
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2704225-X
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  • 8
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    Abstract 290: Circulating FAS Is A Novel Serum-based Diagnostic Biomarker For PAD
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 43, No. Suppl_1 ( 2023-05)
    Details
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. Suppl_1 ( 2023-05)
    Abstract: A persistent challenge is the lack of reliable serum diagnostic tests for peripheral arterial disease (PAD). Serum cholesterol levels lack sensitivity for PAD and are not predictive of disease progression. Our team previously demonstrated that serum circulating Fatty Acid Synthase (cFAS) correlates with incidence of PAD and does not correlate with serum lipids. Therefore, we hypothesized that cFAS can be an independent diagnostic biomarker for PAD in a larger cohort, with or without diabetes. An IRB-approved consecutive (2014-2018) cohort was used to identify individuals with PAD/diabetes, as well as healthy controls. Consented patients provided a serum sample, and total cFAS content was measured with ELISA. Demographics and incidence of PAD/diabetes were collected from chart review. Serum cFAS and demographics were compared, and regression was used to determine correlations with cFAS. A total of 165 patients met inclusion criteria. Of these, 61 (37%) had PAD and diabetes (Group 1), 64 (38.8%) had PAD and no diabetes (Group 2), and 40 (24.2%) were healthy controls (Group 3). Compared to Group 3, Groups 1 & 2 were significantly older, had more males, and higher incidence of cardiovascular co-morbidities (p 〈 0.001). Compared to Group 2, Group 1 had a higher incidence of cardiovascular/cerebrovascular disease, CHF, and HTN (p 〈 0.05). Despite these differences, both Groups 1 & 2 had significantly higher serum cFAS content than Group 3 (p 〈 0.01 and p=0.01, respectively). In the whole cohort, there were significant correlations between cFAS and PAD severity and between cFAS and smoking status. (p=0.02, p=0.01 respectively). Our study suggests that cFAS can serve as an independent serum-based diagnostic biomarker for PAD, regardless of diabetes status. Future studies will further validate this serum biomarker and determine its predictive value for identifying individuals who are at highest risk of disease progression.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    URL: Article
    DOI: 10.1161/atvb.43.suppl_1.290
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1494427-3
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  • 9
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    Abstract 311: Fatty Acid Synthase Targeting Reduces Aortic Atherosclerosis And Inflammation
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 43, No. Suppl_1 ( 2023-05)
    Details
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. Suppl_1 ( 2023-05)
    Abstract: Fatty acid synthase (FAS) catalyzes the elongation of saturated fatty acids. FAS is elevated in liver and adipose tissue in the setting of diabetes, and serum circulating FAS (cFAS) is a marker of peripheral arterial disease. The natural antibiotic Platensimycin (PTM) competitively inhibits FAS. However, the impact of chemical FAS inhibition on atherosclerosis is unknown. We hypothesized that PTM and a liver-specific knockdown of FAS would reduce the burden of aortic atherosclerosis. ApoE-/- mice were placed on a 42% high-fat diet (HFD) with or without PTM (100mpk) for 16 weeks. Similarly, ApoE-/- mice with or without liver-specific knockdown of FAS ( ApoE-/- FasL-/- vs ApoE-/- FasL+/+ ) were placed on a 42% HFD for 16 weeks (Fig. A). Tissue FAS, cFAS, and serum triglycerides (TG) content were measured. FAS/cFAS activity was evaluated with a modified measurement of malonyl-CoA consumption of NADPH, and normalized to content. At 16 weeks, mouse aortas were harvested and stained with oil-red O and CD68 to assess the burden of atherosclerosis and inflammation. Comparisons between murine groups were analyzed using Mann-Whitney and Student t-tests. ApoE-/- mice treated with PTM, significantly reduced tissue FAS and serum cFAS activity (p 〈 0.05), and significantly reduced serum TG (p 〈 0.01). ApoE-/- FasL-/- mice demonstrated increased adipose FAS content and activity (p 〈 0.05), reduced cFAS activity (p 〈 0.05), and increased serum TG (p 〈 0.05). Targeting FAS/cFAS with PTM or in FasL-/- led to decrease in overall total aortic plaque, particularly in the low-resistance thoracic aorta (B; p 〈 0.05).Targeting FAS/cFAS also demonstrated reduced aortic root plaque, and macrophage content(C; p 〈 0.05).This study reveals that selective targeting of FAS/cFAS either with PTM of via liver knockdown, appear to significantly alter serum lipid profiles, aortic atherosclerosis, and plaque inflammation. Thus, FAS/cFAS may be an important therapeutic target to inhibit atheroprogression.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    URL: Article
    DOI: 10.1161/atvb.43.suppl_1.311
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1494427-3
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  • 10
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    New developments in prenatal diagnosis of congenital adrenal hyperplasia
    Elsevier BV ; 2017
    In:  The Journal of Steroid Biochemistry and Molecular Biology Vol. 165 ( 2017-01), p. 121-123
    Details
    In: The Journal of Steroid Biochemistry and Molecular Biology, Elsevier BV, Vol. 165 ( 2017-01), p. 121-123
    Type of Medium: Online Resource
    ISSN: 0960-0760
    URL: Article
    DOI: 10.1016/j.jsbmb.2016.06.016
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
    detail.hit.zdb_id: 1482780-3
    SSG: 12
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