bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relevance of Sex and Subtype in Patients With IBS: An Exploratory Study of Gene Expression
Authors: Weaver Kristen R. , Melkus Gail D’Eramo , Fletcher Jason , Henderson Wendy A. 
Published: December 2019

Background: Psychological state, stress level, and gastrointestinal function are intricately related and relevant to symptom exacerbation in patients with irritable bowel syndrome (IBS), but genetic contributors to this brain–gut connection are not fully understood. The purpose of this exploratory study was to compare gene expression in participants with IBS to that of healthy controls (HC) and to examine patterns of expression in participants with IBS by sex and IBS subtype. Method: Participants were recruited to an ongoing protocol at the National Institutes of Health. Differences in demographic and clinical characteristics were assessed using descriptive statistics and Mann–Whitney U tests. Expression levels of 84 genes were evaluated in peripheral whole blood using Custom RT2 Profiler polymerase chain reaction (PCR) Arrays, and data analysis was performed through GeneGlobe Data Analysis Center. Results: Participants with IBS ( n = 27) reported greater levels of perceived stress ( p = .037) and differed in expression values of ±2 for the genes ADIPOR1, ADIPOR2, CNR2, COMT, OXTR, and PPARA compared to HC ( n = 43). Further analyses by sex and IBS subtype revealed differential patterns of gene expression related to the endocannabinoid system, cytokines, stress, and sex steroid hormones. Conclusions: Diverse yet interconnected processes such as metabolism, inflammation, immunity, social behavior, and pain are associated with differences in gene expression between participants with IBS and HC. These findings lend support for genomic associations with the brain–gut connection in patients with IBS and highlight the relevance of sex and IBS subtype in performing such analyses.
Variability of pelvic axial rotation in patients undergoing total hip arthroplasty
Authors: Premkumar Ajay , Almeida Bryan , Ranawat Chitranjan S , Jerabek Seth A , Esposito Christina I , Mayman David J 
Published: December 2019

Background: Pelvic axial rotation affects the functional orientation of an acetabular component. Every 1° of axial rotation changes functional acetabular anteversion by 1°. There is limited information on pelvic rotation in THA patients, since it is difficult to measure on routine radiographs. Therefore, we used spine-to-ankle biplanar radiography to investigate variability in pelvic rotation in patients before and after THA. Methods: In 156 patients undergoing primary unilateral THA, we measured preoperative, 6 weeks and 1 year postoperative pelvic rotation in both standing and sitting positions using a biplanar radiography system. Patients with fixed pelvic rotation had a similar magnitude and direction of pelvic rotation in all standing or sitting images. We further identified patients with position-independent or position-dependent fixed pelvic rotation. Results: Pelvic rotation was common in THA patients, with 82 patients (53% of 156 patients) having at least 1 image with > 7° of rotational deformity. 12 patients (8% of 156 patients) had fixed rotation, 6 patients (4%) had position-independent fixed axial rotation and 6 patients (4%) had position-dependent fixed axial rotation. Conclusions: It may be important to recognise whether a THA patient has a fixed pelvic axial rotational deformity, where 1 hip is consistently forward or backward in functional imaging. Fixed rotation will increase or decrease the functional anteversion of an acetabular component depending on THA side. Further research might better characterise associations and predictors of fixed axial rotation and its impact on patient outcomes after THA.
Safety and efficacy of autologous hematopoietic stem cell transplantation for multiple sclerosis in Norway
Authors: Kvistad Silje Agnethe Stokke , Lehmann Anne Kristine , Trovik Linn Hereide , Kristoffersen Einar Klæbo , Bø Lars , Myhr Kjell-Morten , Torkildsen Øivind 
Published: December 2019

Background: Hematopoietic stem cell treatment (HSCT) is a promising treatment option for multiple sclerosis (MS), but detailed safety and efficacy measures are still scarce. Objective: To evaluate the efficacy and safety of HSCT in MS. Methods: Retrospective single-center observational study of all MS patients that underwent HSCT in Norway during January 2015 to January 2018. The primary outcome was no evidence of disease activity (NEDA-3) status. Results: A total of 30 patients with a median follow-up time of 26 months (range: 11–48) were evaluated. In total, 25 (83%) achieved NEDA-3 status, and none received disease-modifying treatment after HSCT. For 13 (43%) of the patients, there were sustained improvement in Expanded Disability Status Scale (EDSS) score, and 10 (33%) were working full time after the treatment, compared to only 1 (3%) before treatment. There were no serious treatment-related complications and was no mortality. Five patients (17%) were diagnosed with an autoimmune thyroid disease after the procedure, and 10 (43%) of the women had amenorrhea lasting >12 months and symptoms of ovarian failure. Conclusion: HSCT in MS is an effective and relatively safe treatment option, with few serious complications and no mortality in Norway, so far. However, long-term adverse event with amenorrhea is a common problem.
Failure of talc seromadesis for the treatment of subcutaneous chronic seromas after incisional hernia surgery
Authors: Lopez-Monclus J. , Artes M. , Gonzalez J. , Blazquez L. A. , Lucena J. L. , Robin A. , Munoz J. M. , San-Miguel C. , Garcia-Urena M. A. 
Published: December 2019

Background and Aim: Talc poudrage has been used since many years for sclerosing chronic pleural effusion. Several reports have shown good results managing chronic seromas after breast, vascular, and incisional hernia surgeries. The purpose of this study is to determine the utility of talc seromadesis for the management of chronic seromas after incisional hernia surgery Materials and Methods: Multicentric prospective observational study including patients diagnosed of chronic seromas after incisional hernia surgery. Under local anesthesia and ultrasonographic control, two percutaneous trocars were placed in the seroma, washing the seroma cavity with 0.9% saline solution and aspirating the remaining liquid. A sample of 4 g of talcum powder was introduced in the seroma cavity, and a 15-F drain was left in place. Patients were followed each week during at least 4 weeks after drainage removal. Results: Between January 2013 and December 2016, a total of six patients were enrolled in the study. Talc poudrage was performed without any complications. Drains were pulled out in a mean time of 3 (range: 2–4) weeks. One case of the chronic seromas was efficiently sclerosed with talc without recurrence in time. In three cases, the seroma recurred, and the final solution was surgical decortication of the seroma. In the other two cases, seroma also recurred and were managed with instillation of ethanol and iodine povidone. Conclusion: In our experience, the management of chronic seromas after incisional hernia repair with talc seromadesis is ineffective and is associated with a high rate of seroma recurrence.
Performance After Operative Versus Nonoperative Management of Shoulder Instability in the National Basketball Association
Authors: Li Neill Y. , Lemme Nicholas J. , Defroda Steven F. , Nunez Elvis , Hartnett Davis A. , Owens Brett D. 
Published: December 2019

Background: Although nonoperative management after shoulder instability injury allows an athlete to return to play sooner than operative intervention, higher rates of recurrence have been observed after nonoperative management. However, no study has investigated the differences in performance of National Basketball Association (NBA) players after index shoulder instability events managed nonoperatively versus operatively. Purpose/Hypothesis: The purpose of this study was to identify shoulder instability events in NBA athletes and assess differences in performance after injury with nonoperative versus operative management. We hypothesized that players who undergo operative intervention have reduced risk of recurrence and are able to continue their elite level of play as opposed to those who undergo nonoperative management. Study Design: Cohort study; Level of evidence, 3. Methods: Publicly available injury data from the 1986-1987 through 2017-2018 seasons were reviewed to identify NBA athletes sustaining a shoulder instability event. In addition to characteristics, player performance information, including games played, player efficiency rating (PER), and win shares, was analyzed before and for 3 seasons after injury. Statistical learning models were applied to identify performance variables that have the greatest predictive value to determine players who would benefit from surgery. Results: A total of 60 players with shoulder instability events were identified between 1986 and 2018. After injury, 37 players (61.7%) eventually underwent surgery and 23 players (38.3%) did not. Players who were treated nonoperatively had significantly decreased PER, games played, and offensive win shares in the season after injury ( P < .05). Players who underwent surgery did not see a decline in PER, games played, or win shares. Random forest modeling found that true shooting percentage and win shares per 48 minutes were the performance variables most predictive in determining which players would benefit from surgery after shoulder instability. Conclusion: Players who underwent surgical intervention for shoulder instability maintained their PER, games played, and win share performance characteristics, whereas players who did not undergo surgery had declines in these parameters. Given the demands of shoulder function in basketball and the risk of recurrence after an instability event, surgery enhances a player’s opportunity to maintain a high level of performance after injury.
Reliability of Magnetic Resonance Imaging Prediction of Anterior Cruciate Ligament Autograft Size and Comparison of Radiologist and Orthopaedic Surgeon Predictions
Authors: Hanna Andrew , Hollnagel Katharine , Whitmer Kelley , John Christopher , Johnson Brent , Godin Jonathan , Miller Thomas 
Published: December 2019

Background: In anterior cruciate ligament (ACL) reconstruction, hamstring tendon autografts <8 mm have been associated with increased failure rates. There has been no established modality by which orthopaedic surgeons can preoperatively predict graft sizes. Purpose/Hypothesis: The purposes of this study were to (1) determine whether routine magnetic resonance imaging (MRI) measurement of hamstring tendon cross-sectional area (CSA) can reliably be used by sports medicine fellowship–trained orthopaedic surgeons to predict graft size and (2) determine whether radiologists and sports medicine surgeons are able to discriminate grafts below a predetermined cutoff value. We hypothesized that radiologists will find a correlation between MRI measurement and intraoperative graft size. Similarly, orthopaedic surgeons will be able to correctly estimate the graft size based on MRI measurement. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Included in this study were 30 consecutive patients (15 women and 15 men) (mean age, 23 years [range, 13-43 years]) for whom MRI-determined hamstring tendon CSA and graft size measurements could be compared. Patients were included if they had a preoperative MRI demonstrating acute ACL rupture and were scheduled with 1 of 3 surgeons for a reconstruction performed using the ST and GR tendons. Operative data were collected over 1 year. Sectra imaging software was used to measure the CSA of the semitendinosus (ST) and gracilis (GR) tendons on the preoperative MRIs. Control measurements were performed intraoperatively using a graft sizing block with 0.5-mm increments. Simple linear regression analysis was used to evaluate the ability of MRI measurements to predict autograft size. Logistic regression was used to determine the minimum CSA for a graft of 8 mm. The intraclass correlation coefficient (ICC) was used to evaluate interrater reliability. Results: MRI CSA measurement of the average STGR (ST CSA added to the GR CSA) was a significant predictor of graft size (adjusted R 2 = 0.186; P < .001). The 3 measurements with the strongest correlations with graft size were the ST at the medial femoral condyle (MFC), the STGR at the MFC, and the average STGR. The minimum CSA for the average STGR on MRI to achieve a graft size of 8 mm was 17.168 mm2 ( P < .001). The area under the receiver operating characteristic curve was 0.765. The overall ICC was 0.977. Conclusion: Routine preoperative MRI can be used by both radiologists and orthopaedic surgeons to predict the expected ACL autograft size and identify those below a cutoff of 8 mm. This will help in preoperative planning and graft selection.
Anatomy, Classification, and Management of Ankle Fractures Involving the Posterior Malleolar Fragment: A Literature Review
Authors: Bergman Christian , Morin Matthew , Lawson Kevin 
Published: December 2019

The posterior malleolar fragment is frequently involved in rotational ankle fractures, but diagnosis and definitive management remains controversial. Ankle fractures with a posterior malleolar component that are not identified and treated in a timely manner may contribute significantly to future comorbidities, including continued pain, instability, and the development of arthritis. This article highlights the anatomic features of posterior malleolar ankle fractures, the classification schemes used, and discusses the various nonsurgical and surgical methods currently used. Level of Evidence: Level V, expert opinion.
Yarzhemskiite, K[B5O7(OH)2]⋅H2O, a new mineral from the Chelkar salt dome, Western Kazakhstan
Authors: Pekov Igor V. , Zubkova Natalia V. , Korotchenkova Oksana V. , Chaikovskiy Ilya I. , Yapaskurt Vasiliy O. , Chukanov Nikita V. , Belakovskiy Dmitry I. , Lykova Inna S. , Britvin Sergey N. , Pushcharovsky Dmitry Yu. 
Published: December 2019

AbstractThe new mineral yarzhemskiite, K[B5O7(OH)2]⋅H2O, was found in a halite–sylvite evaporite rock at the Chelkar salt dome, Western Kazakhstan Region, Kazakhstan. It is also associated with carnallite, polyhalite, gypsum, strontioginorite, satimolite and quartz. Yarzhemskiite occurs as separate thick tabular, short prismatic or equant crystals up to 0.5 mm × 0.7 mm × 1 mm and grains having irregular outlines up to 1 mm × 1.5 mm × 2 mm. The mineral is transparent, colourless, with vitreous lustre. It is brittle, the Mohs’ hardness is ca 2½. Cleavage is perfect on {100}. Dmeas is 2.13(1) and Dcalc is 2.112 g cm–3. Yarzhemskiite is optically biaxial (+), α = 1.484(2), β = 1.508(2), γ = 1.546(2), 2Vmeas = 75(10)° and 2Vcalc = 80°. Chemical composition (wt.%, electron microprobe, H2O was calculated by stoichiometry) is: Na2O 0.01, K2O 17.84, CaO 0.07, B2O3 67.21, H2Ocalc 13.91, total 99.04. The empirical formula based on 10 O atoms per formula unit is K0.98B5.005O7(OH)2⋅H2O. Yarzhemskiite is monoclinic, P21/c, a = 9.47340(18), b = 7.52030(16), c = 11.4205(2) Å, β = 97.3002(17)°, V = 807.03(3) Å3 and Z = 4. The strongest reflections of the powder XRD pattern [d,Å(I,%)(hkl)] are: 9.39(86)(100), 4.696(41)(200), 3.296(18)($\bar{1}$13), 3.130(19)(022, 300), 2.935(42)(220), 2.898(100)($\bar{3}$02, $\bar{2}$21, 310), 2.832(56)(004) and 1.867(18)($\bar{2}$25). The crystal structure was solved based on single-crystal X-ray diffraction data, R1 = 3.36%. The structure contains infinite chains built by boron-centred polyhedra. The basic structural unit of the chain is a double ring B5O7(OH)2 consisting of one BO4 tetrahedron and four BO3 triangles. K+ cations centre ten-fold polyhedra which form, together with the borate chains [B5O7(OH)2]–∝, layers linked with each other only via H bonds. The mineral is named in honour of the Russian geologist, petrologist and mineralogist Yakov Yakovlevich Yarzhemskii (1901–?), a specialist in petrology of evaporite rocks and mineralogy and genesis of boron deposits related to evaporites.
Cardiac self-efficacy and quality of life in patients with coronary heart disease: a cross-sectional study from Palestine
Authors: Barham Aya , Ibraheem Reem , Zyoud Sa’ed H. 
Published: December 2019

Abstract
Background
Psychological factors, such as self-efficacy, are important in understanding the progress and management of coronary heart disease (CHD), and how patients make lifestyle modifications to compensate for the disease. The main objectives of this research are to assess patterns of cardiac self-efficacy (CSE) and quality of life (QoL) among CHD patients, and to determine the factors that affect their QoL.

Methods
A cross-sectional descriptive correlational study was carried out between August 2016 and December 2016. We used a structured questionnaire completed by interviewers during face-to-face interviews with patients. Cardiac self-efficacy was evaluated using three scales: 1) the 5-item perceived efficacy in patient- physician interaction scale (PEPPI-5); 2) the self-efficacy for managing chronic diseases 6-item scale (SEMCD-6) and 3) Sullivan’s cardiac self-efficacy scale 13-items (SCSES). The 5-level version of the EuroQoL 5-dimensions questionnaire (EQ-5D-5 L), and Euroqol Visual Analogue Scale (EQ VAS) were used to evaluate health-related QoL (HRQoL) among CHD patients. Multiple binary logistic regression was carried out to evaluate the influence on the QoL score of demographic and medical characteristics, and self-efficacy factors.

Results
A total of 275 patients participated in our study. The patients’ mean age was 59.51 ± 1.005 years. The HRQoL was measured by the EQ-5D-5 L index score and EQ-VAS score; their means were 0.62 ± 0.16 and 57.44 ± 1.61, respectively. The QoL showed moderate positive correlations with the PEPPI-5 (r = 0.419; p-value < 0.001), SEMCD-6 (r = 0.419; p-value < 0.001), and SCSES score (r = 0.273; p-value < 0.001). Multiple binary logistic regression showed that only patients with higher PEPPI-5 score (odds ratio (OR) = 1.11; 95% confidence interval (CI) =1.01–1.22; p = 0.036), and higher SCSES score (OR = 1.10; 95% CI = 1.03–1.17; p = 0.004) were significantly associated with a high QoL score. Moreover, multiple binary logistic regression model showed that patients with higher numbers of medications (OR = 0.23; 95% CI = 0.07–0.78); p = 0.018) remained significantly associated with impaired QoL.

Conclusions
Lower levels of self-efficacy and poorer patient-physician interactions predicted poor HRQoL. Thus, health providers should be aware of these factors in CHD patients when trying to improve their QoL.
XEN® stent complications: a case series
Authors: Gupta Chandni , Mathews Divya 
Published: December 2019

Abstract
Background
XEN® gel stent (Allergan, Dublin/Republic of Ireland) is a relatively new microinvasive glaucoma device providing an ab-interno approach to the subconjunctival space for aqueous drainage and reduction of intraocular pressure. It is thought to be less invasive, reduce surgical time and post-operative infection rates compared with traditional glaucoma procedures. Little information however, has been published regarding complications and subsequent management.

Case presentation
The authors highlight five complicated cases of XEN® stent insertion, how they were managed and key learning points. Cases include: entire stent found at the bottom of the anterior chamber several months after uncomplicated insertion, stent broke into multiple pieces during manipulation within subconjunctiva, XEN45 stent migrated into the anterior chamber 7 months post-operatively and a case of limbal-based conjunctival dissection during open revision which lead to additional scarring around the stent and subsequent raised intraocular pressure.

Conclusions
We present some new and interesting complications of XEN implant as well as potential management options. This can assist clinical decision-making and enable better pre-operative discussions with patients regarding risks of surgery.
Case report: maple syrup urine disease with a novel DBT gene mutation
Authors: Feng Wei , Jia Jinfu , Guan Heyang , Tian Qing 
Published: December 2019

AbstractBackgroundMaple syrup urine disease (MSUD) is a potentially life-threatening metabolic disorder caused by decreased activity of the branched-chain α-ketoacid dehydrogenase (BCKD) complex. Mutations in four genes (BCKDHA, BCKDHB, DLD and DBT) are associated with MSUD. Here, the presenting symptoms and clinical course of a case of MSUD with a novel DBT gene mutation are described.Case presentationWe describe an infant with MSUD with the DBT gene mutation who had drowsiness and poor appetite as well as abnormal findings upon head magnetic resonance imaging (MRI), plasma amino acid analysis and urine organic acid analysis. Genetic testing revealed that both parents had the heterozygous mutation c.1132C > T (p.378X) in chr1:100672078, and the patient had the homozygous mutations c.1132C > T (p.378X) in chr1:100672078. Once diagnosed with MSUD, the patient’s disease was controlled with a diet of BCAA-free enteral formula and thiamine.ConclusionThe mutation c.1132C > T (p.378X) is a novel DBT gene mutation that is associated with MSUD and always has mild clinical manifestations. After timely BCAA-free nutrition and supplementation with thiamine for the patient, the plasma levels of BCAAs reached a safe level, the abnormal range of the multiple intracranial abnormalities was significantly smaller than before, and the symptoms of drowsiness and poor appetite disappeared.