bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medication Adherence of Latino Children and Caregivers: An Integrative Review
Authors: Foronda Cynthia L. , Muheriwa Sadandaula Rose , Fernandez-Burgos Margo , Prather Susan , Nersesian Paula 
Published: December 2019

Introduction: There are significant disparities in medication adherence among underserved minority groups such as Latinos. Adherence to medication is a primary determinant of treatment success. Little is known about medication adherence among Latino children. This integrated review aims to describe what is known about medication adherence among Latino children and explore barriers and facilitators to medication adherence. Method: This review was guided by Whittemore and Knafl’s method of integrative review and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Results: Of the 20 articles reviewed about medication adherence among Latino children, the analysis of these articles revealed four major themes: (1) low adherence, (2) low adherence associations, (3) child outcomes, and (4) effective interventions. Conclusion: Health practitioners should consider medication adherence associations and interventions when collaborating with the family caregiver to improve child outcomes.
Aspiration thrombectomy for the management of acute deep venous thrombosis in the setting of venous thoracic outlet syndrome
Authors: Teter Katherine , Arko Frank , Muck Patrick , Lamparello Patrick J , Khaja Minhaj S , Huasen Bella , Sadek Mikel , Maldonado Thomas S 
Published: December 2019

Objectives Venous thoracic outlet syndrome, known by the eponym Paget–Schroetter syndrome, is seen in healthy, young individuals with “effort-induced thrombosis.” Endovascular therapies, including catheter-directed thrombolysis, have been described in the acute management of the upper extremity deep venous thrombosis; however, we assessed the technical success of treating this entity using a mechanical aspiration thrombectomy system. Methods This was a multi-center retrospective review of patients with venous thoracic outlet syndrome with acute thrombosis treated with the Indigo continuous aspiration mechanical thrombectomy system. Charts from patients with venous thoracic outlet syndrome and acute deep venous thrombosis treated with this system at our institution along with three data sharing locations were reviewed for demographics, deep venous thrombosis risk factors, imaging modalities used for diagnosis, extent of axillosubclavian deep venous thrombosis, treatment details, adjunctive therapies, and complications. The primary outcome was technical success (resolution of >70% of thrombus). Results There were 16 patients (50% male) with a mean age of 33 years (range 17–69 years). Six patients had underlying venous thromboembolism risk factors including use of contraceptives ( n = 2), prior deep venous thrombosis ( n = 3), and known thrombophilia ( n = 1). Fifteen patients had complete venous occlusion, and the extent of venous involvement included subclavian ( n = 14), axillary ( n = 16), and brachial ( n = 7). The majority (81.25%) of patients were treated in a single setting, and technical success was achieved in all cases with the use of adjunctive therapies. Only three patients required additional overnight thrombolytic therapy. Conclusions The Penumbra Indigo system, often in combination with adjunctive catheter-directed thrombolysis and venoplasty, is a safe and effective device for the treatment of acute upper extremity deep venous thrombosis in the setting of Paget–Schroetter syndrome. No patients experienced central embolization or post-operative renal insufficiency. One-third of patients avoided any additional catheter-directed thrombolysis exposure, and technical success was achieved in all cases. A single bleeding complication was observed in a patient undergoing overnight adjunctive catheter-directed thrombolysis. All patients maintained patency until time of first rib resection.
Structures at Risk During Percutaneous Extra-Articular Chevron Osteotomy of the Distal First Metatarsal
Authors: McGann Maria , Langan Travis M. , Brandão Roberto A. , Berlet Gregory , Prissel Mark 
Published: December 2019

Background. Minimally invasive surgery of the forefoot has regained popularity as an alternative to traditional open procedures. Minimally invasive hallux valgus surgery has been shown to be effective and reproducible for the treatment of mild to moderate hallux valgus. The aim of this study is to identify vital structures that are at risk for iatrogenic damage while performing a minimally invasive distal chevron osteotomy due to limited direct visualization. Methods. Ten fresh-frozen below knee cadavers were used for this study. A minimally invasive distal chevron osteotomy and medial eminence resection with a 2.2 mm × 22 mm Shannon burr was performed on each cadaver. Each specimen was dissected to expose the potential structures at risk for injury during the procedure. Structures evaluated included the medial neurovascular bundle, first metatarsophalangeal joint capsule, extensor hallucis longus tendon, flexor hallucis longus tendon, abductor hallucis tendon, and the sesamoid apparatus. Results. Ten specimens were evaluated. The dorsal medial cutaneous nerve was directly injured in 5 of the 10 cadaver specimens and intact/uninjured in the remaining 5 specimens. The flexor hallucis longus, extensor hallucis longus, adductor tendon, sesamoid apparatus, and first metatarsophalangeal joint capsule were uninjured in all specimens. Conclusion. Minimally invasive chevron distal osteotomy and medial eminence resection has a high learning curve. The resection of the medial eminence may iatrogenically injure the dorsal medial cutaneous nerve. The incidence is higher in this study than prior reported cadaveric studies and may warrant extra care to protect vital structures. Level of Evidence: Level IV: Cadaver study
Risk of Complications With the Total Contact Cast in Diabetic Foot Disorders
Authors: Riopelle Alexandria , LeDuc Ryan , Wesolowski Michael , Schiff Adam P. , Pinzur Michael S. 
Published: December 2019

The custom-fabricated total contact cast is commonly used in the treatment of diabetic foot disorders. This resource-consuming treatment option has been associated with iatrogenic morbidity as well as the need for urgent cast removal and inspection of the underlying limb when potential problems arise. Over a 10-year period, 381 diabetic patients had 2265 total contact cast applications by certified orthopaedic technologists, in a university orthopaedic practice, under the supervision of university faculty. Patients were stratified by glycemic control based on hemoglobin A1c levels, and obesity based on body mass index (BMI). Complications were grouped as (1) development of a new ulcer or wound, (2) new or increasing odor or drainage, (3) wound infection, (4) gangrene, (5) newly identified osteomyelitis, and (6) pain or discomfort necessitating cast change or removal. At least 1 complication was observed in 159 of 381 patients. The odds of experiencing a cast-related event for patients with a BMI greater than 30 kg/m2 was 1.55 times greater than patients with a BMI less than 25 kg/m2. As compared to patients with good glycemic control, the odds of experiencing a cast-associated complication was 1.27 times greater in patients with moderate glycemic control and 1.48 times greater in patients with poor glycemic control. The total contact cast is commonly used in the treatment of diabetic foot morbidity. Treatment-associated morbidity may well be greater than previously appreciated. Complications are more likely in patients who have poor glycemic control and are morbidly obese. This information will hopefully stimulate interest in developing commercially available nonrigid alternatives that retain the attributes of the resource-consuming rigid device, with the potential advantage of avoiding the associated morbidity. Levels of Evidence: Level IV, retrospective chart review
Tumor and nodal staging of colon cancer: accuracy of preoperative computed tomography at a Swedish high-volume center
Authors: Korsbakke Kevin , Dahlbäck Cecilia , Karlsson Niklas , Zackrisson Sophia , Buchwald Pamela 
Published: December 2019

Background When deciding treatment options for patients with colon cancer, accurate staging is required. In Sweden, the main preoperative evaluation modality to determine tumor and nodal stage is computed tomography (CT). Purpose The aim of this study was to investigate how well the preoperative (CT-determined) clinical tumor and nodal stage (cTN) correlated with the postoperative histopathological stage (pTN). Another aim was to validate the tumor and nodal stage data in the Swedish Colorectal Cancer Registry (SCRCR). Material and Methods The SCRCR was used to identify patients with colon cancer, treated at a Swedish high-volume center during 2013–2016 (n = 974). Data were gathered from medical records regarding cTN and pTN stage, and predefined patient and tumor variables. The agreement between cTN and pTN was analyzed using kappa statistics. Results After excluding patients with either pre- or postoperative TN stage missing, 383 patients remained for further analyses. The analyses showed an agreement between cT and pT of κ: 0.27 and between cN and pN of κ: 0.21 (fair agreement). When comparing tumors with low (T1–3; N0) versus high risk (T4; N1–2), the kappa value was 0.19 (slight agreement). When comparing the SCRCR to medical records, 78% of completely staged tumors had been correctly reported. Conclusion The agreement between cTN and pTN was low in this study population, indicating a need for enhanced precision of the preoperative staging process. A high frequency of erroneous preoperative staging data in the SCRCR shows the need for further efforts of ensuring correct data transfers into the registry.
Lower Limb Biomechanics During Level Walking After an Isolated Posterior Cruciate Ligament Rupture
Authors: Yu Yuanyuan , Huang Hongshi , Ren Shuang , Shi Huijuan , Zhang Si , Liang Zixuan , Ao Yingfang 
Published: December 2019

Background: The posterior cruciate ligament (PCL) is an important structure in knee stabilization. Knee cartilage degeneration after a PCL injury has been reported in several studies. Understanding the changes in movement patterns of patients with PCL ruptures could help clinicians make specific treatment protocols to restore patients’ sporting ability and prevent joint degeneration. However, the kinematics and kinetics of the lower limb in patients with PCL injuries are still not clear. Purpose: To investigate the biomechanical characteristics during level walking in patients with isolated PCL deficiency. Study Design: Controlled laboratory study. Methods: Three-dimensional videographic and force plate data were collected for 27 healthy male participants (control group) and 25 male patients with isolated PCL-deficiency (PCL-d group) walking at a constant self-selected speed. Paired and independent t tests were performed to determine the differences between the involved and uninvolved legs in the PCL-d group and between the PCL-d and control groups, respectively. Results: Compared with the control leg, both legs in the PCL-d group had smaller knee moments of flexion and internal rotation; greater hip angles of flexion and adduction; greater hip moments of internal rotation; greater ankle angles of extension and adduction; and smaller ankle moments of flexion, adduction, and internal rotation. Moreover, compared with the uninvolved leg in the PCL-d group, the involved leg in the PCL-d group had significantly smaller knee extension angles and moments during the terminal stance phase, greater hip external rotation angles and extension moments, and smaller ankle adduction angles and flexion moments. Conclusion: PCL ruptures altered walking patterns in both the involved and uninvolved legs, which could affect alignment of the lower limb and loading on the knee, hip, and ankle joints. Patients with PCL injuries adapted their hip and ankle to maintain knee stability. Clinical Relevance: The kinematic and kinetic adaptations in the knee, hip, and ankle after a PCL rupture during level walking are likely to be a compensatory strategy for knee instability. The results of this study suggest that these adaptations should be considered in the treatment of patients with PCL ruptures.
Towards a Model for the Development of the Mesolonghi-Aitoliko Sea Lagoon in Greece
Authors: Siampani Mari 
Published: December 2019

The Sea Lagoon of Mesolonghi is located in central-west Greece and is considered to be one of the most significant sea lagoons in Europe in terms of ecological and environmental interests. It is an area of exceptional natural beauty, with a wide variety of rare plants and animals. Characterized as a biotope, it is a habitat protected by the Natura treaty and the Ramsar Convention that occupies 150,000 acres. Traces of continuous human life, as suggested by prehistoric findings, Greek mythology, archaeological sites, Early Christian temples and Byzantine monuments, till the modern period, are present in the area. Most significant examples of traditional architecture are the ‘Ivaries and Pelades’ used by the local fishermen for lodging purposes. The Mesolonghi Sea Lagoon offers an exemplary multidisciplinary laboratory of natural fishing techniques, local crafts and traditional architecture. As such, it is important to study this further for its potential for growth both as a rural landscape and as a form of traditional local tangible and intangible heritage. In this article, we discuss and present the relationships between the benefits of organized/natural sea cultivation processes, architectures’ contribution to the whole attempt of prosperity and economic growth of the community and the re-imagined rural landscape as well as the local development potential in a direction aligned with the environment, the local history and local traditions.
Prompt Improvement of an Enlarging Pigment Epithelial Detachment Following Intravitreal Dexamethasone in Neovascular Age-Related Macular Degeneration
Authors: Powers James H. , Wisely C. Ellis , Sastry Ananth , Fekrat Sharon 
Published: December 2019

Purpose: This report discusses a case of neovascular age-related macular degeneration with mixed serous pigment epithelial detachment (PED) that was unresponsive to antivascular endothelial growth injections but responded to the addition of intravitreal steroid injection. Methods: We report a case. Results: A 75-year-old woman with neovascular age-related macular degeneration developed a mixed serous PED in her right eye. Three monthly aflibercept (Eylea, Regeneron) treatments led to resolution of associated intraretinal fluid; however, the mixed serous and fibrovascular PED significantly increased in size. The addition of intravitreal dexamethasone (Ozurdex, Allergan) to monthly aflibercept led to prompt flattening of the PED. Three months later, the PED recurred despite continued administration of monthly aflibercept. Conclusions: This case supports a growing body of research that PEDs unresponsive to antivascular endothelial growth injections may respond to intravitreal steroid injections.
An Experiential Account of Sexual Dysfunction Among Women with Schizophrenia: A Qualitative Study from India
Authors: Simiyon Manjula , Chandra Prabha , Desai Geetha 
Published: December 2019

Aims: The study aimed to gather the perspectives of women with schizophrenia who had sexual dysfunction (SD) and to assess their perceptions related to discussions about sexual concerns with mental health professionals (MHP). Settings: Female patients attending the outpatient department of a tertiary care university psychiatric hospital, who were diagnosed to have schizophrenia and in remission, were recruited and assessed for SD. Those who had SD and were willing to participate were interviewed for the qualitative study. Methods and Materials: A guided interview format was used to gather their narratives. Interviews were transcribed and translated from audio recordings on the same day. The analysis of transcript from 9 patients reached theoretical saturation. Analysis: The data were retrieved, coded, and systematically organized according to patterns and themes. The manual inductive coding method was used to arrive at the themes. Results: 4 themes were found for the question assessing their perspective regarding SD and 3 themes on their perspectives regarding the discussion with MHP. Many of them had misconceptions regarding their sexual lives and the relationship between sexuality and their illness. It was evident that hardly any MHP had ever inquired about their sexual functioning. Conclusion: This qualitative research on women with schizophrenia having SD gives us in-depth knowledge regarding their snags. Results of such studies will help the clinicians pay justifiable attention to these least spoken problems.
A modern reassessment of glycoprotein-specific direct platelet autoantibody testing in immune thrombocytopenia
Authors: Al-Samkari Hanny , Rosovsky Rachel P. , Karp Leaf Rebecca S. , Smith David B. , Goodarzi Katayoon , Fogerty Annemarie E. , Sykes David B. , Kuter David J. 
Published: December 2019

Key Points
When performed in accordance with modern ASH and ISTH guidelines, PA testing is sensitive and specific for ITP diagnosis. More glycoproteins targeted by autoantibodies predicts for more severe disease, and autoantibodies resolve with clinical remission.
Inhibition of microRNA-29a alleviates hyperoxia-induced bronchopulmonary dysplasia in neonatal mice via upregulation of GAB1
Authors: Hu Yu , Xie Liang , Yu Jing , Fu Hongling , Zhou Dan , Liu Hanmin 
Published: December 2019

Abstract
Background
The main features of bronchopulmonary dysplasia (BPD) are alveolar simplification, pulmonary growth arrest, and abnormal lung function. Multiple studies have highlighted microRNA-29 (miR-29) as a potential biomarker for lung diseases and cancers. Upregulation of miR-29a has been known to downregulate GRB2-associated-binding protein 1 (GAB1), which is often highly expressed in the lung. The current study was designed to investigate the potential role of miR-29a in hyperoxia-induced BPD by targeting GAB1 in a neonatal mouse model.

Methods
The expression of miR-29a and GAB1 in lung tissues of neonatal mice with hyperoxia-induced BPD and mouse alveolar epithelial cells (MLE-12) was determined using RT-qPCR and western blot analysis. Subsequently, the relationship between miR-29a and GAB1 was verified using in silico analysis. In order to assess the effects of miR-29a or GAB1 on BPD, the pathological characteristics of alveoli, as well as proliferation and apoptosis of cells were measured through gain- and loss-of-function studies.

Results
Upregulation of miR-29a and downregulation of GAB1 were evident in both lung tissues and MLE-12 cells following BPD modeling. GAB1 was a direct target gene of miR-29a. Inhibition of miR-29a and overexpression of GAB1 were shown to alleviate lung injury, promote cell proliferation and inhibit apoptosis but reduce chord length in lung tissues of neonatal mice following hyperoxia-induced BPD modeling.

Conclusion
Altogether, down-regulation of miR-29a can potentially elevate GAB1 expression, reducing cell apoptosis and stimulating proliferation, ultimately retarding the development of BPD in mice. This study highlights the potential of a promising new target for preventing BPD.
Disorders of FZ-CRD; insights towards FZ-CRD folding and therapeutic landscape
Authors: Milhem Reham M. , Ali Bassam R. 
Published: December 2019

AbstractThe ER is hub for protein folding. Proteins that harbor a Frizzled cysteine-rich domain (FZ-CRD) possess 10 conserved cysteine motifs held by a unique disulfide bridge pattern which attains a correct fold in the ER. Little is known about implications of disease-causing missense mutations within FZ-CRD families. Mutations in FZ-CRD of Frizzled class receptor 4 (FZD4) and Muscle, skeletal, receptor tyrosine kinase (MuSK) and Receptor tyrosine kinase-like orphan receptor 2 (ROR2) cause Familial Exudative Vitreoretinopathy (FEVR), Congenital Myasthenic Syndrome (CMS), and Robinow Syndrome (RS) respectively. We highlight reported pathogenic inherited missense mutations in FZ-CRD of FZD4, MuSK and ROR2 which misfold, and traffic abnormally in the ER, with ER-associated degradation (ERAD) as a common pathogenic mechanism for disease. Our review shows that all studied FZ-CRD mutants of RS, FEVR and CMS result in misfolded proteins and/or partially misfolded proteins with an ERAD fate, thus we coin them as “disorders of FZ-CRD”. Abnormal trafficking was demonstrated in 17 of 29 mutants studied; 16 mutants were within and/or surrounding the FZ-CRD with two mutants distant from FZ-CRD. These ER-retained mutants were improperly N-glycosylated confirming ER-localization. FZD4 and MuSK mutants were tagged with polyubiquitin chains confirming targeting for proteasomal degradation. Investigating the cellular and molecular mechanisms of these mutations is important since misfolded protein and ER-targeted therapies are in development. The P344R-MuSK kinase mutant showed around 50% of its in-vitro autophosphorylation activity and P344R-MuSK increased two-fold on proteasome inhibition. M105T-FZD4, C204Y-FZD4, and P344R-MuSK mutants are thermosensitive and therefore, might benefit from extending the investigation to a larger number of chemical chaperones and/or proteasome inhibitors. Nonetheless, FZ-CRD ER-lipidation it less characterized in the literature and recent structural data sheds light on the importance of lipidation in protein glycosylation, proper folding, and ER trafficking. Current treatment strategies in-place for the conformational disease landscape is highlighted. From this review, we envision that disorders of FZ-CRD might be receptive to therapies that target FZ-CRD misfolding, regulation of fatty acids, and/or ER therapies; thus paving the way for a newly explored paradigm to treat different diseases with common defects.
What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016–2018
Authors: Inns Thomas , Wilson Deb , Manley Petra , Harris John P. , O’Brien Sarah J. , Vivancos Roberto 
Published: December 2019

Abstract
Background
Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings.

Methods
We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression.

Results
From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 64% of outbreaks with a pathogen identified. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 1.03, 95% CI 1.01–1.05) and fewer cases sampled (aOR 0.74, 95% CI 0.60–0.91), compared to outbreaks caused by other viral pathogens.

Conclusions
These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.