bluuebunny/crossref_metadata_2025_split huggingface dataset:
Para-acetabular Radiopaque Densities in Patients With Femoroacetabular Impingement: A Retrospective Assessment of Prevalence and Characteristics
Authors: Dumont Guillaume D. , Menge Travis J. , Money Adam J. , Carmon Philip 
Published: January 2020

Background: Femoroacetabular impingement (FAI) syndrome is a common source of hip pain associated with chondrolabral injury. There is a subset of patients with FAI syndrome who present with radiopaque densities (RODs) adjacent to the acetabular rim. Purpose: To evaluate the prevalence, characteristics, and patient-specific factors associated with RODs adjacent to the acetabulum in patients treated with hip arthroscopy for symptomatic FAI. Study Design: Case series; Level of evidence, 4. Methods: Between November 2014 and March 2018, a total of 296 patients who underwent hip arthroscopy for FAI with a labral tear were reviewed retrospectively. Patient-specific variables were collected, including age, sex, lateral center-edge angle (LCEA), and alpha angle. Imaging (computed tomography) and surgical reports were reviewed for the location and characteristics of RODs, as well as subsequent labral treatment technique. Patients were excluded if they were treated for extra-articular hip pathology, had a revision procedure, or had a diagnosis other than FAI with a labral tear. No patient was excluded for any history of systemic inflammatory disease. Binary logistic regression was used to compare age, LCEA, and alpha angle for patients with or without radiopaque fragments. An alpha level of 0.05 was used to indicate statistical significance. Results: A total of 204 patients met inclusion criteria; 33 patients (16.2%; 16 males, 17 females) had para-acetabular RODs. There were no statistically significant differences in age ( P = .82), sex ( P = .92), LCEA ( P = .24), or alpha angle ( P = .10) among patients with or without an ROD. Of the 33 patients, 29 (87.9%) had fragments in the anterosuperior quadrant. Overall, 31 patients (93.9%) were treated with labral repair in addition to correction of the underlying bony impingement, while 2 patients (6.1%) underwent focal labral debridement owing to poor labral tissue quality around the RODs. Twenty-five patients (76%) had identifiable RODs, which were excised at the time of surgery. The mean (± SD) ROD size measured on axial and coronal computed tomography imaging was 6.3 ± 5.5 mm and 4 ± 4.5 mm, respectively. Conclusion: Age, sex, LCEA, and alpha angle were not predictive of the presence of para-acetabular RODs. Approximately one-sixth of all patients with FAI had RODs identified on computed tomography, which were typically located at the anterosuperior acetabulum. The majority of hips with para-acetabular RODs were amenable to labral repair. The relative prevalence and lack of predictive patient-specific indicators for these fragments suggest that a high degree of suspicion is necessary when evaluating patients with FAI.
When geography matters: International diversification and firm performance of Spanish multinationals
Authors: Mendoza Xavier , Espinosa-Méndez Christian , Araya-Castillo Luis 
Published: January 2020

This paper studies how the nature and shape of the relationship between inter- national diversification (ID) and performance (P) may vary according to a firm’s geographical focus of internationalization. Using a sample of Spanish multinational firms for the 2004—2012 period we find an M-shaped relationship. However, significant differences are found when the different geographical foci of internationalization are considered. Strong support is found when firms adopt a regional focus (an inverted S-curve when the ID measure refers to the number of foreign countries and an M-curve when it refers to the size of the network of foreign sub- sidiaries), a biregional focus (an S-curve) and a semiglobal focus (an inverted S-curve but also an M-curve with foreign subsidiaries). These findings and their pattern suggest the critical impor- tance of the country of origin and the geographical focus of internationalization in explaining the relationship between ID—P.JEL CLASSIFICATION C33; F23; G15; L25
Survey of Intravitreal Injection Practice Patterns Among Retina Specialists
Authors: Sassalos Thérèse M. , Patel Nish , Andrews Chris , Smith Stephen J. , Musch David C. , Besirli Cagri G. 
Published: January 2020

Purpose: Intravitreal injection therapy (IVT) is the most performed procedure in ophthalmology. This study was conducted to determine current trends in IVT delivery. Methods: An online, 31-question, multiple-choice survey was sent to 1677 retina specialists. The survey consisted of 3 sections: general questions, procedure technique, and postprocedure technique. Results: A total of 264 (16%) retina specialists completed the survey. The use of povidone-iodine (100%) and small-gauge needles (97%) was common, whereas ocular anesthesia was split among lidocaine gel (31%), lidocaine drops (25%), subconjunctival lidocaine (28%), and lidocaine-soaked pledgets (15%). More than 85% indicated povidone-iodine contributes to post-IVT corneal toxicity, and 12% reported that a needlestick injury to physician or staff occurred during IVT. Conclusions: Key areas for IVT improvement include optimized ocular anesthesia, development of a guarded needle for ocular drug delivery, and formulation of a less toxic ocular antiseptic.
Assessment of ST2 for risk of death following graft-versus-host disease in pediatric and adult age groups
Authors: Rowan Courtney M. , Pike Francis , Cooke Kenneth R. , Krance Robert , Carpenter Paul A. , Duncan Christine , Jacobsohn David A. , Bollard Catherine M. , Cruz Conrad Russell Y. , Malatpure Abhijeet , Farag Sherif S. , Renbarger Jamie , Liu Hao , Bakoyannis Giorgos , Hanash Samir , Paczesny Sophie 
Published: January 2020

AbstractAssessment of prognostic biomarkers of nonrelapse mortality (NRM) after allogeneic hematopoietic cell transplantation (HCT) in the pediatric age group is lacking. To address this need, we conducted a prospective cohort study with 415 patients at 6 centers: 170 were children age 10 years or younger and 245 were patients older than age 10 years (both children and adults were accrued from 2013 to 2018). The following 4 plasma biomarkers were assessed pre-HCT and at days +7, +14, and +21 post-HCT: stimulation-2 (ST2), tumor necrosis factor receptor 1 (TNFR1), regenerating islet–derived protein 3α (REG3α), and interleukin-6 (IL-6). We performed landmark analyses for NRM, dichotomizing the cohort at age 10 years or younger and using each biomarker median as a cutoff for high- and low-risk groups. Post-HCT biomarker analysis showed that ST2 (&gt;26 ng/mL), TNFR1 (&gt;3441 pg/mL), and REG3α (&gt;25 ng/mL) are associated with NRM in children age 10 years or younger (ST2: hazard ratio [HR], 9.13; 95% confidence interval [CI], 2.74-30.38; P = .0003; TNFR1: HR, 4.29; 95% CI, 1.48-12.48; P = .0073; REG3α: HR, 7.28; 95% CI, 2.05-25.93; P = .0022); and in children and adults older than age 10 years (ST2: HR, 2.60; 95% CI, 1.15-5.86; P = .021; TNFR1: HR, 2.09; 95% CI, 0.96-4.58; P = .06; and REG3α: HR, 2.57; 95% CI, 1.19-5.55; P = .016). When pre-HCT biomarkers were included, only ST2 remained significant in both cohorts. After adjustment for significant covariates (race/ethnicity, malignant disease, graft, and graft-versus-host-disease prophylaxis), ST2 remained associated with NRM only in recipients age 10 years or younger (HR, 4.82; 95% CI, 1.89-14.66; P = .0056). Assays of ST2, TNFR1, and REG3α in the first 3 weeks after HCT have prognostic value for NRM in both children and adults. The presence of ST2 before HCT is a prognostic biomarker for NRM in children age 10 years or younger allowing for additional stratification. This trial was registered at www.clinicaltrials.gov as #NCT02194439.
Health comorbidities and cognitive abilities across the lifespan in Down syndrome
Authors:   LonDownS Consortium, Startin Carla M. , D’Souza Hana , Ball George , Hamburg Sarah , Hithersay Rosalyn , Hughes Kate M. O. , Massand Esha , Karmiloff-Smith Annette , Thomas Michael S. C. , Strydom Andre 
Published: January 2020

AbstractBackgroundDown syndrome (DS) is associated with variable intellectual disability and multiple health and psychiatric comorbidities. The impact of such comorbidities on cognitive outcomes is unknown. We aimed to describe patterns of physical health and psychiatric comorbidity prevalence, and receptive language ability, in DS across the lifespan, and determine relationships with cognitive outcomes.MethodsDetailed medical histories were collected and cognitive abilities measured using standardised tests for 602 individuals with DS from England and Wales (age range 3 months to 73 years). Differences in prevalence rates between age groups and between males and females were determined using chi-squared or Fisher’s exact tests. In adults, rates for psychiatric comorbidities were compared to expected population rates using standardised morbidity ratios (SMRs). Adapted ANCOVA functions were constructed to explore age and sex associations with receptive language ability across the lifespan, and regression analyses were performed to determine whether the presence of health comorbidities or physical phenotypes predicted cognitive abilities.ResultsMultiple comorbidities showed prevalence differences across the lifespan, though there were few sex differences. In adults, SMRs were increased in males and decreased in females with DS for schizophrenia, bipolar disorder, and anxiety. Further, SMRs were increased in both males and females with DS for dementia, autism, ADHD, and depression, with differences more pronounced in females for dementia and autism, and in males for depression. Across the lifespan, receptive language abilities increasingly deviated from age-typical levels, and males scored poorer than females. Only autism and epilepsy were associated with poorer cognitive ability in those aged 16–35 years, with no relationships for physical health comorbidities, including congenital heart defects.ConclusionsOur results indicate the prevalence of multiple comorbidities varies across the lifespan in DS, and in adults, rates for psychiatric comorbidities show different patterns for males and females relative to expected population rates. Further, most health comorbidities are not associated with poorer cognitive outcomes in DS, apart from autism and epilepsy. It is essential for clinicians to consider such differences to provide appropriate care and treatment for those with DS and to provide prognostic information relating to cognitive outcomes in those with comorbidities.
The primordial tRNA acceptor stem code from theoretical minimal RNA ring clusters
Authors: Demongeot Jacques , Seligmann Hervé 
Published: January 2020

Abstract
Background
Theoretical minimal RNA rings code by design over the shortest length once for each of the 20 amino acids, a start and a stop codon, and form stem-loop hairpins. This defines at most 25 RNA rings of 22 nucleotides. As a group, RNA rings mimick numerous prebiotic and early life biomolecular properties: tRNAs, deamination gradients and replication origins, emergence of codon preferences for the natural circular code, and contents of early protein coding genes. These properties result from the RNA ring’s in silico design, based mainly on coding nonredundancy among overlapping translation frames, as the genetic code’s codon-amino acid assignments determine. RNA rings resemble ancestral tRNAs, defining RNA ring anticodons and corresponding cognate amino acids. Surprisingly, all examined RNA ring properties coevolve with genetic code integration ranks of RNA ring cognates, as if RNA rings mimick prebiotic and early life evolution.

Methods
Distances between RNA rings were calculated using different evolutionary models. Associations between these distances and genetic code evolutionary hypotheses detect evolutionary models best describing RNA ring diversification.

Results
Here pseudo-phylogenetic analyses of RNA rings produce clusters corresponding to the primordial code in tRNA acceptor stems, more so when substitution matrices from neutrally evolving pseudogenes are used rather than from functional protein coding genes reflecting selection for conserving amino acid properties.

Conclusions
Results indicate RNA rings with recent cognates evolved from those with early cognates. Hence RNA rings, as designed by the genetic code’s structure, simulate tRNA stem evolution and prebiotic history along neutral chemistry-driven mutation regimes.
Distribution of allele frequencies for genes associated with physical activity and/or physical capacity in a homogenous Norwegian cohort- a cross-sectional study
Authors: Goleva-Fjellet Sannija , Bjurholt Anne Mari , Kure Elin H. , Larsen Inger Kristin , Støren Øyvind , Sæbø Mona 
Published: January 2020

Abstract
Background
There are large individual differences in physical activity (PA) behavior as well as trainability of physical capacity. Heritability studies have shown that genes may have as much impact on exercise participation behavior as environmental factors. Genes that favor both trainability and participation may increase the levels of PA. The present study aimed to assess the allele frequencies in genes associated with PA and/or physical capacity, and to see if there is any association between these polymorphisms and self-reported PA levels in a cohort of middle-aged Norwegians of Scandinavian descent (n = 831; mean age mean age (± SD) 55.5 ± 3.8 years).

Results
The genotype distributions of the ACTN3 R577X, ACE I/D and MAOA uVNTR polymorphisms were similar to other populations of European descent. When comparing the genotype distribution between the low/medium level PA group (LMPA) and high level PA groups (HPA), a significant difference in ACTN3 577X allele distribution was found. The X allele frequency was 10% lower in the HPA level group (P = 0.006). There were no differences in the genotype distribution of the ACE I/D or MAOA uVNTR polymorphism. Education and previous participation in sports or outdoor activities was positively associated with the self-reported PA levels (P ≤ 0.001).

Conclusions
To the best of our knowledge, this is the first study to report association between ACTN3 R577X genotype and PA level in middle-aged Scandinavians. Nevertheless, the contribution of a single polymorphism to a complex trait, like PA level, is likely small. Socioeconomic variables, as education and previous participation in sports or outdoor activities, are positively associated with the self-reported PA levels.
Marine bacterial communities in the upper gulf of Thailand assessed by Illumina next-generation sequencing platform
Authors: Nimnoi Pongrawee , Pongsilp Neelawan 
Published: January 2020

Abstract
Background
The total bacterial community plays an important role in aquatic ecosystems. In this study, bacterial communities and diversity along the shores of the Upper Gulf of Thailand were first characterized. The association between bacterial communities and types of land use was also evaluated.

Results
The bacterial communities and diversity of seawater in the Upper Gulf of Thailand, with regard to types of land use, were first revealed by using Illumina next-generation sequencing. A total of 4953 OTUs were observed from all samples in which 554 OTUs were common. The bacterial communities in sampling sites were significantly different from each other. The run-off water from three types of land use significantly affected the community richness and diversity of marine bacteria. Aquaculture sites contained the highest levels of community richness and diversity, followed by mangrove forests and tourist sites. Seawater physicochemical parameters including salinity, turbidity, TSS, total N, and BOD5, were significantly different when grouped by land use. The bacterial communities were mainly determined by salinity, total N, and total P. The species richness estimators and OTUs were positively correlated with turbidity. The top ten most abundant phyla and genera as well as the distribution of bacterial classes were characterized. The Proteobacteria constituted the largest proportions in all sampling sites, ranging between 67.31 and 78.80%. The numbers of the Marinobacterium, Neptuniibacter, Synechococcus, Candidatus Thiobios, hgcI clade (Actinobacteria), and Candidatus Pelagibacter were significantly different when grouped by land use.

Conclusions
Type of land use significantly affected bacterial communities and diversity along the Upper Gulf of Thailand. Turbidity was the most influential parameter affecting the variation in bacterial community composition. Salinity, total N, and P were the ones of the important factors that shaped the bacterial communities. In addition, the variations of bacterial communities from site-to-site were greater than within-site. The Proteobacteria, Bacteroidetes, Actinobacteria, Cyanobacteria, Verrucomicrobia, Euryarchaeota, Planctomycetes, Firmicutes, Deep Sea DHVEG-6, and Marinimicrobia were the most and common phyla distributed across the Upper Gulf of Thailand.
Anticoagulant and anti-thrombotic therapy in acute type B aortic dissection: when real-life scenarios face the shadows of the evidence-based medicine
Authors: Bocchino Pier Paolo , De Filippo Ovidio , Piroli Francesco , Scacciatella Paolo , Imazio Massimo , D’Ascenzo Fabrizio , De Ferrari Gaetano Maria 
Published: January 2020

Abstract
Background
Evidence-based recommendations about anticoagulation in acute type B aortic dissection (TBAD) are completely missing, but there is a diffuse conviction that it could prevent the healing process of the dissected aorta’s false lumen. However, several clinical conditions may lead to the necessity to start anticoagulant therapy among patients with acute type B aortic dissection, ranging from atrial fibrillation to more complicated clinical scenarios and the correct management in this kind of patients is still an open issue.

Case presentation
We are presenting a 51-years-old man with multi-infarct encephalopathy referred to us for an acute TBAD and a first diagnosis of ischemic cardiomyopathy complicated by left ventricular (LV) thrombus formation. Coronary angiography revealed a critical stenosis of left anterior descending artery (LAD) treated with drug-eluting stent deployment. The patient was addressed to triple antithrombotic therapy with acetylsalicylic acid, clopidogrel and warfarin with target INR 2.0–2.5. After 6 months, computed tomography angiography revealed the stability of the dissection flap. Cardiac magnetic resonance imaging, however, confirmed the persistence of a small thrombotic formation in LV apex, thus double antithrombotic therapy with warfarin and clopidogrel was instituted. The patient remained asymptomatic during the follow-up period but was advised to suspend his job and physical activities.

Conclusion
Current guidelines do not discuss anticoagulant therapy in the setting of TBAD and large randomized trials are lacking. Despite it is generally considered unsafe to administer anticoagulants in patients with TBAD, we present a case in which triple antithrombotic therapy was well tolerated and did not lead to progression of the intimal flap after 6 months.
Factors associated with successful home discharge after inpatient rehabilitation in frail older stroke patients
Authors: Vluggen Tom P. M. M. , van Haastregt Jolanda C. M. , Tan Frans E. S. , Kempen Gertrudis I. J. M. , Schols Jos M. G. A. , Verbunt Jeanine A. 
Published: January 2020

Abstract
Background
Stroke is a highly prevalent disease among older people and can have a major impact on daily functioning and quality of life. When community-dwelling older people are hospitalized due to stroke, discharge to an intermediate care facility for geriatric rehabilitation is indicated when return to the previous living situation is expected but not yet possible. However, a substantial proportion is still unable to return home after discharge and has to be admitted to a residential care setting. This study aims to identify which factors are associated with home discharge after inpatient rehabilitation among frail and multimorbid older stroke patients.

Methods
This study is a longitudinal cohort study among 92 community-dwelling stroke patients aged 65 years or over. All patients were admitted to one of eight participating intermediate care facilities for geriatric rehabilitation, under the expectation to return home after rehabilitation. We examined whether 16 potentially relevant factors (age; sex; household situation before admission; stroke history; cardiovascular disorders; diabetes mellitus; multimorbidity; cognitive disability; neglect; apraxia; dysphagia; urinary and bowel incontinence; emotional problems; sitting balance; daily activity level; and independence in activities of daily living) measured at admission were associated with discharge to the former living situation. Logistic regression analysis was used for statistical analysis.

Results
Mean age of the patients was 79.0 years (SD 6.4) and 51.1% was female. A total of 71 patients (77.1%) were discharged to the former living situation within 6 months after the start of geriatric rehabilitation. Of the 16 factors analysed, only a higher level of independence in activities of daily living at admission was significantly associated with home discharge.

Conclusions
Our study shows that the vast majority of previously identified factors predicting home discharge among stroke patients, could not predict home discharge among a group of frail and multimorbid older persons admitted to geriatric rehabilitation. Only a higher level of independence in activities of daily living at admission was significantly related to home discharge. Additional insight in other factors that might predict home discharge after geriatric rehabilitation among this specific group of frail older stroke patients, is needed. Trial registration: ISRCTN ISRCTN62286281. Registered 19-3-2010.
A hybrid simulation model approach to examine bacterial genome sequencing during a hospital outbreak
Authors: Elliott Thomas M. , Lee Xing J. , Foeglein Anna , Harris Patrick N. , Gordon Louisa G. 
Published: January 2020

AbstractBackgroundHospital infection control requires timely detection and identification of organisms, and their antimicrobial susceptibility. We describe a hybrid modeling approach to evaluate whole genome sequencing of pathogens for improving clinical decisions during a 2017 hospital outbreak of OXA-181 carbapenemase-producingEscherichia coliand the associated economic effects.MethodsCombining agent-based and discrete-event paradigms, we built a hybrid simulation model to assess hospital ward dynamics, pathogen transmission and colonizations. The model was calibrated to exactly replicate the real-life outcomes of the outbreak at the ward-level. Seven scenarios were assessed including genome sequencing (early or late) and no sequencing (usual care). Model inputs included extent of microbiology and sequencing tests, patient-level data on length of stay, hospital ward movement, cost data and local clinical knowledge. The main outcomes were outbreak size and hospital costs. Model validation and sensitivity analyses were performed to address uncertainty around data inputs and calibration.ResultsAn estimated 197 patients were colonized during the outbreak with 75 patients detected. The total outbreak cost was US$318,654 with 6.1% of total costs spent on sequencing. Without sequencing, the outbreak was estimated to result in 352 colonized patients costing US$531,109. Microbiology tests were the largest cost component across all scenarios.ConclusionA hybrid simulation approach using the advantages of both agent-based and discrete-event modeling successfully replicated a real-life bacterial hospital outbreak as a foundation for evaluating clinical outcomes and efficiency of outbreak management. Whole genome sequencing of a potentially serious pathogen appears effective in containing an outbreak and minimizing hospital costs.