bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of unmet clinical needs in prophylaxis and treatment of venous thromboembolism in at-risk patient groups: pregnancy, elderly and obese patients
Authors: Brenner Benjamin , Arya Roopen , Beyer-Westendorf Jan , Douketis James , Hull Russell , Elalamy Ismail , Imberti Davide , Zhai Zhenguo 
Published: December 2019

Abstract
Background
Venous thromboembolism (VTE) accounts for an estimated 900,000 cases per year in the US alone and constitutes a considerable burden on healthcare systems across the globe.

Objective
To understand why the burden is so high, qualitative and quantitative research was carried out to gain insights from experts, guidelines and published studies on the unmet clinical needs and therapeutic strategies in VTE prevention and treatment in three populations identified as being at increased risk of VTE and in whom VTE prevention and treatment were regarded as suboptimal: pregnant women, the elderly and obese patients.

Methodology
A gap analysis methodology was created to highlight unmet needs in VTE management and to discover the patient populations considered most at risk. A questionnaire was devised to guide qualitative interviews with 44 thrombosis and haemostasis experts, and a review of the literature on VTE in the specific patient groups from 2015 to 2017 was completed. This was followed by a Think Tank meeting where the results from the research were discussed.

Results
This review highlights the insights gained and examines in detail the unmet needs with regard to VTE risk-assessment tools, biomarkers, patient stratification methods, and anticoagulant and dosing regimens in pregnant women, the elderly and obese patients.

Conclusions
Specifically, in pregnant women at high risk of VTE, low-molecular-weight heparin (LMWH) is the therapy of choice, but it remains unclear how to use anticoagulants when VTE risk is intermediate. In elderly patients, evaluation of the benefit of VTE prophylaxis against the bleeding risk is particularly important, and a head-to-head comparison of efficacy and safety of LMWH versus direct oral anticoagulants is needed. Finally, in obese patients, lack of guidance on anticoagulant dose adjustment to body weight has emerged as a major obstacle in effective prophylaxis and treatment of VTE.
Fostering implementation of knowledge into health practice: study protocol for the validation and redevelopment of the Knowledge Uptake and Utilization Tool
Authors: Shankar Sneha , Skinner Kelly , Morton Ninomiya Melody E. , Bhawra Jasmin 
Published: December 2019

AbstractBackgroundMeasurement of what knowledge is taken-up and how that information is used to inform practice and policies can provide an understanding about the effectiveness of knowledge uptake and utilization processes. In 2007, the Knowledge Uptake and Utilization Tool (KUUT) was developed to evaluate the implementation of knowledge into practice. The KUUT has been used by numerous large health organizations despite limited validity evidence and a narrow understanding about how the tool is used in practice and interpreted by users. As such, the overall purpose of this protocol is to redevelop the KUUT and gather validity evidence to examine and support its use in various health-related organizations. This protocol paper outlines a validation and redevelopment procedure for the KUUT using the unitary view of validity.MethodsThe protocol outlined in this article proceeds through four phases, starting with redeveloping the tool, then evaluating validity evidence based on: test content, response processes and internal structure. The initial phase gathers information to redevelop the tool, and evaluates item content and response format. The second phase evaluates response process validity evidence by examining how a variety of users interact with the tool. In the third phase, the tool will be pilot tested with knowledge users and, in the final phase, psychometric properties of the tool will be examined and a final scoring structure will be determined. A knowledge translation plan described herein outlines where the final tool will be housed and how the information about the tool will be disseminated.DiscussionThis protocol outlines a procedure to gather different sources of validity evidence for the KUUT. By addressing limitations in the original KUUT, such as complexities with scoring, a redeveloped KUUT supporting validity evidence will enhance the ability of health-related organizations to effectively use this tool for its intended purpose.
Chronic idiopathic musculoskeletal pain in youth: a qualitative study
Authors: Lefèvre Hervé , Loisel Alexandra , Meunier Brigitte Bader , Deslandre Chantal , Lemoine Noémie , Moro Marie Rose , Quartier Pierre , Lachal Jonathan 
Published: December 2019

Abstract
Background
Chronic musculoskeletal pain (MSP) is frequent in adolescents and has major medical and social consequences. In many cases, when no cause has been clearly established, this pain may be considered to be chronic idiopathic MSP. Our study seeks to identify general criteria for this type of pain through the experience of professionals from tertiary care centers with expertise in pediatric and adolescent chronic MSP.

Methods
Cross-sectional multicenter qualitative study. Semi-structured interviews of 25 professionals at a rheumatology reference center and in its network for pain management, including diverse specialists and professions. Interpretative Phenomenological Analysis is used to explore the data.

Results
This approach led us to identify 10 themes organized around three superordinate themes covering different stages of the diagnostic process: 1) the medical pain history up to the consultation at the reference center; 2) the professional’s subjective feelings about the clinical presentation; 3) from the clinical examination to diagnosis and treatment of chronic idiopathic MSP. The main elements guiding this diagnosis do not come from the physical examination but from the medical history and the professionals’ subjective feelings, that is, their clinical judgment. The professionals’ impression of uneasiness and frustration, induced by patients and their parents, is of major importance.

Conclusion
The principal elements guiding the diagnosis of chronic idiopathic MSP do not come primarily from the physical examination but rather from the pain history and the health professional’s subjective feelings. Our results suggest that the concept of Juvenile Fibromyalgia (JFM) does not appear to cover all situations of chronic idiopathic MSP in adolescence. A constellation of non-organic criteria enables diagnosis of the latter; these criteria should be validated to avoid medical nomadism and multiple investigations and to shorten the interval until patients receive optimal pain management.

Clinical trial registration
clinicaltrials.gov, NCT03171792, https://clinicaltrials.gov/ct2/show/NCT03171792?term=LACHAL&cntry=FR&city=paris&rank=1
Interleukin-1β drives NEDD8 nuclear-to-cytoplasmic translocation, fostering parkin activation via NEDD8 binding to the P-ubiquitin activating site
Authors: Balasubramaniam Meenakshisundaram , Parcon Paul A. , Bose Chhanda , Liu Ling , Jones Richard A. , Farlow Martin R. , Mrak Robert E. , Barger Steven W. , Griffin W. Sue T. 
Published: December 2019

Abstract
Background
Neuroinflammation, typified by elevated levels of interleukin-1 (IL-1) α and β, and deficits in proteostasis, characterized by accumulation of polyubiquitinated proteins and other aggregates, are associated with neurodegenerative disease independently and through interactions of the two phenomena. We investigated the influence of IL-1β on ubiquitination via its impact on activation of the E3 ligase parkin by either phosphorylated ubiquitin (P-Ub) or NEDD8.

Methods
Immunohistochemistry and Proximity Ligation Assay were used to assess colocalization of parkin with P-tau or NEDD8 in hippocampus from Alzheimer patients (AD) and controls. IL-1β effects on PINK1, P-Ub, parkin, P-parkin, and GSK3β—as well as phosphorylation of parkin by GSK3β—were assessed in cell cultures by western immunoblot, using two inhibitors and siRNA knockdown to suppress GSK3β. Computer modeling characterized the binding and the effects of P-Ub and NEDD8 on parkin. IL-1α, IL-1β, and parkin gene expression was assessed by RT-PCR in brains of 2- and 17-month-old PD-APP mice and wild-type littermates.

Results
IL-1α, IL-1β, and parkin mRNA levels were higher in PD-APP mice compared with wild-type littermates, and IL-1α-laden glia surrounded parkin- and P-tau-laden neurons in human AD. Such neurons showed a nuclear-to-cytoplasmic translocation of NEDD8 that was mimicked in IL-1β-treated primary neuronal cultures. These cultures also showed higher parkin levels and GSK3β-induced parkin phosphorylation; PINK1 levels were suppressed. In silico simulation predicted that binding of either P-Ub or NEDD8 at a singular position on parkin opens the UBL domain, exposing Ser65 for parkin activation.

Conclusions
The promotion of parkin- and NEDD8-mediated ubiquitination by IL-1β is consistent with an acute neuroprotective role. However, accumulations of P-tau and P-Ub and other elements of proteostasis, such as translocated NEDD8, in AD and in response to IL-1β suggest either over-stimulation or a proteostatic failure that may result from chronic IL-1β elevation, easily envisioned considering its early induction in Down’s syndrome and mild cognitive impairment. The findings further link autophagy and neuroinflammation, two important aspects of AD pathogenesis, which have previously been only loosely related.
Perceptions of isolation during facility births in Haiti - a qualitative study
Authors: Dev Alka , Kivland Chelsey , Faustin Mikerlyne , Turnier Olivia , Bell Tatiana , Leger Marie Denise 
Published: December 2019

Abstract
Background
Haiti’s maternal mortality, stillbirth, and neonatal mortality rates are the highest in Latin America and the Caribbean. Despite inherent risks, the majority of women still deliver at home without supervision from a skilled birth attendant. The purpose of this study was to elucidate factors driving this decision.

Methods
We conducted six focus group discussions with women living in urban (N = 14) or rural (N = 17) areas and asked them questions pertaining to their reasons for delivering at a facility or at home, perceptions of staff at the health facility, experiences with or knowledge of facility or home deliveries, and prior pregnancy experiences (if relevant). We also included currently pregnant women to learn about their plans for delivery, if any.

Results
All of the women interviewed acknowledged similar perceived benefits of a facility birth, which were a reduced risk of complications during pregnancy and access to emergency care. However, many women also reported unfavorable birthing experiences at facilities. We identified four key thematic concerns that underpinned women’s negative assessments of a facility birth: being left alone, feeling ignored, being subject to physical immobility, and lack of compassionate touch/care. Taken together, these concerns articulated an overarching sense of what we term “isolation,” which encompasses feelings of being isolated in the hospital during delivery.

Conclusion
Although Haitian women recognized that a facility was a safer place for birthing than the home, an overarching stigma of patient neglect and isolation in facilities was a major determining factor in choosing to deliver at home. The Haitian maternal mortality rate is high and will not be lowered if women continue to feel that they will not receive comfort and compassionate touch/care at a facility compared to their experience of delivering with traditional birth attendants at home. Based on these results, we recommend that all secondary and tertiary facilities offering labor and delivery services develop patient support programs, where women are better supported from admission through the labor and delivery process, including but not limited to improvements in communication, privacy, companionship (if deemed safe), respectful care, attention to pain during vaginal exams, and choice of birth position.
Structural parameters for X-ray micro-computed tomography (μCT) and their relationship with the breakage rate of maize varieties
Authors: Hou Junfeng , Zhang Ying , Jin Xiuliang , Dong Pengfei , Guo Yanan , Wang Keru , Fan Yinghu , Li Shaokun 
Published: December 2019

Abstract
Background
High grain breakage rate is the main limiting factor encountered in the mechanical harvest of maize grain. X-ray micro-computed tomography (μCT) scanning technology could be used to obtain the three-dimensional structure of maize grain. Currently, the effect of maize grain structure on the grain breakage rate, determined using X-ray μCT scanning technology, has not been reported. Therefore, the objectives of this study are: (i) to obtain the shape, geometry, and structural parameters related to the breakage rate using X-ray μCT scanning technology; (ii) to explore relationships between these parameters and grain breakage rate.

Result
In this study, 28 parameters were determined using X-ray μCT scanning technology. The maize breakage rate was mainly influenced by the grain specific surface area, subcutaneous cavity volume, sphericity, and density. In particular, the breakage rate was directly affected by the subcutaneous cavity volume and density. The maize variety with high density and low subcutaneous cavity volume had a low breakage rate. The specific surface area (r = 0.758*), embryo specific surface area (r = 0.927**), subcutaneous cavity volume ratio (0.581*), and subcutaneous cavity volume (0.589*) of maize grain significantly and positively correlated with breakage rate. The cavity specific surface area (− 0.628*) and grain density (− 0.934**) of maize grain significantly and negatively correlated with grain breakage rates. Grain shape (length, width, thickness, and aspect ratio) positively correlated with grain breakage rate but the correlation did not reach statistical significance. The susceptibility of grain breakage increased when kernel weight decreased (− 0.371), but the effect was not significant.

Conclusions
The results indicate that X-ray μCT scanning technology could be effectively used to evaluate maize grain breakage rate. X-ray μCT scanning technology provided a more precise and comprehensive acquisition method to evaluate the shape, geometry, and structure of maize grain. Thus, data gained by X-ray μCT can be used as a guideline for breeding resistant breakage maize varieties. Grain density and subcutaneous cavity volume are two of the most important factors affecting grain breakage rate. Grain density, in particular, plays a vital role in grain breakage and this parameter can be used to predict the breakage rate of maize varieties.
Retrospective analysis of fractionated intensity-modulated radiotherapy (IMRT) in the interdisciplinary management of primary optic nerve sheath meningiomas
Authors: Eckert Franziska , Clasen Kerstin , Kelbsch Carina , Tonagel Felix , Bender Benjamin , Tabatabai Ghazaleh , Zips Daniel , Thorwarth Daniela , Frey Bettina , Becker Gerd , Wilhelm Helmut , Paulsen Frank 
Published: December 2019

AbstractBackgroundAs optic nerve sheath meningiomas (ONSM) are rare, there are no prospective studies. Our retrospective analysis focusses on a cohort of patients with uniform disease characteristics all treated with the same radiotherapy regimen. We describe treatment decision making, radiotherapy planning and detailed neuro-ophthalmological outcome of the patients.Methods26 patients with unilateral ONSM extending only to the orbit and the optic canal were evaluated for neuro-ophthalmological outcome. Radiation treatment was planned in a simultaneous integrated boost approach to gross tumor volume (GTV) + 2 mm / 5 mm to 54 Gy / 51 Gy in 1.8 Gy / 1.7 Gy fractions. Follow-up was done by specialized neuro-ophthalmologists. Visual acuity and visual field defects were evaluated after therapy as well as during follow-up.ResultsInterdisciplinary treatment decision for patients with ONSM follows a rather complex decision tree. Radiation treatment planning (equivalent uniform dose (EUD), maximum dose to the optic nerve) improved with experience over time. With this patient selection visual acuity as well as visual field improved significantly at first follow-up after treatment. For visual acuity this also applied to patients with severe defects before treatment. Long term evaluation showed 16 patients with improved visual function, 6 were stable, in 4 patients visual function declined. Interdisciplinary case discussion rated the visual decline as radiation-associated in two patients.ConclusionsWith stringent patient selection radiotherapy for unilateral primary ONSM to 51 Gy / 54 Gy is safe and leads to significantly improved visual function. Interdisciplinary treatment decision and experience of the radiation oncology team play a major role.
Tape suture for stabilization of incomplete posterior pelvic ring fractures—biomechanical analysis of a new minimally invasive treatment for incomplete lateral compression pelvic ring fractures
Authors: Becker Christopher Alexander , Kussmaul Adrian Cavalcanti , Suero Eduardo Manuel , Regauer Markus , Woiczinski Matthias , Braun Christian , Flatz Wilhelm , Pieske Oliver , Kammerlander Christian , Boecker Wolfgang , Greiner Axel 
Published: December 2019

Abstract
Background
Incomplete lateral compression fractures (including AO Type B2.1) are among the most common pelvic ring injuries. Although the treatment of choice remains controversial, sacroiliac (SI) screws are commonly used for the operative treatment of incomplete lateral compression fractures of the pelvic ring. However, the disadvantages of SI screws include the risk of nerve root or blood vessel injury. Recently, tape sutures have been found useful as stabilizing material for the treatment of injuries of the syndesmosis, the rotator cuff and knee ligaments. In this current study, we aimed to test the biomechanical feasibility of tape sutures to stabilize the pelvis in the setting of AO Type B2.1 injury.

Methods
Six human cadaveric pelvises underwent cyclic loading to compare the biomechanical stability of different osteosynthesis methods in a B2.1 fracture model. The methods tested in this experiment were a FiberTape® suture and the currently established SI screw. A 3D ultrasound tracking system was used to measure fracture fragment motion. Linear regression was used to model displacement and stiffness at the posterior and anterior pelvic ring.

Results
At the posterior fracture site, the FiberTape® demonstrated similar displacement (2.2 ± 0.8 mm) and stiffness (52.2 ± 18.0 N/mm) compared to the sacroiliac screw (displacement 2.1 ± 0.6 mm, P >  0.999; stiffness 50.8 ± 13.0 N/mm, P > 0.999).
Considering the anterior fracture site, the FiberTape® again demonstrated similar displacement (3.8 ± 1.3 mm) and stiffness (29.5 ± 9.0 N/mm) compared to the sacroiliac screw (displacement 2.9 ± 0.8 mm, P = 0.2196; stiffness 37.5 ± 11.5 N/mm, P = 0.0711).

Conclusion
The newly presented osteosynthesis, the FiberTape®, shows promising results for the stabilization of the posterior pelvic ring in AO Type B2.1 lateral compression fractures compared to a sacroiliac screw osteosynthesis based on its minimal-invasiveness and the statistically similar biomechanical properties.
Plate-related results of opening wedge high tibial osteotomy with a carbon fiber reinforced poly-ether-ether-ketone (CF-PEEK) plate fixation: a retrospective case series of 346 knees
Authors: Hartz Claudia , Wischatta Ralph , Klostermeier Eckhardt , Paetzold Malte , Gerlach Klaus , Pries Frank 
Published: December 2019

AbstractBackgroundWhile open wedge high tibial osteotomy (owHTO) is an established standard procedure to treat medial osteoarthritis of the knee in combination with varus deformity, it bears the risk of postoperative hardware failures and lateral cortical hinge fractures. This in turn can lead to an accelerated osteoarthritis, non-union, or a loss of correction accuracy. The purpose of the study was to evaluate the radiologic outcomes of owHTO with a carbon fiber reinforced poly-ether-ether-ketone (CF-PEEK) plate fixation in patients with medial osteoarthritis and varus deformity.MethodsThree hundred twenty-four consecutive patients (346 knees) who were treated with owHTO using the PEEKPower HTO plate were included in this retrospective study; 89.9% of the patients were overweight or obese. Patients were followed by conventional radiographs over a 12-month period. Typical plate-related results such as the time and quality of gap healing as well as the correction accuracy were analyzed. Furthermore, the number of lateral cortex fractures was determined.ResultsBony consolidation was observed after a mean gap healing time of 4.0 ± 1.7 months independent on the patients’ weight (p = 0.2302). With increasing gap sizes, bony healing was significantly prolonged (p < 0.001). Additionally, patients with greater gap sizes had a significantly increased risk for a lateral cortex fracture (p = 0.0041). However, none of the patients had a non-union 1 year postoperative. A hinge fracture occurred in 30% of patients. Hinge fractures with Takeuchi grades I and II increased the gap healing time compared to no fracture (p = 0.0069 andp = 0.0002, respectively), but only 1.2% of patients with hinge fracture had a clinical relevant loss of correction ≥ 3 mm. No implant failures were found.ConclusionsOpen wedge HTO using the PEEKPower HTO plate for patients with medial osteoarthritis of the knee in combination with tibial varus deformity leads to excellent bony consolidation also in cases with a hinge fracture, a gap size > 12 mm as well as for severely obese patients.
Effect of hospital volume on outcomes of total hip arthroplasty: a systematic review and meta-analysis
Authors: Mufarrih Syed Hamza , Ghani Muhammad Owais Abdul , Martins Russell Seth , Qureshi Nada Qaisar , Mufarrih Sayyeda Aleena , Malik Azeem Tariq , Noordin Shahryar 
Published: December 2019

AbstractBackgroundA shift in the healthcare system towards the centralization of common yet costly surgeries, such as total hip arthroplasty (THA), to high-volume centers of excellence, is an attempt to control the economic burden while simultaneously enhancing patient outcomes. The “volume-outcome” relationship suggests that hospitals performing more treatment of a given type exhibit better outcomes than hospitals performing fewer. This theory has surfaced as an important factor in determining patient outcomes following THA. We performed a systematic review with meta-analyses to review the available evidence on the impact of hospital volume on outcomes of THA.Materials and methodsWe conducted a review of PubMed (MEDLINE), OVID MEDLINE, Google Scholar, and Cochrane library of studies reporting the impact of hospital volume on THA. The studies were evaluated as per the inclusion and exclusion criteria. A total of 44 studies were included in the review. We accessed pooled data using random-effect meta-analysis.ResultsResults of the meta-analyses show that low-volume hospitals were associated with a higher rate of surgical site infections (1.25 [1.01, 1.55]), longer length of stay (RR, 0.83[0.48–1.18]), increased cost of surgery (3.44, [2.57, 4.30]), 90-day complications (RR, 1.80[1.50–2.17]) and 30-day (RR, 2.33[1.27–4.28]), 90-day (RR, 1.26[1.05–1.51]), and 1-year mortality rates (RR, 2.26[1.32–3.88]) when compared to high-volume hospitals following THA. Except for two prospective studies, all were retrospective observational studies.ConclusionsThese findings demonstrate superior outcomes following THA in high-volume hospitals. Together with the reduced cost of the surgical procedure, fewer complications may contribute to saving considerable opportunity costs annually. However, a need to define objective volume-thresholds with stronger evidence would be required.Trial registrationPROSPEROCRD42019123776.