bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Radiographic Posterior Tibial Slope Is Associated With Subsequent Injury Following Revision Anterior Cruciate Ligament Reconstruction
Authors: Napier Richard J. , Garcia Enrique , Devitt Brian M. , Feller Julian A. , Webster Kate E. 
Published: November 2019

Background: Increased posterior tibial slope has been identified as a possible risk factor for injury to the anterior cruciate ligament (ACL) and has also been shown to be associated with ACL reconstruction graft failure. It is currently unknown whether increased posterior tibial slope is an additional risk factor for further injury in the context of revision ACL reconstruction. Purpose: To determine the relationship between posterior tibial slope and further ACL injury in patients who have already undergone revision ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 330 eligible patients who had undergone revision ACL reconstruction between January 2007 and December 2015 were identified from a clinical database. The slope of the medial and lateral tibial plateaus was measured on perioperative lateral radiographs by 2 fellowship-trained orthopaedic surgeons using a digital software application. The number of subsequent ACL injuries (graft rupture or a contralateral injury to the native ACL) was determined at a minimum follow-up of 2 years (range, 2-8 years). Tibial slope measurements were compared between patients who sustained further ACL injury to either knee and those who did not. Results: There were 50 patients who sustained a third ACL injury: 24 of these injuries were to the knee that underwent revision ACL reconstruction, and 26 were to the contralateral knee. Medial and lateral slope values were significantly greater for the third-injury group compared with the no–third injury group (medial, 7.5° vs 6.3° [ P = .01]; lateral, 13.6° vs 11.9° [ P = .001]). Conclusion: Increased posterior tibial slope, as measured from lateral knee radiographs, was associated with increased risk of graft rupture and contralateral ACL injury after revision ACL reconstruction. This is consistent with the concept that increased posterior slope, particularly of the lateral tibial plateau, is an important risk factor for recurrent ACL injury.
The Patient–Provider Continuum of Care: Narratives of People Living With Comorbid HIV and Diabetes in Northern Thailand
Authors: Moise Rhoda K , Srithanaviboonchai Kriengkrai , Alsolami Ali , Soares Mary H , Elewonibi Bilikisu Reni , Tolmasky Marcelo E , Wood Michele M 
Published: November 2019

Background: Among South-East Asia Region countries, Thailand has a high prevalence of HIV with an increasing significant comorbidity of diabetes mellitus (DM). Objective: Guided by syndemics, the purpose of this qualitative study is to develop insight into the experience of patients living with comorbid HIV and DM in Northern Thailand for quality improvement. Methods: Interviews were conducted in 2 groups for content analysis: (1) people living with comorbid HIV and DM and (2) health-care staff providing care to patients living with the comorbidity. Results: Participants’ (N = 12) ages ranged from 42 to 56 (mean = 49). Health staff (N = 12) generated complementary narratives. All participants reported onset of diabetes after discovering they were HIV infected. Content analysis revealed emergent themes regarding (1) knowledge and perceptions and (2) management framed by syndemics and chronicity. Conclusion: Findings suggest routine training for patient education and provider integration of care. Macrosocial factors such as limited access and resources and biological factor such as drug interactions are noted as key considerations for future interventions and alterations in the care for patients with comorbid HIV and DM.
Headaches in the emergency department –a survey of patients’ characteristics, facts and needs
Authors:   on behalf of the School of Advanced Studies of the European Headache Federation (EHF-SAS), Doretti Alberto , Shestaritc Irina , Ungaro Daniela , Lee John-Ih , Lymperopoulos Loukas , Kokoti Lili , Guglielmetti Martina , Mitsikostas Dimos Dimitrios , Lampl Christian 
Published: November 2019

Abstract

Background and aim
Headache is very often the cause for seeking an emergency department (ED). However, less is known about the different diagnosis of headache disorders in the ED, their management and treatment. The aim of this survey is to analyse the management of headache patients in two different ED in Europe.

Methods
This retrospective survey was performed from September 2018 until January 2019. Patients were collected from the San Luca Hospital, Milan, Italy and the Ordensklinikum Barmherzige Schwestern, Linz, Austria. Only patients with a non-traumatic headache, as the primary reason for medical clarification, were included. Patients were analysed for their complexity and range of examination, their diagnoses, acute treatment and overall efficacy rate.

Results
The survey consists of 415 patients, with a mean age of 43.32 (SD ±17.72); 65% were female. Technical investigation was performed in 57.8% of patients. For acute treatment non-steroidal-anti-inflammatory drugs (NSAIDs) were the most used, whereas triptans were not given. A primary headache disorder was diagnosed in 45.3% of patients, being migraine the most common, but in 32% of cases the diagnosis was not further specified. Life-threatening secondary headaches accounted for less than 2% of cases.

Conclusions
The vast majority of patients attending an ED because of headache are suffering from a primary headache disorder. Life-threatening secondary headaches are rare but seek attention. NSAIDs are by far the most common drugs for treating headaches in the ED, but not triptans.
The role of Acinetobacter baumannii response regulator BfmR in pellicle formation and competitiveness via contact-dependent inhibition system
Authors: Krasauskas Renatas , Skerniškytė Jūratė , Armalytė Julija , Sužiedėlienė Edita 
Published: November 2019

Abstract

Background
Acinetobacter baumannii is one of the most important opportunistic pathogens responsible for hospital acquired infections. It displays multi-drug resistance profile and has the ability to colonize surfaces and persist under harsh conditions. A. baumannii two-component signal transduction system BfmRS, consisting of response regulator BfmR and sensor kinase BfmS, has been implicated in the control of various virulence-related traits and has been suggested to act as a global modulator of A. baumannii physiology.

Results
Here, we assessed the role of BfmR regulator in pellicle formation and bacterial competition, features important for the establishment of A. baumannii in clinical environment. We show that BfmR is required for the pellicle formation of A. baumannii, as ΔbfmRS mutant lacked this phenotype. The loss of bfmRS also greatly reduced the secretion of A. baumannii Hcp protein, which is a component of T6SS secretion system. However, T6SS-mediated killing phenotype was not impaired in ΔbfmRS mutant. On the contrary, the same mutation resulted in the transcriptional activation of contact-dependent inhibition (CDI) system, which A. baumannii used to inhibit the growth of another clinical A. baumannii strain and a closely related species Acinetobacter baylyi.

Conclusions
The obtained results indicate that BfmR is not only required for the pellicle phenotype induction in A. baumannii, but also, due to the down-regulation of a CDI system, could allow the incorporation of other A. baumannii strains or related species, possibly increasing the likelihood of the pathogens’ survival.
Activation and function of receptor tyrosine kinases in human clear cell renal cell carcinomas
Authors: Zhang Qing , Liu Jian-He , Liu Jing-Li , Qi Chun-Ting , Yan Lei , Chen Yu , Yu Qiang 
Published: November 2019

Abstract

Background
The receptor tyrosine kinases (RTKs) play critical roles in the development of cancers. Clear cell renal cell carcinoma (ccRCC) accounts for 75% of the RCC. The previous studies on the RTKs in ccRCCs mainly focused on their gene expressions. The activation and function of the RTKs in ccRCC have not been fully investigated.

Methods
In the present study, we analyzed the phosphorylation patterns of RTKs in human ccRCC patient samples, human ccRCC and papillary RCC cell lines, and other kidney tumor samples using human phospho-RTK arrays. We further established ccRCC patient-derived xenograft models in nude mice and assessed the effects of RTKIs (RTK Inhibitors) on the growth of these cancer cells. Immunofluorescence staining was used to detect the localization of keratin, vimentin and PDGFRβ in ccRCCs.

Results
We found that the RTK phosphorylation patterns of the ccRCC samples were all very similar, but different from that of the cell lines, other kidney tumor samples, as well as the adjacent normal tissues. 9 RTKs, EGFR1–3, Insulin R, PDGFRβ, VEGFR1, VEGFR2, HGFR and M-CSFR were found to be phosphorylated in the ccRCC samples. The adjacent normal tissues, on the other hand, had predominantly only two of the 4 EGFR family members, EGFR and ErbB4, phosphorylated. What’s more, the RTK phosphorylation pattern of the xenograft, however, was different from that of the primary tissue samples. Treatment of the xenograft nude mice with corresponding RTK inhibitors effectively inhibited the Erk1/2 signaling pathway as well as the growth of the tumors. In addition, histological staining of the cancer samples revealed that most of the PDGFRβ expressing cells were localized in the vimentin-positive periepithelial stroma.

Conclusions
Overall, we have identified a set of RTKs that are characteristically phosphorylated in ccRCCs. The phosphorylation of RTKs in ccRCCs were determined by the growing environments. These phosphorylated/activated RTKs will guide targeting drugs development of more effective therapies in ccRCCs. The synergistical inhibition of RTKIs combination on the ccRCC suggest a novel strategy to use a combination of RTKIs to treat ccRCCs.
The prognostic association of SPAG5 gene expression in breast cancer patients with systematic therapy
Authors: Zhu Chenjing , Menyhart Otilia , Győrffy Balázs , He Xia 
Published: November 2019

Abstract

Background
Despite much effort on the treatment of breast cancer over the decades, a great uncertainty regarding the appropriate molecular biomarkers and optimal therapeutic strategy still exists. This research was performed to analyze the association of SPAG5 gene expression with clinicopathological factors and survival outcomes.

Methods
We used a breast cancer database including 5667 patients with a mean follow-up of 69 months. Kaplan-Meier survival analyses for relapse free survival (RFS), overall survival (OS), and distant metastasis-free survival (DMFS) were performed. In addition, ROC analysis was performed to validate SPAG5 as a prognostic candidate gene.

Results
Mean SPAG5 expression value was significantly higher with some clinicopathological factors that resulted in tumor promotion and progression, including poor differentiated type, HER2 positive or TP53 mutated breast cancer. Based on ROC-analysis SPAG 5 is a suitable prognostic marker of poor survival. In patients who received chemotherapy alone, SPAG5 had only a moderate and not significant predictive impact on survival outcomes. However, in hormonal therapy, high SPAG5 expression could strongly predict prognosis with detrimental RFS (HR = 1.57, 95% CI 1.2–2.06, p = 0.001), OS (HR = 2, 95% CI 1.05–3.8, p = 0.03) and DMFS (HR = 2.36, 95% CI 1.57–3.54, p <  0.001), respectively. In addition, SPAG5 could only serve as a survival predictor in ER+, but not ER- breast cancer patients. Patients might also be at an increased risk of relapse despite being diagnosed with a lower grade cancer (well differentiated type).

Conclusions
SPAG5 could be used as an independent prognostic and predictive biomarker that might have clinical utility, especially in ER+ breast cancer patients who received hormonal therapy.
Effect of mild hypothermia on lung injury after cardiac arrest in swine based on lung ultrasound
Authors: Wu Chunshuang , Xu Jiefeng , Jin Xiaohong , Chen Qijiang , Li Zilong , Zhang Mao 
Published: November 2019

AbstractBackgroundLung injury is common in post-cardiac arrest syndrome, and is associated with increased morbidity and mortality. The aim of this study was to evaluate the effect of mild hypothermia on lung injury after cardiac arrest in swine based on lung ultrasound.MethodsTwenty-three male domestic swine weighing 36 ± 2 kg were randomly assigned to three groups: therapeutic hypothermia (TH,n = 9), normothermia (NT,n = 9), and sham control (control,n = 5) groups. Sham animals only underwent surgical preparation. The animal model was established with 8 min of ventricular fibrillation followed by 5 min of cardiopulmonary resuscitation. Therapeutic hypothermia was induced and maintained until 24 h post-resuscitation in the TH group by surface blanket cooling, followed by rewarming at a rate of 1 °C/h for 5 h. The extravascular lung water index (ELWI), pulmonary vascular permeability index (PVPI), PO2/FiO2, and lung ultrasound score (LUS) were measured at baseline and at 1, 3, 6, 12, 24, and 30 h after resuscitation. After euthanizing the swine, their lung tissues were quickly obtained to evaluate inflammation.ResultsAfter resuscitation, ELWI and PVPI in the NT group were higher, and PO2/FiO2was lower, than in the sham group. However, those measures were significantly better in the TH group than the NT group. The LUS was higher in the NT group than in the sham group at 1, 3, 6, 12, 24, and 30 h after resuscitation. The LUS was significantly better in the TH group compared to the NT group. The lung tissue biopsy revealed that lung injury was more severe in the NT group than in the TH group. Increases in LUS were highly correlated with increases in ELWI (r = 0.613;p < 0.001) and PVPI (r = 0.683;p < 0.001), and decreases in PO2/FiO2(r = − 0.468;p < 0.001).ConclusionsMild hypothermia protected against post-resuscitation lung injury in a swine model of cardiac arrest. Lung ultrasound was useful to dynamically evaluate the role of TH in lung protection.
Compression therapy following posterior lumbar interbody fusion: a prospective, randomized, clinical study
Authors: Sun Wu , Gao Jing-hua , Zhu Li-guo , Xiao Wei , Wang Zhen-zhong , Yang Ke-xin , Zhang Qing , Wang Bao-jian 
Published: November 2019

AbstractBackgroundWound-related complications are an inevitable issue faced by spinal surgeons. Negative pressure drainage remains the most commonly used method to prevent postoperative hematoma and related complications. This prospective, randomized, controlled study was conducted to evaluate the efficacy of compression therapy following posterior lumbar interbody fusion, with emphasis on pain, anemia, and inflammation.MethodsSixty consecutive patients who have undergone posterior lumbar interbody fusion in the age range 43–78 years, with an average age of 59 years, were selected and randomly assigned into two groups. Factors, such as drainage volume, visual analog scale (VAS) pain score for back pain, white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (Hb) levels, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels assessed on the 1st, 3rd, and 10th days postoperatively, were compared between the two groups.ResultsThe average follow-up was 6 months, ranging from 3 to 11 months. Drainage volume, VAS score, and CRP levels on the 10th day after the surgery were found to be significantly lower in the treatment group than in the control group. RBC count and Hb levels on the 3rd and 10th postoperative days were observed to be significantly higher in the treatment group than in the control group (P < 0.05). During discharge, the wounds of the patients of the both groups had healed and neither showed any symptoms of infection, hematoma, or necrosis.ConclusionCompression therapy relieves pain, alleviates anemia, and the inflammatory response following posterior lumbar interbody fusion.Trial registrationChiCTR1800015825on chictr.org.cn, April 23, 2018, the trial registry is Chinese Clinical Trial Registry.
Parents’ experiences of an e-health intervention implemented in pediatric healthcare: a qualitative study
Authors: Larsson Ingrid , Svedberg Petra , Arvidsson Susann , Nygren Jens M. , Carlsson Ing-Marie 
Published: November 2019

Abstract

Background
The growing field of participation in healthcare has the potential to provide a number of benefits for children, patients, healthcare professionals and also the healthcare systems. According to the Convention on the Rights of the Child (UNCRC), children have the right to participate in their own healthcare and make their voice heard. Children’s opportunities for understanding their conditions, sharing their views and participating in decisions regarding their care depend on healthcare professionals but also on parents’ ability to communicate and include children. E-health solutions can remove barriers to children’s communication with healthcare professionals. The aim of this study was to explore parents’ perspectives on the outcomes of an e-health solution, Sisom, used by children during healthcare appointments.

Methods
The empirical data is based on interviews with 16 parents. In the present study constructivist, grounded theory was chosen as the method.

Results
The theory of enhancing participation, by orientating communication about healthcare towards the voice of the child instead of the parents, summarizes the process of how the outcome of Sisom for children lead to enhanced participation, by making the child the main actor and an agent in his/her own healthcare. The facilitators for achieving participation in Sisom were four interrelated outcomes; engaging, voice-guarding, raising awareness and integrity preserving. In addition to generating increased participation, it emerged that the use of Sisom also initiated a process, which was evident in all four subcategories that facilitated the child in coping with the experience of having an illness.

Conclusions
We conclude, that Sisom orientated communication about healthcare towards the voice of the child instead of the parents as well as including the child in the dialogue with the healthcare professional and thus increasing the child’s participation and human rights.
Relationships between the antral follicle count, steroidogenesis, and secretion of follicle-stimulating hormone and anti-Müllerian hormone during follicular growth in cattle
Authors: Sakaguchi Kenichiro , Yanagawa Yojiro , Yoshioka Koji , Suda Tomoko , Katagiri Seiji , Nagano Masashi 
Published: November 2019

Abstract

Background
The antral follicle count (AFC) in mammalian ovaries positively correlates with female fertility. To clarify the causes of differences in fertility between low and high AFC cows, we investigated follicular growth dynamics and hormone concentrations in plasma, follicular fluid, and in vitro growth (IVG) media at different stages of follicular growth.

Methods
Seven cows were divided into high AFC (n = 4, > 30 follicles) and low AFC (n = 3, < 30 follicles) groups based on the peak AFC detected by ultrasonography. These cows were subjected to estrous synchronization, daily ovarian ultrasonography, and blood collection. Their follicular fluid was collected from dominant follicles at different stages (selection, luteal, and ovulatory phases). In another experiment, we cultured oocyte-cumulus-granulosa cell complexes collected from early antral follicles (< 1 mm) for 12 days. Estradiol-17β (E2), testosterone (T), progesterone (P4), and anti-Müllerian hormone (AMH) concentrations in follicular fluids and plasma were measured. Plasma follicle-stimulating hormone (FSH) concentrations were examined. E2, P4, and AMH concentrations were also measured in IVG media.

Results
The numbers of small (< 4 mm) and intermediate (4–8 mm) follicles were larger in the high AFC group than in the low AFC group (P < 0.05). The number of intermediate follicles was stable in the low AFC group, indicating consistent development. However, the number of these follicles fluctuated in the high AFC group. Plasma FSH concentrations were higher, whereas E2 and T concentrations were lower in the low AFC group (P < 0.05). E2 concentrations and the E2/P4 ratio in ovulatory follicles and IVG media on day 8 were higher in the high AFC group (P < 0.05). AMH concentrations in plasma and IVG media (P < 0.01) were higher in the high AFC group.

Conclusions
The weaker response to FSH of granulosa cells caused low E2 production in the low AFC group, resulting in high FSH concentrations and the consistent development of intermediate follicles. Conversely, higher E2 concentrations suppressed FSH secretion in the high AFC group. Granulosa cells in the high AFC group had the ability to produce more AMH than those in the low AFC group throughout IVG culture.
Associations of plasma high-sensitivity C-reactive protein concentrations with all-cause and cause-specific mortality among middle-aged and elderly individuals
Authors: Li Zhi-Hao , Zhong Wen-Fang , Lv Yue-Bin , Kraus Virginia Byers , Gao Xiang , Chen Pei-Liang , Huang Qing-Mei , Ni Jin-Dong , Shi Xiao-Ming , Mao Chen , Wu Xian-Bo 
Published: November 2019

Abstract

Background
The association of high-sensitivity C-reactive protein (hsCRP) with mortality is controversial. We aimed to investigate the associations of hsCRP concentrations with the risks of all-cause and cause-specific mortality and identify potential modifying factors affecting these associations among middle-aged and elderly individuals.

Methods
This community-based prospective cohort study included 14,220 participants aged 50+ years (mean age: 64.9 years) from the Health and Retirement Study. Cox proportional hazard models were employed to estimate the associations between the hsCRP concentrations and the risk of all-cause and cause-specific mortality with adjustment for sociodemographic and lifestyle factors, self-reported medical history, and other potential confounders.

Results
In total, 1730 all-cause deaths were recorded, including 725 cardiovascular- and 417 cancer-related deaths, after an 80,572 person-year follow-up (median: 6.4 years; range: 3.6–8.1 years). The comparisons of the groups with the highest (quartile 4) and lowest (quartile 1) hsCRP concentrations revealed that the adjusted hazard ratios and 95% confidence intervals were 1.50 (1.31–1.72) for all-cause mortality, 1.44 (1.13–1.82) for cardiovascular mortality, and 1.67 (1.23–2.26) for cancer mortality. The associations between high hsCRP concentrations and the risks of all-cause, cardiovascular, and cancer mortality were similar in the men and women (P for interaction > 0.05).

Conclusions
Among middle-aged and older individuals, elevated hsCRP concentration could increase the risk of all-cause, cardiovascular, and cancer mortality in men and women.