bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ten-Year Results of the Press Fit Condylar Sigma Cobalt–Chrome Total Knee Replacement
Authors: Brenkel Ivan , Walmsley Phil , Keenan Oisin 
Published: April 2018

AbstractTotal knee arthroplasty (TKA) is reliant on safe and effective implants. The Press Fit Condylar Sigma Cobalt–Chrome (PFCSCC) was introduced in 2006, but no reports have examined long-term failure rates and patient-reported outcome measures (PROMs). The primary aim of this study was to assess survival outcomes of the PFCSCC at 10 years after implantation. Prospective data collection was performed on all patients undergoing primary TKA in one orthopaedic department using this prosthesis exclusively from February 1, 2006, to January 31, 2007. Follow-up was at 10 years. Survival analysis was performed using two primary outcome measures: (1) all-cause joint revision and (2) aseptic revision. Secondary outcomes measures included the American Knee Society Score (AKSS) and Oxford Knee Score (OKS). In total, 249 knees of 233 patients underwent primary TKA. Mean patient age was 66.7 years (range 34–80), and mean body mass index (BMI) was 30 kg/m2 (20.7–40.1). Reviewing all causes of revisions, 14 joints (5.6%) of 14 patients required reoperation. Of these, nine were for deep infection, including six in the first year. Four (1.6%) underwent aseptic revision. Mean AKSS changed from 47.6 to 90.4 (n = 140; p < 0.001) at 10 years, and mean OKS changed from 38.3 to 23.2 (n = 149; p < 0.001). Prospective analysis of consecutive TKA cases using this design of prosthesis demonstrated high survival rates of 94.4% (all-cause revision) and 98.4% (aseptic revision) at 10 years. Postoperative gains in PROMs were sustained at 10 years. These real-world data represent a substantial extension to previous reports for the PFCSCC and suggest that it is not prone to late mechanical failure.
Achieving Minimum Clinically Important Difference in Oxford Knee Score and Short Form-36 Physical Component Summary Is Less Likely with Single-Radius Compared with Multiradius Total Knee Arthroplasty in Asians
Authors: Bin Abd Razak Hamid , Allen John , Chong Hwei Chi , Tan Hwee Chye , Lee Wu Chean 
Published: April 2018

AbstractSingle-radius (SR) and multiradius (MR) total knee arthroplasties (TKAs) have produced similar outcomes, albeit most studies originate from Western nations. There are known knee kinematic differences between Western and Asian patients after TKA. The aim of this study is to compare the short-term patient-reported outcome measures (PROMs) of SR-TKA versus MR-TKA in Asians. Registry data of 133 SR-TKA versus 363 MR-TKA by a single surgeon were analyzed. Preoperative and 2-year postoperative range of motion (ROM) and PROMs were compared with Student's t-test and Mann–Whitney U-test. Logistic regression model was used to evaluate the odds of SR-TKA or MR-TKA achieving the minimum clinically important difference (MCID) of studied outcomes. Patients in both groups had similar age (65.7 ± 7.6 vs. 65.8 ± 8.2 years; p = 0.317), gender proportion (71% females vs. 79% females; p = 0.119), and ethnic distribution (80% Chinese vs. 84% Chinese; p = 0.258). Preoperatively, there were no statistically significant differences between both groups for ROM, Knee Society Score (KSS), Oxford Knee Score (OKS), and Short Form (SF)-36 scores. At 2 years, all outcomes were statistically similar or failed to achieve a difference of MCID. Controlling for all preoperative variables, SR-TKA has significantly lower odds of achieving MCID for OKS (odds ratio [OR]: 0.275, 95% confidence interval [CI]: 0.114–0.663; p = 0.004) and SF-36 Physical Component Summary (PCS) (OR: 0.547; 95% CI: 0.316–0.946; p = 0.031) compared with MR-TKA. In conclusion, there are no significant differences in the absolute PROMs between SR-TKA and MR-TKA at 2 years following TKA in Asians. However, SR-TKA has significantly lower odds of achieving the MCID for OKS and SF-36 PCS.
Colgajo perforante de la segunda arteria metacarpiana dorsal: Estudio anatómico en cadáveres y experiencia clínica
Authors: Posso Z Carolina , Delgado A David , Aguilar H Jeison , Vélez R Daniel , Velásquez Juan 
Published: April 2018

Introducción Los defectos de cobertura de la mano y de los dedos de tamaño moderado son frecuentes y representan un reto para el cirujano reconstructivo. Existen varias opciones locales disponibles, y el conocimiento de la anatomía vascular de la zona nos ofrece nuevas posibilidades de cobertura.
Material y métodos Se realizó un estudio anatómico en 13 extremidades de cadáveres frescos, describiendo las perforantes cutáneas en el tercio distal de la segunda arteria metacarpiana dorsal. Se presenta adicionalmente nuestra experiencia clínica inicial con el uso del colgajo perforante metacarpiano dorsal en siete casos.
Resultados De forma consistente se encontró en todos los cadáveres la presencia de perforantes distales, y la ausencia de la juntura tendinae, lo que obliga a usar la cabeza del metacarpiano como límite para el punto pivote del colgajo en nuestra población, a diferencia de las descripciones anatómicas previas. En la serie de casos clínicos, el colgajo logró resolver adecuadamente todos los defectos, y se presentó solo un caso de necrosis parcial.
Conclusión Luego del seguimiento de los casos clínicos reconstruidos con ese colgajo, se evidencia su versatilidad, anatomía vascular confiable y baja tasa de complicaciones, convirtiéndolo en una opción de primera línea para la cobertura de defectos digitales.
A Virtual Reality Cataract Surgery Course for Residents
Authors: Paul Samantha , Scott Ingrid , Paul Alfred , Greenberg Paul 
Published: April 2018

AbstractWe report on two key updates to the publically available Brown ophthalmology residency virtual reality (VR) cataract surgery course. The first is a validated proficiency-based VR simulator test. The second is a mental skills training curriculum derived from a course shown to decrease novice general surgeons' cognitive stress under difficult performance conditions.
Interobserver Variability of the Diagnosis of Scaphoid Proximal Pole Fractures
Authors: Beks Reinier , Drijkoningen Tessa , Claessen Femke , Guitton Thierry , Ring David ,   Science of Variation Group
Published: April 2018

Purpose Fractures of the proximal pole of the scaphoid are prone to adverse outcomes such as nonunion and avascular necrosis. Distinction of scaphoid proximal pole fractures from waist fractures is important for management but it is unclear if the distinction is reliable.
Methods A consecutive series of 29 scaphoid fractures from one tertiary hospital was collected consisting of 5 scaphoid proximal pole and 24 scaphoid waist fractures. Fifty-seven members of the Science of Variation Group (SOVG) were randomized to diagnose fracture location and displacement by using radiographs alone or radiographs and a computed tomography (CT) scan.
Results Observers reviewing radiographs alone and observers reviewing radiographs and CT scans both had substantial agreement on fracture location (κ = 0.82 and κ = 0.80, respectively; p = 0.54). Both groups had only fair agreement on fracture displacement (κ = 0.28 and κ = 0.35, respectively; p = 0.029).
Conclusion Proximal pole fractures are sufficiently distinct from proximal waist fractures that CT does not improve reliability of diagnosis.
Level of Evidence Level IV interobserver reliability case-control study.
Might Bilirubin Serve as a Natural Antioxidant in Response to Neonatal Encephalopathy?
Authors: Bin-Nun Alona , Mimouni Francis , Kasirer Yair , Schors Irina , Schimmel Michael , Kaplan Michael , Hammerman Cathy 
Published: April 2018

Background Neonatal asphyxia is often associated with hepatic injury. We hypothesized that this might lead to increased bilirubin concentrations.
Study Design Term neonates admitted between January 2015 and April 2017 who remained hospitalized for ≥ 4 days and who had serial serum bilirubin concentrations recorded were divided into those with neonatal encephalopathy (NE) and controls. Serial serum bilirubin concentrations during the first days of life were compared between groups.
Results Twenty-nine neonates with NE and 84 age-matched controls were identified. Mean total serum bilirubin concentrations of NE babies were significantly lower than those controls throughout the first days of life. At 96 hours of age, NE serum bilirubin concentrations were 4.5 (3.2, 5.8) versus controls of 10.5 (9.4, 11.5) mg/dL (p < 0.0001). The mean area under the curve (AUC) for the NE group was 268 (215, 321) versus 663 (608, 718), p < 0.0001, for the control group. All of the NE babies remained below the 40th percentile of the Bhutani curve and none required phototherapy.
Conclusion Contrary to our hypothesis, bilirubin concentrations in NE infants are significantly lower than expected during the first 4 days postnatally. We speculate that, under conditions of severe oxidative stress, bilirubin is consumed as an antioxidant.
Laryngopharyngealer Reflux
Authors: Reiter Rudolf , Heyduck Adrienne , Seufferlein Thomas , Hoffmann Thomas , Pickhard Anja 
Published: April 2018

ZusammenfassungDie Prävalenz von laryngopharyngealem Reflux (LPR) wird in der Allgemeinbevölkerung mit bis zu 31 % angegeben. Bei Patienten mit Stimmproblemen bzw.
Kehlkopferkrankungen tritt ein LPR bei ca. 50 % der Patienten als Begleiterscheinung auf. Typische refluxbedingte Erkrankungen am Larynx sind eine chronische
Laryngitis und das Kontaktgranulom. Nicht abschließend geklärt ist die Rolle des LPR bei der Genese des Stimmlippenkarzinoms. Für die Diagnose des LPR gibt es
noch keine evidenzbasierten Daten, er kann jedoch üblicherweise klinisch aus der Kombination typischer Symptome (Heiserkeit, chronischer Hustenreiz/Räuspern,
Globusgefühl/Dysphagie) und dem charakteristischen laryngoskopischen Bild (ein Schleimhauterythem bzw. eine Schleimhauthyperplasie mit Fältelung der
Interarytenoidregion und ein Stimmlippenödem) gestellt werden. Gelegentlich wird eine LPR zusätzlich durch eine pharyngeale 24h-pH-Metrie-Untersuchung
gesichert. Die Therapie des LPR umfasst mehrere Bereiche, wie z.B. diätetische Maßnahmen, die medikamentöse Therapie mit Protonenpumpeninhibitoren (PPIs) und
ggf. eine chirurgische Intervention. Bei symptomatischen Patienten erfolgt oft eine Therapie mit PPIs, bei der der HNO-Arzt im engen Dialog mit dem
Gastroenterologen steht.
Small Hydropower Development in Rwanda: Trends, Opportunities and Challenges
Authors: Geoffrey Gasore , Zimmerle Daniel , Ntagwirumugara Etienne 
Published: April 2018

Abstract
The Rift Valley region of Sub-Saharan Africa represents a promising area for the development of small (<5MW) hydropower resources. This study compiles data from government and UN agency reports to analyze different development outlooks. The study found that there has been a rapid deployment of small hydropower in the last 10 years. From the current total deployed small hydro of 47.5 MW, 16.5MW (35%) were deployed from 1957 to 1984 while the remaining 31 MW (65%) were deployed from 2007 to 2017. While all systems constructed prior to 1985 are grid-connected, one third of the 24 facilities constructed after 2007 are connected to off-grid systems. The study provides an overview of the economic incentives for developing small hydropower systems in Rwanda and the potential contribution of that development to Rwanda’s electrification goals.
Chiron: translating nanopore raw signal directly into nucleotide sequence using deep learning
Authors: Teng Haotian , Cao Minh Duc , Hall Michael B , Duarte Tania , Wang Sheng , Coin Lachlan J M 
Published: April 2018

Abstract
Sequencing by translocating DNA fragments through an array of nanopores is a rapidly maturing technology that offers faster and cheaper sequencing than other approaches. However, accurately deciphering the DNA sequence from the noisy and complex electrical signal is challenging. Here, we report Chiron, the first deep learning model to achieve end-to-end basecalling and directly translate the raw signal to DNA sequence without the error-prone segmentation step. Trained with only a small set of 4,000 reads, we show that our model provides state-of-the-art basecalling accuracy, even on previously unseen species. Chiron achieves basecalling speeds of more than 2,000 bases per second using desktop computer graphics processing units.
A hyperactivating proinflammatory RIPK2 allele associated with early-onset osteoarthritis
Authors: Jurynec Michael J , Sawitzke Allen D , Beals Timothy C , Redd Michael J , Stevens Jeff , Otterud Brith , Leppert Mark F , Grunwald David Jonah 
Published: April 2018

Abstract
Osteoarthritis (OA) is a common debilitating disease characterized by abnormal remodeling of the cartilage and bone of the articular joint. Ameliorating therapeutics are lacking due to limited understanding of the molecular pathways affecting disease initiation and progression. Notably, although a link between inflammation and overt OA is well established, the role of inflammation as a driver of disease occurrence is highly disputed. We analyzed a family with dominant inheritance of early-onset OA and found that affected individuals harbored a rare variant allele encoding a significant amino acid change (p.Asn104Asp) in the kinase domain of receptor interacting protein kinase 2 (RIPK2), which transduces signals from activated bacterial peptidoglycan sensors through the NF-κB pathway to generate a proinflammatory immune response. Functional analyses of RIPK2 activity in zebrafish embryos indicated that the variant RIPK2104Asp protein is hyperactive in its signaling capacity, with augmented ability to activate the innate immune response and the NF-κB pathway and to promote upregulation of OA-associated genes. Further we show a second allele of RIPK2 linked to an inflammatory disease associated with arthritis also has enhanced activity stimulating the NF-κB pathway. Our studies reveal for the first time the inflammatory response can function as a gatekeeper risk factor for OA.
Rethinking the outpatient medication list: increasing patient activation and education while architecting for centralization and improved medication reconciliation
Authors: Pandolfe Frank , Wright Adam , Slack Warner V , Safran Charles 
Published: April 2018

AbstractObjectiveIdentify barriers impacting the time consuming and error fraught process of medication reconciliation. Design and implement an electronic medication management system where patient and trusted healthcare proxies can participate in establishing and maintaining an inclusive and up-to-date list of medications.MethodsA patient-facing electronic medication manager was deployed within an existing research project focused on elder care management funded by the AHRQ, InfoSAGE, allowing patients and patients’ proxies the ability to build and maintain an accurate and up-to-date medication list. Free and open-source tools available from the U.S. government were used to embed the tenets of centralization, interoperability, data federation, and patient activation into the design.ResultsUsing patient-centered design and free, open-source tools, we implemented a web and mobile enabled patient-facing medication manager for complex medication management.ConclusionsPatient and caregiver participation are essential to improve medication safety. Our medication manager is an early step towards a patient-facing medication manager that has been designed with data federation and interoperability in mind.
Cost Transparency in Neurosurgery: A Single-Institution Analysis of Patient Out-of-Pocket Spending in 13 673 Consecutive Neurosurgery Cases
Authors: Mooney Michael A , Yoon Seungwon , Cole Tyler , Sheehy John P , Bohl Michael A , Barranco F David , Nakaji Peter , Little Andrew S , Lawton Michael T 
Published: April 2018

Abstract

BACKGROUND
Patient out-of-pocket (OOP) spending is an increasingly discussed topic; however, there is minimal data available on the patient financial burden of surgical procedures.

OBJECTIVE
To analyze hospital and surgeon expected payment data and patient OOP spending in neurosurgery.

METHODS
This is a retrospective cohort study of neurosurgical patients at a tertiary-referral center from 2013 to 2016. Expected payments, reflecting negotiated costs-of-care, as well as actual patient OOP payments for hospital care and surgeon professional fees were analyzed. A 4-tiered model of patient OOP cost sharing and a multivariate model of patient expected payments were created.

RESULTS
A total of 13 673 consecutive neurosurgical cases were analyzed. Patient age, insurance type, case category, severity of illness, length of stay (LOS), and elective case status were significant predictors of increased expected payments (P < .05). Craniotomy ($53 397 ± 811) and posterior spinal fusion ($48 329 ± 864) were associated with the highest expected payments. In a model of patient OOP cost sharing, nearly all neurosurgical procedures exceeded yearly OOP maximums for Healthcare Marketplace plans. Mean patient payments for hospital care and surgeon professional fees were the highest for anterior/lateral spinal fusion cases for commercially insured patients ($1662 ± 165). Mean expected payments and mean patient payments for commercially insured patients increased significantly from 2013 to 2016 (P < .05).

CONCLUSION
Expected payments and patient OOP spending for commercially insured patients significantly increased from 2013 to 2016, representing increased healthcare costs and patient cost sharing in an evolving healthcare environment. Patients and providers can consider this information prior to surgery to better anticipate the individual financial burden for neurosurgical care.
Petrosal Meningiomas: Factors Affecting Outcome and the Role of Intraoperative Multimodal Assistance to Microsurgery
Authors: Tomasello Francesco , Angileri Filippo Flavio , Conti Alfredo , Scibilia Antonino , Cardali Salvatore , La Torre Domenico , Germanò Antonino 
Published: April 2018

Abstract

BACKGROUND
Petrous meningiomas (PMs) represent a subset of posterior fossa tumors accounting for ∼8% of all intracranial meningiomas. Surgical treatment of PMs is challenging because of their relationships with vital neurovascular structures of the cerebellopontine angle.

OBJECTIVE
To investigate independent pre- and intraoperative predictors of PM surgery outcome.

METHODS
We reviewed the surgical and outcome data of patients who underwent microsurgical resection of PMs from 1997 to 2016. From 2007 onward, a multimodal intraoperative protocol consisting of intraoperative neuromonitoring (IONM), endoscopy, and indocyanine green (ICG) videoangiography was applied. Outcome variables included extent of resection, Karnofsky performance status (KPS), overall survival, and progression-free survival (PFS).

RESULTS
A total of 54 patients were included. Independent predictors of gross total resection (GTR) included retromeatal location (P < .0175; odds ratio [OR] 4.05), absence of brainstem compression (P < .02; OR 3.55), and histological WHO grade I (P < .001; OR 3.47). Nongiant size (P < .012; OR 4.38), and WHO grade I (P < .0001; OR 7.7) were independent predictors of stable or improved KPS. The use of multimodal intraoperative tools to assist surgery independently predicted GTR (P < .002; OR 6.8) and good KPS (P < .018; OR 4.23). Nongiant size (P = .01) and WHO grade I (P = .002) were significantly associated with increased PFS.

CONCLUSION
Notwithstanding the limitations of a retrospective study, our results suggest that support of microsurgery by a combination of IONM, endoscopy, and ICG videoangiography may improve patient outcome in PM surgery.
Back to Living
Authors: Randall Edin T. , Smith Kelly R. , Conroy Caitlin , Smith Allison M. , Sethna Navil , Logan Deirdre E. 
Published: April 2018

Objectives:
To provide a descriptive account of long-term functioning (≥5 y posttreatment) among youth who completed intensive interdisciplinary pain treatment (IIPT) for pediatric chronic pain conditions.

Materials and Methods:
A total of 95 patients (mean age at follow-up=20.0 y) treated at least 5 years previously at a single IIPT program completed questionnaires assessing pain, functional disability, health care utilization, academic/career achievement, and quality of life. Data analyses focused on pain, functioning, and progress toward developmental goals at long-term follow-up.

Results:
The majority of respondents report significant reduction in pain compared with preadmission (P<0.001). Five years posttreatment, average functional disability scores were in the minimal range, with statistically significant decrease in functional disability from time of admission (P<0.001). Nearly 80% of respondents characterized themselves as having no functional difficulties at follow-up. Clinically significant improvement was established for both pain and function. Respondents generally reported developmentally appropriate status, with 89% graduating high school on schedule.

Discussion:
Results show long-term positive functioning among individuals who underwent intensive rehabilitation treatment for chronic pain as children or adolescents. Despite experiencing one or more pain flares at some point after treatment, most former IIPT patients report minimal to no ongoing functional disability, complete or partial resolution of pain symptoms, and developmentally appropriate progress toward goals (eg, school completion, independent living).
Herpesvirus Infection in Infants with Gastroschisis
Authors: Francis Stephen S. , Wiemels Joseph L. , Yang Wei , Shaw Gary M. 
Published: April 2018

Background:
Gastroschisis is a congenital malformation that has been shown to be more common in younger mothers and appears to be increasing in prevalence in the United States and elsewhere. Epidemiologic data suggest a potential role of infection and recent studies report an association between maternal antibodies to human herpesviruses (HHV) and development of gastroschisis.

Methods:
In this study, we examined newborn bloodspots from 50 children with gastroschisis and 50 healthy controls using a highly sensitive digital droplet polymerase chain reaction assay covering eight human herpesviruses [herpes simplex sirus 1/2, Epstein-Barr virus (HHV-4), cytomegalovirus (HHV-5), HHV-6A/B, HHV-7, and HHV-8], to examine the presence of herpesvirus DNA at birth, which would suggest in utero infection.

Results:
One control tested positive for low-level cytomegalovirus infection. We found no evidence of an association between herpesvirus DNA in neonatal blood spots taken at birth and gastroschisis.

Conclusions:
Our results do not support direct involvement of herpesviruses in the etiology of gastroschisis. However, there are several limitations in our study, most notably the known induction of this congenital malformation early in pregnancy and our analysis of blood taken at birth. Therefore, we cannot conclude that herpesviruses play no role in the etiology of gastroschisis and further research is needed to better define this relationship.