bluuebunny/crossref_metadata_2025_split huggingface dataset:
Platelet-Rich Plasma Versus Hyaluronic Acid Injections for the Treatment of Knee Osteoarthritis: Results at 5 Years of a Double-Blind, Randomized Controlled Trial
Authors: Di Martino Alessandro , Di Matteo Berardo , Papio Tiziana , Tentoni Francesco , Selleri Filippo , Cenacchi Annarita , Kon Elizaveta , Filardo Giuseppe 
Published: December 2018

Background: Platelet-rich plasma (PRP) injections have been proposed as a new conservative option for knee degeneration to provide symptomatic relief and delay surgical intervention. Although the current literature provides some evidence on the benefits of this technique compared with viscosupplementation, no studies have been performed to compare their long-term effects. Purpose: To compare the long-term clinical outcomes provided by intra-articular injections of either PRP or hyaluronic acid (HA) to treat knee degenerative disease. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients with a history of chronic symptomatic knee degenerative changes and osteoarthritis (Kellgren-Lawrence grade 0-3) were enrolled: 192 patients were randomized to undergo 3 blinded weekly intra-articular injections of either PRP or HA. Patients were prospectively evaluated before the injection and then at 2, 6, 12, and 24 months and a mean of 64.3 months (SD, 7.8 months) of follow-up. Evaluation was based on International Knee Documentation Committee (IKDC) subjective (main outcome), EuroQol visual analog scale, and Tegner scores; 167 patients reached the final evaluation. Results: Both treatments were effective in improving knee functional status and symptoms over time: Mean ± SD IKDC subjective score improved significantly for both PRP and HA groups ( P < .0005) and remained stable over time up to 24 months (from 53.3 ± 14.3 to 67.3 ± 18.1 and from 50.3 ± 13.2 to 62.1 ± 20.8 for PRP and HA groups, respectively). At final evaluation, a significant IKDC reduction was observed in both treatment groups, with the PRP group still presenting significantly higher values compared with baseline: PRP 60.5 ± 19.0 ( P < .001 vs baseline), HA 55.7 ± 18.8 (not significant vs baseline). A comparative analysis showed no significant intergroup difference in any of the clinical scores at any follow-up point. The median duration of patient subjective perception of symptomatic relief was 9 months for HA and 12 months for PRP (not significant). The only significant difference was observed in the rate of reintervention at 24 months, which was significantly lower in the PRP group (22.6% vs 37.1%, P = .036). Conclusion: Both treatments were effective in improving knee functional status and symptoms over time. PRP did not provide an overall superior clinical improvement compared with HA in terms of either symptomatic-functional improvement at different follow-up points or effect duration. Registration: NCT01670578 (ClinicalTrials.gov identifier).
Response of the Injured Tendon to Growth Factors in the Presence or Absence of the Paratenon
Authors: Müller Sebastian A. , Quirk Nicholas P. , Müller-Lebschi Julia A. , Heisterbach Patricia E. , Dürselen Lutz , Majewski Martin , Evans Christopher H. 
Published: December 2018

Background: The paratenon is important for Achilles tendon healing. There is much interest in the use of exogenous growth factors (GFs) as potential agents for accelerating the healing of damaged Achilles tendons. Purpose/Hypothesis: The present study used a rat model to study the responses of the injured Achilles tendon to GFs in the presence or absence of the paratenon. The hypothesis was that responses of the injured tendon to GFs would be lower in the absence of a paratenon. Study Design: Controlled laboratory study. Methods: A 4-mm defect was created in the right Achilles tendon of 60 skeletally mature rats, which were treated with a validated combination of GFs (bFGF, BMP-12, and TGF-β1). Animals were randomly assigned to the intact paratenon (IP) group or resected paratenon (RP) group. Healing was studied anatomically, mechanically, and histologically after 1, 2, and 4 weeks. Results: IP tendons showed improved healing compared with RP tendons. IP tendons were significantly stronger (32.2 N and 48.9 N, respectively) than RP tendons (20.1 N and 31.1 N, respectively) after 1 and 2 weeks. IP tendons did not elongate as much as RP tendons and had greater cross-sectional areas (18.0 mm2, 14.4 mm2, and 16.4 mm2, respectively) after 1, 2, and 4 weeks compared with RP tendons (10.5 mm2, 8.4 mm2, and 11.9 mm2, respectively). On histology, earlier collagen deposition and parallel orientation of fibrils were found for IP tendons. Conclusion: The paratenon is essential for efficient Achilles tendon healing. Healing with GFs in this Achilles tendon defect model was superior in the presence of the paratenon. Clinical Relevance: Biological approaches to tendon engineering using GFs are in vogue and have been shown to improve healing of the rat Achilles tendon, most likely by inducing progenitor cells located within the paratenon. Clinically, resection or incision of the paratenon has been proposed for wound closure. Our data demonstrate the fundamental importance of the paratenon, which therefore should be preserved during Achilles tendon repair, especially if augmented with products such as platelet-rich plasma or autologous conditioned serum that are rich in GFs.
Hamstring Injuries in Major League Baseball Pitchers: Implications in Graft Selection for Ulnar Collateral Ligament Reconstruction
Authors: Howard Daniel R. , Banffy Michael B. , ElAttrache Neal S. 
Published: December 2018

Background: Hamstring tendons are commonly harvested as autograft for ulnar collateral ligament reconstruction. There is no consensus in the literature whether the hamstring tendon should be harvested from the ipsilateral (drive) leg or contralateral (landing) leg of baseball pitchers undergoing ulnar collateral ligament reconstruction. Hamstring injuries commonly occur in baseball players, but there are no reports on their incidence specifically among Major League Baseball (MLB) pitchers, nor are there reports on whether they occur more commonly in the drive leg or the landing leg. Hypothesis: Hamstring injuries occur more commonly in the landing legs of MLB pitchers. Study Design: Descriptive epidemiology study. Methods: MLB pitchers who sustained hamstring injuries requiring time spent on the disabled list were identified from publicly available sources over 10 seasons. Demographics of the pitchers and injury and return-to-sport data were collected. Hamstring injuries to the drive leg were compared with injuries to the landing leg. Results: Sixty-five pitchers had 78 disabled list stints due to hamstring injuries over 10 seasons. The landing leg was injured in 67.9% of cases, and the most common mechanism of injury was pitching. There were no significant differences in demographics between pitchers who sustained drive leg and landing leg injuries. There was no significant difference in mechanism of injury or time to return to sport between pitchers who sustained drive leg and landing leg injuries. Conclusion: The landing leg is more commonly injured than the drive leg among MLB pitchers who sustain hamstring injuries. There is no difference in time to return to sport between pitchers who sustain drive leg and landing leg injuries. More research is required to determine whether there is a difference in performance or future injury between hamstring tendons harvested from the drive leg and the landing leg for ulnar collateral ligament reconstruction among pitchers.
Obstructive Sleep Apnea and Sleep Position: Does It Matter for Infants With a Cleft Palate?
Authors: Greenlee Christopher J. , Scholes Melissa A. , Gao Dexiang , Friedman Norman R. 
Published: December 2018

Objective:To determine whether nonsupine sleep improves obstructive sleep apnea (OSA) in infants with cleft palate undergoing polysomnography (PSG).Design:Retrospective chart review.Setting:Tertiary care pediatric hospital.Patients:Twenty-seven infants (1 month to 1 year) with cleft palate with or without cleft lip (CP ± L) undergoing PSG testing for suspected OSA were included.Main Outcome Measures:Polysomnography measures included obstructive apnea–hypopnea index (OAHI), central apnea–hypopnea index (CAHI), oxygen saturation (SpO2) nadir, SpO2, and end-tidal carbon dioxide (ETCO2).Results:Twenty-three PSGs with at least 20 minutes of sleep in both the supine and the nonsupine positions were analyzed. The supine OAHI (mean: 16.8 events/hour; standard deviation [SD]: 18.5) and nonsupine OAHI (mean: 12.6 events/hour; SD: 12.6) did not differ significantly ( P = .10). The supine CAHI (mean: 1.9 events/hour; SD: 2.7) and nonsupine CAHI (mean: 3.1 events/hour; SD: 3.7; P = .15), the supine SpO2nadir (mean: 81.2%; SD: 6.3) and nonsupine SpO2nadir (mean: 81.8%; SD: 5.3; P = .70), the supine mean SpO2(mean: 95.5%; SD: 1.9) and nonsupine mean SpO2saturation (mean: 95.3%; SD: 2.4; P = .34), and the supine ETCO2(mean: 45.4 mm Hg; SD: 5.3) and nonsupine ETCO2(mean: 42.5 mm Hg; SD: 10.1; P = .24) were also similar.Conclusions:There were no significant improvements in OSA metrics during nonsupine sleep in infants with CP ± L. Prior to recommending nonsupine positioning which increases infant’s exposure to sudden infant death syndrome risk, we advocate obtaining a PSG to verify an objective improvement in OSA.
Correlation between sclerostin and Dickkopf-1 with aortic arterial stiffness in patients with type 2 diabetes: A prospective, cross-sectional study
Authors: Yang Hsin-Yu , Wu Du-An , Chen Ming-Chun , Hsu Bang-Gee 
Published: December 2018

Background: Sclerostin and Dickkopf-1 are extracellular inhibitors of the canonical Wnt/β-catenin signalling pathway, which is implicated in the development of arterial stiffness. However, the correlation between aortic stiffness and sclerostin or Dickkopf-1 levels in patients with type 2 diabetes mellitus is unknown. Methods: Fasting blood samples were collected from 125 patients with type 2 diabetes mellitus. Aortic stiffness was measured by carotid–femoral pulse wave velocity, and high aortic stiffness was defined by a carotid–femoral pulse wave velocity of >10 m/s. The serum sclerostin and Dickkopf-1 concentrations were determined using commercially available enzyme-linked immunosorbent assays. Results: In total, 46 patients with type 2 diabetes mellitus (36.8%) had high levels of aortic stiffness. Compared to the control group without aortic stiffness, this group was significantly older, had higher systolic and diastolic blood pressures, had higher blood urea nitrogen, creatinine, urinary albumin-to-creatinine ratio and serum sclerostin levels, and had significantly lower high-density lipoprotein cholesterol levels and estimated glomerular filtration rates. After adjusting for confounders, serum sclerostin [odds ratio = 1.005 (1.002–1.007), p = 0.002] levels remained an independent predictor of aortic stiffness. Multivariate analysis showed that the serum sclerostin level ( β = 0.374, adjusted R2 change = 0.221, p < 0.001) was positively associated with carotid–femoral pulse wave velocity. Conclusion: Serum levels of sclerostin, but not Dickkopf-1, are positively correlated with carotid–femoral pulse wave velocity and independently predict aortic stiffness in patients with type 2 diabetes mellitus.
Arthroscopic Bankart Repairs With and Without Remplissage in Recurrent Adolescent Anterior Shoulder Instability With Hill-Sachs Deformity
Authors: Hughes Jessica L. , Bastrom Tracey , Pennock Andrew T. , Edmonds Eric W. 
Published: December 2018

Background: Recurrent shoulder dislocation after surgical intervention in adolescents with anterior instability is now understood to occur with a relatively high frequency. The remplissage procedure is successfully used in the adult population to mitigate the ability of a Hill-Sachs lesion to engage the anterior glenoid and can be used during an arthroscopic Bankart repair for anterior shoulder instability. Purpose: To compare the clinical outcomes in adolescent patients who underwent a Bankart repair with or without remplissage for treatment of recurrent anterior shoulder instability and associated Hill-Sachs defects. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted on adolescents who underwent a remplissage procedure for recurrent anterior shoulder instability from 2009 to 2017 at a single institution. Controls were identified in a cohort of patients who underwent a Bankart repair only and were matched based on age, sex, and size of Hill-Sachs lesion. All patients were then contacted to determine instability recurrence as well as to complete the shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and the Pediatric Adolescent Shoulder Score (PASS) outcome surveys. Results: Twenty-one adolescents underwent a remplissage procedure, and 20 matched controls underwent only a Bankart procedure. A significantly higher rate of recurrence was noted in the Bankart-only patients (8/17) compared with remplissage patients (2/15) ( P = .04). No statistical difference was found in patient-reported outcome scores between treatment groups or in range of motion measurements ( P > .05). In a subset of patients in the remplissage group with pre- and postoperative surveys available, mean ± SD scores for PASS (77 ± 11) and QuickDASH (19 ± 12) improved when compared with preoperative scores (PASS, 54 ± 16; QuickDASH, 35 ± 28), but only the PASS score was statistically improved (PASS, P = .003; QuickDASH, P = .23). Conclusion: The addition of the remplissage procedure to a Bankart repair is a reasonable surgical option to treat a Hill-Sachs deformity in adolescents with anterior shoulder instability. The success of this additional procedure may be due to filling the Hill-Sachs defect, or perhaps it augments stability through a mechanism of posterior capsulorrhaphy. Either way, this young athletic population appears to have a lower rate of recurrence and improved patient-reported outcomes with a remplissage procedure to address the Hill-Sachs deformity.
EGFR-Mutant Adenocarcinomas That Transform to Small-Cell Lung Cancer and Other Neuroendocrine Carcinomas: Clinical Outcomes
Authors: Marcoux Nicolas , Gettinger Scott N. , O’Kane Grainne , Arbour Kathryn C. , Neal Joel W. , Husain Hatim , Evans Tracey L. , Brahmer Julie R. , Muzikansky Alona , Bonomi Philip D. , del Prete Salvatore , Wurtz Anna , Farago Anna F. , Dias-Santagata Dora , Mino-Kenudson Mari , Reckamp Karen L. , Yu Helena A. , Wakelee Heather A. , Shepherd Frances A. , Piotrowska Zofia , Sequist Lecia V. 
Published: December 2018

Purpose Approximately 3% to 10% of EGFR (epidermal growth factor receptor) -mutant non–small cell lung cancers (NSCLCs) undergo transformation to small-cell lung cancer (SCLC), but their clinical course is poorly characterized. Methods We retrospectively identified patients with EGFR-mutant SCLC and other high-grade neuroendocrine carcinomas seen at our eight institutions. Demographics, disease features, and outcomes were analyzed. Results We included 67 patients—38 women and 29 men; EGFR mutations included exon 19 deletion (69%), L858R (25%), and other (6%). At the initial lung cancer diagnosis, 58 patients had NSCLC and nine had de novo SCLC or mixed histology. All but these nine patients received one or more EGFR tyrosine kinase inhibitor before SCLC transformation. Median time to transformation was 17.8 months (95% CI, 14.3 to 26.2 months). After transformation, both platinum-etoposide and taxanes yielded high response rates, but none of 17 patients who received immunotherapy experienced a response. Median overall survival since diagnosis was 31.5 months (95% CI, 24.8 to 41.3 months), whereas median survival since the time of SCLC transformation was 10.9 months (95% CI, 8.0 to 13.7 months). Fifty-nine patients had tissue genotyping at first evidence of SCLC. All maintained their founder EGFR mutation, and 15 of 19 with prior EGFR T790M positivity were T790 wild-type at transformation. Other recurrent mutations included TP53, Rb1, and PIK3CA. Re-emergence of NSCLC clones was identified in some cases. CNS metastases were frequent after transformation. Conclusion There is a growing appreciation that EGFR-mutant NSCLCs can undergo SCLC transformation. We demonstrate that this occurs at an average of 17.8 months after diagnosis and cases are often characterized by Rb1, TP53, and PIK3CA mutations. Responses to platinum-etoposide and taxanes are frequent, but checkpoint inhibitors yielded no responses. Additional investigation is needed to better elucidate optimal strategies for this group.
Synthetic Methodologies for Structurally Defined Linked-[n]Rotaxanes with Permethylated Cyclodextrins: Platform for Functionalized Molecular Electronics
Authors: Masai Hiroshi , Terao Jun 
Published: December 2018

Abstract
Insulated molecular wires, π-conjugated molecules insulated by nonconductive macrocycles, have been regarded as key components in the field of single-molecule electronics. Their various functionalities were attributed to their π-conjugated systems and enhanced by their macrocyclic insulation. We have recently proposed that the linked-structures resulting from π-conjugation with cyclic molecules, especially with permethylated cyclodextrins, were effective for preparing various types of functionalized insulated molecular wires for use in molecular electronics. The unique self-threading supramolecules called linked-[n]rotaxanes, are reported to have the enhanced functional properties of molecular wires. The development of such insulated molecular wires has been strongly supported by precise engineering protocols with fine synthetic techniques for making self-threading supramolecular structures. In this account, we systematically describe and categorize synthetic procedures for making structurally defined linked-[n]rotaxanes via various reaction systems with focus on the threading and fixation systems peculiar to linked-[n]rotaxane structures.
An extension of the Alma-Ata vision for primary health care in light of twenty-first century evidence and realities
Authors: Perry Henry B. 
Published: December 2018

This paper builds upon and extends the definition of primary health care in the 1978 Declaration of Alma-Ata. The definition proposes a stronger role for community-based delivery of services and community mobilization, participation and empowerment. It calls for a stronger integration with vertical, disease-specific programs. And, finally, it calls for a strong role for certain curative services (including basic and essential surgery) that many today would not consider as part of primary health care. There is growing evidence that communities can and should play a stronger role than has traditionally been the case, that community-level workers who are properly trained and supported can provide effective services outside of health facilities, and that primary health centers staffed with non-specialist physicians and even non-physician clinicians can perform many of the lower-level inpatient services now performed at first-level referral hospitals. An approach to primary health care that is appropriate to the local context and that merges local epidemiological priorities with the communities' perceived priorities will make it possible to engage communities as partners. Currently, essential and basic health care services are available to only one-half of the world’s population. The full development of primary health care as envisioned here will accelerate progress in achieving Health for All as envisioned at the International Conference on Primary Health Care in 1978.
Oral health status of community dwelling adults aged 50 years and over in Ireland. A cross-sectional analysis of the Wave 3 TILDA cohort.
Authors: Naseer Amara , McLoughlin Jacinta , Donoghue Orna A. , Kenny Rose Anne , O'Connell Brian 
Published: December 2018

Background: Little is known about the current oral health status of adults in Ireland. The aim of this study was to measure the oral health status of community dwelling adults aged 50 years and over in Ireland, and to compare the current status to previous surveys of oral health in adults. Methods: The Irish Longitudinal Study on Ageing (TILDA) Wave 3 provided an opportunity to assess the oral health of a subset of TILDA participants. Respondents attending for health assessments at the TILDA centre were offered an oral health examination. The World Health Organization examination criteria were used. Results: Out of the 3111 people who were offered the oral health assessment (OHA), 2525 were examined. Adults below 50 years of age (n=17) and 4 respondents whose oral health data were unavailable at time of analysis were omitted, giving a final sample of 2504 respondents. Among the OHA sample, 9.9% (249) were edentate; 11.5% (159) of females and 8% (90) of males. Of those aged 65 years and older, 15.6% were edentate compared with 40.9% in 2000-02. The mean number of teeth present in those aged 65 years or older was 14.9 for males and 14.2 for females compared with 9.9 and 7.4, respectively, in 2000-02. 56.8% of the dentate sample had 10 or more tooth contacts. The mean DMFT of those aged 50 years or more was 18.5 and the Root Caries Index (RCI) was 6.3. For adults aged 65 years and over, the mean DMFT decreased from 25.9 to 20.1 and the Root Caries Index decreased from 11.6 to 9.1, between 2000-02 and 2014-15. Conclusion: The results suggest an improvement in oral health status of community dwelling adults aged 50 years and over in Ireland as compared to the previous Irish survey of 2000-02.
The generic name Abrothallus (Abrothallales, Dothideomycetes), and names proposed in the genus by Giuseppe De Notaris, Søren Christian Sommerfelt, and Ignaz Kotte
Authors: Suija Ave , Hawksworth David L. , Pérez-Ortega Sergio 
Published: December 2018

AbstractThe date of publication of the generic name Abrothallus is discussed, along with typification of the Abrothallus names proposed by Giuseppe De Notaris, Søren Christian Sommerfelt, and Ignaz Kotte. Pertinent historical collections have been examined, and each typication is supplied with a description in order to facilitate correct identifications. The new combination A. santessonii (≡ Vouauxiomyces santessonii) is proposed, and the species description updated to include the sexual morph.
Polycaprolactone / bioactive glass hybrid scaffolds for bone regeneration
Authors: Bossard Cédric , Granel Henri , Wittrant Yohann , Jallot Édouard , Lao Jonathan , Vial Christophe , Tiainen Hanna 
Published: December 2018

Abstract
Bioactive glasses (BG) bond to bone and stimulate bone regeneration, but they are brittle. Inorganicorganic hybrids appear as promising bone substitutes since they associate the bone mineral forming ability of BG with the toughness of polymers. Hybrids comprised of polycaprolactone (PCL) and SiO2-CaO BG were produced by sol-gel chemistry and processed into porous scaffolds with controlled pore and interconnection sizes. The obtained scaffolds are highly flexible, meaning that PCL effectively introduces toughness. Apatite formation is observed within 24 hours of immersion in simulated body fluid (SBF) and is not limited to the surface as the entire hybrid progressively changes into bone-like minerals. The degradation rate is suitable for bone regeneration with a 13.2% weight loss after 8 weeks of immersion. Primary osteoblasts cultured in scaffolds demonstrate that the samples are not cytotoxic and provide good cell adhesion. The in vivo study confirms the bioactivity, biocompatibility and suitable degradation rate of the hybrid. A physiological bone made of trabeculae and bone marrow regenerates. The structure and kinetic of bone regeneration was similar to the implanted commercial standard based on bovine bone, demonstrating that this new synthetic PCL-BG hybrid could perform as well as animal-derived bone substitutes.