bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary Subtalar Joint Osteoarthritis Following Total Ankle Replacement
Authors: Sokolowski Marc , Krähenbühl Nicola , Wang Chen , Zwicky Lukas , Schweizer Christine , Horn Lang Tamara , Hintermann Beat 
Published: July 2019

Background: An advantage of total ankle replacement (TAR) compared to ankle fusion is that by maintaining motion, the occurrence of hypermobility of adjacent joints may be prevented. This could affect the development of symptomatic subtalar joint osteoarthritis (OA). The aim of the study was to determine the incidence of subtalar joint fusion and the progression of subtalar joint OA following TAR. Methods: Secondary subtalar joint fusion rate was determined from a cohort of 941 patients receiving primary TAR between 2000 and 2016. The indication for fusion, the time interval from primary TAR to fusion, and the union rate were evaluated. To assess the progression of subtalar joint OA, degenerative changes of the subtalar joint were classified in 671 patients using the Kellgren-Lawrence score (KLS) prior to TAR and at latest follow-up. Results: In 4% (37) of the patients, a secondary subtalar joint fusion was necessary. The indication for fusion was symptomatic OA in 51% (19), hindfoot instability in 27% (10), osteonecrosis of the talus in 19% (7), and cystic changes of the talus in 3% (1) of the patients. Time from primary TAR to subtalar joint fusion due to progressive OA was 5.0 (range, 0.3-10) years and for other reasons 1.6 (range, 0.2-11.6) years ( P = .3). In 68% (456) of the patients, no progression of subtalar joint OA was observed. Conclusion: The incidence of secondary subtalar joint fusion was low. The most common reason for subtalar joint fusion following TAR was symptomatic OA. Level of Evidence: Level IV, case series.
Should the CDC’s recommendations for promptly removing unnecessary centrally inserted central catheters be enhanced? Ultrasound-guided peripheral venous cannulation to fully comply
Authors: Iordanou Stelios , Middleton Nicos , Papathanassoglou Elisavet , Palazis Lakis , Raftopoulos Vasilios 
Published: July 2019

Purpose: In an effort to reduce catheter-related bloodstream infection’s incidence rates in an intensive care unit, several evidence-based procedures recommended by the Centers for Disease Control and Prevention for centrally inserted central catheters were implemented. A failure to fully comply with the recommendation for prompt removal of the centrally inserted central catheters was attributed, mainly to the difficulties and inadequacies raised from establishing peripheral venous access. Methods: The ultrasound-guided peripheral venous cannulation method as a supplementary intervention to the Centers for Disease Control and Prevention’s recommendations was incorporated and examined during the subsequent year. Results: A significant reduction on catheter-related bloodstream infection incidence rates out of the expected range was found. Centrally inserted central catheters utilization ratios were reduced by 10.7% (p < 0.05; 58%–47%) and the catheter-related bloodstream infection incidence rate was reduced by 11.7 per thousand device–days (15.9–4.16/1000 centrally inserted central catheters days (2015–2016 group, respectively)). Conclusion: The reduction of catheter-related bloodstream infection was higher than that described in the published literature. This probably shows that the combination of the five evidence-based procedures recommended by the Centers for Disease Control and Prevention together with that of ultrasound-guided peripheral venous cannulation method can increase the compliance with the Category IA recommendation for removal or avoidance of unnecessary placement of centrally inserted central catheters and decrease the catheter-related bloodstream infections in a more effective way, by affecting the patients’ centrally inserted central catheter exposure.
Breath alcohol concentration, hazardous drinking and preloading among Swedish university students
Authors: Elgàn Tobias H , Durbeej Natalie , Gripenberg Johanna 
Published: July 2019

Background: Approximately half of all young adults in Sweden are university students, and alcohol consumption is often a central part of students’ social lives. Heavy drinking is associated with negative consequences, such as poor study skills, sexual risk-taking, violence and accidents. The aim of the present study is to assess the levels of alcohol intoxication as well as hazardous alcohol use among students at Swedish universities. Methods: In an alcohol field study, students (≥18 years old) were randomly selected and invited to participate. The settings were eight different parties at four universities in Sweden. Alcohol intoxication was measured using a breath analyser for breath alcohol concentration (BrAC). Demographic data (i.e., sex, age, number of years at the university) and responses to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) were gathered through face-to-face interviews for the assessment of hazardous alcohol use. Results: In total, 723 students were invited to participate, 605 of whom consented (84% response rate). The mean age of the respondents was 22.2 years, and the proportion of women was 37%. A majority of the respondents (91%) reported drinking before arriving at the parties. Among those who had consumed alcohol before arriving, the average BrAC was 0.086%, and 36% had BrACs of 0.100% or more. The proportion of students reporting hazardous use was 86% for women and 87% for men. Conclusions: This study provides the actual levels of intoxication among university students in four different cities. Alcohol intoxication and hazardous use among Swedish university students is a concern, and the university setting is an important arena for implementation of alcohol prevention strategies.
Modified Peritoneal Flap Hernioplasty Versus Retromuscular Technique for Incisional Hernia Repair: a Retrospective Cohort Study
Authors: Petersson P. , Montgomery A. , Petersson U. 
Published: July 2019

Background and Aims: We present an open retromuscular mesh technique for incisional hernia repair, the modified peritoneal flap hernioplasty, where the fascia is sutured to the mesh and the hernia sac utilized for anterior mesh coverage. The aim was to describe the modified peritoneal flap hernioplasty technique and to compare it to a retromuscular repair, without component separation, regarding short-term complications, patient satisfaction, abdominal wall complaints, and recurrent incisional hernia. Materials and Methods: Consecutive patients operated electively with modified peritoneal flap hernioplasty technique (December 2012–December 2015) or retromuscular technique (Jan 2011–Oct 2014) were included in a retrospective single-center cohort study. Outcomes were evaluated from the Swedish Ventral Hernia Registry, by chart review, physical examination, and an abdominal wall complaints questionnaire. Results: The modified peritoneal flap hernioplasty group ( n = 78) had larger hernias (mean width 10.4 vs 8.5 cm, p = 0.005), more advanced Centers for Disease Control classification ( p = 0.009), and more simultaneous gastrointestinal-tract surgery (23.1% vs 11.5%, p = 0.041) than the retromuscular group ( n = 96). No difference in short-term complications was seen. Incisional hernia recurrence was lower in the modified peritoneal flap hernioplasty group (1.4% vs 10.3%, p = 0.023), and patients were more satisfied (93.8% vs 81.7%, p = 0.032). Follow-up time was shorter in the modified peritoneal flap hernioplasty group (614 vs 1171 days, p < 0.001). Conclusion: This retrospective study showed similar rates of short-term complications, despite more complex hernias in the modified peritoneal flap hernioplasty group. Furthermore, a lower incisional hernia recurrence rate for the modified peritoneal flap hernioplasty technique compared with the retromuscular technique used in our department was found. If this holds true with equally long follow-up remains to be proven.
Effects of telmisartan and losartan treatments on bone turnover markers in patients with newly diagnosed stage I hypertension
Authors: Aydoğan Berna İ , Erarslan Emrah , Ünlütürk Uğur , Güllü Sevim 
Published: July 2019

Introduction: Telmisartan is an angiotensin-II receptor type-1 blocker and a partial agonist for peroxisome proliferator-activated receptor-γ. The aim of this study was to determine the potential effects of telmisartan on bone metabolism and turnover markers. Methods: Forty-two patients with newly diagnosed stage I hypertension who were prescribed telmisartan 80 mg/day or losartan 100 mg/day were included. Serum levels of calcium, phosphorus, 25-hydroxy vitamin D, bone-specific alkaline phosphatase, osteocalcin, interleukin 6 and 24-hour urinary N-terminal telopeptide were measured at the beginning and after 12 weeks of treatment. Results: When treatment arms were evaluated together, significantly increased 25-hydroxy vitamin D levels ( p=0.01), and decreased parathormone (PTH) ( p<0.001), bone-specific alkaline phosphatase ( p=0.01), osteocalcin ( p=0.045), urinary N-terminal telopeptide ( p<0.001) and interleukin 6 levels ( p=0.006) were observed. After eliminating the 25-hydroxy vitamin D effect, significant changes were not observed at any of the parameters. None of the levels of parameters were different between groups. Conclusions: Neither telmisartan, despite its partial peroxisome proliferator-activated receptor-γ agonistic effect, nor losartan treatment had significant effects on bone turnover markers in newly diagnosed stage I hypertensive patients.
Characterization of the prognostic values of the NDRG family in gastric cancer
Authors: Yu Chaoran , Hao Xiaohui , Zhang Sen , Hu Wenjun , Li Jianwen , Sun Jing , Zheng Minhua 
Published: July 2019

Background: The N-myc downstream-regulated gene ( NDRG) family, NDRG1-4, has been involved in a wide spectrum of biological functions in multiple cancers. However, their prognostic values remain sparse in gastric cancer (GC). Therefore, it is crucial to systematically investigate the prognostic values of the NDRG family in GC. Methods: The prognostic values of the NDRG family were evaluated by Kaplan–Meier Plotter and SurvExpress. The mRNA of the NDRG family was investigated in The Cancer Genome Atlas (TCGA). Transcription factors (TFs) and miRNAs associated with the NDRG family were predicted by NetworkAnalysis. The prognostic values of DNA methylation levels were analyzed by MethSurv. The correlation between immune cells and the NDRG family was evaluated by the Tumor Immune Estimation Resource (TIMER) database. Results: High levels of mRNA expression of NDRG2 and NDRG3 were associated with a favorable prognosis in all GCs. In HER2− GC, NDRG1 was significantly associated with a poor prognosis of GC [hazard ratio (HR) = 1.65, 95% confidence interval (CI) = 1.16–2.33, p = 0.0046]. In HER2+ GC, NDRG4 showed a poor prognosis (HR = 1.4, 95% CI: 1.06–1.85, p = 0.017). NDRG4 was an independent prognostic factor in recurrence-free survival by TCGA cohort. The low-risk NDRG-signature group displayed a significantly favorable survival outcome than the high-risk group (HR = 1.76, 95% CI: 1.2–2.59, p = 0.00385). The phosphorylated protein NDRG1 (NDRG1_pT346) displayed a favorable overall survival and was significantly associated with HER2 and phosphorylated HER2. Epidermis development was the top biological process (BP) for coexpressed genes associated with NDRG1 and NDRG4, while mitotic nuclear division and mitotic cell processes were the top BPs for NDRG2 and NDRG3, respectively. Overall, 6 CpGs of NDRG1, 4 CpGs of NDRG2, 3 CpGs of NDRG3 and 24 CpGs of NDRG4 were associated with significant prognosis. CD4+ T-cells showed the highest correlation with NDRG4 (correlation = 0.341, p = 2.14e−11). Furthermore, BCL6 in follicular helper T-cells (Tfh) cells showed the highest association with NDRG4 (correlation = 0.438, p = 00e+00). Conclusions: This study analyzed the multilevel prognostic values and biological roles of the NDRG family in GC.
No Effect of Platelet-Rich Plasma Injections as an Adjuvant to Autologous Cartilage Chips Implantation for the Treatment of Chondral Defects
Authors: Olesen Morten Lykke , Christensen Bjørn Borsøe , Foldager Casper Bindzus , Hede Kris Chadwick , Jørgensen Natasja Leth , Lind Martin 
Published: July 2019

Background Repair of chondral injuries using cartilage chips has recently demonstrated clinical feasibility. Autologous platelet-rich plasma (PRP) is a potential promising technique for improving healing response during cartilage repair. Purpose To assess the cartilage repair tissue quality after autologous cartilage chips treatment (CC) with and without repeated local injections of PRP for the treatment of full-thickness focal chondral defects of the knee. Materials and Methods Two full-thickness chondral defects (Ø = 6 mm) were created in the medial and lateral trochlea facets of each knee in 6 skeletally mature Göttingen minipigs. The 2 treatment groups were (1) CC with 1 weekly PRP injection for 3 weeks ( n = 12) and (2) CC alone ( n = 12). The animals were euthanized after 6 months. Samples of whole blood and PRP were analyzed for concentrations of platelets and nucleated cells. The composition of the cartilage repair tissue was assessed using gross appearance assessment, histomorphometry, and semiquantitative scoring (ICRS II). Results Histological evaluation demonstrated no significant difference in the content of hyaline cartilage (CC + PRP: 18.7% vs. CC: 19.6%), fibrocartilage (CC + PRP: 48.1% vs. CC: 51.8%), or fibrous tissue (CC + PRP: 22.7% vs. CC: 21.8%) between the treatment groups. Macroscopic evaluation did not demonstrate any difference between groups. Conclusions PRP injections after CC in the treatment of full-thickness cartilage injuries demonstrated no beneficial effects in terms of macroscopic and histologic composition of cartilage repair tissue.
Predictors of self-care activities of outpatient diabetic residents in Harar and Dire Dawa: A hospital-based cross-sectional study
Authors: Ayele Behailu Hawulte , Mengesha Melkamu Merid , Tesfa Tewodros 
Published: July 2019

Objectives: Diabetes mellitus is a metabolic disorder of major public health importance due to its prevalence and potential health complication. The success of long-term maintenance therapy of diabetes patients depends largely on their ability to adherence to self-care practices. Africa’s most populous country, Ethiopia, has the highest burden of diabetes mellitus. However, studies on self-care activities of diabetic patients are limited. Therefore, this study measures the level of self-care activities of diabetic patients in a follow-up clinic of public hospitals in Harar and Dire Dawa, Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted on 320 randomly selected diabetic patients in Harar and Dire Dawa. A standard diabetic self-care activity interview tool was used to collect the data. Data were entered into Epi-data v 3.1 and STATA v 14.2 was used for analysis. Our outcome variable, self-care activities, has three ordered categories and a robust Ordinal logistic regression was used to identify predictors. All statistical tests with p-value <0.05 were considered as statistically significant. Results: The self-care activities of study participants were rated good for 38.1% (95% confidence interval: 32.94, 43.60). Being rural residents (adjusted odds ratio = 0.38, 95% confidence interval: 0.17, 0.82), attended secondary education (adjusted odds ratio = 2.96, 95% confidence interval: 1.51, 5.78), uncontrolled blood glucose (adjusted odds ratio = 1.68, 95% confidence interval: 1.02, 2.79), and had diabetic complications (one, adjusted odds ratio = 1.91, 95% confidence interval: 1.08, 3.38; two or more, adjusted odds ratio = 4.71, 95% confidence interval: 1.81, 12.25) were significantly associated with the better diabetes mellitus self-care activities. Conclusion: Significant number of diabetes mellitus patients living in rural areas did not adhere to diabetic self-care activities. This is more evident among participants who have limited or no formal education and patients with controlled blood glucose level. Therefore, individualized diabetic lifestyle education programs in follow-up clinics should target these population groups to improve self-care.
Staff perspectives from Australian hospitals seeking to improve implementation of thrombolysis care for acute stroke
Authors: Paul Christine , D’Este Catherine , Ryan Annika , Jayakody Amanda , Attia John , Oldmeadow Christopher , Kerr Erin , Henskens Frans , Grady Alice , Levi Christopher R 
Published: July 2019

Background: Intravenous thrombolysis is one of few evidence-based treatments for acute stroke. Treatment uptake is low outside major stroke care centres. There is a need for greater understanding of barriers encountered by clinicians when seeking to increase thrombolysis rates. Aim: The aim of this study is to describe physicians’ and nurses’ perceptions regarding thrombolysis for acute stroke at hospitals in the earlier stages of thrombolysis implementation. Methods: A cross-sectional paper survey completed by physicians’ and nurses’ was distributed to 1127 staff at stroke care units, emergency departments or equivalent stroke care facilities at 19 Australian hospitals, as part of a cluster randomised controlled trial for thrombolysis implementation and systems improvement. Results: Of 1127 potential participants, 503 (148 physicians and 355 nurses) completed surveys (45% response rate). Over 90% agreed that thrombolysis improved the odds of independent survival. However, 42% to 58% agreed that there were limitations in the evidence base. A small proportion of staff indicated deficits in technical competencies. Interactive or competency-based training was reported by less than two-thirds of the sample. Challenges such as quick bed availability were identified. Emergency department physicians were less positive towards the treatment compared with nurses (p < 0.001), stroke care unit physicians were more positive than nurses (p = 0.047) and older clinicians were more positive than younger clinicians (p = 0.007). Conclusion: Australian hospitals seeking to address barriers to stroke thrombolysis implementation may benefit from the availability of interactive and competency-based training, staff performance feedback, support to make beds available quickly and bypass arrangements to quickly deliver acute stroke patients to appropriate facilities.
Incomplete Contracts, Power and Efficiency: A Theoretical Analysis
Authors: Motiram Sripad 
Published: July 2019

This paper formalizes the idea that the allocation of tasks and adoption of technology in capitalist firms could be inefficient. Some previous studies have attempted this exercise, but the framework and results in this paper are different. The paper models contracts that are incomplete owing to the presence of unforeseen/indescribable contingencies, which opens up the possibility of renegotiation. Renegotiation can improve outcomes, but also leads to a hold-up problem. Given this, the equilibrium allocation is inefficient compared to other (non-hierarchical) alternatives. The extent of the inefficiency can be linked to the degree of incompleteness. This model captures insights from the literature on the microeconomic roots of inefficiency and the exercise of control and power. It also provides a concrete setting where indescribable contingencies do (and do not) matter—a much-debated issue. JEL Codes: D21, B1, B2
Antibiotics inhibit tumor and disease activity in cutaneous T-cell lymphoma
Authors: Lindahl Lise M. , Willerslev-Olsen Andreas , Gjerdrum Lise M. R. , Nielsen Pia R. , Blümel Edda , Rittig Anne H. , Celis Pamela , Herpers Bjorn , Becker Jürgen C. , Stausbøl-Grøn Birgitte , Wasik Mariusz A. , Gluud Maria , Fredholm Simon , Buus Terkild B. , Johansen Claus , Nastasi Claudia , Peiffer Lukas , Kubat Linda , Bzorek Michael , Eriksen Jens O. , Krejsgaard Thorbjørn , Bonefeld Charlotte M. , Geisler Carsten , Mustelin Tomas , Langhoff Erik , Givskov Michael , Woetmann Anders , Kilian Mogens , Litman Thomas , Iversen Lars , Odum Niels 
Published: July 2019

Abstract
This paper reports that aggressive antibiotic treatment inhibits disease activity and lymphocyte proliferation in cutaneous T-cell lymphoma (CTCL). The study offers important evidence for a link between bacterial infection, activation of the immune system, and CTCL progression.
Ibrutinib plus lenalidomide and rituximab has promising activity in relapsed/refractory non–germinal center B-cell–like DLBCL
Authors: Goy Andre , Ramchandren Radhakrishnan , Ghosh Nilanjan , Munoz Javier , Morgan David S. , Dang Nam H. , Knapp Mark , Delioukina Maria , Kingsley Edwin , Ping Jerry , Beaupre Darrin M. , Neuenburg Jutta K. , Ruan Jia 
Published: July 2019

AbstractThe investigators report on the promising activity of a phase 1b trial of the targeted therapy triplet rituximab, ibrutinib, and lenalidomide in patients with relapsed non–germinal center diffuse large B-cell lymphoma (DLBCL).
Randomized controlled study of ECP with methoxsalen as first-line treatment of patients with moderate to severe cGVHD
Authors: Jagasia Madan , Scheid Christof , Socié Gérard , Ayuk Francis Ayuketang , Tischer Johanna , Donato Michele L. , Bátai Árpád , Chen Heidi , Chen Sheau-Chiann , Chin Thomas , Boodée Henri , Mitri Ghaith , Greinix Hildegard T. 
Published: July 2019

Abstract
The investigation of extracorporeal photopheresis (ECP) plus standard of care (SoC) (SoC+ECP) in chronic graft-versus-host disease (cGVHD) within prospective, randomized clinical studies is limited, despite its frequent clinical use. This phase 1/pilot study was the first randomized, prospective study to investigate ECP use as first-line therapy in cGVHD, based on the 2015 National Institutes of Health (NIH) consensus criteria for diagnosis and response assessment. Adult patients with new-onset (≤3 years of hematopoietic stem cell transplantation) moderate or severe cGVHD were randomized 1:1 to 26 weeks of SoC+ECP vs SoC (corticosteroids and cyclosporine A/tacrolimus) between 2011 and 2015. The primary endpoint was overall response rate (ORR), defined as complete or partial response, at week 28 in the intention-to-treat population (ITT). Other outcomes included quality of life (QoL) measures and safety. Sixty patients were randomized; ITT included 53 patients (SoC+ECP: 29; SoC: 24). Week 28 ORR was 74.1% (SoC+ECP) and 60.9% (SoC). Investigator-assessed ORR was 56.0% (SoC+ECP) and 66.7% (SoC). Patients treated with SoC experienced a decline in QoL over the 28-week study period; QoL remained unchanged in SoC+ECP patients. Most frequent treatment-emergent adverse events (TEAEs) in SoC+ECP patients were hypertension (31.0%), cough (20.7%), dyspnea (17.2%), and fatigue (17.2%). Seventeen patients (SoC+ECP: 8; SoC: 9) experienced 35 serious adverse events (SAEs). No TEAEs or SAEs were considered related to the ECP instrument or methoxsalen. The encouraging short-term results of this study could inform the design of subsequent studies. This trial was registered at www.clinicaltrials.gov as #NCT01380535.