bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparative study of serum adiponectin levels in patients of acute coronary syndrome with and without central obesity
Authors: Tiwari Shashank R. , S. Lokesh , P. Arunprasath , R. Arun Kumar 
Published: January 2019

Background: Coronary artery disease burden has been on a rise globally with it emerging as the principle cause of death even in the Indian subcontinent. Serum adiponectin has recently gained interest due to its close relation with atherosclerotic CAD and Metabolic syndrome. The levels of serum adiponectin are reduced in ACS. There is a paucity of studies in South Indian population comparing the effect of central obesity in patient with ACS. The aim of the present endeavour was to study the association of serum adiponectin in risk evaluation of patient with acute coronary syndrome with and without central obesityMethods: The study was conducted in a tertiary center in patient who presented with first time ACS they were grouped into two groups based on the presence and absence of central obesity. Central obesity was defined on the basis of waist to hip ratio. Serum adiponectin levels were estimated in both the groups using ELISA method. The results were statistically analyzed using t- test.Results: Authors concluded that the mean age of patients presenting first time with ACS was 55±12years in both the group. There was a significantly raised LDL and Total Cholesterol (TC) level in patient with central obesity. The estimated serum adiponectin level was reduced in both the group with more significant reduction in group with central obesity. The mean adiponectin level in CAD patients with central obesity was 2.326±1.437µg/ml as compared to 3.486±1.6999μg/ml in patients without central obesity, which was statistically significant (p value <0.0049).Conclusions: Authors concluded that serum adiponectin levels were reduced in both the group with ACS with a further reduction in patient with central obesity. It was also observed that there was a significant relation between adiponectin level and visceral fat as compared to superficial fat, as adiponectin was significantly reduced in patient higher waist-hip ratio.
Multiple Myeloma and Primary Sjogren’s Syndrome Combined with Unexplained Elevation of CA-125 Levels
Authors: Du Jun , Deng ShuHui , Qiu LuGui , An Gang 
Published: January 2019

Background: Multiple myeloma (MM) and its precursor, monoclonal gammopathy of undetermined significance (MGUS), have been linked with several autoimmune conditions like primary Sjögren’s Syndrome (pSS). Several studies link MM with autoimmune disorders. However, the data has not yet been fully analyzed or systematized.Case presentation: We described a 60-year-old Chinese woman diagnosed as multiple myeloma who presented with ocular and oral sicca symptoms, unexplained elevation of CA-125. In this patient, there was an inner connection between MM and pSS remaining to be investigated further.Conclusions: Multiple myeloma and primary Sjögren’s Syndrome could be coexisting due to the similar physiopathologic mechanism, which might be the explanation of bortezomib’s effectiveness. Moreover, tumor marker like CA-125 might be elevated owing to the secretion of CD-138+ve plasma cells.
OLHAR, OUVIR E ESCREVER NOS JÚRIS DE POLICIAIS MILITARES DE SÃO PAULO
Authors: Da Silva Ferreira Poliana 
Published: January 2019

Este trabalho apresenta resultados parciais de uma pesquisa em andamento cujo objeto é o tratamento judicial dos homicídios dolosos praticados por policiais militares no sistema de justiça de São Paulo em diferentes âmbitos do Direito, seja criminal, administrativo ou cível. Foram estudados múltiplos casos. O estudo de caso “convida os pesquisadores em direito a observar o sistema de justiça sem as barreiras impostas pelas áreas jurídicas, a atentar às interaçõesprocessuais e às suas implicações ao desfecho do caso” (Machado, 2014, p. 14). Foram, portanto, valorizadas a leitura e análise dos documentos pertinentes, bem como observações participantes nos Júris, além de entrevistas semidirigidas com os profissionais de diversas instituições da área. Assim, o “olhar” sobre o tratamento jurídico e judicial dos homicídios dolosos praticados por policiais militares nos remete ao “olhar etnográfico”, sensibilizado pela teoria disponível. Um olhar atento aos rituais, encenações e estratégias dos atores no jogo que é o Tribunal do Júri. O “ouvir” demanda a “criação de espaços semânticos compartilhados por ambos os interlocutores”, isto é, cabe ouvirmos como os atores que operam nas diferentes áreas reconstroem o grave problema da letalidade policial durante suas ações. O “escrever” conduz à reconstrução de narrativas que comporão o mosaico desenhado pela pesquisadora, a partir de hipóteses como a de que a atuação do Estado nos processos de responsabilização varia radicalmente conforme as características sociais e étnico-raciais das vítimas.
A Study of EFL Students‘ Awareness on Apology through Cross Cultural Learning Activities
Authors: Permatasari Ardiyani Widya , Kristina Diah , Sumardi Sumardi 
Published: January 2019

This study was aimed at exploring what types of cross cultural learning activities used that contribute to EFL students’ awareness on apology function, and how the process occurred at an EFL tertiary level. The data analyzed in this study were collected in Satya Wacana Christian University and Sebelas Maret University. The study was a mixed method in nature using a questionnaire and interview adapted from previous studies. The quantitative data was obtained from six Indonesian EFL students using Discourse Completion Tasks Questionnaires (DCTQ), while the qualitative data obtained from individual interviews carried out with six EFL students. The results showed that there were group discussion and role playing used as cross cultural learning activities which contributed to EFL students’ awareness on apology functions. Another finding also indicated the use of apology strategies performing those two learning activities. It was unveiled that that EFL students employed numerous apology strategies that they were well aware of how to use adequate apology forms to meet the requirement of certain situations and relationships, and that they felt the need for explaining and avoiding interpretation of their responses as an apology.
Hemi-paretik Serebral Palsili Çocuklarda Sanal Gerçeklik Uygulamasının Kaba Motor Becerileri Üzerine Etkisi
Authors: ARAN Orkun Tahir , ŞAHİN Sedef , KÖSE Barkın , HURİ Meral 
Published: January 2019

Amaç: Sanal gerçeklik (SG) uygulamasının hemiparetik serebral palsili (HSP) çocukların kaba motor beceri düzeyi üzerine etkisini incelemek amacıyla planlandı.Gereç ve yöntem: Yaş ortalaması 10,4 ± 2,92 yıl olan HSP’li çocuk (12 erkek-8 kız) çalışmaya dâhil edildi. Bilgisayar yazılımı için özel olarak programlanmış SG oyunları, haftada bir kez 30 dakika süreyle 8 hafta boyunca çocuklara uygulandı. Kaba motor beceri düzeyleri Bruininks - Oseretsky Motor Yeterlilik Testi Kısa Formu'nun (BOMYT-KF) 1-4 alt testleri ile müdahale öncesi, 4. ve 8. Haftalarda olmak üzere 3 kez tekrarlandı. Müdahalenin etkileri tekrarlanan ölçümler ANOVA yöntemi ile analiz edildi.Bulgular: Çocukların 11'inin sağ ve 9’ununda sol HSP olduğu bulundu. Kaba motor beceri düzeyleri müdahale öncesi 7,60 ± 3,16, müdahalenin 4. Haftasında 10,75 ± 2,61, müdahale sonrası (8. haftada) 12,65 ± 2,47 olarak bulundu. BOMYT-KF’nun tüm alt testlerindeki artış, istatistiksel olarak anlamlı bulundu (p&lt;0.05). 4. ve 8. Hafta ölçümleri arası ölçümlerde denge ve kuvvet alt bölümlerinde istatistiksel olarak anlamlı fark bulundu (p&lt;0.05).Sonuç: HSP’li çocuklarda en az dört haftalık SG müdahalesi ile tedavi programlarının geliştirilmesinin, koşma, denge, bilateral koordinasyon ve kuvvet gibi kaba motor beceri düzeylerini artırabilir. HSP çocuklara yapılan rehabilitasyon uygulamalarında SG uygulamalarının daha yaygın olarak kullanılması ile çocukların motor becerilerinde daha fazla kazanım sağlayacağını düşünmekteyiz.
From Disaster Response to Community Recovery: Nongovernmental Entities, Government, and Public Health
Authors: Sledge Daniel , Thomas Herschel F. 
Published: January 2019

In this article, we examine the role of nongovernmental entities (NGEs; nonprofits, religious groups, and businesses) in disaster response and recovery. Although media reports and the existing scholarly literature focus heavily on the role of governments, NGEs provide critical services related to public safety and public health after disasters. NGEs are crucial because of their ability to quickly provide services, their flexibility, and their unique capacity to reach marginalized populations. To examine the role of NGEs, we surveyed 115 NGEs engaged in disaster response. We also conducted extensive field work, completing 44 hours of semistructured interviews with staff from NGEs and government agencies in postdisaster areas in Texas, Florida, Puerto Rico, Northern California, and Southern California. Finally, we compiled quantitative data on the distribution of nonprofit organizations. We found that, in addition to high levels of variation in NGE resources across counties, NGEs face serious coordination and service delivery problems. Federal funding for expanding the capacity of local Voluntary Organizations Active in Disaster groups, we suggest, would help NGEs and government to coordinate response efforts and ensure that recoveries better address underlying social and economic vulnerabilities.
Funding for Abstinence-Only Education and Adolescent Pregnancy Prevention: Does State Ideology Affect Outcomes?
Authors: Fox Ashley M. , Himmelstein Georgia , Khalid Hina , Howell Elizabeth A. 
Published: January 2019

Objectives. To examine the relationship between adolescent pregnancy–prevention and sexuality and abstinence-only education funding and adolescent birthrates over time. Also, to determine whether state ideology plays a moderating role on adolescent reproductive health, that is, whether the funding has its intended effect at reducing the number of adolescent births in conservative but not in liberal states. Methods. We modeled time-series data on federal abstinence-only and adolescent pregnancy–prevention and sexuality education block grants to US states and rates of adolescent births (1998–2016) and adjusted for state-level confounders using 2-way fixed-effects models. Results. Federal abstinence-only funding had no effect on adolescent birthrates overall but displayed a perverse effect, increasing adolescent birthrates in conservative states. Adolescent pregnancy–prevention and sexuality education funding eclipsed this effect, reducing adolescent birthrates in those states. Conclusions. The millions of dollars spent on abstinence-only education has had no effect on adolescent birthrates, although conservative states, which experience the greatest burden of adolescent births, are the most responsive to changes in sexuality education–funding streams.
Reconsidering Strategies for Managing Chronic Periprosthetic Joint Infection in Total Knee Arthroplasty
Authors: Srivastava Karan , Bozic Kevin J. , Silverton Craig , Nelson Andrew J. , Makhni Eric C. , Davis Jason J. 
Published: January 2019

Background:
Periprosthetic joint infection (PJI) following total knee arthroplasty is a growing concern, as the demand for total knee arthroplasty (TKA) expands annually. Although 2-stage revision is considered the gold standard in management, there is substantial morbidity and mortality associated with this strategy. One-stage revision is associated with lower mortality rates and better quality of life, and there has been increased interest in utilizing the 1-stage strategy. However, surgeons are faced with a difficult decision regarding which strategy to use to treat these infections, considering uncertainty with respect to eradication of infection, quality of life, and societal costs with each strategy. The purpose of the current study was to use decision analysis to determine the optimal decision for the management of PJI following TKA.

Methods:
An expected-value decision tree was constructed to estimate the quality-adjusted life-years (QALYs) and costs associated with 1-stage and 2-stage revision. Two decision trees were created: Decision Tree 1 was constructed for all pathogens, and Decision Tree 2 was constructed solely for difficult-to-treat infections, including methicillin-resistant infections. Values for parameters in the decision model, such as mortality rate, reinfection rate, and need for additional surgeries, were derived from the literature. Medical costs were derived from Medicare data. Sensitivity analysis determined which parameters in the decision model had the most influence on the optimal strategy.

Results:
In both decision trees, the 1-stage strategy produced greater health utility while also being more cost-effective. In the Monte Carlo simulation for Decision Trees 1 and 2, 1-stage was the dominant strategy in about 85% and 69% of the trials, respectively. Sensitivity analysis showed that the reinfection and 1-year mortality rates were the most sensitive parameters influencing the optimal decision.

Conclusions:
Despite 2-stage revision being considered the current gold standard for infection eradication in patients with PJI following TKA, the optimal decision that produced the highest quality of life was 1-stage revision. These results should be considered in shared decision-making with patients who experience PJI following TKA.

Level of Evidence:
Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.
Full-Thickness Cartilage Defects Are Important Independent Predictive Factors for Progression to Total Knee Arthroplasty in Older Adults with Minimal to Moderate Osteoarthritis
Authors: Everhart Joshua S. , Abouljoud Moneer M. , Kirven J. Caid , Flanigan David C. 
Published: January 2019

Background:Knee osteoarthritis (OA) severity on radiographs is not a reliable predictor of symptom severity. The purpose of this study was to determine whether full-thickness defects or OA grade are predictive of the progression to total knee arthroplasty in older patients without end-stage arthritis.Methods:This study included 1,319 adults aged 45 to 79 years (mean age [and standard deviation], 61.0 ± 9.2 years) who were enrolled in the Osteoarthritis Initiative, a prospective multicenter study with median 9-year follow-up data. All participants had Kellgren-Lawrence grade-0 to 3 (no to moderate) OA on bilateral radiographs; patients with grade-4 (severe) OA were excluded. The presence and total surface area of full-thickness cartilage defects on the tibia or the weight-bearing portion of the femoral condyle were determined. The risk of total knee arthroplasty due to defect presence and size as well as OA grade was determined with Cox proportional-hazards modeling after controlling for baseline variables including, but not limited to, age, sex, race, weight, knee alignment, symptom severity, quality-of-life scores, and activity level.Results:Four hundred and ninety-six patients (37.6%) had full-thickness defects. The incidence of knee arthroplasty was 0.57% per person-year for adults without a full-thickness defect and 2.15% for those with a defect. After adjusting for confounders, the presence of a full-thickness defect increased the risk of total knee arthroplasty regardless of OA grade, with higher risk demonstrated for larger (≥2 cm2) defects (hazard ratio [HR] = 5.27 [95% confidence interval (CI) = 2.70 to 10.3]; p < 0.001) compared with smaller (<2 cm2) defects (HR = 2.65 [95% CI = 1.60 to 4.37]; p < 0.001). Compared with nonarthritic knees (grade 0 to 1), mild arthritis (grade 2) did not increase total knee arthroplasty risk (HR = 0.71 [95% CI = 0.31 to 1.60]); moderate arthritis (grade 3) increased total knee arthroplasty risk in adults without a full-thickness defect (HR = 3.15 [95% CI = 1.34 to 7.40]; p = 0.009) but not in adults with a defect (HR = 0.64 [95% CI = 0.28 to 1.49]; p = 0.30).Conclusions:Full-thickness cartilage defects were a major determinant of future knee arthroplasty in older adults with minimal to moderate OA, even after adjusting for baseline knee symptom severity. Baseline radiographic severity grade was only associated with future total knee arthroplasty risk in the absence of a full-thickness defect.Level of Evidence:PrognosticLevel IV. See Instructions for Authors for a complete description of levels of evidence.
Infantile Supracondylar Humeral Fractures (Patients Less Than Two Years of Age)
Authors: Mehlman Charles T. , Denning Jaime Rice , McCarthy James J. , Fisher Michael L. 
Published: January 2019

Background:
The age range for supracondylar humeral fractures spans from 1 to 14 years of age; most published studies have analyzed patients as non-age-segregated cohorts. Some isolated studies focused on the upper age range, demonstrating a male predominance and more severe fractures. The purpose of the current study was to analyze a large cohort of patients with surgically treated supracondylar humeral fractures at the low end of the age range (<2 years of age).

Methods:
Patients <2 years of age were identified from surgical billing records. Pin constructs were categorized as lateral column-only fixation or medial and lateral column fixation. All patients were followed through fracture-healing. Substantial loss of reduction was defined as a Baumann angle that changed ≥10° between surgery and healing or as a lateral rotation percentage (i.e., Gordon index) of ≥50% at the time of healing. The Fisher exact test was used for statistical analysis.

Results:
One hundred and three patients met our inclusion criteria. There were 69 female and 34 male patients (a 2:1 female-to-male ratio). Two patients did not have adequate follow-up radiographs. Of the 46 patients with bicolumnar fixation, 5 (11%) demonstrated loss of reduction compared with 20 (36%) of 55 patients with lateral column-only fixation. This difference between the groups was significant (p = 0.005). The group with lateral column-only fixation had 4.7-times-higher odds of loss of reduction (95% confidence interval, 1.6 to 13.8). A subset of patients had in-cast imaging that allowed calculation of the posterior sagittal cast index (a measure of cast fit). Eight of 15 patients who had a posterior sagittal cast index of ≥0.20 experienced loss of reduction, while only 1 of 19 patients with a cast index value of <0.20 had loss of reduction (p = 0.004).

Conclusions:
Supracondylar humeral fractures were twice as common in females in this very young cohort. We also found a nearly 5-times-higher odds of loss of reduction when fracture fixation was of the lateral column only.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Three-Dimensional Computed Tomography Analysis of Spinal Canal Length Increase After Surgery for Adolescent Idiopathic Scoliosis
Authors: Yahara Yasuhito , Seki Shoji , Makino Hiroto , Watanabe Kei , Uehara Masashi , Takahashi Jun , Kimura Tomoatsu 
Published: January 2019

Background:
The most severe complication after surgery for adolescent idiopathic scoliosis is spinal cord injury. There is a relationship between corrective surgery and subsequent elongation of the spinal canal. We sought to investigate which factors are involved in this phenomenon.

Methods:
Seventy-seven patients with adolescent idiopathic scoliosis (49 with Lenke type 1 and 28 with type 2) who underwent spinal correction surgery were included. The mean patient age at surgery was 14.2 years (range, 11 to 20 years). The spines of all patients were fused within the range of T2 to L2, and computed tomography (CT) data were retrospectively collected. We measured the preoperative and postoperative lengths of the spinal canal from T2 to L2 using 3-dimensional (3D) CT-based imaging software. We also examined the association between the change in T2-L2 spinal canal length and the radiographic parameters.

Results:
The length of the spinal canal from T2 to L2 was increased by a mean of 8.5 mm in the patients with Lenke type 1, 12.7 mm in those with type 2, and 10.1 mm overall. Elongation was positively associated with the preoperative main thoracic Cobb angle in both the type-1 group (R = 0.43, p < 0.005) and the type-2 group (R = 0.77, p < 0.000001). The greatest elongation was observed in the periapical vertebral levels of the main thoracic curves.

Conclusions:
Corrective surgery for adolescent idiopathic scoliosis elongated the spinal canal. The preoperative proximal, main thoracic, and thoracolumbar/lumbar Cobb angles are moderate predictors of postoperative spinal canal length after scoliosis surgery.

Clinical Relevance:
It is important to understand how much the spinal canal is elongated after surgery to lessen the risk of intraoperative and postoperative neurological complications.
Shale’s Big Sand Switch Is Delivering Dollars, But Not Eroding All Concerns
Authors: Jacobs Trent 
Published: January 2019

Where shale producers in Texas are getting their proppant has turned out to be one of the sector’s most significant market transformations since the onset of the oil industry’s downturn.
The 4-year movement toward using regional sands from within the state has been a major
economic win for the operators leading it. The production results are encouraging. Supply chains are more efficient. Yet, there remain long-term concerns.
Distinguished by their roundness and high-crush strengths, northern white sands from the US Midwest had served as the ubiquitous proppant of choice for much of the unconventional revolution—supplying 75% of the sector’s frac sand in 2014. Then crude prices collapsed.
Northern white sand accounts for just over 40% of today’s market. Nearly a quarter of the supply now comes from within the Permian Basin thanks to more than a dozen new in-basin sand mines that opened within the past year.
The additional supplies have forced the premium northern white sand suppliers in the US Midwest into price parity with the regional sands in Texas. However, without the need for cross-country rail shipments from Wisconsin or other northern states, the all-in cost of the Texas alternatives is actually about 60% less—amounting to a reduction of $40–$50 per ton.
Previously, operators avoided the use of these regionals sands due to their lower quality. The fear was that their more brittle grains tend to compact quicker, cutting off hydrocarbon flow from within the fractured reservoir. But for the most intense horizontal well designs that use 40 to 50 million lbs of sand, the arbitrage can amount to more than $1 million of freed up capital per well.
“The way I look at it is, if you can save that much money, then it doesn’t take very long until you’ve already funded a new well,” said Scott Forbes, a proppant expert with the consultancy Wood Mackenzie.
Forbes has been visiting the in-basin mines in Texas and speaking with buyers for the past year. In terms of production issues, he has heard of isolated cases where improper sand cleaning operations at some of the new mines may have contributed to poor well completions.
Overall though, the sentiment Forbes has picked up on from the shale patch is that the gains outweigh any losses seen so far. Companies that were the first to switch to regional sands “are pretty well sold on it,” he shared, adding that their gains are creating pressure on the hold-outs to follow suit.
The big sand shift started early on in the downturn as producers in Texas sought economic refuge by “debundling” their reliance on service companies and sourced brown sands (i.e., Brady or Hickory Sands) directly from mines in the central part of the state. The second act—the arrival of the in-basin operations—is solidifying the transition sooner than many anticipated.