bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament avulsion fractures with the use of an adjustable loop suspensory device
Authors: Han Fucai , Pearce Christopher Jon , Lee Bernard Chee Siang 
Published: May 2019

Introduction: To describe the clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament (PCL) avulsion fractures with/without associated tibia plateau fractures using an adjustable loop suspensory fixation device. Methods: Four male patients who have sustained PCL tibia avulsion fractures with/without associated tibia plateau fractures were operated on in a single centre using an arthroscopic adjustable loop suspensory device technique. After arthroscopic evaluation and reduction of the fracture using a probe and PCL drill guide, a proximal medial tibial mini incision was used to drill a bone tunnel through the fracture fragment. An adjustable loop suspensory device was relayed through the bone tunnel via a transtibial manner, and the button device was flipped onto the bony fragment for fixation. The associated tibial plateau fractures were then fixed if present. Knee function at the last follow-up was evaluated by International Knee Documentation Committee (IKDC), Knee Injury And Osteoarthritis Outcome Score (KOOS), Lysholm scores. Range of motion and knee stability were assessed, and fracture union was evaluated by plain radiographs. Results: All patients underwent the operation successfully with no major complications encountered. All were followed up for a minimum of 6 months. There was no instability reported by the patients or found during objective evaluation using posterior drawer test and reverse pivot shift test. All fractures achieved union. Mean post-operative Lysholm score was 91.5 (range 85–95), IKDC score was 85.1 (range 74.7–89.7) and KOOS was 89.3 (range 81.5–94.6). All patients returned to their pre-injury activities of daily living and work. Radiographic evaluation showed union at the fracture site in all four patients at the last follow-up. Conclusion: This arthroscopic procedure is a viable minimally invasive technique that is appropriate in minimally displaced avulsion fractures of the PCL with associated tibia plateau fractures. Level of Evidence: Case Series, IV
Assessing Diagnostic Reasoning Using a Standardized Case-Based Discussion
Authors: Sutherland Ruth M , Reid Katharine J , Chiavaroli Neville G , Smallwood David , McColl Geoffrey J 
Published: May 2019

Background: Development of diagnostic reasoning (DR) is fundamental to medical students’ training, but assessing DR is challenging. Several written assessments focus on DR but lack the ability to dynamically assess DR. Oral assessment formats have strengths but have largely lost favour due to concerns about low reliability and lack of standardization. Medical schools and specialist medical colleges value many forms of oral assessment (eg, long case, Objective Structured Clinical Examination [OSCE], viva voce) but are increasingly searching for ways in which to standardize these formats. We sought to develop and trial a Standardized Case-Based Discussion (SCBD), a highly standardized and interactive oral assessment of DR. Methods: Two initial cohorts of medical students (n = 319 and n = 342) participated in the SCBD as part of their assessments. All students watch a video trigger (based on an authentic clinical case) and discuss their DR with an examiner for 15 minutes. Examiners probe students’ DR and assess how students respond to new standardized clinical information. An online examiner training module clearly articulates expected student performance standards. We used student achievement and student and examiner perceptions to gauge the performance of this new assessment form over 2 implementation years. Results: The SCBD was feasible to implement for a large student cohort and was acceptable to students and examiners. Most students and all examiners agreed that the SCBD discussion provided useful information on students’ DR. The assessment had acceptable internal consistency, and the associations with other assessment formats were small and positive, suggesting that the SCBD measures a related, yet novel construct. Conclusions: Rigorous, standardized oral assessments have a place in a programme of assessment in initial medical training because they provide opportunities to explore DR that are limited in other formats. We plan to incorporate an SCBD into our clinical assessments for the first year of clinical training, where teaching and assessing basic DR is emphasized. We will also explore further examiners’ understanding of and approach to assessing DR.
Improved Compliance With Anesthesia Quality Measures After Implementation of Automated Monthly Feedback
Authors: McCormick Patrick J. , Yeoh Cindy , Vicario-Feliciano Raquel M. , Ervin Kaitlin , Tan Kay See , Yang Gloria , Mehta Meghana , Tollinche Luis 
Published: May 2019

PURPOSE: Minimization of postoperative complications is important in patients with cancer. We wished to improve compliance with anesthesiology quality measures through staff education reinforced with automated monthly feedback. METHODS: The anesthesiology department implemented a program to capture and report quality metrics. After staff education, monthly e-mail reports were sent to each anesthesiology physician and nurse anesthetist to detail individual compliance rates for a set of quality measures. For each measure, the proportion of patient cases that passed the measure before and after implementation of the program was compared using a two-sample proportion test. RESULTS: After exclusions, we analyzed 15 of 23 quality measures. Of the 15 measures, 11 were process measures, and four were outcome measures. Of the 11 process measures, seven demonstrated statistically significant improvements ( P < .01). The most improved measure was TEMP-02 (core temperature measurement), which increased from 69.6% to 85.7% (16.1% difference; P < .001). Also improved were PUL-02 (low tidal volume, less than 8 mL/kg ideal body weight; 15.4% difference; P < .001) and NMB-01 (train of four taken; 12.2% difference; P < .001). The outcome measure TEMP-03 (perioperative temperature management) had a statistically significant increase of a small magnitude (0.2% difference; P < .001). No other outcome measures showed statistically significant improvement. CONCLUSION: After implementation of a comprehensive quality improvement program, our group observed significant improvements in anesthesia quality measure compliance for several process measures. Future work is needed to determine if this initial success can be preserved and associated with improved outcomes.
Identification of Betamethasone-Regulated Target Genes and Cell Pathways in Fetal Rat Lung Mesenchymal Fibroblasts
Authors: Seow Bennet K L , McDougall Annie R A , Short Kelly L , Wallace Megan J , Hooper Stuart B , Cole Timothy J 
Published: May 2019

AbstractPreterm birth is characterized by severe lung immaturity that is frequently treated antenatally or postnatally with the synthetic steroid betamethasone. The underlying cellular targets and pathways stimulated by betamethasone in the fetal lung are poorly defined. In this study, betamethasone was compared with corticosterone in steroid-treated primary cultures of fetal rat lung fibroblasts stimulated for 6 hours and analyzed by whole-cell transcriptome sequencing and glucocorticoid (GC) receptor (GR) chromatin immunoprecipitation sequencing (ChIP-Seq) analysis. Strikingly, betamethasone stimulated a much stronger transcriptional response compared with corticosterone for both induced and repressed genes. A total of 483 genes were significantly stimulated by betamethasone or corticosterone, with 476 stimulated by both steroids, indicating a strong overlap in regulation. Changes in mRNA levels were confirmed by quantitative PCR for eight induced and repressed target genes. Pathway analysis identified cell proliferation and cytoskeletal/cell matrix remodeling pathways as key processes regulated by both steroids. One target, transglutaminase 2 (Tgm2), was localized to fetal lung mesenchymal cells. Tgm2 mRNA and protein levels were strongly increased in fibroblasts by both steroids. Whole-genome GR ChIP-Seq analysis with betamethasone identified GC response element–binding sites close to the previously characterized GR target genes Per1, Dusp1, Fkbp5, and Sgk1 and near the genes identified by transcriptome sequencing encoding Crispld2, Tgm2, Hif3α, and Kdr, defining direct genomic induction of expression in fetal lung fibroblasts via the GR. These results demonstrate that betamethasone stimulates specific genes and cellular pathways controlling cell proliferation and extracellular matrix remodeling in lung mesenchymal fibroblasts, providing a basis for betamethasone’s treatment efficacy in preterm birth.
Case Article—Baseball Analytics: Advancing to Prescriptive Analytics in the Major League Baseball Front Office
Authors: Barnes Sean L. , Bjarnadóttir Margrét V. 
Published: May 2019

This case uses player evaluation and personnel decision making in Major League Baseball (MLB) to introduce many of the key steps of data analytics projects. The data analytics process is a unique combination of art and science, and teaching the art of data analytics is challenging to do in a standard classroom setting with small data sets. The goal of this case is to move beyond the simple “cookie cutter” data sets and introduce students to the challenges of dealing with real data to answer important questions, as well as introduce or reinforce multiple data-mining/machine-learning methods. The case builds on a very rich data set collected by the authors, which allows for students or groups of students to arrive at different answers to the same question. An extensive teaching note with sample questions and the associated R code and output are at https://doi.org/10.1287/ited.2018.0201ca .
Managing ‘last tooth in the arch syndrome’ and restoring retruded contact position
Authors: Ali Kameran , Addison Thomas 
Published: May 2019

Occlusally challenging scenarios can arise during the restoration of teeth involved in the patient's Retruded Contact Position (RCP). During preparation of a tooth that provides the RCP, practitioners may encounter problems whereby they lose occlusal clearance to place an occlusal coverage restoration over the tooth in question. This may come as a shock to the practitioner, often resulting in further excessive and unplanned tooth preparation, or reduction of the opposing tooth to create occlusal clearance. This paper aims to provide a guide on how to recognize and avoid the potential pitfalls of restoring retruded contact position, through the use of proper planning and by employing appropriate management techniques. CPD/Clinical Relevance: Understanding of the relevant occlusal considerations will allow the practitioner to restore teeth involved with RCP predictably and conservatively.
Clinical audit: the importance of early detection and referral of impacted maxillary canines
Authors: Aiyegbusi Oluwatoyin , Nandra Sukbir 
Published: May 2019

A retrospective clinical audit was conducted to analyse referrals for impacted maxillary canines received by the Orthodontic Department of Queen Elizabeth Hospital, Kings Lynn. The primary aim of the audit was to determine if patients with impacted maxillary canines were referred at the appropriate age of 12 or under, as required by the Royal College of Surgeons of England guidelines and, secondly, to determine if appropriate radiographs were taken in patients aged 10 and over, as recommended by British Orthodontic Society Radiography guidelines. The results indicate that there is a significant shortfall in meeting the 100% standards set for both clinical guidelines. CPD/Clinical Relevance: This article highlights the importance of timely referral of suspected impacted maxillary canines and explores the potential consequences to both patient and practitioner of failing to refer patients by the appropriate age.
Effects of Interventions Addressing School Environments or Educational Assets on Adolescent Sexual Health: Systematic Review and Meta‐analysis
Authors: Peterson Amy J. , Donze Melissa , Allen Elizabeth , Bonell Chris 
Published: May 2019

CONTEXTSchool‐based interventions that aim to modify sexual health knowledge, attitudes and behaviors have mixed and often unsustained effects on adolescent sexual health outcomes. However, observational evidence suggests that broader school‐related factors, such as school climate and academic attainment, can influence outcomes.METHODSNine databases were searched in July 2017 for randomized and quasi‐experimental evaluations of interventions addressing school‐level environment or student‐level educational assets, to examine whether such interventions can promote young people's sexual health. Searches were limited to studies published since 1990 but were not restricted by language. Studies were assessed for risk of bias and synthesized narratively and meta‐analytically.RESULTSSearches yielded 11 evaluations, published from 1999 to 2016, of interventions related to school‐level environment or student‐level educational assets. Because of inconsistent reporting, the risk of bias was not clear for most studies, and meta‐analysis was possible for only one outcome. The meta‐analysis of three randomized trials provided some evidence that school‐environment interventions may delay sexual debut (pooled odds ratio, 0.5). Narrative synthesis of the remaining outcomes found mixed results, but suggests that interventions addressing school‐level environment may delay sexual debut and that those addressing student‐level educational assets may reduce risk of pregnancy and STDs.CONCLUSIONSAdditional and more rigorous evidence is needed to assess the probability that interventions addressing school‐related factors are effective and to provide better understanding of the mechanisms by which they may work to improve adolescent sexual health.
Clinical and Histologic Overlap and Distinction Among Various Hamartomatous Polyposis Syndromes
Authors: Gilad Ophir , Rosner Guy , Fliss-Isakov Naomi , Aharon-Kaspi Sivan , Strul Hana , Gluck Nathan , Kariv Revital 
Published: May 2019

INTRODUCTION:
Hamartomatous polyposis syndromes (HPS) are rare autosomal-dominant inherited disorders associated with gastrointestinal (GI) tract and other cancers. HPS include Peutz-Jeghers syndrome (PJS), juvenile polyposis syndrome (JPS), and phosphatase and tensin homolog hamartomatous tumor syndromes (PHTS). Diagnosis, management, and outcome prediction of HPS pose a clinical challenge. To characterize genotype, phenotype, histology and outcomes of individuals with HPS.

METHODS:
A retrospective cohort study (2004–2017) of consecutive patients that were clinically diagnosed with HPS that visited a specialized GI oncology clinic. Demographic, clinicopathological, and genetic data were obtained from medical records.

RESULTS:
Fifty-two individuals from 34 families were included. Common clinical manifestations were GI bleeding (40% JPS, 23% PJS, and 25% PHTS) and bowel obstruction (46.15% PJS and 11.4% JPS). Twenty patients (38.4%) underwent surgery, 5 of whom required multiple procedures. Higher polyp burden was associated with the need for surgery (P = 0.007). Polyp histology varied widely with 69.2% of patients exhibiting histology different from the syndrome hallmark. GI cancer history was positive in 65%, 40%, and 50% of JPS, PJS, and PHTS families, respectively. Five (9.6%) patients developed cancers (one patient each had small bowel-1, colon-1, and thyroid-1, one patient had both small bowel adenocarcinoma and breast cancer, and one had both breast cancer and liposarcoma). Twenty (38.4%) patients tested positive for STK11, PTEN, SMAD4, BMPR1A, or AKT1 mutations: Sanger sequencing and multi-gene next generation sequencing panels detected mutations in 40.9% and 100% of tested cases, respectively.

DISCUSSION:
HPS patients present versatile phenotypes with overlapping clinical and histological characteristics. Polyp burden is associated with the need for surgery. Next-generation sequencing increases mutation detection.
A TRADUÇÃO COMO EXERCÍCIO DE TEATRO
Authors: Molinari Renata M. , Paula Eduardo De , De Castro Maurício Paroni 
Published: May 2019

Título: A tradução como exercício de teatro
Resumo: A partir dos processos de criações desenvolvidos junto a Thierry Salmon, da orientação de pesquisa sobre o seu teatro e dos materiais escolhidos para as versões brasileiras, este texto reflete sobre a tradução como uma outra possiblidade do fazer teatral.
Palavras-chave: Teatro, Thierry Salmon, Tradução, Homenagem, Encenação.

Titolo: La traduzione come esercizio di teatro
Riassunto: Considerando i processi di creazione svolti assieme a Thierry Salmon, l’orientamento della ricerca sul suo teatro e dei materiali scelti per le versioni brasiliane, questo testo riflette sulla traduzione come un`altra possibilità di essere all’interno del fare teatrale.
Parole chiave: Teatro, Thierry Salmon, Traduzione, Omaggio, Regia.

Title: The translation as an exercise of the theater
Abstract: Considering the creation processes carried out together with Thierry Salmon, the orientation of the research on his theater and the materials chosen for the brazilian versions, this text reflects on the translation as another possibility to be inside the theater.
Keywords: Theatre, Thierry Salmon, Translation, Tribute, Staging.
PENTESILÉIA E O PROJETO AMAZONAS
Authors: Molinari Renata M. , De Paula Eduardo , De Castro Maurício Paroni 
Published: May 2019

Título: Pentesiléia e o Projeto Amazonas: duplo olhar para uma dramaturgia – [com] Um fragmento de diálogo à distância com Thierry Salmon
Resumo: Escrito a partir dos registros observados em seu caderno de anotações, este texto funciona como um memorial lacunar das ações criativas empreendidas durante os processos de criações dramatúrgico e espetacular de “O assalto ao céu”. O texto é acompanhado por um fragmento de diálogo com Thierry Salmon, que deixa alguns rastros sobre as questões norteadoras de seus interesses artísticos.
Palavras-chave: Thierry Salmon, Renata Molinari, Dramaturgia, Encenação, Teatro.

Titolo: Pentesilea e il Progetto Amazzone: doppio sguardo per una drammaturgia – con un frammento di dialogo a distanza con Thierry Salmon
Riassunto: Scritto a partire dalle annotazioni sul proprio taccuino di lavoro, questo testo si presenta come una traccia frammentata delle azioni creative messe in moto durante il percorso di creazione drammaturgica e spettacolare de L’assalto al cielo. Il testo è seguito di un frammento di conversazione con Thierry Salmon, che coglie alcuni spunti sulle questioni di fondo legate alle sue scelte artistiche.
Parole chiave: Thierry Salmon, Renata Molinari, Dramaturgia, Regia, Teatro.

Title: Penthesilea and the Amazon Project: dual perspective on a dramaturgy[with] a fragment of a distance dialogue with Thierry Salmon
Abstract: Written from the records observed in his notebook, this text works as ‘lacunar memorial’ of the creative actions undertaken during the dramaturgical and staging processes of “The assault on the sky”. The text is accompanied by a fragment of dialogue with Thierry Salmon, which leaves some clues on questions concerning his artistic interests.
Keywords: Thierry Salmon, Renata Molinari, Dramaturgy, Staging, Theatre.
Results of studying the clinical efficacy and safety of tofacitinib in the treatment of psoriatic arthritis
Authors: Korotaeva T. V. , Loginova E. Yu. 
Published: May 2019

The paper reviews of the data available in the literature on the clinical efficacy and safety of tofacitinib (TOFA) in the treatment of psoriatic arthritis (PsA). It considers the mechanism of action of TOFA, which is mainly in the selective inhibition of signal transmission due to its effect on the activity of JAK3 and/or JAK1, the enzymes that ensure the function of turning on and turning off the signals transmitted by cytokines. TOFA is noted to directly or indirectly act on a wide range of a number of molecules that play an important role in the pathogenesis of PsA.The paper analyzes the current data on the clinical efficacy of TOFA in treating PsA, which have been obtained in the 12-month OPAL Broaden study including patients with PsA and an inadequate response to synthetic disease-modifying anti-rheumatic drugs and in the 6-month OPAL Beyond study enrolling those with PsA and an inadequate response to tumor necrosis factor-α (TNF-α) inhibitors. It is noted that the results of these studies confirmed the efficacy of the drug in treating PsA not only according to the data of objective (medical) monitoring, but also to the subjective characteristics of pain, to the global assessment of disease activity, fatigue, as well as the mental and physical components of the SF-36 quality of life questionnaire.It is concluded that the current findings allow JAK inhibitors to be recommended as a new pathogenetically sound approach to treating PsA and suggest that TOFA has benefits in managing patients unresponsive to therapy with TNF-α inhibitors.
Medium- and long-term results of high tibial osteotomy in patients with primary and secondary knee osteoarthritis with varus deformity
Authors: Byalik V. E. , Makarov S. A. , Alekseeva L. I. , Byalik E. I. 
Published: May 2019

The most common operation for knee osteoarthritis (OA) is total knee arthroplasty (TKA); however, the latter is associated with the development of severe complications. This was the reason for the revival of the interest of orthopedic traumatologists in high tibial osteotomy (HTO), the essence of which is to transfer the load away from the affected medial part of the knee joint (KJ) to the intact lateral one.Objective: to evaluate the medium- and long-term results of open-wedge (OW) HTO in primary and secondary I–III stage knee OA.Patients and methods. The Laboratory of Orthopedic Rheumatology and Rehabilitation, V.A. Nasonova Research Institute of Rheumatology, performed 10 OW HTOs in 9 patients in 2005 to 2009 and 21 more OW HTOs in 19 patients in 2014 to 2018 (a total of 31 operations). The male/female ratio was 2.5:1. The mean age of the patients was 57.6±12.5 years; the body mass index (BMI) was 28.5±3.6 kg/m2 ; the correction angle was 11.7±2.5°. Preoperative planning was performed using the Miniaci method; the X-ray stage of knee OA was evaluated according to the Kellgren–Lawrence classification. OW HTO was carried out. For assessment of its results, the investigators determined the degree of pain using a visual analogue scale (VAS) and the KJ status by the Knee Society Score (KSS) scale. The results were assessed at one (n=31), 3.5±0.6 (n=28), and 8.5±1.3 (n=10) years.Results and discussion. There was a tendency to worsen surgical results over time. The mean VAS values for pain at 1, 3.5, and 8.5 years were as follows: 9.8±10.3; 21.2±16.2 and 38±15.5 mm, respectively. In the same periods, the KSS functional scores were 83.6±14.8, 85.2±12.6, and 80.5±14.2; the objective scores were 80.7±8.5, 75.2±12.7, and 67.8±16.3. There was a strong correlation between the severity of pain and the functional and objective KSS scores (-0.78, -0.81 years, and -0.91 at 1, 3.5, and 8.5 years, respectively; p<0.05). At 3.5±0.6 years, the survival rate after OW HTO was 96.6%. None of the patients examined at 8.5±1.3 years after OW HTO needed TKA. The surgical result was studied in 2 patients at 14 years; one patient underwent TKA, the other refused surgical intervention, the result was satisfactory.Conclusion. OW HTO has limited indications for use. However, in patients who are allowed to undergo this operation, pain syndrome can be relieved, by maintaining and/or improving KJ function; in most cases, TKA can be delayed for more than 10 years.