bluuebunny/crossref_metadata_2025_split huggingface dataset:
A meta-analysis of MDR1 polymorphisms rs1128503 and rs1045642 and susceptibility to hepatocellular carcinoma
Authors: Chang Qing , He Zhong-lin , Peng Yu-chong , Duan Shi-gang , Dai Yu-xin , Zhao Xiao-hui 
Published: June 2019

Objective A relationship between polymorphisms rs1128503 and rs1045642 in the multidrug resistance 1 gene ( MDR1) and susceptibility to hepatocellular carcinoma (HCC) has been reported but is inconclusive. This study was performed to explore the significance of MDR1 polymorphisms rs1128503 and rs1045642 in screening and diagnosis of HCC. Methods Studies of association analyses between MDR1 gene polymorphisms rs1128503 and rs1045642 and HCC were selected from three foreign language databases (PubMed, Cochrane, and Embase) and three Chinese databases (Wanfang, China National Knowledge Infrastructure, and China Knowledge Network) and subjected to meta-analysis. Results We found no significant relationship between the rs1128503 polymorphism and susceptibility to HCC in 4 cohorts and no significant relationship between the rs1045642 polymorphism and susceptibility to HCC in 3 cohorts. Conclusions There was no relationship between polymorphisms rs1128503 or rs1045642 of the MDR1 gene and susceptibility to HCC.
Appendiceal stump closure with polymeric clips is a reliable alternative to endostaplers
Authors: Vuille-dit-Bille Raphael , Soll Christopher , Mazel Peter , Staerkle Ralph F. , Breitenstein Stefan 
Published: June 2019

Objective Polymeric (Hem-o-lok) clips represent a novel technique with which to ligate the appendiceal stump following laparoscopic appendectomy. We compared the outcomes of using polymeric clips versus endostaplers for complicated and uncomplicated appendicitis. Methods Six hundred seventy-three consecutive patients undergoing laparoscopic appendectomy with polymeric clips or endostaplers for acute appendicitis were assessed. The primary outcome was the incidence of intra-abdominal abscesses. Predictors of postoperative intra-abdominal abscesses were calculated using univariate and multivariate analyses. Results Polymeric clips were used in 65% of patients and endostaplers were used in 35%. Hem-o-lok clips were not only applied in patients with uncomplicated appendicitis (83%), but also in those with complicated appendicitis (26%). The frequency of intra-abdominal abscesses using polymeric clips and endostaplers was similar in both patients with uncomplicated appendicitis (1% vs. 3%, respectively) and complicated appendicitis (2% vs. 6%, respectively). The univariate and multivariate analyses showed that the stump closure technique was not a risk factor for postoperative abscesses. Conclusions Closure of the appendiceal stump using the nonabsorbable Hem-o-lok ligation system in patients with both uncomplicated and complicated appendicitis is a safe alternative to the application of endostaplers.
Osteochondritis Dissecans of the Humeral Trochlea: Characterization of a Rare Disorder Based on 28 Cases
Authors: Wang Kemble K. , Bixby Sarah D. , Bae Donald S. 
Published: June 2019

Background:Osteochondritis dissecans (OCD) of the humeral trochlea is very rare. It may cause pain, mechanical symptoms, and loss of elbow motion, typically in the adolescent athlete. However, little published information is available regarding this condition.Purpose:To describe the clinical presentation, radiographic features, and prognosis of trochlear OCD.Study Design:Case series; Level of evidence, 4.Methods:Over a 10-year period, 28 patients presented to a tertiary pediatric hospital with trochlear OCD. Medical records and imaging were analyzed to characterize presentation, lesions appearances, and outcomes.Results:Mean ± SD age at presentation was 13.4 ± 1.6 years, and 13 of the 28 patients were male. The most common presenting symptom was pain (93%), followed by crepitus (54%). Evidence of trochlear OCD could be seen on initial radiographs in 94% of cases but was commonly missed. Coexisting capitellar OCD lesions were the most common associated abnormalities seen on magnetic resonance imaging (21%). Investigators noted 2 predominant patterns: “typical” trochlear OCD lesions (89%) were located on the lateral crista of the trochlea, 3.1 ± 4.4 mm lateral to the apex of the trochlear groove. This location corresponded to the medial tip of the capitellar epiphyseal ossification center and was not actually on the trochlear ossification center. “Atypical” trochlear OCD lesions (11%) were located more posteromedially. Trochlear OCD lesions in 4 elbows were managed surgically, while the remainder were managed nonoperatively. At mean ± SD follow-up of 13 ± 8 months, 12 patients (43%) were asymptomatic. A further 5 patients had ongoing crepitus but no pain (18%), and 4 patients (14%) underwent surgical treatment for their trochlear OCD (osteochondral fixation, n = 1; drilling/curettage, n = 3); 3 of the 4 patients experienced some improvement in pain.Conclusion:Although rare, trochlear OCD can cause considerable elbow problems. Clinicians should be aware of this differential diagnosis. Plain radiographs should be carefully scrutinized for subtle signs of trochlear OCD, particularly in the repetitive or overhead athlete with elbow pain. Although most patients’ symptoms will improve with activity modification, some may require surgery.
Suicide and Self-Harm in Recent Immigrants in Ontario, Canada: A Population-Based Study
Authors: Saunders Natasha Ruth , Chiu Maria , Lebenbaum Michael , Chen Simon , Kurdyak Paul , Guttmann Astrid , Vigod Simone 
Published: June 2019

Objective: To estimate the rates of suicide and self-harm among recent immigrants and to determine which immigrant-specific risk factors are associated with these outcomes. Methods: Population-based cohort study using linked health administrative data sets (2003 to 2017) in Ontario, Canada which included adults ≥18 years, living in Ontario ( N = 9,055,079). The main exposure was immigrant status (long-term resident vs. recent immigrant). Immigrant-specific exposures included visa class and country of origin. Outcome measures were death by suicide or emergency department visit for self-harm. Cox proportional hazards estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Results: We included 590,289 recent immigrants and 8,464,790 long-term residents. Suicide rates were lower among immigrants ( n = 130 suicides, 3.3/100,000) than long-term residents ( n = 6,354 suicides, 11.8/100,000) with aHR 0.3, 95% CI, 0.2 to 0.3. Male–female ratios in suicide rates were attenuated in immigrants. Refugees had 2.1 (95% CI, 1.3 to 3.6; rate 6.1/100,000) and 2.8 (95% CI, 2.5 to 3.2) times the likelihood of suicide and self-harm, respectively, compared with nonrefugee immigrants. Self-harm rate was lower among immigrants ( n = 2,256 events, 4.4/10,000) than long-term residents ( n = 68,039 events, 9.7/10,000 person-years; aHR 0.3; 95% CI, 0.3 to 0.3). Unlike long-term residents, where low income was associated with high suicide rates, income was not associated with suicide among immigrants and there was an attenuated income gradient for self-harm. Country of origin-specific analyses showed wide ranges in suicide rates (1.4 to 9.9/100,000) and self-harm (1.8 to 14.9/10,000). Conclusion: Recent immigrants have lower rates of suicide and self-harm and different sociodemographic predictors compared with long-term residents. Analysis of contextual factors including immigrant class, origin, and destination should be considered for all immigrant suicide risk assessment.
Management of severe stifle trauma: 2. Periarticular fractures
Authors: Conte Alessandro , Addison Elena 
Published: June 2019

Practical relevance: Periarticular stifle fractures are uncommon but challenging injuries to treat. There may be concurrent damage to the ligaments and stabilising structures of the stifle joint itself, which should also be evaluated (see Part 1 of this article series). Improved knowledge of the fixation options and biomechanical challenges of these injuries will aid clinical decision-making and effective repair. Clinical challenges: Due to their nature, periarticular fractures may have small juxta-articular fragments, which require additional thought to address during stabilisation. In juvenile animals, these fractures typically involve the physis and often can be managed with cross pin fixation. In adult cats, locking fixation, specialised plates or external skeletal fixators can be utilised to address the juxta-articular fragments. Readers should also be aware of patellar fracture and dental anomaly syndrome (PADS), where cats develop insufficiency fractures affecting the patella and proximal tibia. A careful oral examination should be performed in affected patients, as these cats may have persistent deciduous teeth. Close attention should be paid to preoperative radiographs for evidence of chronicity of the injury including sclerosis of the patella, remodelling and blunting of the fracture lines. Aims: The aims of the article are to review the current literature surrounding periarticular fractures of the stifle joint and to summarise the diagnosis, treatment, outcome and complications of each fracture type. As well as discussing general fracture fixation and biomechanical principles applicable to both dogs and cats, information is provided on specific issues facing cats, such as PADS. Evidence base: Published data is limited, with reports including only a small number of cats. The information and recommendations in this article have therefore been drawn from a combination of the available literature and the authors’ clinical experience.
Multiple sclerosis relapse risk in the postoperative period: Effects of invasive surgery and anesthesia
Authors: De Lott Lindsey B , Zerafa Samantha , Shedden Kerby , Dunietz Galit Levi , Earley Michelle , Segal Benjamin M , Braley Tiffany J 
Published: June 2019

Background: Postoperative multiple sclerosis (MS) relapses are a concern among patients and providers. Objective: To determine whether MS relapse risk is higher postoperatively. Methods: Data were extracted from medical records of MS patients undergoing surgery at a tertiary center (2000–2016). Conditional logistic regression estimated within-patient unadjusted and age-adjusted odds of postoperative versus preoperative relapse. Results: Among 281 patients and 609 surgeries, 12 postoperative relapses were identified. The odds of postoperative versus preoperative relapse in unadjusted (odds ratio (OR) = 0.56, 95% confidence interval (CI) = 0.18–1.79; p = 0.33) or age-adjusted models (OR = 0.66, 95% CI = 0.20–2.16; p = 0.49) were not increased. Conclusions: Surgery/anesthesia exposure did not increase postoperative relapse risk. These findings require confirmation in larger studies.
Risk prediction tools in cardiovascular disease prevention: A report from the ESC Prevention of CVD Programme led by the European Association of Preventive Cardiology (EAPC) in collaboration with the Acute Cardiovascular Care Association (ACCA) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP)
Authors: Rossello Xavier , Dorresteijn Jannick AN , Janssen Arne , Lambrinou Ekaterini , Scherrenberg Martijn , Bonnefoy-Cudraz Eric , Cobain Mark , Piepoli Massimo F , Visseren Frank LJ , Dendale Paul 
Published: June 2019

Abstract
Risk assessment and risk prediction have become essential in the prevention of cardiovascular disease. Even though risk prediction tools are recommended in the European guidelines, they are not adequately implemented in clinical practice. Risk prediction tools are meant to estimate prognosis in an unbiased and reliable way and to provide objective information on outcome probabilities. They support informed treatment decisions about the initiation or adjustment of preventive medication. Risk prediction tools facilitate risk communication to the patient and their family, and this may increase commitment and motivation to improve their health. Over the years many risk algorithms have been developed to predict 10-year cardiovascular mortality or lifetime risk in different populations, such as in healthy individuals, patients with established cardiovascular disease and patients with diabetes mellitus. Each risk algorithm has its own limitations, so different algorithms should be used in different patient populations. Risk algorithms are made available for use in clinical practice by means of – usually interactive and online available – tools. To help the clinician to choose the right tool for the right patient, a summary of available tools is provided. When choosing a tool, physicians should consider medical history, geographical region, clinical guidelines and additional risk measures among other things. Currently, the U-prevent.com website is the only risk prediction tool providing prediction algorithms for all patient categories, and its implementation in clinical practice is suggested/advised by the European Association of Preventive Cardiology.
Review of Subaxial Cervical Spine Injuries Presenting to a Tertiary-Level Hospital in Nepal: Challenges in Surgical Management in a Third World Scenario
Authors: Dhakal Gaurav Raj , Bhandari Ravi , Dhungana Siddartha , Poudel Santosh , Gurung Ganesh , Kawaguchi Yoshiharu , Riew K. Daniel 
Published: June 2019

Study Design: Epidemiological retrospective study. Objective: To describe the demographics, timing to surgery, delay, short-term neurological recovery, and complications in surgically treated subaxial cervical trauma in a resource-constrained country. Methods: Thirty consecutive subaxial cervical trauma patients presenting to a trauma hospital in Nepal between December 2015 and August 2017 were analyzed as a retrospective cohort. Patients were segregated into 4 groups based on the timing to surgery: within 2 days, 3 to 7 days, 8 to 30 days, and >31 days. Results: There were 27 male and 3 female patients with mean age 40 years. Twenty-four sustained fall injury, and 27 patients were from outside Kathmandu. No patients were treated within the first 48 hours; only 9 were treated between 3 and 7 days, 16 between 8 and 30 days, and 5 a month later. Major delay was finance and operating room availability. Thirteen patients had a C6C7 involvement followed by C5C6 in 6 patients. Seven patients had complete neurological deficit while 18 patients had incomplete deficit. A total of 46.7% improved their neurology in 6 months. No neurological recovery was observed in complete deficit patients. Conclusion: Seventy percent of our patients were treated longer than 1 week after injury, which would likely be considered unacceptable in most first world countries. As expected, the outcomes for many of these patients were far worse than reported in North American centers with early access to medical care and insurance. Despite this, nearly half of our patients improved neurologically following treatment; hence, surgery holds hope of some restoration of neurologic deficits.
The effect of the hip joint endoprosthesis length after a total hip arthroplasty: A biomechanical study
Authors: Smyris Andreas-Foivos , Potsika Vassiliki T. , Farmakis Ioannis-Ilias K. , Tachos Nikolaos , Fotiadis Dimitrios I. , Xenakis Theodoros A. , Pakos Emilios E. 
Published: June 2019

Background/purpose: Total hip arthroplasty is a safe, cost-effective surgical intervention which restores mobility and alleviates pain from most kinds of hip arthritis. The proposed biomechanical study evaluates the effect of the stem size on the mechanical environment of the hip and its association with aseptic loosening. Methods: Medium left, fourth-generation, composite femoral models were used, and different prosthesis dimensions were examined. Fourteen strain gages were placed at specific positions on the femur. Load cycles were programmed to simulate single-leg stance of gait of a normal-weight subject. Results: Microstrains in the anterior and posterior region of the femur shaft were found to decrease with increasing the stem length, while no specific tendency was observed in the regions of the great and lesser trochanteric as well as in the medial and lateral femur. Conclusion: This study indicates that shorter implants are subjected to higher strains distally to the pertrochanteric area.
Correlation of PROMIS Physical Function, Pain Interference, and Depression in Pediatric and Adolescent Patients in the Ambulatory Sports Medicine Clinic
Authors: Makhni Eric C. , Meldau Jason E. , Blanchett Jacob , Borowsky Peter , Stephens Jeffrey , Muh Stephanie , Moutzouros Vasilios 
Published: June 2019

Background: Recently, interest has increased in incorporating the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) outcomes into clinical and research applications in sports medicine. The PROMIS forms have not been studied in pediatric and adolescent sports medicine patients. Purpose/Hypothesis: The goal of this study was to determine the correlation between PROMIS Computer Adaptive Test (CAT) forms measuring physical function, pain interference, and depression in pediatric and adolescent patients seen in the ambulatory sports medicine clinic. We hypothesized that there would be a negative correlation between physical function and pain interference as well as depression, as has been demonstrated in adult patient populations. Study Design: Cross-sectional study; Level of evidence, 3. Methods: All patients aged 8 to 17 years seen by 3 shoulder and sports medicine providers were included in this study. Patients completed a series of PROMIS CAT forms at clinic visits, including the PROMIS-PF and PROMIS-UE (Physical Function and Upper Extremity; depending on the nature of the complaint), PROMIS-PI (Pain Interference), and PROMIS-Depression subscales. Pearson correlation coefficients were calculated between the PROMIS forms as well as with other patient demographic data. Results: A total of 236 patient visits (152 patients) were included in the study, comprising 712 total PROMIS CAT forms. A negative correlation was found between PROMIS-PF and both PROMIS-Depression ( R = –0.34) and PROMIS-PI ( R = –0.76). These correlations with PROMIS-Depression and PROMIS-PI were –0.21 and –0.75, respectively, when considering the PROMIS-UE CAT. Patient demographic information had minimal impact on PROMIS scores as well as on correlations between scores. Conclusion: Correlations between physical function, pain interference, and depression were found to be similar in pediatric patients as they are in adult patients, as measured by PROMIS CAT forms.
Monazite-(Ce) and xenotime-(Y) microinclusions in fluorapatite of the pegmatites from the Volta Grande mine, Minas Gerais state, southeast Brazil, as witnesses of the dissolution–reprecipitation process
Authors: Alves Felipe Emerson André , Neumann Reiner , Ávila Ciro Alexandre , Faulstich Fabiano Richard Leite 
Published: June 2019

AbstractFluorapatite with monazite-(Ce) and xenotime-(Y) microinclusions occurs in the lithium–caesium–tantalum pegmatite body A of the Volta Grande mine, Minas Gerais state, Southeast Brazil. The fluorapatite displays faint zoning, detected mainly by cathodoluminescence. Electron probe and laser ablation analyses indicate that zoning in the fluorapatite corresponds to variation in Mn and rare-earth element (REE) content. Such compositional variation is attributed to partial removal of the REE from the fluorapatite structure during a dissolution–reprecipitation process, forming monazite-(Ce) and xenotime-(Y) microinclusions in the REE-depleted zones of the fluorapatite. These inclusions exhibit an inherited geochemical signature, manifested by low Th and U concentrations when compared to monazite and xenotime crystallised from melts. Rhodochrosite and calcite inclusions are also associated with monazite-(Ce) and xenotime-(Y) and are probably products of the same process, recycling Ca, Mn, and CO32− from the fluorapatite through the following reaction: [Ca(5–2a–b–½x),Naa,(Y + REE)a,Mnb][(PO4)3–x(CO3)x(F)] + Fluid[a(2Ca2+ + P5+) + (x–b)(Ca2+) + H2O)] → [Ca5(PO4)3(F,OH)] + a[(Y + REE)PO4] + b[Mn(CO3)] + (x–b)[Ca(CO3)] + Fluid a[Na+].On the basis of new fluid-inclusion analyses, we propose that a hot (T > 204.5°C), salty (16 wt.% eq. NaCl, attributed to LiCl), hydrous fluid mediated the dissolution–reprecipitation of the fluorapatite. This fluid corresponds to similarly described Li-rich fluids which were suggested to have re-equilibrated the mineralogical assemblage at the Volta Grande mine.
In vivo dynamics of human hematopoietic stem cells: novel concepts and future directions
Authors: Scala Serena , Aiuti Alessandro 
Published: June 2019

Abstract
Unveiling the mechanisms and the cellular dynamics at the basis of human hematopoietic homeostasis has been a main focus for the scientific community since the discovery of a pool of multipotent hematopoietic stem cells (HSCs) capable of sustaining the hematopoietic output throughout life and after transplantation. Recently, new works shed light on the (1) differentiation paths, (2) size and replication rate of human HSC population at steady state, and (3) role of the distinct subpopulations comprising the hematopoietic stem and progenitor cell reservoir after transplantation. These papers exploited cutting-edge technologies, including vector integration site clonal tracking, spontaneous mutations, and deep transcriptome profiling. Here we discuss the latest updates in human hematopoietic system biology and in vivo dynamics, highlighting novel concepts and common findings deriving from different approaches and the future directions of these studies. Taken together, this information contributed to partially resolving the complexity of the in vivo HSC behavior and has major implications for HSC transplantation and gene therapy as well as for the development of future therapies.
Impact of Teratoma on the Cumulative Incidence of Disease-Related Death in Patients With Advanced Germ Cell Tumors
Authors: Funt Samuel A. , Patil Sujata , Feldman Darren R. , Motzer Robert J. , Bajorin Dean F. , Sheinfeld Joel , Tickoo Satish K. , Reuter Victor E. , Bosl George J. 
Published: June 2019

PURPOSE In men with metastatic germ cell tumors (GCTs), risk-directed treatment is determined, in part, by a distinction between seminoma and nonseminomatous GCT (NSGCT). The importance of NSGCT cell type is uncertain. We evaluated the long-term impact of teratoma on survival in patients with NSGCT. METHODS Prechemotherapy, primary tumors from patients who received platinum-based chemotherapy were studied, and the histology was confirmed by a genitourinary pathologist. The cumulative incidence of disease-related death (CIDD) was the primary end point, and a competing-risk analysis was performed. RESULTS Tumors were available from 232 patients, including 193 with NSGCT. An element of teratoma was present in 82 NSGCT primary tumors (42%). With a median follow-up of 17 years (range, 0.3 to 35 years), 58 patients with NSGCT died, 47 as a result of GCT and 11 as a result of other causes. Most GCT deaths occurred within the first 5 years and were associated with pretreatment risk status ( P < .001). Death as a result of other causes rose steadily after 15 years and was not associated with risk status ( P = .66). A higher CIDD was observed in patients who had NSGCT with teratoma than those with NSGCT without teratoma and seminoma (5-year CIDD rate, 27.4%, 17.4%, and 10.3%, respectively; P = .03). A higher CIDD was observed in patients who had NSGCT with mature teratoma compared with those with either NSGCT with immature teratoma or NSGCT without teratoma (5-year CIDD rate, 38.1%, 19.9%, and 17.4%, respectively; P = .01). CONCLUSION The presence of teratoma, particularly mature teratoma, in an NSGCT primary tumor is associated with a higher CIDD, consistent with the hypothesis that differentiation is associated with adverse outcomes. Death as a result of non-GCT causes is not associated with risk status and must be separated from GCT death when evaluating long-term survival.