bluuebunny/crossref_metadata_2025_split huggingface dataset:
One Dose of Intravenous Tranexamic Acid Is Equivalent to Two Doses in Total Hip and Knee Arthroplasty
Authors: Wilde Jeffrey M. , Copp Steven N. , McCauley Julie C. , Bugbee William D. 
Published: July 2018

Background:
Tranexamic acid (TXA) helps to prevent excessive blood loss during total hip arthroplasty (THA) and total knee arthroplasty (TKA), but the most efficacious dosing protocol has not been ascertained. The purpose of this study was to identify whether 1 dose of intravenous TXA is equivalent to 2 doses for reducing blood loss and transfusion rates following THA and TKA without an increase in complications.

Methods:
We identified 1,736 patients who underwent THA (592 who did not receive TXA, 454 who received 1 dose of TXA, and 690 who received 2 doses) and 2,042 patients who underwent TKA (744 who did not receive TXA, 499 who received 1 dose, and 799 who received 2 doses) from 2012 to 2016. The differences among groups with regard to the change in hemoglobin levels, rate of allogeneic blood transfusions, and rate of complications were assessed.

Results:
Patients who underwent THA and received 1 dose or 2 doses of TXA had similar drops in the mean hemoglobin levels postoperatively (2.9 g/dL and 3.1 g/dL, respectively; p = 0.197) and both had a smaller drop than the control group (3.6 g/dL; p < 0.001 compared with the 1 and 2-dose groups). These findings were confirmed by a multivariate analysis that controlled for age, sex, and preoperative hemoglobin level. Transfusion was required for 12.5% of the patients who underwent THA without receiving TXA, no patient who received 1 dose, and 0.7% of the patients who received 2 doses. The patients who underwent TKA and received 1 dose or 2 doses of TXA had similar mean drops in the hemoglobin level postoperatively (2.4 g/dL and 2.4 g/dL, respectively; p = 0.891), and both had less of a drop than the control group (2.9 g/dL; p < 0.001 compared with the 1 and 2-dose groups). These findings were also confirmed by a multivariate analysis that controlled for age, sex, and preoperative hemoglobin level. Transfusion was required for 4.3% of the patients who underwent TKA without receiving TXA, 0.4% of those who received 1 dose, and 0.3% of those who received 2 doses. Similar rates of perioperative complications occurred among all groups.

Conclusions:
One dose of TXA was as effective as 2 doses for decreasing blood loss and transfusion rates after THA and TKA without an increase in complications.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Adductor Canal Block Compared with Periarticular Bupivacaine Injection for Total Knee Arthroplasty
Authors: Grosso Matthew J. , Murtaugh Taylor , Lakra Akshay , Brown Anthony R. , Maniker Robert B. , Cooper H. John , Macaulay William , Shah Roshan P. , Geller Jeffrey A. 
Published: July 2018

Background:
In the last decade, the widespread use of regional anesthesia in total knee arthroplasty has led to improvements in pain control, more rapid functional recovery, and reductions in the length of the hospital stay. The aim of this study was to compare the efficacy of adductor canal blocks (ACB) and periarticular anesthetic injections (PAI), both with bupivacaine, for pain management in total knee arthroplasty.

Methods:
One hundred and fifty-five patients undergoing primary total knee arthroplasty under spinal anesthesia were randomized to 1 of 3 groups: ACB alone (15 mL of 0.5% bupivacaine), PAI alone (50 mL of 0.25% bupivacaine with epinephrine), and ACB+PAI. The primary outcome in this study was the visual analog scale (VAS) pain score in the immediate postoperative period. Secondary outcomes included postoperative opioid use, activity level during physical therapy, length of hospital stay, and knee range of motion.

Results:
The mean VAS pain score was significantly higher after use of ACB alone, compared with the score after use of ACB+PAI, on postoperative day 1 (POD1) (3.9 versus 3.0, p = 0.04) and POD3 (4.2 versus 2.0, p = 0.02). Total opioid consumption through POD3 was significantly higher when ACB alone had been used (131 morphine equivalents [ME]) compared with PAI alone (100 ME, p = 0.02) and ACB+PAI (98 ME, p = 0.02). Opioid consumption in the ACB-alone group was significantly higher than that in the ACB+PAI group on POD2 and POD3 and significantly higher than that in the PAI-alone group on POD2. There was no significant difference in opioid consumption between the patients treated with PAI alone and those who received ACB+PAI. The activity level during physical therapy on POD0 was significantly lower after use of ACB alone (26 steps) than after use of PAI alone (68 steps, p < 0.001) or ACB+PAI (65 steps, p < 0.001).

Conclusions:
This randomized controlled clinical trial demonstrated significantly higher pain scores and opioid consumption after total knee arthroplasty done with an ACB and without PAI, suggesting that ACB alone is inferior for perioperative pain control. There were no significant differences between PAI alone and ACB+PAI with regard to pain or opioid consumption.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Association Between Race and Ethnicity and Hip Fracture Outcomes in a Universally Insured Population
Authors: Okike Kanu , Chan Priscilla H. , Prentice Heather A. , Paxton Elizabeth W. , Navarro Ronald A. 
Published: July 2018

Background:
Prior studies have documented racial and ethnic disparities in hip fracture treatment and outcome, and unequal access is commonly cited as a potential mediator. We sought to assess whether disparities in hip fracture outcome persist within a universally insured population of patients enrolled in a managed health-care system.

Methods:
A U.S. integrated health systems registry was used to identify patients who underwent treatment for a hip fracture when they were ≥60 years of age from 2009 to 2014. Patient demographics, procedure details, and outcomes were obtained from the registry. Differences in outcome according to race/ethnicity were analyzed using multivariable regression analysis with adjustment for socioeconomic status and other potential confounders.

Results:
Of 17,790 patients, 79.4% were white, 3.9% were black, 9.4% were Hispanic, and 7.4% were Asian. Compared with white patients, black patients had a similar 1-year mortality rate (odds ratio [OR] = 0.93, 95% confidence interval [CI] = 0.79 to 1.09, p = 0.37), Hispanic patients had a lower rate (OR = 0.85, 95% = CI = 0.75 to 0.96, p = 0.01), and Asian patients also had a lower rate (OR = 0.65, 95% CI = 0.56 to 0.76, p < 0.001). There were no differences in terms of surgical delay, 90-day emergency department visits, or reoperations during the patient’s lifetime (p > 0.05) between the groups. Compared with white patients, black and Hispanic patients had fewer 90-day postoperative complications (p = 0.04 and p = 0.01, respectively); 90-day unplanned readmissions were less common among Asian patients (p = 0.03) but more common among black patients (p = 0.01).

Conclusions:
In this study of hip fractures treated in an integrated managed care system, minority patients were found to have postoperative mortality rates that were similar to, or lower than, those of white patients. These findings may be related to the equal access and/or standardized protocols associated with treatment in this managed care system.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Validation Study of the Thumb Ossification Composite Index (TOCI) in Idiopathic Scoliosis
Authors: Hung Alec Lik-Hang , Shi Benlong , Chow Simon Kwoon-Ho , Chau Wai-Wang , Hung Vivian Wing-Yin , Wong Ronald Man-Yeung , Liu King-Lok , Lam Tze-Ping , Ng Bobby Kin-Wah , Cheng Jack Chun-Yiu 
Published: July 2018

Background:
The new simplified thumb ossification composite index (TOCI) based on ossification of the thumb epiphyses and adductor sesamoid has demonstrated simplicity, excellent reliability, and high accuracy for predicting skeletal maturity, comparable with the Sanders simplified skeletal maturity system (SSMS). It was our belief that, because the terminology of the SSMS system has been commonly used for skeletal maturity prediction in idiopathic scoliosis in publications over the past decade, the clinical applicability of the TOCI system would increase if the stages in the 2 systems were found to be interchangeable and highly correlated.

Methods:
Hand radiographs of 125 premenarchal girls with newly diagnosed adolescent idiopathic scoliosis who had been followed longitudinally until skeletal maturity were all scored with use of the Tanner-Whitehouse III (TW3) system (stages E through I), the TOCI, and the SSMS. The scores for the epiphyses of the ulnar 4 digits were compared with those for the thumb and correlated with the timing of peak height velocity. Correlations were analyzed with the chi-square test and Cramer V and Somers delta correlations.

Results:
Six hundred and forty-five hand radiographs (an average of 5 for each girl with idiopathic scoliosis) and 11,517 epiphyses were scored. The rate of concordance between TW3 stages F, G, and I for the thumb proximal phalangeal epiphysis and those for all of the epiphyses of the ulnar 4 digits were 72.5%, 72.5%, and 89.9%, respectively. The overall concordance rate (including all epiphyses) was 71.3%, with a very high Cramer V correlation and significance (p < 0.01). High interchangeability was demonstrated for the TOCI and SSMS stages, supported by a high Somers delta correlation (>0.8) with significance (p < 0.05).

Conclusions:
The TOCI is highly practical for clinical use, and its stages are highly interchangeable with those of the SSMS.

Clinical Relevance:
The TOCI could serve as a simplified “marker” of skeletal maturity on hand radiographs and minimize the learning-curve problems associated with the SSMS in a busy clinical practice.
Outcomes of Physeal-Sparing ACL Reconstruction with Iliotibial Band Autograft in Skeletally Immature Prepubescent Children
Authors: Kocher Mininder S. , Heyworth Benton E. , Fabricant Peter D. , Tepolt Frances A. , Micheli Lyle J. 
Published: July 2018

Background:Anterior cruciate ligament (ACL) tears are occurring in youth athletes with increasing frequency. Many ACL reconstruction procedures designed to allow for continued growth in patients with open physes have been described, but large series with mid- to long-term outcomes data are lacking. The purpose of the current study was to assess the clinical outcomes of a large cohort of prepubescent children who underwent a physeal-sparing, combined intra- and extra-articular ACL reconstruction with iliotibial (IT) band autograft over a 23-year period.Methods:Included in our analysis were 237 patients (240 knees) who underwent ACL reconstruction using IT band autograft at Tanner stage 1 or 2 (mean age of 11.2 ± 1.7 years). Physical examination data were analyzed for 225 of the 240 knees (mean follow-up, 25.8 months), and 137 (57%) of the knees had corresponding patient-reported clinical outcomes (patient-reported graft rupture and Pediatric International Knee Documentation Committee [Pedi-IKDC], Tegner activity scale, and Lysholm scores; mean follow-up, 6.2 years). Rates of growth arrest, IT band graft-harvest morbidity, and return to sports were analyzed.Results:Physical examination revealed that 96.8% of the knees were grade A on the Lachman test and 98.8% were grade A on the pivot-shift test. Graft rupture occurred in 9 (6.6%) of 137 knees, at an average of 33.5 months (range, 8.2 months to 8.0 years) postoperatively. For patients who did not sustain a graft rupture, the mean Pedi-IKDC score was 93.3 ± 11.0, the mean Lysholm score was 93.4 ± 9.9, and the mean score on the Tegner activity scale was 7.8 (mode, 7). While lateral thigh asymmetry at the IT band harvest site was noted by 48% of the subjects, only 1.6% reported associated pain. No cases of limb-length discrepancy or angular deformity were observed.Conclusions:This procedure was associated with excellent functional outcomes, minimal risk of growth disturbance, and a low graft-rupture rate in skeletally immature prepubescent children. These results appear durable at mid- to long-term follow-up, at an average of >6 years postoperatively.Level of Evidence:TherapeuticLevel IV. See Instructions for Authors for a complete description of levels of evidence.
New Distances to Four Supernova Remnants
Authors: Ranasinghe S. , Leahy D. A. , Tian Wenwu 
Published: July 2018

Object:
Distances are found for four supernova remnants without previous distance measurements. H I spectra and H I channel maps are used to determine the maximum velocity of H I absorption for the four Supernova Remnants (SNRs).

Method:
We examined 13CO emission spectra and channel maps to look for possible molecular gas associated with each SNR, but did not find any.

Result:
The resulting distances for the SNRs are 3.5 ± 0.2 kpc (G24.7+0.6), 4.7 ± 0.3 kpc (G29.6+0.1), 4.1 ± 0.5 kpc (G41.5+0.4) and 4.5 ± 0 .4 - 9.0 ± 0.4 kpc (G57.2+0.8).
PERFIL SOCIODEMOGRÁFICO, SOCIOECONÔMICO E ESPORTIVO DE TENISTAS INFANTOJUVENIS BRASILEIROS DE ELITE
Authors: Andrade Alexandro , Casagrande Pedro De Orleans , Bevilacqua Guilherme Guimarães , Pereira Fabiano Souza , Alves Julianne Fic , Goya Ana Luiza , Coimbra Danilo Reis 
Published: July 2018

O estudo objetivou descrever o perfil sociodemográfico, socioeconômico e esportivo de tenistas infantojuvenis brasileiros competitivos de elite. Participaram 130 tenistas, sendo 102 homens e 28 mulheres. A maioria dos tenistas é natural das Regiões Sudeste e Sul e houve um predomínio de tenistas treinando nessas regiões. A maioria dos tenistas pertence à classe socioeconômica A. Em média, os tenistas iniciaram no tênis aos oito anos e o início em competições de tênis foi aos 11 anos. Os tempos médios de prática e de prática competitiva dos tenistas foram de sete e quatro anos, respectivamente. Já foram finalistas em competição internacional 16% dos atletas e aproximadamente a metade já disputou finais em competições internacionais e nacionais. Concluiu-se que os tenistas investigados são oriundos das classes econômicas mais altas. Além disso, os tenistas apresentaram grande volume de treino e tempo de prática.
Sensitivity to diazepam after a single session of forced swim stress in weaning Wistar rats
Authors: Bernal-Morales Blandina , Guillén-Ruiz Gabriel , Cueto-Escobedo Jonathan , Rodríguez-Landa Juan Francisco , Contreras Carlos M. 
Published: July 2018

Abstract
The present study investigated the sensitivity to stress and diazepam in weaning (21-day old) Wistar rats. A single 15-min session of forced swimming was used to induce anxiety-like behavior. The group that was forced to swim exhibited an increase in anxiety-like behavior in the elevated plus maze (EPM) and open field test (OFT) compared to the non-stressed group. Diazepam (1 h before the tests) reduced anxiety-like behavior in rats forced to swim compared to the vehicle stressed group. The dose-response curve for diazepam indicated that the 0.5 mg kg−1 dose (1 h before the EPM and OFT) was the minimum effective dose in reducing anxiety-like behavior without altering locomotor activity in weaning rats. These results indicate that weaning rats can develop anxiety-like behavior after a brief, single session of stress, and that rats at this age are seemingly more sensitive to diazepam than adult rats, which may be taken into account for clinical applications.
Effect of surface hydrophobicity of therapeutic protein loaded in polyelectrolyte nanoparticles on transepithelial permeability
Authors: Miklavžin Ana , Cegnar Mateja , Kerč Janez , Kristl Julijana 
Published: July 2018

Abstract
Oral delivery of protein drugs is greatly limited by low hydrophobicity, an important determinant for intestinal epithelial permeation and bioavailability. Herein, surface properties of recombinant erythropoietin were investigated using the fluorescent dye bis-ANS to monitor relative hydrophobicity for correlation with permeabilities with Caco-2 cells. At various pHs, bis-ANS fluorescence intensity indicated different surface hydrophobicities of erythropoietin molecules. Erythropoietin incorporated in chitosan or chitosan-trimethylchitosan (CS-TMC) nanoparticles prepared by polyelectrolyte complexation and ionotropic gelation with tripolyphosphate also showed different surface hydrophobicities. Chitosan nanoparticles with erythropoietin provided the most hydrophobic surface, followed by free erythropoietin (in water) and that loaded into CS-TMC nanoparticles. Chitosan nanoparticles were more effective than CS-TMC nanoparticles for permeation of erythropoietin across Caco-2 cell monolayers; the lowest permeability was shown by erythropoietin itself. Thus, hydrophilic protein molecules complexed with polyelectrolytes can provide more hydrophobic surfaces that enhance transepithelial permeability. This bis-ANS method also provides valuable information for the design of polyelectrolyte nanoparticules for oral delivery of protein drugs.
Effect of Pasteurella multocida Soluble Antigen Stimulation on the In Vitro Response of Peripheral Blood Mononuclear Cells of Holstein Calves
Authors: Ohtsuka Hiromichi , Inoue Maki , Maeda Yosuke , Tanabe Taishi , Tajima Motoshi 
Published: July 2018

Abstract
The expressions of cytokines mRNA, including interleukin-4 (IL-4), interleukin- 17A (IL-17A) and interferon-gamma (IFN-γ), their master regulatory transcription factors, and signal transducers and activator of transcription (STAT) stimulated in vitro with Pasteurella (P.) multocida soluble antigen were examined in peripheral blood mononuclear cells (PBMC) from Holstein calves. The healthy Holstein calves were divided into three groups; 2 weeks old (2W Group, N=8), 6 weeks old (6W Group, N=8), and 10 weeks old (10W Group, N=8). PBMC were stimulated in vitro by soluble antigen of P. multocida. There were significantly lower expressions of IFN-γ, IL-4, and STAT-6 mRNA of PBMC stimulated with P. multocida soluble antigen in the 2W Group compared to that in the 10W Group. Expression of IL-17A and IFN-γ in PBMC stimulated with P. multocida soluble antigen were significantly higher compared with the PBMC without stimulation in the 6W groups. The results of the present study demonstrated that 2W old calves had decreased cytokine expression of PBMC when in vitro stimulated with P. multocida soluble antigen in vitro.
DOPE–oleic acid–Ca2+ as DNA condensing agent
Authors: Galliková D. , Liskayová G. , Búcsi A. , Hubčík L. , Martínez J.C. , Uhríková D. 
Published: July 2018

Abstract
Phospholipid-based non-viral carriers composed of neutral phospholipid dioleoylphosphatidylethanolamine (DOPE) and the binary mixture DOPE–oleic acid (OA) are examined as potential DNA delivery vectors. The process of DNA condensation in the presence of Ca2+ ions has been monitored through changes in emmision intensity of fluorescent probe ethidium bromide. The decline in fluorescence intensity with increasing Ca2+ concentration at two different time intervals was correlated with the binding capacity of complexes and possible release of DNA from the complex. The microstructure of DOPE–OA mixtures at different OA/DOPE molar ratios and that of DOPE–OA–DNA–Ca2+ complexes were determined using synchrotron small angle X-ray diffraction (SAXD). We identified inverted hexagonal phase HII as the dominant structure. OA affects the lattice parameter of HII formed by DOPE. With the increasing OA/DOPE molar ratio, the lattice parameter decreases, which results in significantly lower fraction of DNA bound to the OA-enriched complexes.
Additions and Corrections to the List of Alien Plant Species of Lithuania
Authors: Gudžinskas Zigmantas 
Published: July 2018

AbstractAddition of nine alien plant species and correction of the taxonomic position of one alien species was provided in this publication. Occurrence of three species, Gossypium hirsutum, Leymus racemosus and Senna obtusifolia, has not been reported in Lithuania, yet. Gossypium hirsutum and Senna obtusifolia are casual grain immigrants and their naturalization in the country is unlikely. Leymus racemosus probably has spread to Lithuania from Kaliningrad region of Russia, where it has been introduced intentionally. Currently, this species is treated as naturalized in the Curonian Spit (Western Lithuania). The status of Bellis perennis, which previously had variously been treated as native or alien species in Lithuania, was discussed. Although Malus domestica, Medicago ×varia, Oenothera casimiri and Salix ×fragilis have been reported occurring in Lithuania long ago, their status in the country has not been clearly defined. Considering non-native origin of one or both parental species of these four species, they also should be treated as alien in the country. Based on the results of taxonomic treatments, the occurrence of Salix euxina in Lithuania was confirmed. Cultivated and escaped plants, formerly known under the name Aronia melanocarpa, in fact are intergeneric hybrids and should be treated as ×Sorbaronia mitschurinii. Distribution, habitats, naturalization and impact of ten alien species were discussed. Notes on the taxonomy of several alien species were presented. Comments on improper documentation of several published molecular studies were presented and problems of the result interpretation were discussed.
Assessment of the Potential of Introduction, Establishment and Further Spread of Invasive Alien Plant Species of European Union Concern in Lithuania
Authors: Gudžinskas Zigmantas , Žalneravičius Egidijus , Petrulaitis Lukas 
Published: July 2018

AbstractThe list of invasive alien species of European Union concern currently includes 23 plant species. The aim of this study was to assess the potential and importance of introduction pathways for invasive alien plant species in Lithuania, to estimate probability of their establishment and further spread in the country. Analysis of all available information revealed that three species (Asclepias syriaca,Heracleum sosnowskyiandImpatiens glandulifera) currently occur in Lithuania and the latter two are widespread invasive species in the country. The remaining 20 plant species have not been registered in the wild in Lithuania so far. Four of these,Gunnera tinctoria,Lysichiton americanus,Myriophyllum aquaticumandPennisetum setaceum, are occasionally cultivated in gardens or other outdoor areas, and six species, e.g.Cabomba caroliniana,Eichhornia crassipes, Lagarosiphon major, are cultivated in aquaria or other indoor spaces. Naturalization of seven species is unlikely in the country, whereas naturalization of 13 species (Lysichiton americanus,Myriophyllum aquaticum,Pennisetum setaceum, etc.) is plausible. Five of the analysed and still not recorded species are recognized as potentially invasive in Lithuania; the invasion of five species is plausible and that of 10 species is unlikely. The most important pathway of introduction of the analysed species is ornamental gardening. Three species that have not been recorded in Lithuania, but occur in the neighbouring regions of Europe (Elodea nuttallii,Heracleum mantegazzianum,Heracleum persicum) can enter the country by natural means. Importance of permanent studies and surveys on alien plants aiming to ensure early detection and eradication of invasive species is discussed.