bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic anterior tibial stress fractures in athletes: No crack but intense remodeling
Authors: Schilcher Jörg , Bernhardsson Magnus , Aspenberg Per 
Published: May 2019

PurposeDelayed healing of anterior tibial stress fractures in athletes is related to high tensional forces acting across a putative fracture gap. These forces lead to crack propagation and create strains that exceed tissue differentiation thresholds for new bone to form in the gap. The “dreaded black line” is a radiographic hallmark sign of stress fractures considered to represent a transverse fracture gap. However, whether a fracture gap truly exists at the microscopic level remains unclear. The aim of this study was to describe the area of the “dreaded black line” microscopically and to identify signs of delayed healing.MethodsBetween 2011 and 2016, we included seven athletes with chronic anterior mid‐shaft tibial stress fractures. The fracture site was excised as a cylindrical biopsy. The biopsy was evaluated with micro‐CT and histology. The formation of new bone in the defect was evaluated radiographically.ResultsThe “dreaded black line” seen on pre‐operative radiographs in all patients could not be seen on the microscopic level. Instead, the area of the putative crack showed widened resorption cavities, lined with active osteoblasts, and surrounded by immature bone. This area of intense remodeling seemed to create a false impression of a fracture line on radiographs. Complete cortical continuity was restored at the biopsy site at median 8 months (range 6‐13 months).ConclusionTibial stress fractures in athletes normally show no fracture defect, but a region of increased remodeling. The healing process is already ongoing but seems mechanically insufficient.
Cardiorespiratory fitness as a predictor of short‐term and lifetime estimated cardiovascular disease risk
Authors: Swainson Michelle G. , Ingle Lee , Carroll Sean 
Published: May 2019

Development of cardiovascular disease (CVD) remains a public health concern for young to middle‐aged adults, now exacerbated by the increasing prevalence of obesity and sedentary lifestyles. Cardiorespiratory fitness (CRF) improves the reclassification of short‐term (10‐year) CVD risk, but has not been uniformly defined across studies. This study evaluated cross‐sectional differences in short‐term and lifetime CVD risk scores, across both absolute metabolic equivalent (MET) and sex‐ and age‐standardized CRF categories in 805 apparently healthy young to middle‐aged adults (68% male; 47.4 ± 7.2 years). CVD risk factors were evaluated, and estimated cardiorespiratory fitness (CRF) measurements (METS and peak VO2) were derived from a submaximal Bruce treadmill test. CRF measures also included post‐exercise heart rate recovery (HRR) data. Consistent trends showing more favorable risk factor profiles and lower short‐term CVD (QRISK2), and CVD mortality (SCORE) scores, associated with higher levels of CRF were evident in both sexes. Lifetime CVD risk (Q‐Lifetime) was highest in the lowest CRF categories. Peak VO2 and HRR following submaximal exercise testing contributed to the variability in short‐term and lifetime CVD risk. Global CVD risk predictions were examined across different contemporary CRF classifications with inconsistent findings. Recommended absolute MET and sex‐ and age‐standardized CRF categories were significantly associated with both short‐term and lifetime risk of CVD outcomes. However, compared to internationally derived normative CRF standards, cohort‐specific CRF categories resulted in markedly different proportion of individuals classified in the “poor” CRF category at higher CVD risk.
Potential and Impediments to Senior Citizens’ Volunteering to Maintain Basic Services in Shrinking Regions
Authors: Mettenberger Tobias , Küpper Patrick 
Published: May 2019

AbstractAgainst the background of demographic change and municipal austerity, policy‐makers are evoking the crucial role that younger retirees could play in supplementing the provision of basic services through volunteering. This article ties into this discussion, critically questioning the potential of (younger) senior citizens’ volunteering as a way of maintaining basic services in shrinking regions. Qualitative interviews from two regional case studies in rural Germany provide insights into the motivations, forms and contexts of such volunteering. The empirical results show that the potential for basic service provision is limited. Key players engaged in multiple activities and more‐passive types of contact‐seekers have little interest in taking on further tasks. Traditional basic services do not fit in with the interests of potential volunteers, and time budgets are constrained by alternative activities and commitments. Furthermore, volunteering is hampered by very basic structural conditions of peripheral rural life. Overall, our results reflect the heterogeneity and diversity of (older) rural milieus and lifestyles, and challenge persistent scientific perceptions of rural and, especially, village populations as place‐based closely knit communities.
Early infectious complications after autologous hematopoietic cell transplantation for multiple myeloma
Authors: Rahman Shafia , Rybicki Lisa , Ky Hamilton Betty , Pohlman Brad , Jagadeesh Deepa , Cober Eric , Kalaycio Matt , Dean Robert , Sobecks Ronald , Mossad Sherif B. , Majhail Navneet S. 
Published: May 2019

AbstractBackgroundThe spectrum of infectious complications in autologous hematopoietic cell transplant recipients (AHCT) with multiple myeloma has not been well described in the recent era of novel agent induction and improved supportive care.MethodsWe conducted a retrospective cohort study of 413 adult myeloma AHCT recipients at our institution from 2007‐2016 to describe the cumulative incidence and risk factors for various infections and FN occurring within the first 100 days after AHCT. Additionally, landmark analysis was done among 404 patients who survived at least 100 days after transplant admission to estimate the association of infections with subsequent non‐relapse mortality (NRM), overall survival (OS), and relapse‐free survival (RFS).ResultsCumulative incidences (95% CI) of infection events by day 100 were: FN 43% (38‐48), any infection 21% (17‐25), bacterial 17% (14‐21), viral 4% (3‐7) and fungal 1% (0.5‐3), central line‐associated blood stream infection 3% (2‐6), and Clostridium difficile colitis 6% (4‐8). Patients with infection had a longer initial transplant hospitalization (median 17 vs 16 days, P < 0.01), more readmissions (31% vs 8%, P < 0.01), and spent more days in hospital in first 100 days (median 18 vs 16 days, P < 0.01). A 100‐day mortality was low and similar between groups (2% vs 1%, P = 0.28). In landmark analysis of 404 100‐day survivors, OS was worse among patients with early infections (hazard ratio 1.54 [1.03‐2.30], P = 0.03), although there was no difference in NRM and RFS.ConclusionsNotwithstanding advances in supportive care, early infectious complications remain a relevant source of morbidity and require attention in myeloma AHCT recipients.
Serological and molecular screening of umbilical cord blood for Toxoplasma gondii infection
Authors: Botein Eman F. , Darwish Ahmad , El‐Tantawy Nora L. , EL‐baz Rizk , Eid Mohamed I. , Shaltot Ali M 
Published: May 2019

AbstractBackgroundHuman umbilical cord blood has proven to be a successful alternate source of hematopoietic stem cells for pediatric patients with major hematologic disorders. Toxoplasma gondii is a global opportunistic protozoan which cause fatal complications in immunocompromised individuals.AimOur goal is to study the prevalence of toxoplasmosis in umbilical cord blood (UCB) and to assess the sensitivity of ELISA and PCR for Toxoplasma infection screening.Material and MethodsOne hundred cord blood samples were collected immediately after delivery. Anti‐Toxoplasma IgG and IgM antibodies were determined using ELISA method; Toxoplasma DNA was detected using nested PCR technique. Total nucleated cells (TNC) and HB were also determined. Demographic data and risk factors data related to the transmission of toxoplasmosis, were collected from mothers.ResultsAmong 100 cord blood samples, 36 (36%) were positive for anti‐Toxoplasma IgG antibodies and 6 (6%) were positive for anti‐Toxoplasma IgM antibodies. The nested PCR showed 11 (11%) samples containing Toxoplasma DNA from which, 6 (55%) samples were IgM positive. There was no significant association between the risk of Toxoplasma transmission and cord blood positivity for toxoplasmosis.ConclusionOwing to the prevalence of toxoplasmosis, its rapid progression and its fatal outcome in immunocompromised patients, cord blood screening for toxoplasmosis with nested PCR should be incorporated into cord blood bank screening protocols.
A guide to indications, components and interpretation of urodynamic investigations
Authors: Taithongchai Annika , Sultan Abdul H , Thakar Ranee 
Published: May 2019

Key content

Indications for urodynamic investigations include urinary tract symptoms such as urge incontinence, stress urinary incontinence (SUI) and neurological urinary incontinence.

Components of urodynamic testing include a physical assessment along with representative uroflowmetry with post‐void residual (PVR), transurethral cystometry and a pressure‐flow study.

It is important for clinicians to understand key physiological measurements and parameters of lower urinary tract function.

There are many factors to consider when interpreting results from urodynamic investigations, and it is vital for documentation to be accurate and methodical.

Learning objectives

To understand the key indications and components of urodynamics and how to define a clear question prior to starting investigations.

To learn accepted physiological parameters for lower urinary tract functions and apply these to a concise method of interpreting urodynamic results.

To acknowledge the limitations of an investigation when attempting to reproduce pathology in an artificial environment.

Ethical issues

Should all women undergoing an incontinence procedure have urodynamic investigations?

Who to believe – the patient or the test?
Multiple sclerosis and pregnancy
Authors: Kanagaraj Priya , Evangelou Nikos , Kapoor Dipanwita 
Published: May 2019

Key content

Multiple sclerosis (MS) is a chronic neurological disease that manifests with clinical and subclinical attacks of central nervous system demyelination.

Women are at least twice as likely as men to suffer from MS, with a mean age of onset of 30 years.

Pregnancy has no adverse long‐term effect on disease progression, but it is associated with a higher relapse rate in the immediate postpartum period.

Pregnancy can worsen pre‐existing urinary/bowel dysfunction and motor problems.

MS is not associated with significant obstetric or neonatal complications.

Learning objectives

To understand how to manage pregnant women with MS in the multidisciplinary setting.

To understand the importance of pre‐pregnancy counselling for women with MS who are on disease‐modifying drugs.

To understand the implications of pregnancy on MS symptoms and their management.

To be aware of the benefits of breastfeeding and the safety of disease‐modifying drugs and lactation.

Ethical issues

In the absence of clear guidelines, should women ever be advised to avoid pregnancy?

Should women be offered in vitro fertilisation treatment, which is known to increase disease relapse?
The effect of subchronic oral exposure to zearalenone on hematologic and biochemical analytes, and the blood redox status of adult rabbit bucks
Authors: Tsouloufi Theodora K. , Tsakmakidis Ioannis A. , Tsousis Georgios , Papaioannou Nikolaos , Tzika Eleni , Kritsepi‐Konstantinou Maria 
Published: May 2019

AbstractBackgroundZearalenone (ZEN) is a mycoestrogen with a ubiquitous presence in animal feeds, which also has hematotoxic, hepatotoxic, nephrotoxic, and immunotoxic properties. However, there is a paucity of literature that discusses the effects of ZEN on rabbits.ObjectivesThe aim of this study was to evaluate the effect of a prolonged, low‐level (50 μg ZEN/kg body weight) exposure on the clinicopathologic and redox status analytes of rabbit bucks.MethodsTen adult bucks were included in the study. Each underwent a 7‐week control period, followed by a 7‐week exposure period. Water or ZEN solutions were daily administered orally (0.5 mL) during the control and exposure periods, respectively. Blood samples were collected weekly for Complete Blood Counts, serum biochemical analyte and reactive oxygen metabolite (ROM) measurements. Data were analyzed using a mixed model, and the level of significance was set at a P of <0.05.ResultsDuring the ZEN exposure period, significant increases were noted in the red blood cell distribution width (RDW) and mean platelet volumes (MPVs), as well as in the white blood cell, monocyte, and eosinophil counts. Significant increases were observed in aspartate aminotransferase and total bilirubin, whereas urea, creatinine, glucose, total calcium, sodium, and potassium concentrations were significantly decreased. The ROM concentrations did not differ significantly between the control and ZEN exposure periods.ConclusionsUnder the present experimental conditions, ZEN affected some of the clinicopathologic analytes of adult rabbit bucks; these changes were mostly indicative of mild hepatocellular damage and dysfunction, inflammatory and/or allergic responses, and renal tubular damage. A ZEN dose of 50 μg/kg body weight did not seem to affect the blood redox status of bucks, as evaluated by the ROM concentrations.
Thermal Performance and Operating Regimes of a Flat Pulsating Heat Pipe for the Temperature Homogenization of Two Symmetric Plates
Authors: Dell'innocenti Aline , Lips Stéphane , Sartre Valérie , Blet Nicolas , Coulloux Jérôme , Bonjour Jocelyn 
Published: May 2019

Abstract
A copper–water closed flat pulsating heat pipe (PHP), 3.4 m long and of inner diameter 4 mm, was manufactured and tested. This PHP aims both at homogenizing the temperature of a large aluminum plate, of surface area 150 × 420 mm2, and at lowering its mean temperature by transferring the heat to an adjacent heat sink of same dimensions. The PHP thermal resistance is measured at various heat transfer rates, condenser temperatures, and inclination angles. It decreases when the heat transfer rate increases or when the PHP is progressively tilted from the vertical unfavorable orientation to a favorable one. Resistance values as low as 0.04 K/W are measured. Whatever the conditions, a minimum heat input of 200 W is necessary for the correct start-up of the PHP. A map of the operating regimes—no-flow, oscillating, intermittent, and stable behavior—is proposed. Nonreproducibility effects are highlighted in tilted position, leading to different operating regimes at increasing and decreasing heat loads, but also more broadly depending on the history of the working operating conditions of the PHP. However, the concept proposed in this work is very promising for applications involving large heat source and heat sink.
Intrathrombus polymer coating deposition: a pilot study of 91 patients undergoing endovascular therapy for acute large vessel stroke. Part I: Histologic frequency
Authors: Mehta Rashi I , Rai Ansaar T , Vos Jeffrey A , Solis Orestes E , Mehta Rupal I 
Published: May 2019

BackgroundPolymer coating embolism due to vascular medical device use is an increasingly recognized iatrogenic complication. This phenomenon has been linked with various adverse effects including neuroinflammation, acute ischemic stroke, cerebral hemorrhage, and death. Notably, procedure- and device-specific risks of this complication are poorly investigated. In this study, we evaluate the detectable frequency of intra-arterial polymer coating delamination among patients who underwent endovascular thrombectomy for treatment of acute ischemic stroke due to large vessel occlusion.MethodsNinety-two cerebral thrombectomy specimens were retrospectively analyzed for the presence of polymer coating particulates. Histologic findings were correlated with demographic and procedural details and patient outcomes.ResultsEvidence of polymer coating deposition was found in 30 of 92 extracted thrombi (33%). No correlation between intrathrombus polymer deposition and use of a specific thrombectomy device such as a stent retriever, aspiration catheter, or guide catheter was found. However, heterogeneous patterns of device use suggest a number of culprit devices. A trend toward longer procedure times and multiple thrombectomy passes was noted in positive cases. Intrathrombus polymer deposition was not associated with adverse clinical outcomes as measured by the 90-day modified Rankin Scale (mRS); however, small sample size and follow-up intervals limit interpretation. Ninety-day outcomes based on mRS may not fully capture the clinical effects of acute and/or delayed intracerebral polymer complications.ConclusionIn light of documented adverse neurologic effects, the frequency of intrathrombus polymer particulates indicates the need for consensus testing methods and large-scale long-term prospective clinical device trials, with inclusion of relevant endpoints to better assess biomaterial and device risks to patients.
Intra-arterial chemotherapy for retinoblastoma: an updated systematic review and meta-analysis
Authors: Ravindran Krishnan , Dalvin Lauren A , Pulido Jose S , Brinjikji Waleed 
Published: May 2019

Background and purposeIntra-arterial chemotherapy for retinoblastoma has been adopted as a first-line treatment option by numerous tertiary centers. The effect of intra-arterial chemotherapy on future rates of metastatic disease as well as on globe salvage in advanced eyes remains relatively unknown.MethodsA search of PubMED, MEDLINE, EMBASE, and Web of Science electronic databases was conducted from inception until January 2019 for studies with a minimum of 10 patients reporting outcomes and complications following intra-arterial chemotherapy for retinoblastoma.ResultsA total of 20 studies met the inclusion criteria for analysis, comprising 873 patients and 1467 eyes. Only one study was comparative; there was substantial heterogeneity in reported outcomes and several overlapping patient cohorts that were published. Across all studies, 174 of 1467 eyes were enucleated (11.8%). Metastatic disease occurred in 8 of 513 patients (1.6%). Globe salvage was achieved in 318 of 906 (35.6%) cases of advanced retinoblastoma. The most common ocular complication was retinal detachment, occurring in 23% of eyes, and the most common systemic complications were transient fever and nausea/vomiting.ConclusionsThere is a paucity of higher-level evidence with adequate follow-up surrounding the long-term safety of intra-arterial chemotherapy and effect on metastasis in retinoblastoma. Studies to date have been limited by short-term follow-up. Longitudinal prospective studies could provide greater insight into the ability of intra-arterial chemotherapy to reduce the risk of retinoblastoma metastasis.
Short regimen of rituximab plus lenalidomide in follicular lymphoma patients in need of first-line therapy
Authors: Zucca Emanuele , Rondeau Stephanie , Vanazzi Anna , Østenstad Bjørn , Mey Ulrich J. M. , Rauch Daniel , Wahlin Björn E. , Hitz Felicitas , Hernberg Micaela , Johansson Ann-Sofie , de Nully Brown Peter , Hagberg Hans , Ferreri Andrés J. M. , Lohri Andreas , Novak Urban , Zander Thilo , Bersvendsen Hanne , Bargetzi Mario , Mingrone Walter , Krasniqi Fatime , Dirnhofer Stefan , Hayoz Stefanie , Hawle Hanne , Vilei Simona Berardi , Ghielmini Michele , Kimby Eva 
Published: May 2019

AbstractThe SAKK 35/10 phase 2 trial, developed by the Swiss Group for Clinical Cancer Research and the Nordic Lymphoma Group, compared the activity of rituximab vs rituximab plus lenalidomide in untreated follicular lymphoma patients in need of systemic therapy. Patients were randomized to rituximab (375 mg/m2 IV on day 1 of weeks 1-4 and repeated during weeks 12-15 in responding patients) or rituximab (same schedule) in combination with lenalidomide (15 mg orally daily for 18 weeks). Primary end point was complete response (CR)/unconfirmed CR (CRu) rate at 6 months. In total, 77 patients were allocated to rituximab monotherapy and 77 to the combination (47% poor-risk Follicular Lymphoma International Prognostic Index score in each arm). A significantly higher CR/CRu rate at 6 months was documented in the combination arm by the investigators (36%; 95% confidence interval [CI], 26%-48% vs 25%; 95% CI, 16%-36%) and confirmed by an independent response review of computed tomography scans only (61%; 95% CI, 49%-72% vs 36%; 95% CI, 26%-48%). After a median follow-up of 4 years, significantly higher 30-month CR/CRu rates and longer progression-free survival (PFS) and time to next treatment (TTNT) were observed for the combination. Overall survival (OS) rates were similar in both arms (≥90%). Toxicity grade ≥3 was more common in the combination arm (56% vs 22% of patients), mainly represented by neutropenia (23% vs 7%). Addition of lenalidomide to rituximab significantly improved CR/CRu rates, PFS, and TTNT, with expected higher, but manageable toxicity. The excellent OS in both arms suggests that chemotherapy-free strategies should be further explored. This trial was registered at www.clinicaltrials.gov as #NCT01307605.
Identification and transcriptome analysis of erythroblastic island macrophages
Authors: Li Wei , Wang Yaomei , Zhao Huizhi , Zhang Huan , Xu Yuanlin , Wang Shihui , Guo Xinhua , Huang Yumin , Zhang Shijie , Han Yongshuai , Wu Xianfang , Rice Charles M. , Huang Gang , Gallagher Patrick G. , Mendelson Avital , Yazdanbakhsh Karina , Liu Jing , Chen Lixiang , An Xiuli 
Published: May 2019

AbstractThe erythroblastic island (EBI), composed of a central macrophage and surrounding erythroid cells, was the first hematopoietic niche discovered. The identity of EBI macrophages has thus far remained elusive. Given that Epo is essential for erythropoiesis and that Epor is expressed in numerous nonerythroid cells, we hypothesized that EBI macrophages express Epor so that Epo can act on both erythroid cells and EBI macrophages simultaneously to ensure efficient erythropoiesis. To test this notion, we used Epor-eGFPcre knockin mouse model. We show that in bone marrow (BM) and fetal liver, a subset of macrophages express Epor-eGFP. Imaging flow cytometry analyses revealed that &gt;90% of native EBIs comprised F4/80+Epor-eGFP+ macrophages. Human fetal liver EBIs also comprised EPOR+ macrophages. Gene expression profiles of BM F4/80+Epor-eGFP+ macrophages suggest a specialized function in supporting erythropoiesis. Molecules known to be important for EBI macrophage function such as Vcam1, CD169, Mertk, and Dnase2α were highly expressed in F4/80+Epor-eGFP+ macrophages compared with F4/80+Epor-eGFP− macrophages. Key molecules involved in iron recycling were also highly expressed in BM F4/80+Epor-eGFP+ macrophages, suggesting that EBI macrophages may provide an iron source for erythropoiesis within this niche. Thus, we have characterized EBI macrophages in mouse and man. Our findings provide important resources for future studies of EBI macrophage function during normal as well as disordered erythropoiesis in hematologic diseases such as thalassemia, polycythemia vera, and myelodysplastic syndromes.