bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Predicting the Outcome After Arthroscopically Assisted Stabilization of Acute High-Grade Acromioclavicular Joint Dislocations
Authors: Maziak Nina , Audige Laurent , Hann Carmen , Minkus Marvin , Scheibel Markus 
Published: August 2019

Background: Factors influencing the outcome after arthroscopically assisted stabilization of acute high-grade acromioclavicular (AC) joint dislocations remain poorly investigated. Purpose: To identify determinants of the radiological outcome and investigate associations between radiological and clinical outcome parameters. Study Design: Cohort study; Level of evidence, 3. Methods: The authors performed a retrospective analysis of patients who underwent arthroscopically assisted stabilization for acute high-grade AC joint dislocations. The following potential determinants of the radiological outcome were examined using univariable and multivariable regression analyses: timing of surgery, initial AC joint reduction, isolated coracoclavicular (CC) versus combined CC and AC stabilization, ossification of the CC ligaments, age, and overweight status. In addition, associations between radiological (ie, CC difference, dynamic posterior translation [DPT]) and clinical outcome parameters (Subjective Shoulder Value, Taft score [TS] subjective subcategory, and Acromioclavicular Joint Instability Score [ACJI] pain subitem) were evaluated using univariable analysis. Results: One hundred four patients with a mean (±SD) age of 38.1 ± 11.5 years were included in this study. The mean postoperative follow-up was 2.2 ± 0.9 years. Compared with patients with an overreduced AC joint after surgery, the CC difference was 4.3 mm (95% CI, 1.3-7.3; P = .006) higher in patients with incomplete reduction. Patients with anatomic reduction were 3.1 times (95% CI, 1.2-7.9; P = .017) more likely to develop DPT than those with an overreduced AC joint. An incompletely reduced AC joint was 5.3 times (95% CI, 2.1-13.4; P < .001) more likely to develop DPT versus an overreduced AC joint. Patients who underwent isolated CC stabilization were 4.8 times (95% CI, 1.1-21.0; P = .039) more likely to develop complete DPT than patients with additional AC stabilization. Significantly higher CC difference values were noted for patients who reported pain on the subjective TS ( P = .025). Pain was encountered more commonly in patients with DPT ( PTS = .049; PACJI = .038). Conclusion: Clinicians should consider overreduction of the AC joint because it may lead to favorable radiological results. Because of its association with superior radiographic outcomes, consideration should also be given to the use of additional AC cerclage.
Use of an On-Site Outpatient Pharmacy for Acquisition of Antiretroviral Medications Compared to Off-Site Pharmacy Options: Impact on Retention in Care and Clinical Outcomes in People Living With HIV
Authors: Lauer Brian R. , Duggan Joan M. , Eitniear Lindsey , Jung Rose , Sahloff Eric G. 
Published: August 2019

Background: Few published studies have examined the relationship between pharmacy location and retention in care or clinical outcome in people living with HIV (PLWH). Objective: The study purpose was to determine whether using an on-site/in-clinic pharmacy to obtain antiretroviral therapy increased retention in care and virologic suppression rates. Methods: PLWH attending a Ryan White outpatient clinic in an academic center were matched based on age and insurance. Rates of retention in care ( ≥2 medical visits/calendar year) were assessed between patients using a pharmacy on-site in the clinic versus patients use off-site pharmacy options. Virologic suppression [viral load(VL)<200 copies/mL], completing ≥2 VL, and CD4 count were compared between pharmacy types. Results: 137 on-site pharmacy patients and 274 off-site pharmacy patients met inclusion and matching criteria. 91.2% of on-site pharmacy users attended ≥2 clinic visits compared to 83.2% of off-site pharmacy users ( P = .0275) and were approximately twice as likely to complete ≥2 clinic visits (odds ratio: 2.032; 1.071-3.857). A similar proportion of the on-site pharmacy group achieved virologic suppression compared to the off-site pharmacy group (92.7% vs 89.1%; P = .239, respectively). Conclusions: On-site pharmacies may provide an opportunity to positively impact retention in care and clinical outcomes for PLWH.
Effects of quercetin and rosuvastatin each alone or in combination on cyclophosphamide-induced premature ovarian failure in female albino mice
Authors: Elkady MA , Shalaby S , Fathi F , El-Mandouh S 
Published: August 2019

Background: Cyclophosphamide (CP) causes premature ovarian failure (POF) due to ovarian toxicity. The toxicity mechanism is attributed to oxidative stress, inflammation, and apoptosis. We assessed whether quercetin and rosuvastatin could promote ovarian protection against CP ovotoxicity. Methods: A total of 80 female BALB/c mice were randomly assigned; 10 mice into each of eight groups. Group 1 (control), group 2 (EH), group 3 (CP), group 4 (QH), group 5 (QL), group 6 (RH), group 7 (RL), and group 8 (COM). Results: Quercetin and rosuvastatin groups (4:8) showed signs of restored ovarian function in the form of a significant, dose-dependent increase in primordial follicles number, serum anti-Mullerian hormone level, and ovarian tissue glutathione level ( p < 0.05) versus group 3, and a significant, dose-dependent decrease in atretic follicles number and ovarian tissue level of malondialdehyde ( p < 0.05) versus group 3. Immunohistochemistry analysis demonstrated a lower expression of caspase and nuclear factor-kappa B of groups (4:8) versus group 3, although quercetin and rosuvastatin showed a nonsignificant reduction in tumor volume. Conclusions: We demonstrated the protective effect of quercetin and rosuvastatin against ovarian toxicity and POF induced by CP without compromising its antitumor effect.
Infratentorial and spinal cord lesions: Cumulative predictors of long-term disability?
Authors: Dekker Iris , Sombekke Madeleine H , Balk Lisanne J , Moraal Bastiaan , Geurts Jeroen JG , Barkhof Frederik , Uitdehaag Bernard MJ , Killestein Joep , Wattjes Mike P 
Published: August 2019

Objective: The objective of the study was to determine whether early infratentorial and/or spinal cord lesions are long-term cumulative predictors of disability progression in multiple sclerosis (MS). Methods: We selected 153 MS patients from the longitudinal Amsterdam MS cohort. Lesion analysis was performed at baseline and year 2. Disability progression after 6 and 11 years was measured using the Expanded Disability Status Scale (EDSS) and EDSS-plus (including 25-foot walk and 9-hole peg test). Patients with spinal cord or infratentorial lesions were compared for the risk of 6- and 11-year disability progression to patients without spinal cord or infratentorial lesions, respectively. Subsequently, patients with lesions on both locations were compared to patients with only spinal cord or only infratentorial lesions. Results: Baseline spinal cord lesions show a higher risk of 6-year EDSS progression (odds ratio (OR): 3.6, p = 0.007) and EDSS-plus progression (OR: 2.5, p = 0.028) and 11-year EDSS progression (OR: 2.8, p = 0.047). Patients with both infratentorial and spinal cord lesions did not have a higher risk of 6-year disability progression than patients with only infratentorial or only spinal cord lesions. Conclusion: The presence of early spinal cord lesions seems to be a dominant risk factor of disability progression. Simultaneous presence of early infratentorial and spinal cord lesions did not undisputedly predict disability progression.
The Dilemma of Drains after Pancreatoduodenectomy: Still an Issue?
Authors: Andersson R. , Søreide K. , Ansari D. 
Published: August 2019

Background and Aims: Routine drainage after pancreatoduodenectomy is a controversial issue. In this article, we present and discuss the current evidence on abdominal drains in pancreatic surgery. Material and Methods: Review of the pertinent English-language literature. Results: There is a growing body of evidence showing a lack of benefit of prophylactic drainage after pancreatoduodenectomy. Randomized trials have reported similar outcomes with or without routine drains. If drains were used, early removal was found to be superior to late removal in patients with a low risk of postoperative pancreatic fistula. Consequently, criteria for early drain removal have been developed based on the measurement of drain amylase levels. On the contrary, there exists a subgroup of patients where drains may have a role. In patients with high risk of pancreatic fistula formation, such as those having a soft pancreatic texture, small pancreatic duct and high body mass index, the placement of drains may give sentinel information about future clinical deterioration. The drain may thus help reduce failure-to-rescue rates. Conclusion: Despite much research, there are many unanswered questions regarding drains in pancreatic surgery. It is evident that routine drainage should be abandoned for a more selective strategy. Furthermore, what is needed is a postoperative warning score that early on can identify patients at risk of a pancreatic fistula, without the routine placement of drains.
Antinociceptive effectiveness of the inhibition of NCX reverse-mode action in rodent neuropathic pain model
Authors: Huang Yang , Wen Li-Li , Xie Jing-Dun , Ouyang Han-Dong , Chen Dong-Tai , Zeng Wei-An 
Published: August 2019

Background Chronic neuropathic pain is a debilitating condition that remains difficult to treat. The Na+-Ca2+ exchanger (NCX) is a transporter that can exchange Ca2+ with Na+ in either direction to maintain intracellular Ca2+ homeostasis. However, the effect of NCX on neuropathic pain remains unclear. Therefore, in this study, we aimed to clarify whether neuropathic pain is altered by NCX. Methods Adult Sprague–Dawley rats and mice (NCX2 knockout and wild type) were randomized to receive spinal nerve ligation surgery or intrathecal injection. Using behavioral testing to analyze the withdrawal thresholds and thermal withdrawal latency of rats after surgery or intrathecal injection. Immunohistochemistry and Western blotting were used to analyze the changes of NCX protein and downstream signaling pathways in rats dorsal root ganglion. We isolated the dorsal root ganglion neurons of adult rats using Fluo-4AM to detect the Ca2+ imaging in neurons after drug treatment. Results NCX was expressed in the sensory neurons of rodent dorsal root ganglia. NCX expression was altered in ipsilateral L4–6 dorsal root ganglion neurons in spinal nerve ligation rats. Intrathecal injection of an inhibitor of reverse-mode NCX activity (KB-R7943 5∼20 µg) had an antinociceptive effect in spinal nerve ligation rats, and the effect lasted for 3 h. We measured the expression of signaling pathway molecules in dorsal root ganglion neurons, and only the p-extracellular signal-regulated kinase (ERK) 1/2 level was reduced after intrathecal injection in the spinal nerve ligation group compared to the control group. In cultured dorsal root ganglion neurons, inhibitors of reverse-mode NCX activity (KB-R7943 and ORM-10103) restrained Ca2+ overload after tumor necrosis factor alpha (TNF-α) or lipopolysaccharide (LPS) treatment. NCX2 knockout mice presented an antinociceptive effect that lasted for more than 28 days after spinal nerve ligation surgery. The p-ERK1/2 level in NCX2 knockout mice ipsilateral L4–6 dorsal root ganglion neurons was lower than that in wild-type mice. Conclusions NCX proteins may mediate neuropathic pain progression via the Ca2+ and ERK pathways. NCX represents a potential target for the treatment of neuropathic pain.
Reproductive health care utilization among refugees in Jordan: Provisional support and domestic violence
Authors: Pierce Hayley 
Published: August 2019

Objectives: Conflict and displacement are associated with poverty, disruption of services, loss of identity, reduced care for reproductive needs, and reduced provision of health care, among other things. This article uses the framework outlined by Obermeyer and Potter to test how refugee and native status influence utilization of reproductive health services and experience with domestic violence in a context of high refugee inhabitants and strong refugee-focused non-governmental organization presence. This article addresses the following: (1) coverage, source, and method of contraceptives; (2) variation in reproductive health experience by source of contraception; and finally, (3) factors determining variation in the utilization of reproductive health services and domestic violence experiences for individuals living in and out of refugee camps. Methods: The data is the 2012 Jordan Demographic and Health Survey, and the method utilized is logistic regression. Results: Findings suggest that refugee women serviced by the United Nations Relief and Works Agency have greater access to health-related resources (family planning and contraception), but they have weaker positions in the family as evidenced by domestic violence experiences. Conclusion: It is plausible that provisional resources are the easiest for an aid organization to provide, while the complications of identity loss and the loss of a sense of space pose a challenge for refugees and aid organizations.
Long-term follow up after endoscopic valve therapy in patients with severe emphysema
Authors: Gompelmann Daniela , Heinhold Tobias , Rötting Matthias , Bischoff Elena , Kontogianni Konstantina , Eberhardt Ralf , Herth Felix J. F. 
Published: August 2019

Background and objective: Endoscopic valve therapy is a treatment modality in patients with advanced emphysema and absent interlobar collateral ventilation (CV). So far, long-term outcome following valve implantation has been insufficiently evaluated. The aim of this study was to investigate the real-world efficacy of this interventional therapy over 3 years. Methods: From 2006 to 2013, 256 patients with severe emphysema in whom absent CV was confirmed underwent valve therapy. The 3-year effectiveness was evaluated by pulmonary function testing (VC, FEV1, RV, TLC), 6-minute-walk test (6-MWT) and dyspnea questionnaire (mMRC). Long-term outcome was also assessed according to the radiological outcome following valve placement. Results: Of 256 patients treated with valves, 220, 200, 187, 100 and 66 patients completed the 3-month, 6-month, 1-year, 2-year and 3-year follow-up (FU) visit, respectively. All lung function parameters, 6-MWT and mMRC were significantly improved at 3- and 6-month FU. At 1-year FU, patients still experienced a significant improvement of all outcome parameters expect VC (L) and TLC (%). At 2 years, RV (L and %) and TLC (L and %) remained significantly improved compared to baseline. Three years after valve therapy, sustained significant improvement in mMRC was observed and the proportion of patients achieving a minimal clinically important difference from baseline in RV and 6-MWT was still 71% and 46%, respectively. Overall, patients with complete lobar atelectasis exhibited superior treatment outcome with 3-year responder rates to FEV1, RV and 6-MWT of 10%, 79% and 53%, respectively. Conclusions: Patients treated by valves experienced clinical improvement over 1 year following valve therapy. Afterwards, clinical benefit gradually declines more likely due to COPD progression. The reviews of this paper are available via the supplemental material section.
Therapeutic exercise for adults post-distal radius fracture: An overview of systematic reviews of randomized controlled trials
Authors: Ziebart Christina , Nazari Goris , MacDermid Joy C 
Published: August 2019

Introduction Optimizing recovery after a distal radius fracture is a major concern. There continues to be discrepancies in findings on whether therapeutic exercise improves activity and participation by reducing limitations such as pain and range of motion after fracture. The main objective of this overview was to critically appraise the evidence to establish the effectiveness of therapeutic exercise to improve impairment for adults after a distal radius fracture. Methods An overview of systematic reviews was used, which summarizes a number of systematic reviews. PubMed, CINAHL, PEDro, Scopus, Web of Science, and Cochrane Library were searched. Systematic reviews were included in this overview if the study population was adults after a distal radius fracture, and the intervention group was therapeutic exercise. A systematic review was excluded from this overview if it did not include randomized controlled trials, the full text was not published, or if they were scoping or narrative reviews. The outcomes evaluated were pain, function/disability, range of motion, and strength. Results Five systematic reviews were included in this overview, with between 7 and 26 randomized controlled trials included in the SRs. The overall quality of the reviews was low with two systematic reviews rated as low quality and three rated as critically low quality on the AMSTAR 2 assessment tool. Conclusion The quality of reviews was low, with high risk of bias. All reviews were inconclusive due to limitations in the number and quality of randomized controlled trials. Due to the low quality of evidence, it remains unclear what the effectiveness of exercise is to improve impairments after a distal radius fracture.
Assessing the information quality and usability of My Health Record within a health literacy framework: What’s changed since 2016?
Authors: Walsh Louisa , Hemsley Bronwyn , Allan Meredith , Dahm Maria R , Balandin Susan , Georgiou Andrew , Higgins Isabel , McCarthy Shaun , Hill Sophie 
Published: August 2019

Background: This study examined the health literacy demands of My Health Record (MyHR) in the context of preparing for a government-announced opt-out system by repeating two studies of health information and usability conducted in 2016. Objective: To examine whether Australia’s MyHR meets the information and usability needs of people at risk of low health literacy and changes since 2016. Method: Content analysis: Informed by the 2016 methods and findings, measures of information quality, themes and target audiences were recorded and reported for each online consumer-facing health information resource. Heuristic evaluation: An evaluation of the MyHR and supporting information website was conducted using a predetermined checklist of usability criteria. A list of usability violations for both websites was identified. Results: Total number of resources grew from 80 in 2016 to 233 in 2018. There was little change since 2016 to average readability levels, target audiences, presentation style, links between resources and usability of MyHR. Compared to 2016, this study demonstrated increases in resources from non-government organisations; video resources; translated resources; and resources with themes of privacy, security and post-registration use. Conclusion: This study identified some improvements in information quality since 2016, but gaps remain in information quality and usability which may negatively impact the ability for people with low health literacy to access and use MyHR. Implications: This study provides a framework for ongoing monitoring and evaluation of the suitability of MyHR for people at risk of low health literacy.
Split Thickness Skin Graft of the Foot and Ankle Bolstered With Negative Pressure Wound Therapy in a Diabetic Population: The Results of a Retrospective Review and Review of the Literature
Authors: Gkotsoulias Efthymios 
Published: August 2019

Split thickness skin graft (STSG) is a versatile procedure performed for the treatment of wounds resulting from varying pathology. This remains very useful because of its ability for quick healing and low complication rate. The surface of the foot and ankle is an area frequently affected by severe skin and soft tissue structure infections (SSTIs) whose treatment results in wounds. These infections and resultant surgical wounds are commonly seen patients with diabetes. The objective of the present study was to retrospectively evaluate initial healing and immediate post-operative outcomes following STSG application in a diabetic population when negative pressure wound therapy (NPWT) was used as a bolster. Ten patients were identified, including 11 surgical wounds, who underwent STSG bolstered with NPWT from January 2016 to October 2018. Mean follow-up was 13 months (range 1-33 months) with an average time to heal of 17 days (range 14-30 days) for 11 surgical wounds averaging 57 cm2 (range 6.3 - 91 cm2). Consistent improved outcomes have been demonstrated when compared to alternative bolstering techniques available in the literature making a STSG bolstered with NPWT a powerful tool in the reconstruction of diabetic foot wounds resulting from the treatment of infection. Levels of Evidence: Level IV
A 3-Dimensional In Vitro Model of Zonally Organized Extracellular Matrix
Authors: Walzer Sonja M. , Toegel Stefan , Chiari Catharina , Farr Sebastian , Rinner Beate , Weinberg Annelie-Martina , Weinmann Daniela , Fischer Michael B. , Windhager Reinhard 
Published: August 2019

Objective Functional cartilage repair requires the new formation of organized hyaline cartilaginous matrix to avoid the generation of fibrous repair tissue. The potential of mesenchymal progenitors was used to assemble a 3-dimensional structure in vitro, reflecting the zonation of collagen matrix in hyaline articular cartilage. Design The 3-dimensional architecture of collagen alignment in pellet cultures of chondroprogenitors (CPs) was assessed with Picrosirius red staining analyzed under polarized light. In parallel assays, the trilineage capability was confirmed by calcium deposition during osteogenesis by alizarin S staining and alkaline phosphatase staining. Using reverse transcription–quantitative polymerase chain reaction (RT-qPCR), mRNA levels of ALP, RUNX2, and BGLAP were assessed after 21 days of osteoinduction. Lipid droplets were stained with oil red O and adipogenic differentiation was confirmed by RT-qPCR analysis of PPARG and LPL gene expression. Results Under conditions promoting the chondrogenic signature in self-assembling constructs, CPs formed an aligned extracellular matrix, positive for glycosaminoglycans and collagen type II, showing developing zonation of birefringent collagen fibers along the cross section of pellets, which reflect the distribution of collagen fibers in hyaline cartilage. Induced osteogenic and adipogenic differentiation confirmed the trilineage potential of CPs. Conclusion This model promotes the differentiation and self-organization of postnatal chondroprogenitors, resulting in the formation of zonally organized engineered hyaline cartilage comparable to the 3 zones of native cartilage.