bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repair Integrity in Patients Returning for an Unscheduled Visit After Arthroscopic Rotator Cuff Repair: Retorn or Not?
Authors: Rizvi Syed Mohammed Taif , Lam Patrick , Murrell George A.C. 
Published: June 2018

Background: After rotator cuff repair, some patients have ongoing problems significant enough to warrant presentation to a clinic for reassessment. Purpose/Hypothesis: The purpose of this study was to determine whether this cohort of patients was more likely to have a healed rotator cuff. We hypothesized that patients who had an unscheduled postoperative visit were more likely to have a healed rotator cuff than those who did not have an unscheduled postoperative visit. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 321 consecutive patients who underwent arthroscopic rotator cuff repair were evaluated; of these, 50 patients had an unscheduled return to clinic that included an ultrasound assessment of the cuff repair within 4 months postoperatively. Repair integrity was evaluated in all patients at 6 months postoperatively via ultrasonography. Results: The failure-to-heal rate was greater in patients who had an unscheduled assessment (8/50; 16%) than in those who did not (14/275; 5%) ( P = .01). The patients most likely to have a repair failure were those who were assessed before 2 weeks and after 12 weeks (7/18; 39%) compared with those who were assessed between 3 and 12 weeks (1/32; 3%) ( P = .001). The failure-to-heal rate was very low in patients who had an unscheduled assessment with a tear size smaller than 4 cm2 (0/34; 0%) compared with those with tear sizes greater than 4 cm2 (8/16; 50%) ( P < .0001, Fisher exact text). Conclusion: Patients who had an unscheduled clinic visit after rotator cuff repair had a 16% chance of a failed healing response, whereas those who did not have an unscheduled visit had a 5% rate of failed healing. The risk of a failed healing response was greater if the tear was larger than 4 cm2, if patients presented within 2 weeks following surgery, or if they presented after 12 weeks postsurgery.
Cost-effectiveness of Treating Severe Childhood Caries under General Anesthesia versus Conscious Sedation
Authors: Burgette J.M. , Quiñonez R.B. 
Published: June 2018

Background: Two common methods of treating pediatric dental patients with severe early childhood caries (S-ECC) are general anesthesia (GA) and conscious sedation (CS). We sought to first evaluate the cost-effectiveness of treating S-ECC with GA versus CS and then compare the cost-effectiveness at 2 time points: 2011 and 2015. Methods: We used a decision tree model to produce 2-y estimates of costs and outcomes from the Medicaid perspective. The model cohort consisted of healthy 3-y-olds with S-ECC in need of a theoretical set of dental treatments to be performed under either a single GA visit or 3 CS visits. Outcomes were measured in caries-free months. Costs were evaluated in 2015 US dollars. Costs, probabilities, and outcomes were estimated from published data, expert opinion, and Medicaid billing at an academic health center. One-way and probabilistic sensitivity analyses were performed. Results: As compared with CS, GA resulted in 4 additional caries-free months per child. The cost of a caries-free month for GA versus CS rose from $596 in 2011 to $881 in 2015. These findings were sensitive to loss to follow-up for subsequent CS visits and total cost of GA. Conclusions: Comprehensive S-ECC treatment had better outcomes when performed under GA versus CS. However, GA was not cost saving when compared with CS. While the cost of dental treatment increased for both GA and CS from 2011 to 2015, the cost rose faster for GA. These results have important implications due to the increasing cost to Medicaid insurance and the rising number of young children being treated for S-ECC under GA. Knowledge Transfer Statement: Medicaid policy makers can use the results of this study to evaluate the cost-effectiveness of dental treatment for young children with S-ECC at 2 time points: 2011 and 2015. Compared with CS, GA resulted in a longer amount of time during which children were free from dental caries but at a higher cost. The cost difference rose from 2011 to 2015.
Fever worsens outcomes in animal models of ischaemic stroke: A systematic review and meta-analysis
Authors: de Jonge Jeroen C , Wallet Justin , van der Worp H. Bart 
Published: June 2018

Background Subfebrile temperatures and fever in the first days after stroke are associated with a greater risk of a poor outcome. If this relation is causal, prevention of hyperthermia may improve outcome. Causality can be tested in animal models. We therefore assessed the effects of hyperthermia on outcomes in animal models of ischaemic stroke and explored under which conditions prevention of hyperthermia could be most effective. Methods We performed a systematic review and meta-analysis of data from animal experiments testing the effect of spontaneous or induced hyperthermia on outcome after focal cerebral ischaemia. Our primary outcome measure was infarct size. Normalised mean differences were combined using the random effects model and stratified meta-analysis was used to explore the impact of study characteristics. Results We included 19 publications, reporting on 49 comparisons involving 603 animals. Overall, hyperthermia increased infarct size by 43.4% (95% confidence interval, 29.8–56.9%) and worsened neurobehavioral outcomes by 48.5% (17.2–79.8%). The increase in infarct size was larger with higher temperatures. Hyperthermia was most harmful if present for more than 2 h and when started at the time of artery occlusion rather than later. Conclusion Hyperthermia substantially increased infarct size in animal models of ischaemic stroke, suggesting that the relation between fever and poor outcome observed in patients is at least in part causal. These data provide support to trials testing the effect of the prevention of fever with antipyretic drugs in patients with acute stroke.
Extravascular coagulation in hematopoietic stem and progenitor cell regulation
Authors: Nguyen T. Son , Lapidot Tsvee , Ruf Wolfram 
Published: June 2018

AbstractThe hemostatic system plays pivotal roles in injury repair, innate immunity, and adaptation to inflammatory challenges. We review the evidence that these vascular-protective mechanisms have nontraditional roles in hematopoietic stem cell (HSC) maintenance in their physiological bone marrow (BM) niches at steady-state and under stress. Expression of coagulation factors and the extrinsic coagulation initiator tissue factor by osteoblasts, tissue-resident macrophages, and megakaryocytes suggests that endosteal and vascular HSC niches are functionally regulated by extravascular coagulation. The anticoagulant endothelial protein C receptor (EPCR; Procr) is highly expressed by primitive BM HSCs and endothelial cells. EPCR is associated with its major ligand, activated protein C (aPC), in proximity to thrombomodulin-positive blood vessels, enforcing HSC integrin α4 adhesion and chemotherapy resistance in the context of CXCL12-CXCR4 niche retention signals. Protease-activated receptor 1–biased signaling by EPCR-aPC also maintains HSC retention, whereas thrombin signaling activates HSC motility and BM egress. Furthermore, HSC mobilization under stress is enhanced by the fibrinolytic and complement cascades that target HSCs and their BM niches. In addition, coagulation, fibrinolysis, and HSC-derived progeny, including megakaryocytes, synergize to reestablish functional perivascular HSC niches during BM stress. Therapeutic restoration of the anticoagulant pathway has preclinical efficacy in reversing BM failure following radiation injury, but questions remain about how antithrombotic therapy influences extravascular coagulation in HSC maintenance and hematopoiesis.
How I treat myelofibrosis after failure of JAK inhibitors
Authors: Pardanani Animesh , Tefferi Ayalew 
Published: June 2018

Abstract
The introduction of JAK inhibitors, leading to regulatory approval of ruxolitinib, represents a major therapeutic advance in myelofibrosis (MF). Most patients experience reduction in splenomegaly and improved quality of life from symptom improvement. It is a paradox, however, that, despite inhibition of signaling downstream of disease-related driver mutations, JAK inhibitor treatment is not associated with consistent molecular or pathologic responses in MF. Furthermore, there are important limitations to JAK inhibitor therapy including development of dose-limiting cytopenias and/or nonhematological toxicities such as neuropathy or opportunistic infections. Over half of the patients discontinue treatment within 3 years of starting treatment. Although data are sparse, clinical outcome after JAK inhibitor “failure” is likely poor; consequently, it is important to understand patterns of failure to select appropriate salvage treatment(s). An algorithmic approach, particularly one that incorporates cytogenetics/molecular data, is most helpful in selecting stem cell transplant candidates. Treatment of transplant-ineligible patients relies on a problem-based approach that includes use of investigational drugs, or consideration of splenectomy or radiotherapy. Data from early phase ruxolitinib combination studies, despite promising preclinical data, have not shown clear benefit over monotherapy thus far. Development of effective treatment strategies for MF patients failing JAK inhibitors remains a major unmet need.
Correlation between gonial angle and dynamic tongue collapse in children with snoring/sleep disordered breathing – an exploratory pilot study
Authors: Anderson S. , Alsufyani N. , Isaac A. , Gazzaz M. , El-Hakim H. 
Published: June 2018

Background Drug induced sleep endoscopy (DISE) is hoped to identify reasons of failure of adenotonsillectomy (AT) in treating pediatric sleep disordered breathing (SDB). Maxillomandibular disproportion has been studied as another association which may explain alternative pathogenesis of SDB. We aimed to explore the relation between the size of the gonial angle and inclination of the epiglottis measured from cone beam CT (CBCT) and tongue base collapse based on DISE in children with SDB. Method A retrospective chart review was conducted at a tertiary pediatric center. Children (6-17 years old) assessed at a multi-disciplinary Upper Airway Clinic, diagnosed with SDB and maxillo-mandibular disproportion (MMD), and who underwent DISE were eligible. Variables obtained from the electronic medical records of the clinic and prospective database included demographics, comorbidities, surgeries performed, investigations, DISE findings and CBCT findings. The gonial angle of subjects with and without tongue base collapse (TBC) on SNP were compared. Results In total 29 patients (13 male, 8 female) age 6-17 (median= 9) were eligible for the study from January 2009 – July 2016. We included 11 subjects, and 10 comparators. The mean gonial angle of the TBC group was 139.3°± 7.6°, while that of the comparison group was 129.4°±3.5 (mean difference -9.937, 95% CI of -15.454 to - 4.421, P = 0.001, power of test 0.95). Additionally, the mean inclination of the epiglottis had a mild positive correlation (r=0.32, p<0.05) with the gonial angle, in the whole cohort. Conclusions This pilot study suggests that TBC may be mediated by a wider gonial angle in children with SDB patients. The posterior tilt of the epiglottis on CBCT may be a surrogate sign of TBC.
Dillenia indica fruit prevents cisplatin-induced kidney injury in experimental rats through modulation of oxidative stress, marker enzyme, and biochemical changes
Authors: Sen Saikat , Chakraborty Raja , Kalita Pratap 
Published: June 2018

Abstract
Background
Dillenia indica fruit is known for its numerous health benefits in folk medicine including its use to cure kidney diseases. The present study was designed to investigate the protective effect of D. indica fruit extracts on cisplatin-induced nephrotoxicity.

Methods
A nephrotoxic dose of cisplatin (3 mg/kg b.w./day, i.p) was administered every fifth day to the animals receiving vehicle or fruit extracts (methanol, ethyl acetate, and petroleum ether) daily for 25 days. Rats were sacrificed on the 25th day, and the effect of extracts was assessed by determining the alterations in various serum and urine parameters, membrane-bound enzyme, and antioxidant defense system in kidney tissue.

Results
Increase in serum urea, uric acid, creatinine, blood urea nitrogen, phospholipid, and cholesterol and a decrease in urine urea, uric acid, creatinine, and creatinine clearance rate were reported in the cisplatin control group. Cisplatin alters electrolyte balance, brush border membrane marker enzyme (i.e., alkaline phosphatase, γ-glutamyl transferase, leucine aminopeptidase) activity, and redox balance significantly. Methanol and ethyl acetate extracts of D. indica fruit produced beneficial effect and ameliorated serum and urine parameter to normal. Extract administration increases Na+/K+-ATPase activity and different enzymatic and non-enzymatic antioxidants positively, whereas lipid peroxidation reduced significantly. Extracts exhibited a potent in vitro antioxidant activity.

Conclusion
Taking into account these results, it can be assumed that D. indica fruit could be the future key candidate which may maximize the clinical use of cisplatin in the treatment of different cancer without nephrotoxicity.
Intensified Therapy of Acute Lymphoblastic Leukemia in Adults: Report of the Randomized GRAALL-2005 Clinical Trial
Authors: Huguet Françoise , Chevret Sylvie , Leguay Thibaut , Thomas Xavier , Boissel Nicolas , Escoffre-Barbe Martine , Chevallier Patrice , Hunault Mathilde , Vey Norbert , Bonmati Caroline , Lepretre Stéphane , Marolleau Jean-Pierre , Pabst Thomas , Rousselot Philippe , Buzyn Agnès , Cahn Jean-Yves , Lhéritier Véronique , Béné Marie C. , Asnafi Vahid , Delabesse Eric , Macintyre Elizabeth , Chalandon Yves , Ifrah Norbert , Dombret Hervé ,   for the Group of Research on Adult ALL (GRAALL)
Published: June 2018

Purpose To evaluate randomly the role of hyperfractionated cyclophosphamide (hyper-C) dose intensification in adults with newly diagnosed Philadelphia chromosome–negative acute lymphoblastic leukemia treated with a pediatric-inspired protocol and to determine the upper age limit for treatment tolerability in this context. Patients and Methods A total of 787 evaluable patients (B/T lineage, 525 and 262, respectively; median age, 36.1 years) were randomly assigned to receive a standard dose of cyclophosphamide or hyper-C during first induction and late intensification. Compliance with chemotherapy was assessed by median doses actually received during each treatment phase by patients potentially exposed to the full planned doses. Results Overall complete remission (CR) rate was 91.9%. With a median follow-up of 5.2 years, the 5-year rate of event-free survival (EFS) and overall survival (OS) was 52.2% (95% CI, 48.5% to 55.7%) and 58.5% (95% CI, 54.8% to 61.9%), respectively. Randomization to the hyper-C arm did not increase the CR rate or prolong EFS or OS. As a result of worse treatment tolerance, advanced age continuously affected CR rate, EFS, and OS, with 55 years as the best age cutoff. At 5 years, EFS was 55.7% (95% CI, 51.8% to 59.4%) for patients younger than 55 years of age versus 25.8% (95% CI, 19.9% to 35.6%) in older patients (hazard ratio, 2.16; P < .001). Patients ≥ 55 years of age, in whom a lower compliance to the whole planned chemotherapy was observed, benefited significantly from hyper-C, whereas younger patients did not. Conclusion No significant benefit was associated with the introduction of a hyper-C sequence into a frontline pediatric-like adult acute lymphoblastic leukemia therapy. Overall, tolerability of an intensive pediatric-derived treatment was poor in patients ≥ 55 years of age.
Notch1 is asymmetrically distributed from the beginning of embryogenesis and controls the ventral center
Authors: Castro Colabianchi Aitana M. , Revinski Diego R. , Encinas Paula I. , Baez María Verónica , Monti Renato J. , Rodríguez Abinal Mateo , Kodjabachian Laurent , Franchini Lucía F. , López Silvia L. 
Published: June 2018

ABSTRACT
Based on functional evidence, we have previously demonstrated that early ventral Notch1 activity restricts dorsoanterior development in Xenopus. We found that Notch1 has ventralizing properties and abolishes the dorsalizing activity of β-catenin by reducing its steady state levels, in a process that does not require β-catenin phosphorylation by glycogen synthase kinase 3β. In the present work, we demonstrate that Notch1 mRNA and protein are enriched in the ventral region from the beginning of embryogenesis in Xenopus. This is the earliest sign of ventral development, preceding the localized expression of wnt8a, bmp4 and Ventx genes in the ventral center and the dorsal accumulation of nuclear β-catenin. Knockdown experiments indicate that Notch1 is necessary for the normal expression of genes essential for ventral-posterior development. These results indicate that during early embryogenesis ventrally located Notch1 promotes the development of the ventral center. Together with our previous evidence, these results suggest that ventral enrichment of Notch1 underlies the process by which Notch1 participates in restricting nuclear accumulation of β-catenin to the dorsal side.
TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia: a cross-sectional study
Authors: Sofyanti Ervina , Boel Trelia , Soegiharto Benny , Auerkari Elza I. 
Published: June 2018

Background: Temporomandibular joint disorder (TMD) includes symptoms of pain and dysfunction in the muscles of mastication and the temporomandibular joint. Differences in vertical condylar height, observed in the assessment of mandibular asymmetry, is a structural alteration that represents a risk factor for TMD. The study aimed to evaluate the association between TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia. Methods: The cross-sectional study included 18-25-year-old (mean ± SD, 21.9 ± 2.0 years) old orthodontic patients admitted to the Dental Hospital of Universitas Sumatera Utara, Medan, between June 2016 and March 2017. Vertical mandibular asymmetry was assessed from all 106 subjects using Kjellberg’s technique from pre-treatment panoramic radiographs. The TMD symptoms were assessed by structural interviews using modified questionnaires based on Temporomandibular Disorder Diagnostic Index and Fonseca’s Anamnestic Index. Results: Of the 106 subjects, 26 (24.5% of the total) with vertical mandibular symmetry and 39 (36.8%) with vertical mandibular asymmetry were positive for TMD symptoms. By contrast, 17 patients (16.0% of the total) with vertical condylar symmetry and 24 patients (22.6%) with vertical mandibular asymmetry were regarded negative for TMD symptoms. There was no significant difference (p=0.520) in TMD symptoms based on vertical mandibular symmetry. Conclusion: The results from this studied Sumatran population indicate that there are common TMD symptoms in young adult orthodontic patients, but there is no significant association between vertical mandibular asymmetry and TMD symptoms. Further study on the development of TMD, mandibular asymmetry and treatment planning for growing patients is suggested, using longitudinal and transitional approaches.
What does it mean if a patient is positive for anti-Jo-1 in routine hospital practice? A retrospective nested case-control study
Authors: Jobanputra Paresh , Malick Feryal , Derrett-Smith Emma , Plant Tim , Richter Alex 
Published: June 2018

Background: It is widely believed that patients bearing auto-antibodies to histidyl tRNA synthetase (anti-Jo-1) very likely have a connective tissue disease including myositis and interstitial lung disease. The value of positive tests in low disease prevalence settings such as those tested in routine care is unknown. We sought to determine the value of anti-Jo-1 auto-antibodies in routine practice.Methods: Our study was a nested case control study within a retrospective cohort of all patients tested for anti-ENA our hospital, from any hospital department, between January 2013 and December 2014. Data was extracted from electronic records of anti-Jo-1 positive patients and randomly selected ENA negative patients (ratio of 1:2), allowing for a minimum follow up of at least 12 months after first testing.Results:4009 samples (3581 patients) were tested. Anti-ENA was positive in 616 (17.2%) patients, 40 (1.1%) were anti-Jo-1 positive. Repeat ENA testing was done for 350/3581 (9.8%) patients (428 of 4009 (10.7%) samples) and in 7/40 (17.5%) of anti-Jo-1 positive patients. The median interval between the first and second request was 124 days (inter-quartile range 233 days). The frequencies of interstitial lung disease (ILD), myositis and Raynaud’s were comparable for anti-Jo-1 positive patients (n=40) and 80 randomly selected ENA negative controls. Positive tests led to additional diagnostic testing in the absence of clinical disease. Sensitivity of Jo-1 for ILD was 50% (CI 19-81%), specificity 68% (CI 59-77%), positive predictive value 12.5% (CI 4 to 27%) and negative predictive value 93.8% (CI 86-98%). Of 10 (25%) patients with high anti-Jo1 levels, 3 had ILD, one myositis and two a malignancy (disseminated melanoma and CML). Conclusion:Anti-Jo-1 is uncommon in a heterogenous hospital population and is only weakly predictive for ILD. Repeated test requests were common and potentially unnecessary indicating that controls over repeat requests could yield significant cost savings.
Discrete-Time System Optimal Dynamic Traffic Assignment (SO-DTA) with Partial Control for Physical Queuing Networks
Authors: Samaranayake Samitha , Krichene Walid , Reilly Jack , Monache Maria Laura Delle , Goatin Paola , Bayen Alexandre 
Published: June 2018

We consider the System Optimal Dynamic Traffic Assignment (SO-DTA) problem with Partial Control for general networks with physical queuing. Our goal is to optimally control any subset of the networks agents to minimize the total congestion of all agents in the network. We adopt a flow dynamics model that is a Godunov discretization of the Lighthill–Williams–Richards partial differential equation with a triangular flux function and a corresponding multicommodity junction solver. The partial control formulation generalizes the SO-DTA problem to consider cases where only a fraction of the total flow can be controlled, as may arise in the context of certain incentive schemes. This leads to a nonconvex multicommodity optimization problem. We define a multicommodity junction model that only requires full Lagrangian paths for the controllable agents, and aggregate turn ratios for the noncontrollable (selfish) agents. We show how the resulting finite horizon nonlinear optimal control problem can be efficiently solved using the discrete adjoint method, leading to gradient computations that are linear in the size of the state space and the controls. The online appendix is available at https://doi.org/10.1287/trsc.2017.0800 .
Chronic lymphocytic leukaemia: A guide for practice nurses
Authors: Perry Margaret Ann 
Published: June 2018

Chronic lymphocytic leukaemia is the most common type of leukaemia. Margaret Ann Perry gives an overview of the condition and how practice nurses can support patients This article is part three of a series on types of leukaemia and focuses on chronic lymphocytic leukaemia, the most common type of adult leukaemia in the Western world. The disease mainly affects older adults, and is often diagnosed incidentally when the patient has a blood test for something else. This article aims to increase knowledge and understanding of the disease presentation, diagnosis, and management, so that nurses will feel more confident in supporting patients and their families.