bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior tibialis tendon rupture associated with closed medial malleolus fracture and avulsion of anterior talofibular ligament: A case report and review of the literature
Authors: Vosoughi Amir Reza , Ravanbod Hamid , Gilheany Mark , Erfani Mohammad Ali , Mozaffarian Kamran 
Published: February 2018

Introduction:Traumatic rupture of posterior tibialis tendon in association with medial malleolus fracture is extremely rare.Case Presentation:We demonstrate our experience in the management of a complete posterior tibialis tendon (PTT) rupture and anterior talofibular ligament avulsion fracture from the talus in association with medial malleolus fracture in a 30-year-old male motorcyclist without any open wounds.Discussion:We believe this to be the first reported injury of this type in the literature. Closed ankle fractures may obscure surrounding tendon rupture and the clinician may be tempted to focus on the osseous injuries rather than the significance of associated soft tissue injures.Conclusion:This particular case demonstrates the importance of assessing for PTT injury in situations where high velocity impact to the ankle results in malleolar fracture.
Cleft Skeletal Asymmetry
Authors: Patel Delnaz S. , Jacobson Rachel , Duan Yao , Zhao Linping , Morris David , Cohen Mimis N. 
Published: February 2018

Objective: To quantitatively measure the extent of 3D asymmetry of the facial skeleton in patients with unilateral cleft lip and palate (UCLP) using an asymmetry index (AI) approach, and to illustrate the applicability of the index in guiding and measuring treatment outcome. Method: Two groups of subjects between the ages of 15 and 20 who had archived CBCT scan were included in this study. Twenty-five patients with complete UCLP were compared with 50 age-matched noncleft subjects. The CBCT scans were segmented and landmarked for 3D anthropometric analysis. An AI was calculated as a quantitative measure of the extent of facial skeletal asymmetry. Results: For the control group, the AI ranged from 0.72 ± 0.47 at A point to 4.77 ± 1.59 at Gonion. The degree of asymmetry increased with the increasing laterality of the landmark from the midsagittal plane. In the UCLP group, the values of AI significantly increased compared to the control group at nearly all measured landmarks. The extent of the asymmetry to involve the upper, middle, and lower facial skeleton varied widely with the individual patient with UCLP. Conclusion: The asymmetry index is capable of capturing the 3D facial asymmetry of subjects with UCLP and as a basis for classification of the extent of the asymmetry. We found the index to be applicable in surgical planning and in measuring the outcome in improving the symmetry in patients who have undergone orthognathic surgery.
Use of the Sphenoid Flap in Repair of the Wide Cleft Palate
Authors: Khan Khurram , Hardwicke Joseph , Seselgyte Rimante , Morris Paul , Thorburn Guy , Kangesu Loshan , Swan Marc C. , Richard Bruce 
Published: February 2018

Objective: In wide palatal defects, closure of the nasal layer can prove a considerable challenge. Mobilizing nasal flaps posteriorly usually facilitates soft palate closure. However, the defect is often too wide within the hard palate; hence, bilateral vomerine flaps are frequently required. Despite this, there is often a small defect in the nasal layer at the posterior septum (typically equating to the hard-soft palate junction), which has to be left to heal by secondary intention with the resulting increased risk of fistula formation and the potential deleterious long-term effect on speech due to cicatricial migration of the reconstructed levator sling anteriorly. We describe our experience in the use of the sphenoid flap to obtain tension-free primary closure of the nasal layer. Methods: A retrospective multi-center study assessing all sphenoid flap procedures undertaken at both Birmingham Children’s Hospital and Great Ormond Street Hospital. Key demographic and medical data was collected pre-, peri-, and postoperatively across the 2 sites. Results: A total of 66 patients underwent the use of a sphenoid flap to aid closure of the nasal layer. The average age at time of repair was 9.7 months. More than half (55%, n = 36) were isolated cleft palates, and 35% (n = 23) were BCLPs. Forty-two percent of all patients had Robin sequence. The average cleft width was 14.4 mm. The overall fistula rate was 25.8% (n = 17). Conclusions: We describe the operative technique, indications, and our experience in the use of the sphenoid flap in wide cleft palate repair.
Association of WNT Pathway Genes With Nonsyndromic Cleft Lip With or Without Cleft Palate
Authors: Vijayan V. , Ummer R. , Weber R. , Silva R. , Letra A. 
Published: February 2018

Objective: Nonsyndromic cleft lip with or without cleft palate (NSCL±P) is a common craniofacial anomaly with multifactorial etiology. Evidence suggests that variations in WNT pathway genes contribute to an increased susceptibility to NSCL±P. The aim of this study was to investigate the association of AXIN1, APC, CTNNB1, DVL2, and GSK3β gene variants with NSCL±P in a case-control data set from Brazil. Patients: 471 individuals with NSCL±P and 504 unrelated control individuals of Caucasian ethnicity. Design: Twenty single-nucleotide polymorphisms (SNPs) in/nearby AXIN1, APC, CTNNB1, DVL2, and GSK3B genes were genotyped using Taqman chemistry in a Viia7 sequence detection instrument. Genotype, allele, and haplotype frequencies were compared among NSCL±P patients and controls using Fisher exact test, implemented in PLINK software. The level of significance was established at P ≤.002 under Bonferroni correction. In silico analysis of SNP function was assessed using MirSNP database. Results: Significant association was found between GSK3B rs13314595 genotypes and NSCL±P ( P = .0006). Additionally, nominal associations were found between DVL2 (rs35594616) and APC (rs448475) with NSCL±P ( P = .02 and P = .03, respectively). SNP haplotypes for GSK3B and APC genes showed nominal associations with NSCL±P ( P < .05). In silico analysis predicted that APC rs448475 harbors a binding site for the microRNA miR-617 and that the switch from a G allele to C allele enhances binding, whereas DVL2 rs35594616 did not appear to harbor microRNA-binding sites. Conclusion: This study shows for the first time the association between GSK3B and NSCL±P and confirms the role of additional WNT pathway genes as candidates for NSCL±P.
The Significance of Uvula After Palatoplasty
Authors: Elsherbiny Ahmed , Mazeed Ahmed S. , Saied Samia , Grant John H. 
Published: February 2018

Objective: This study aims to examine the importance of the uvula as a part of palatoplasty outcome and to assess the aesthetic results of the conventional versus a new technique for uvuloplasty. Design/Participants: The study included 2 groups of patients undergoing palatoplasty. Group I consisted of 20 cleft palate patients repaired with the conventional uvula repair, combining the 2 hemi-uvulae. Group II consisted of 20 patients repaired with our new technique, sacrificing one hemi-uvula and centralizing the remaining one. The aesthetic outcome was assessed in both groups. A questionnaire was distributed to the families of both groups to assess their concern about the uvula after palate repair. Setting: Cleft unit at a tertiary care center. Results: Sixty-five percent of parents considered the uvula as important functionally and aesthetically after palate repair whereas 35% either did not care or were not sure about its importance. Results of the aesthetic outcome of the 2 techniques for uvula reconstruction showed that uvula was absent in 4 cases in group I versus 1 in group II ( P > .05), small in 8 cases of group I versus 4 in group II ( P > .05), bifid in 5 cases of group I versus none in group II ( P < .05), became deviated in no case of group I versus 4 in group II ( P > .05), and was satisfactory in 3 cases of group I versus 11 in group II ( P < .05). Conclusions: Among the respondents, the uvula was a significant concern to the parents of cleft patients and should be given more attention during repair. The described technique had better aesthetic outcome over the conventional one of combining the 2 hemi-uvulae.
The Temporal Region in Unilateral Coronal Craniosynostosis
Authors: Masserano Benjamin , Woo Albert S. , Skolnick Gary B. , Naidoo Sybill D. , Proctor Mark R. , Smyth Matthew D. , Patel Kamlesh B. 
Published: February 2018

Objective: To compare postoperative temporal expansion in patients treated with fronto-orbital advancement or endoscopy-assisted craniectomy with cranial orthotic therapy. Design: This is a retrospective, multicenter cohort study of patients with unilateral coronal craniosynostosis (UCS). Setting: Computed tomographic (CT) scans were drawn from UCS patients treated at Boston Children’s Hospital or St Louis Children’s Hospital. Patients: The study included 56 patients with UCS after fronto-orbital advancement (n = 32) or endoscopic repair (n = 24) and 10 age-matched controls. Intervention: Fronto-orbital advancement entails a craniotomy of the frontal bone and superior orbital rim followed by reshaping and forward advancement. Endoscopic repair is the release of the synostotic suture and guidance of further growth of the cranium using a molding orthotic. Main Outcome Measures: Measures included posterior temporal width, anterior temporal width, orbital width, and anterior cranial fossa area taken preoperatively and 1 year postoperatively. Linear regression was performed to assess 1 year postoperative improvement in symmetry; covariates included preoperative symmetry and type of surgery. Results: Both treatments showed improvement in orbital width and anterior cranial fossa area symmetry 1 year postoperatively ( P < .001), but no significant improvement in posterior or anterior temporal width symmetry. Linear regression revealed no difference between the 2 procedures in any of the 4 measurements (.096 ≤ P ≤ .898). Conclusions: Fronto-orbital advancement and endoscopic repair show equivalent outcomes 1 year postoperatively in all 3 width measurements and anterior cranial fossa area. Neither procedure produced significant improvement in temporal width.
Safety and Efficacy Concerns of Autologous Fat Grafting for Velopharyngeal Insufficiency
Authors: Phua Yun S. , Edmondson Mark J. , Kerr Rachel J. , Macgill Kirstie A. , Teixeira Rodrigo P. , Burge Jonathan A. 
Published: February 2018

Objective: Autologous fat grafting of the velopharynx has been well described for the treatment of velopharyngeal insufficiency (VPI), with most studies purporting it as a technique with low morbidity useful in the treatment of mild VPI. Prompted by 3 cases of obstructive sleep apnea (OSA) following fat grafting of the velopharynx, we undertook a review of the outcomes of this procedure at our unit. Design: Retrospective case series. Participants: All patients who underwent autologous fat grafting for VPI at the Royal Children’s Hospital Melbourne. Main Outcome Measures: Preoperative nasendoscopy findings, perceptual speech assessment results, and rates of revisional surgery and complications. Results: Twenty-eight patients were included in the study. Three patients (11%) developed severe OSA requiring removal of the grafted fat. In a subanalysis of cleft patients, there was a reported improvement in hypernasality in 63% though only 25% had complete resolution of their hypernasality. Patients who had an improvement in speech were more likely to have a velopharyngeal gap of less than 0.5 cm2 on preoperative nasendoscopy. All 3 patients who developed OSA had syndromes associated with hypotonia. Conclusions: This study raises serious concerns over the safety and efficacy of fat grafting for VPI. Overall, there was a relatively high complication rate with generally poor speech results in our series of patients. Stringent criteria should be used to select candidates for fat grafting, namely, a velopharyngeal gap less than 0.5 cm2 and the absence of a syndrome associated with hypotonia.
Intratissue Percutaneous Electrolysis vs Corticosteroid Infiltration for the Treatment of Plantar Fasciosis
Authors: Iborra-Marcos Álvaro , Ramos-Álvarez Juan José , Rodriguez-Fabián Guillermo , Del Castillo-González Federico , López-Román Antonio , Polo-Portes Carlos , Villanueva-Martínez Manuel 
Published: February 2018

Background: Corticosteroid infiltration (CI) is commonly used for treatment of plantar fasciosis. In recent years, however, interest has grown in the use of intratissue percutaneous electrolysis (EPI) for the treatment of tendinopathies. The aim of our study was to compare the effectiveness of the above techniques in the treatment of plantar fasciosis. Methods: The results achieved over a period of 1 year following the use of these techniques to treat plantar fasciosis were examined. There were 64 patients; 32 of whom were treated with ultrasound-guided EPI and 32 with ultrasound-guided CI. A clinical examination was performed and ultrasound taken before treatment and at 3, 6, and 12 months. Clinical assessments were made using a visual analog scale (VAS) to record pain and the Foot and Ankle Disability Index (FADI) to evaluate function. Ultrasound was used to determine the thickness of the plantar fascia. Results: Both the ultrasound-guided EPI and CI techniques were associated with significant clinical and echographic improvements at 12 months post-treatment ( P < .001). Conclusion: Both techniques were effective in the treatment of PF, providing excellent VAS pain and FADI results at 12 months. However, CI required fewer patient visits and appeared to provide somewhat better VAS and FADI results. Level of Evidence: Level III, retrospective comparative study.
Differentiation of isomeric haloanilines by tosylation in combination with electrospray ionization mass spectrometry
Authors: Wang Shanshan , Cheng Yuanyuan , Chen Mengmeng , Jiang Kezhi 
Published: February 2018

Differentiation of the isomeric haloanilines still remains a challenging and necessary analytic task due to their identical retention time in chromatography and similar mass spectra. In this work, p-tosylation of haloanilines by reaction of haloanilines with p-toluenesulfonyl chloride resulted in the corresponding N-tosyl haloanilines. Fragmentation of protonated N-tosyl haloanilines in electrospray ionization tandem mass spectrometry (ESI-MS/MS) mainly resulted in tosyl cation, haloaniline radical cation, and halohydroxyaniline radical cation. The MS/MS of the three group isomeric derivatives showed significant difference in abundance distribution of these product ions, respectively. Theoretical calculations showed that the stability of the ion-neutral complex (INC) is a key factor influencing the relative intensity of the product ions. The three group isomeric derivatives were also separated by high performance liquid chromatograph (HPLC) at conventional conditions. p-Tosylation combined tandem MS (or HPLC) technique were carried out to realize the differentiation of isomeric haloanilines.
Connect, Refresh, and Energize: Enabling Organizational Innovation Capacities Through Self-Determination Theory
Authors: Sipe Lori J. 
Published: February 2018

The Problem In the past decade, consumer spending on unique experiences (like vacations and concerts) relative to consumer spending on material goods (like vehicles and clothing) has increased dramatically. This has prompted renewed interest in studying the workplace practices of firms that place the co-created customer experience at the heart of their innovation efforts. In this industry context, innovation is collective, incremental, and ongoing. An updated perspective on developing and maintaining organizational capacities for continuous innovation in the experience economy is needed. The Solution A research-based model of organizational capacities for experience innovation is presented. The author discusses how the dimensions labeled Connect, Refresh, and Energize are consistent with key concepts of basic psychological needs and optimal motivation perspectives. This article helps make the business case for self-determination theory from the perspective of senior managers in the field. The Stakeholders The specific leadership practices are measurable and can be practically applied by managers and human resource development (HRD) scholar-practitioners in their own organizations.
Ultrasound-Assisted Catheter-Directed Thrombolysis for Submassive Pulmonary Embolism
Authors: Mohan Prasoon P. , Manov John J. , Contreras Francisco , Langston Michael E. , Doshi Mehul H. , Narayanan Govindarajan 
Published: February 2018

Purpose: Catheter-directed thrombolysis (CDT) is a relatively new therapy for pulmonary embolism that achieves the superior clot resolution compared to systemic thrombolysis while avoiding the high bleeding risk intrinsically associated with that therapy. In order to examine the efficacy and safety of CDT, we conducted a retrospective cohort study of patients undergoing ultrasound-assisted CDT at our institution. Methods: The charts of 30 consecutive patients who underwent CDT as a treatment of pulmonary embolism at our institution were reviewed. Risk factors for bleeding during thrombolysis were noted. Indicators of the right heart strain on computed tomography and echocardiogram, as well as the degree of pulmonary vascular obstruction, were recorded before and after CDT. Thirty-day mortality and occurrence of bleeding events were recorded. Results: Nine (30%) patients had 3 or more minor contraindications to thrombolysis and 14 (47%) had major surgery in the month prior to CDT. Right ventricular systolic pressure and vascular obstruction decreased significantly after CDT. There was a significant decrease in the proportion of patients with right ventricular dilation or hypokinesis. Decrease in pulmonary vascular obstruction was associated with nadir of fibrinogen level. No patients experienced major or moderate bleeding attributed to CDT. Conclusion: Catheter-directed thrombolysis is an effective therapy in rapidly alleviating the right heart strain that is associated with increased mortality and long-term morbidity in patients with pulmonary embolism with minimal bleeding risk. Catheter-directed thrombolysis is a safe alternative to systemic thrombolysis in patients with risk factors for bleeding such as prior surgery. Future studies should examine the safety of CDT in patients with contraindications to systemic thrombolysis.
Jordanian adolescents’ health behaviour and school climate
Authors: Nassar Omayyah , Shaheen Abeer Mohammed , Jarrah Samiha S , Norton Mary E , Khalaf Inaam A , Mohammad Hamdan Khaldoun 
Published: February 2018

Aim This study was conducted to assess the occurrence of physical activity, nutritional habits, tooth brushing and seat belt use behaviour among adolescent school students in Jordan, and to examine the effect of psychosocial aspects of school on these behaviours. Method A cross-sectional descriptive correlational design was used to draw a sample of in-school adolescents aged between 11 and 15 years. The final sample included 1166 adolescents from five public and two private schools. Study participants filled in a translated version of the health behaviour in school aged children questionnaire. Descriptive statistics, correlational (point biserial), and bivariate analyses (chi-square tests) were used to analyse the data. Results Among the study sample 34.5% of the adolescents practised exercise outside school hours once a week or less frequently, and only 53.1% of them brushed their teeth more than once a day. Regarding seat belt use, 44.7% of the adolescents used them rarely or never. Concerning carbonated sugary drinks and sweets consumption, about 64% and 83.3% of the adolescents, respectively, consumed them once a day or more often. The percentages of adolescents who never drank low fat or whole fat milk were 43.1% and 38.2%, respectively. Conclusions The study concluded that school adolescents do engage in unhealthy behaviour. Psychosocial aspect of schools were associated with students’ physical activity, nutritional habits, tooth brushing and seat belt use behaviours.
Synthesis and substrate properties towards HIV-1 reverse transcriptase of new diphosphate analogues of 9-[(2-phosphonomethoxy)ethyl]adenine
Authors: Laux Wolfgang HG , Priet Stéphane , Alvarez Karine , Peyrottes Suzanne , Périgaud Christian 
Published: February 2018

Background The replacement of β,γ-pyrophosphate by β,γ-phosphonate moieties within the triphosphate chain of 5′-triphosphate nucleoside analogues was previously studied for various antiviral nucleoside analogues such as AZT and 2′,3′-dideoxynucleosides. Thus, it has been shown that these chemical modifications could preserve, in some cases, the terminating substrate properties of the triphosphate analogue for HIV-RT. Herein, we aimed to study such 5′-triphosphate mimics based on the scaffold of the well-known antiviral agent 9-[(2-phosphonomethoxy)ethyl]adenine (PMEA, Adefovir). Methods Synthesis involved coupling of a morpholidate derivative of PMEA with appropriate pyrophosphoryl analogues. The relative efficiencies of incorporation of the studied diphosphate phosphonates were measured using subtype B WT HIV-1 RT in an in vitro susceptibility assay, in comparison to the parent nucleotide analogue (PMEApp). Results Searching for nucleoside 5′-triphosphate mimics, we have synthesized and studied a series of diphosphate analogues of PMEA bearing non hydrolysable bonds between the and phosphorus atoms. We also examined their relative inhibitory capacity towards HIV-1 reverse transcriptase in comparison to the parent nucleotide analogue (PMEApp). Only one of them appeared as a weak inhibitor (IC50 = 403.0 ± 75.5 µM) and proved to be less effective than PMEApp (IC50 = 6.4 ± 0.8 µM). Conclusion PMEA diphosphoryl derivatives were designed as potential substrates and/or inhibitors of various viral polymerases. These modifications dramatically affect their ability to inhibit HIV-RT.
Accelerated collagen turnover in women with angina pectoris without obstructive coronary artery disease: An iPOWER substudy
Authors: Nielsen Signe H , Mygind Naja D , Michelsen Marie M , Bechsgaard Daria F , Suhrs Hannah E , Genovese Federica , Nielsen Henning B , Brix Susanne , Karsdal Morten , Prescott Eva , Kastrup Jens 
Published: February 2018

Aim Collagens are major cardiac extracellular matrix components, known to be actively remodelled and accumulated during diffuse myocardial fibrosis. We evaluated whether accelerated collagen turnover described by neo-epitope biomarkers reflecting collagen formation and degradation separates patients with diffuse myocardial fibrosis from asymptomatic controls. Methods and results Seventy-one women with angina pectoris without significant coronary artery disease assessed by invasive coronary angiogram were included. Competitive enzyme-linked immunosorbent assays (ELISAs) measuring circulating protein fragments in serum assessed the formation and degradation of collagen type III (Pro-C3, C3M and C3C), IV (P4NP7S and C4M), V (Pro-C5 and C5M) and VI (Pro-C6 and C6M), and degradation of collagen type I (C1M). Serum samples from 32 age-matched asymptomatic women were included as controls. Symptomatic women presented significantly elevated levels of Pro-C6, C3C, C3M, C4M and C8-C ( p < 0.0001–0.0058) and significantly decreased levels of Pro-C3, C5M and C6M ( p < 0.0001–0.041), reflecting accelerated collagen turnover and an imbalanced collagen formation and degradation compared to controls. Cardiac magnetic resonance T1 mapping was performed to determine extracellular volume fraction and thus diffuse myocardial fibrosis. A significant association was identified between C5M and extracellular volume fraction by cardiac magnetic resonance ( p = 0.01). Conclusion Women with angina pectoris, but without significant obstructive coronary artery disease, showed an imbalanced collagen turnover compared to asymptomatic controls. The examined biomarkers are tools to monitor active collagen remodelling in patients with angina pectoris, in risk of developing myocardial fibrosis.