bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Surgical Technique on Cement Mantle Strength in Total Hip Arthroplasty
Authors: Webb J. M. , Mahajan A. J. , Bannister G. C. , Haynes R. C. , Miles A. W. 
Published: May 2019

A tapered aluminium model was designed to simulate the internal geometry of the reamed femoral medullary cavity. The surface of the model was coated with blood and then polymethylmethacrylate cement (Simplex P, Howmedica UK) was inserted retrograde, prograde, prograde with a venting tube, prograde with a perforated distal cement restrictor, all with a cement gun; and manually by thumbing with a venting tube. Casts were examined radiographically, weighed, measured and tested to failure in compression. Using the same cementing techniques, both concentric and eccentric mantles were produced by insertion of a prosthesis, with or without spacers, and tested to failure in hoop tension. Cast weight correlated with cement strength per unit weight and volume. Casts produced by the retrograde technique were heaviest and those produced by prograde with a venting and thumbed mantles the weakest. Concentric mantles were stronger than eccentric. Incomplete spacers ensured concentricity but weakened the mantle such that no benefit was gained. Complete precast spacers also ensured concentricity and a minimum mantle thickness but did not compromise mantle strength. The best method of inserting cement in the femur during total hip arthroplasty is retrograde with a complete precast spacer.
Endovascular treatment for acute carotid T and carotid non-T occlusion: A retrospective multicentre study of 81 patients
Authors: Ota Takahiro , Shigeta Keigo , Amano Tatsuo , Kaneko Junya 
Published: May 2019

Background The functional prognosis of patients with carotid T occlusion is poor, but few comprehensive studies have investigated carotid non-T occlusion, in which the terminal internal carotid artery portion is unobstructed. We aimed to elucidate the clinical features of carotid non-T occlusion by comparing patients with acute carotid T occlusion and carotid non-T occlusion. Methods Among 362 patients who underwent thrombectomy between January 2015 and June 2018, 20 and 61 were diagnosed with carotid non-T occlusion and carotid T occlusion, respectively. We compared preoperative clinical findings, treatment strategies, treatment complications and functional outcomes between the two groups. Results Age, sex, preoperative National Institutes of Health stroke scale, cerebral infarction subtypes and medical history did not significantly differ. In contrast, preoperative diffusion-weighted imaging–Alberta Stroke Program early computed tomography scores were 9 (1–11) and 6.5 (0–11) for the carotid non-T occlusion and carotid T occlusion groups, respectively ( P = 0.015). The duration of treatment or the median number of passes (2.5 vs. 2.0), the numbers of patients with thrombolysis in cerebral infarction 2b/3, bleeding complications and modified Rankin scale scores of 0–2 on postoperative day 90 did not significantly differ between the two groups. Manual aspiration before, internal carotid artery arrest while crossing a lesion and injection into the contralateral side were significantly more frequent in patients with carotid non-T occlusion. Intracranial internal carotid artery stenosis was significantly more frequent in patients with carotid non-T occlusion ( n = 4, 20%) than carotid T occlusion ( n = 0), and 10% of patients with carotid non-T occlusion had arterial dissection. Conclusion Patients with carotid non-T occlusion more frequently had a background of intracranial internal carotid artery stenosis or arterial dissection than patients with carotid T occlusion. Specific treatment strategies should be developed to improve the clinical outcomes of patients with carotid non-T occlusion.
The New Role of Sirtuin1 in Human Osteoarthritis Chondrocytes by Regulating Autophagy
Authors: Liao Fa-Xue , Huang Fei , Ma Wen-Guang , Qin Kun-Peng , Xu Peng-Fei , Wu Yun-Feng , Wang Hao , Chang Jun , Yin Zong-Sheng 
Published: May 2019

Objective The aim of this study is to investigate the role of Sirtuin1 (Sirt1) in the regulation of autophagy for human osteoarthritis (OA) chondrocytes. Design All cartilage samples were collected from human donors, including young group, aged group, and OA group. Primary chondrocytes were isolated and cultured with Sirt1 activator or inhibitor. Sirt1 expression in cartilage tissue and chondrocytes was evaluated, and the deacetylation activity of Sirt1 was determined. The alteration of autophagy activity after upregulating or downregulating Sirt1 was detected. Chondrocytes were treated with autophagy activator and inhibitor, and then the protein level of Sirt1 was examined. The interactions between Sirt1 and autophagy-related proteins Atg7, microtubule associated protein 1 light chain 3 (LC3), and Beclin-1 were determined by using immunoprecipitation. Results The assay of articular cartilage revealed that the expression of Sirt1 might be age-related: highly expressed in of younger people, and respectively decreased in the elderly people and OA patients. In vitro study was also validated this result. Further study confirmed that higher levels of Sirt1 significantly increased autophagy in aged chondrocytes, while the lower expression of Sirt1 reduced autophagy in young chondrocytes. Of note, the high levels of Sirt1 reduced autophagy in OA chondrocytes. When the chondrocytes were treated with autophagy activator or inhibitor, we found the expression of Sirt1 was not affected. In addition, we found that Sirt1 could interact with Atg7. Conclusion These results suggest that Sirt1 in human chondrocytes regulates autophagy by interacting with autophagy related Atg7, and Sirt1 may become a more important target in OA treatment.
Osteochondral Repair and Electromechanical Evaluation of Custom 3D Scaffold Microstructured by Direct Laser Writing Lithography
Authors: Maciulaitis Justinas , Miskiniene Milda , Rekštytė Sima , Bratchikov Maksim , Darinskas Adas , Simbelyte Agne , Daunoras Gintaras , Laurinaviciene Aida , Laurinavicius Arvydas , Gudas Rimtautas , Malinauskas Mangirdas , Maciulaitis Romaldas 
Published: May 2019

Objective The objective of this study was to assess a novel 3D microstructured scaffold seeded with allogeneic chondrocytes (cells) in a rabbit osteochondral defect model. Design Direct laser writing lithography in pre-polymers was employed to fabricate custom silicon-zirconium containing hybrid organic-inorganic (HOI) polymer SZ2080 scaffolds of a predefined morphology. Hexagon-pored HOI scaffolds were seeded with chondrocytes (cells), and tissue-engineered cartilage biocompatibility, potency, efficacy, and shelf-life in vitro was assessed by morphological, ELISA (enzyme-linked immunosorbent assay) and PCR (polymerase chain reaction) analysis. Osteochondral defect was created in the weight-bearing area of medial femoral condyle for in vivo study. Polymerized fibrin was added to every defect of 5 experimental groups. Cartilage repair was analyzed after 6 months using macroscopical (Oswestry Arthroscopy Score [OAS]), histological, and electromechanical quantitative potential (QP) scores. Collagen scaffold (CS) was used as a positive comparator for in vitro and in vivo studies. Results Type II collagen gene upregulation and protein secretion was maintained up to 8 days in seeded HOI. In vivo analysis revealed improvement in all scaffold treatment groups. For the first time, electromechanical properties of a cellular-based scaffold were analyzed in a preclinical study. Cell addition did not enhance OAS but improved histological and QP scores in HOI groups. Conclusions HOI material is biocompatible for up to 8 days in vitro and is supportive of cartilage formation at 6 months in vivo. Electromechanical measurement offers a reliable quality assessment of repaired cartilage.
Improving self-management of people with type 2 diabetes in the first years after diagnosis: Development and pilot of a theory-based interactive group intervention
Authors: van Puffelen Anne L , Heijmans Monique JWM , Schellevis François G , Nijpels Giel , Rijken Mieke 
Published: May 2019

Objectives: To describe how principles of self-regulation and social support could be integrated in a group intervention to improve self-management of people with type 2 diabetes mellitus in the early phase of illness and to pilot its suitability in a primary care setting. Methods: Principles of the Common-Sense Model of Self-Regulation, Social Cognitive Theory of Self-Regulation and social support theories were integrated in the intervention. Based on this, a three-session group course was developed to challenge illness perceptions of participants that discourage adequate self-management, to practice goal-setting and behavioural actions and to create a supportive environment. The intervention was piloted with persons with early-stage (1–3 years post diagnosis) type 2 diabetes mellitus selected in general practice in the Netherlands. Data about the suitability of the intervention were retrieved by means of observation and audio-recording of the sessions, an evaluation form filled in by the participants and an evaluation meeting with the group leaders. Results: In total, 16 type 2 diabetes mellitus patients participated in the pilot, who were divided into a group of single participants (N = 8) and a group (N = 8) who participated with their partner. Discrepancies between perceptions of one’s own condition and type 2 diabetes mellitus in general were observed. Goal-setting and developing action plans appeared to be difficult tasks for many participants, whereas others felt these exercises were not useful as they did not feel a need to make changes in living with diabetes. The group-based format was appreciated as was the participation of partners. Conclusion: Challenging the illness perceptions of persons with early-stage type 2 diabetes mellitus by a brief interactive group course is feasible and important, as many of these people tend to underestimate the seriousness of their diabetes. However, motivating persons with early-stage type 2 diabetes mellitus to participate in self-management interventions remains a challenge. Offering the intervention as an integral part of type 2 diabetes mellitus management in primary care is desirable.
Building Brand Through B2B Route—Del Monte in India
Authors: Sharma Anuj 
Published: May 2019

Del Monte, a global food and beverage company, entered into Indian market in 2008. Del Monte established Joint Venture with Field Fresh which at that time dealt in exports of agricultural fresh produce. Yogesh Bellani, CEO of Field Fresh had the responsibility of establishing the Del Monte brand in India. Yogesh faced lots of challenges as there was very little brand awareness of the company and also there were many established players in the market. Del Monte first launched canned pineapples to be followed by canned fruit juices. Yogesh started building Del Monte brand on quality and timely delivery. Yogesh targeted big quick service restaurants (QSRs) like Dominos, Sub Way, MacDonald, Pizza Hut and Burger King for supplying its products. This was a unique way of establishing the brand through B2B route. After having established the brand through B2B route, Yogesh targeted B2C market. Del Monte launched several new products like tomato ketchup, entire Italian category, and eggless mayonnaise through modern trade route. In initial years, Yogesh established the brand and created revenue for the company. Subsequently he focussed on improving the profitability. His current challenge was to manage both which are conflicting in nature. He was also thinking of brand repositioning for future growth.
Statistical Validation of the Grand Rapids Arch Collapse Classification
Authors: Burkard David , Patton Daniel , Padley Michelle , Maskill John David , Bohay Donald Raymond , Anderson John Gregory 
Published: May 2019

Background: The Grand Rapids Arch Collapse Classification system was devised in 2011 to assist physicians’ and patients’ understanding of the mechanisms underlying arch collapse. Five types of arch collapse are described, based on which part of the foot or ankle is affected. The purpose of this study was to determine the inter- and intrarater reliability of this classification system when used by physicians with various levels of training. Methods: A senior author identified a stratified selection of 50 patients (10 per classification type) who presented with foot/ankle pain and suitable radiographs. A survey was designed using prediagnosis radiographs and clinical synopses of the patient’s chart. The survey consisted of a description of the classification scheme and the 50 cases in a randomized order. Eight weeks later, they repeated the test to analyze for intra-rater agreement. Results: Of the 33 physicians who received the survey, 26 completed the first round (16 attendings, 4 foot and ankle fellows, and 6 residents). Overall, there was substantial agreement among raters in all five types. Kappa scores for each type were 0.72, 0.65, 0.72, 0.70, 0.63, respectively. The combined kappa score was 0.68. After 8 weeks, 13 of the 26 participants repeated the study. A Kappa analysis was once again performed for the 13 respondents, which produced a substantial level of agreement with a value of 0.74 for intrarater reliability. Conclusion: The Grand Rapids Arch Collapse Classification system was designed to provide an accessible mechanism for physicians to consistently describe arch collapse, its effects, and the conditions associated with it. The utility of this system is wholly reliant on the repeatability among clinicians. This study has demonstrated that the classification system has substantial rates of reliability among physicians of different levels of experience and training. Level of evidence: Level IV.
Efficacy and predictors of response of lenalidomide and rituximab in patients with treatment-naive and relapsed CLL
Authors: Strati Paolo , Takahashi Koichi , Peterson Christine B. , Keating Michael J. , Thompson Philip A. , Daver Naval G. , Jain Nitin , Burger Jan A. , Estrov Zeev , O'Brien Susan M. , Kantarjian Hagop M. , Wierda William G. , Futreal P. Andrew , Ferrajoli Alessandra 
Published: May 2019

Key Points
The combination of lenalidomide and rituximab is highly effective in patients with CLL and low baseline β2-microglobulin levels. Mutations in the NOTCH signaling pathway are associated with worse outcome in patients with CLL treated with lenalidomide and rituximab.
Experimental and numerical investigations of primary flow patterns and mixing in laboratory meandering channel
Authors: Park Sung Won , Ahn Jungkyu 
Published: May 2019

AbstractConsidering fundamental hydraulics, fluid dynamics, and experimental analysis should be analyzed simultaneously with mathematical methods due to the effects of hydraulic properties such as meandering form, sediment, and so on. In this research, to reveal the effects of hydraulic characteristics and longitudinal and transverse coefficients based on the two-dimensional advection-dispersion equation, a laboratory experimental channel has been conducted and analyzed. Additionally, results of experiments have been compared with horizontal two dimensional distributions of flow velocity and concentration fields with respect to the water depth and inlet discharge using two-dimensional depth-averaged numerical models based on FEM (Finite Element Method). SMS and RAMS have been applied with the same experimental conditions and compared. From the analysis of velocity profiles, primary and secondary flows have been visualized. Also the result of pollutant clouds illustrated from the results of tracer tests with an instantaneous and centered injection of solute transport, separation, superposition and stagnation could be deduced outwards of two meandering sections. And same types of characteristics of velocity and pollutant transport could be defined with two-dimensional numerical models.
Guns and psychiatry: what psychiatrists need to know
Authors: Mortimer Ann M. 
Published: May 2019

SUMMARYThe private ownership of firearms for participation in shooting sports, subject to a rigorous process of certification by the police, is not uncommon in the UK. Primary care medical involvement in this process is currently a contentious issue. The mental health of firearms owners is clearly germane to public safety: suicide is by far the greatest concern, alongside security breaches. Homicide committed with legally held firearms is very rare: there is very little cross-over between legitimate shooting sports and crime involving firearms. The perpetrators of family annihilation and single-incident mass killings using firearms in the UK have not been known to psychiatry, although a minority have been found to be mentally disordered post hoc. Regarding suicidality, there is little if any difference between those at risk who own firearms and those who do not, excepting that firearm suicide attempts are highly likely to be fatal. Guidance is offered in this article on the identification of patients who own firearms, the evaluation of risks and how to manage these in practical terms.LEARNING OBJECTIVESAfter reading this article you will be able to:
•demonstrate a basic knowledge of varieties of sporting firearms and understand the differences between legitimate and criminal use of firearms in the UK•appreciate mental health problems related to the private ownership of firearms and the risks of suicidality•understand the role of the police in certification and how to raise concerns when a patient's access to firearms is an issue.
Training in psychiatry: making person-centred care a reality
Authors:   RCPsych Person-Centred Training and Curriculum Scoping Group
Published: May 2019

The RCPsych curriculum for core trainees is currently undergoing review and revision. The Person-Centred Training and Curriculum Scoping Group, which fed into the revision, reported in 2018. This paper shares key findings from the report and offers suggestions on implementing person-centred care in postgraduate psychiatric training and assessment. The scoping group recommended that training and the curriculum should be explicitly person-centred. Among its other recommendations was that skills relating to person-centred practice should be assessed, and the planning, development and delivery of local MRCPsych courses should be co-produced alongside people with lived experience of mental health conditions.Declaration of interestAll authors contributed to the development and writing of College Report CR215.
SAT-384 The Health Burden of Adrenal Insufficiency in a United Kingdom-based Population
Authors: Adam Safwaan , Minder Steimer Anna-Elisabeth , Ho Jan Hoong , Whittle Liam , Stein Norman , Trainer Peter 
Published: May 2019

Abstract
Context: Adrenal insufficiency (AI) is associated with reduced life expectancy and increased morbidity even after glucocorticoid replacement therapy. Aim Our aim was to assess the co-morbid burden of AI in a United Kingdom-based population. Methods We retrospectively studied patients diagnosed between 1996 and 2014 (minimum disease duration 12 months) with primary (PAI; n=55 [23 females]; CAH excluded) and secondary AI (SAI; n=79 [29 females]; Cushing’s syndrome and acromegaly excluded) using an electronic patient database (n=352000) in North West England. Patients with AI were identified by diagnostic codes and glucocorticoid prescriptions. Each patient with PAI or SAI was matched to non-AI patients with the same gender and date of birth (control cohort n=35172). Outcome measures were change in weight, prevalence of co-morbid illness (type 2 diabetes [T2D], prediabetes, hypertension, cardiovascular disease [CVD] and osteoporosis) and hospital admissions during the study period. Results In PAI, 91% of patients were treated with hydrocortisone (mean dose 23 ±8 mg) and 9% with prednisolone (mean dose 3 ±2 mg). In SAI, 94% of patients were treated with hydrocortisone (mean dose 18 ±8 mg) and 5% with prednisolone (mean dose 6 ±3 mg). The annual weight change compared to controls was significantly higher in PAI (median 1.16 kg [0.15-2.96], vs -0.01 kg [-0.49 – 0.41]; P=0.001) and SAI (median 0.55 kg [-1.49 – 1.57] vs median -0.47 kg [-0.99 – 0.32]; P=0.045). When comparing the weight at the time of diagnosis to the last available weight in the study period, a higher proportion of patients were within the overweight/obese category (BMI ≥ 25 kg/m2) for PAI (38% [baseline] vs 70% [study end]; P=0.028) but not SAI (85% [baseline] vs 73% [study end]; P=0.327) and controls (65% [baseline] vs 56% [study end]; P=0.218). For PAI, the prevalence of prediabetes (22% vs 10%), T2D (9% vs 5%), hypertension (38% vs 30%) and CVD (9% vs 5%) was significantly (p&lt;0.05) different to controls. For SAI, the prevalence of prediabetes (27% vs 19%), T2D (20% vs 10%), hypertension (68% vs 53%) was significantly different (P&lt;0.05) to controls. There were no differences in the prevalence of CVD between patients with SAI and controls (10% vs 10%; P=0.87). The risk ratio for osteoporosis to controls was 4.00 (P=0.025) for PAI and 4.33 (P=0.018) for SAI. The ratio (to controls) of the number of acute hospital admissions was higher in both PAI (5:1; P=0.011) and SAI (7:1; P=0.017). Conclusion PAI and SAI are both associated with a higher prevalence of co-morbid disease and increased hospital admissions suggesting a greater health burden. The excessive glucocorticoid replacement dose (especially in PAI) may have influenced the adverse metabolic changes observed. Statement of Support ViroPharma, now part of Shire, Lexington, MA, USA provided financial support but were not involved in the study design or interpretation of the data.
Exploring Chinese Poetry with Digital Assistance: Examples from Linguistic, Literary, and Historical Viewpoints
Authors: Liu Chao-Lin , Mazanec Thomas J. , Tharsen Jeffrey R. 
Published: May 2019

Abstract
Digital tools provide instrumental services to the study of Chinese poetry in an era of big, open data. The authors employed nine representative collections of Chinese poetry, covering the years 1046 BCE to 1644 CE, in their demonstrations. They demonstrate sophisticated software that allows researchers to extract source material that meets multiple search criteria, which may consider words, poets, collections, and time of authoring, paving the way for new explorations of Chinese poetry from linguistic, literary, artistic, and historical viewpoints. Analytic tools help researchers uncover information concealed in poetic works that are related to aesthetic expressions, personal styles, social networks, societal influences, and temporal changes in Chinese poetry. The increasing accessibility of digitized texts, along with sophisticated digital tools, such as the ones these authors developed and demonstrate here, can thereby enhance the efficiency and effectiveness for exploring and studying classical Chinese poetry.