bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Factors That Contribute to Adolescent Bony Stress Injury in Secondary School Athletes: A Comparative Analysis With a Healthy Athletic Control Group
Authors: Nussbaum Eric D. , Bjornaraa Jaynie , Gatt Charles J. 
Published: January 2019

Background: Bony stress injuries (BSIs) are common among adolescents involved in high school sports. A better understanding of factors that contribute to adolescent BSI is needed to target preventative measures. Hypothesis: Individuals who suffer a BSI will demonstrate significant differences in training methods, sleep, diet, and history of injury compared with a healthy, noninjured control group. Study Design: Descriptive epidemiologic study. Methods: Data from the National High School Stress Fracture Registry (NHSSFR), an internet-based adolescent BSI survey, were used to identify variables reported with adolescent (13-18 years of age) BSI. These findings were compared with a survey of 100 (50 males, 50 females) healthy athletic controls to identify significant differences between healthy adolescents and those with BSI. Results: A total of 346 stress fractures were reported in 314 (206 females, 108 males) athletes within the NHSSFR. Comparison with healthy control participants demonstrated multiple significant findings. In particular, body mass index was significantly lower for patients with BSI injury compared with controls ( P < 0.001). Patients slept significantly less than the control group (7.2 vs 7.95 hours; F = 34.41; P < 0.001). Females also slept significantly less hours than males (7.2 vs 7.63 hours; F = 11.02; P < 0.001). Fifty-eight percent of those who reported a BSI did not engage in any weight training. Those with a BSI had significantly higher average stress ratings than control participants (1.67 vs 1.42; P < 0.001), and females also rated their stress levels significantly higher than males (1.8 vs 1.38; P < 0.001). A significant difference between patients with any BSI and control participants existed for history of “shin splints” (Pearson χ2 = 28.31; P < 0.001), and females also expressed having shin pain lasting for longer than 4 weeks (Pearson χ2 = 8.12; P < 0.001) and more often (Pearson χ2 = 5.84; P = 0.02) than males. There was also a significant difference between patients with BSI and control subjects regarding dairy intake (2.25 vs 2.69; F = 6.43; P = 0.01). Conclusion: Findings revealed significant differences between those who reported a BSI relative to healthy athletic adolescents. These differences included body mass index, prior history of shin splints, involvement in weight training, amount of sleep, daily stress, and dairy intake. Preventive measures should be developed to address these areas to reduce the incidence of BSIs in the adolescent population.
Extensive unroofing of myocardial bridge: A case report and literature review
Authors: Mok Salvior , Majdalany David , Pettersson Gosta B 
Published: January 2019

Background: Myocardial bridge is defined as a segment of a coronary artery that takes an intramyocardial course. The presence of myocardial bridge has been observed in as many as 40%–80% of cases on autopsy, angiographically from 0.5% to 16.0%, and often asymptomatic. However, it has been associated with angina, coronary spasm, myocardial infarction, arrhythmias, syncope, sudden cardiac arrest, and death. Conflicting opinions exist on the timing of surgical intervention for myocardial bridge. Methods: We present an unusual case of a young female, with prior aortic surgery, who had refractory chest pain despite optimal medical therapy. Stress testing revealed anterior ischemia. Cardiac catherization showed myocardial bridge of the left anterior descending artery with significant compromise of blood flow (fractional flow reserve = 0.75 with adenosine). We proceeded with surgery. Intraoperatively, we found an unusually long (10-cm) intramyocardial segment of the left anterior descending artery which was managed by surgically unroofing. Our patient felt better post procedure. Repeat cardiac catheterization showed no further narrowing of the left anterior descending artery with a fractional flow reserve of 0.87 in its distal segment. Results/discussion: Myocardial bridge is present mostly in female patients (74.5%), with median age at 56.2 years and mostly involving the left anterior descending artery (77.2%). The average length of myocardial bridge is 21.85 ± 16.10 mm (range: 5–70 mm). Our case is unique as the involved myocardial bridge was 10 cm in length, the longest ever reported. Multiple imaging modality revealed significant coronary insufficiency, with a subsequent clinical and angiographic improvement upon unroofing of the culprit coronary vessel. Conclusion: Management decision on myocardial bridge remains controversial. This is a case of the longest symptomatic myocardial bridge, with a subsequent improvement post unroofing.
Combined excision and ablation of ampullary tumors with biliary or pancreatic intraductal extension is effective even in malignant neoplasms
Authors: Pérez-Cuadrado-Robles Enrique , Piessevaux Hubert , Moreels Tom G , Yeung Ralph , Aouattah Tarik , Komuta Mina , Dano Hélène , Jouret-Mourin Anne , Deprez Pierre H 
Published: January 2019

BackgroundThe feasibility and outcome of endoscopic resection in ampullary tumors with intraductal growth remains unclear.ObjectiveTo assess the safety, feasibility and outcomes of these patients treated by thermal ablation.MethodsRetrospective observational study. All consecutive patients who underwent an endoscopic snare papillectomy with a 6‐month minimum follow‐up were included. Ablation was performed with cystotomes and soft/forced coagulation. Successful endoscopic treatment was defined as no adenomatous residual tissue or recurrence observed at follow‐up.ResultsOf 86 patients presenting with an ampullary tumor, 73 (58 ± 14 years old, 49% men, 34% familial adenomatous polyposis) (median tumor size: 20 mm, range: 8–80) were included. En bloc and curative resection rates were achieved in 46.6% and 83.6%, respectively.Intraductal ingrowth was seen in 18 (24.7%) patients and histologically confirmed in 12 (16.4%). Intraductal ablation achieved a 100% success rate, with a 20‐month median follow‐up. Most of these patients had malignant forms (n = 8, 66.7%), with a higher adenocarcinoma rate (33.3% versus 3.3%, p = 0.001) compared to extraductal tumors.Overall, there was a 20.5% complication rate with no significant differences between both groups (p = 0.676).ConclusionsIntraductal ablation achieves a high therapeutic success rate in ampullary tumors with ≤20 mm ductal extension, even in malignant forms or biliary and pancreatic involvement. The technique is feasible, cheap and safe and may avoid major surgery.
Appropriateness of pancreatic resection in high‐risk individuals for familial pancreatic ductal adenocarcinoma: a patient‐level meta‐analysis and proposition of the Beaujon score
Authors: de Mestier Louis , Muller Marie , Cros Jérôme , Vullierme Marie-Pierre , Vernerey Dewi , Maire Frédérique , Dokmak Safi , Rebours Vinciane , Sauvanet Alain , Lévy Philippe , Hammel Pascal 
Published: January 2019

BackgroundAbout 5% of pancreatic ductal adenocarcinomas are inherited due to a deleterious germline mutation detected in 20% or fewer families. Pancreatic screening in high‐risk individuals is proposed to allow early surgical treatment of (pre)malignant lesions. The outcomes of pancreatic surgery in high‐risk individuals have never been correctly explored.ObjectivesTo evaluate surgical appropriateness and search for associated factors in high‐risk individuals.MethodsA patient‐level meta‐analysis was performed including studies published since 1999. Individual classification distinguished the highest risk imaging abnormality into low‐risk or high‐risk abnormality, and the highest pathological degree of malignancy of lesions into no/low malignant potential or potentially/frankly malignant. Surgical appropriateness was considered when potentially/frankly malignant lesions were resected.ResultsThirteen out of 24 studies were selected, which reported 90 high‐risk individuals operated on. Low‐risk/high‐risk abnormalities were preoperatively detected in 46.7%/53.3% of operated high‐risk individuals, respectively. Surgical appropriateness was consistent in 38 (42.2%) high‐risk individuals, including 20 pancreatic ductal adenocarcinomas (22.2%). Identification of high‐risk abnormalities was strongly associated with surgical appropriateness at multivariate analysis (P = 0.001). We proposed a score and nomogram predictive of surgical appropriateness, including high‐risk abnormalities, age and existence of deleterious germline mutation.ConclusionOverall, 42.2% of high‐risk individuals underwent appropriate surgery. The proposed score might help selecting the best candidates among high‐risk individuals for pancreatic resection.
‘You feel like you haven’t got any control’: A qualitative study of side effects from medicines
Authors: O’Donovan Bernadine , Rodgers Ruth M , Cox Anthony R , Krska Janet 
Published: January 2019

Objectives An aging UK population and multi-morbidity means patients are receiving an increasing number of medicines. This can lead to greater risk of unintended side effects. The aim of this study was to increase understanding of how people identify and manage side effects from their medicines. Design A qualitative interview study with patients who had experienced side effects, recruited from community pharmacies. Methods This study examined patients’ experiences of side effects and the impact of these effects on their daily life. Fifteen participants were interviewed – 10 females and 5 males, with ages that ranged between 25 and 80 years, using different types and numbers of medicines. Results Thematic analysis revealed six themes: side effect experience, identification, adherence, information use, coping and body awareness. Participants described a wide range of physical and psychological symptoms which had both explicit and implicit impact on their lives. A system of identification based on constructed cognitive processes was common across participants. A variety of strategies were used by participants to cope with their side effects which included information seeking, social support seeking and non-adherent behaviours. Conclusions Psychological factors, such as medication beliefs, symptom interpretation and body awareness, contribute to cognitive and behavioural processes used to identify and manage side effects. These processes can have significant impacts on an individual’s decisions about adherence.
The HLA-B −21 dimorphism impacts on NK cell education and clinical outcome of immunotherapy in acute myeloid leukemia
Authors: Hallner Alexander , Bernson Elin , Hussein Brwa Ali , Ewald Sander Frida , Brune Mats , Aurelius Johan , Martner Anna , Hellstrand Kristoffer , Thorén Fredrik B. 
Published: January 2019

AbstractNatural killer (NK) cell function is regulated by inhibitory receptors, such as the family of killer immunoglobulin-like receptors (KIRs) and the NKG2A/CD94 heterodimer. These receptors recognize cognate HLA class I molecules on potential target cells, and recent studies imply that an HLA-B dimorphism at position −21 in the gene segment encoding the leader peptide dictates whether NK cell regulation primarily relies on the KIRs or the NKG2A/CD94 receptor. The impact of this HLA-B dimorphism on NK cell–mediated destruction of leukemic cells or on the course of leukemia is largely unknown. In a first part of this study, we compared functions of NK cells in subjects carrying HLA-B −21M or 21T using interleukin-2 (IL-2)–activated NK cells and leukemic cells from patients with acute myeloid leukemia (AML). Subjects carrying HLA-B −21M harbored better-educated NKG2A+ NK cells and displayed superior capacity to degranulate lytic granules against KIR ligand-matched primary leukemic blasts. Second, we aimed to define the potential impact of HLA-B −21 variation on the course of AML in a phase 4 trial in which patients received IL-2–based immunotherapy. In keeping with the hypothesis that 21M may be associated with improved NK cell functionality, we observed superior leukemia-free survival and overall survival in −21M patients than in −21T patients during IL-2–based immunotherapy. We propose that genetic variation at HLA-B −21 may determine the antileukemic efficacy of activated NK cells and the clinical benefit of NK cell–activating immunotherapy.
A randomized controlled trial to test the efficacy of trans-tympanic injections of a sodium thiosulfate gel to prevent cisplatin-induced ototoxicity in patients with head and neck cancer
Authors: Rolland Viannique , Meyer François , Guitton Matthieu J. , Bussières Richard , Philippon Daniel , Bairati Isabelle , Leclerc Mathieu , Côté Mathieu 
Published: January 2019

Background Cisplatin-induced hearing loss is frequent and severe. Antioxidants such as sodium thiosulfate (STS) can neutralize the effects of cisplatin. The objective of the trial was to test the efficacy of trans-tympanic injections of a STS gel to prevent cisplatin-induced ototoxicity. Methods Eligible participants were newly diagnosed patients with stage III or IV squamous cell carcinoma of the mouth, oropharynx, hypopharynx, or larynx and scheduled to be treated by concurrent chemoradiation (CCR). Patients with asymmetric hearing were not eligible. The planed treatment included cisplatin 100 mg/m2 at days 1, 22 and 43. A baseline pre-treatment complete audiometric evaluation (pure tone at frequencies ranging from 0.5 to 14 kHz, bone conduction at 0.5–4 kHz and DPOAEs) was performed. Adverse effects were noted according to CTCAE. On the day before the beginning of CCR, eligible and consenting patients were randomized to receive a trans-tympanic injection of the gel either in the left ear or in the right ear. A final post-treatment complete audiometric evaluation was scheduled to be performed 1 month after the end of CCR by audiologists kept blind to the ear assignment. For the main outcome, the permanent threshold shift (PTS) in decibel (dB) was calculated as the difference between the final and baseline measures at all pure tone frequencies at 0.5–14 kHz for each patient and for each ear. The main outcome was assessed blindly in a mixed linear model with the PTS as the dependent variable and intervention, frequency, their interaction and radiation dose to the cochlea as independent variables. Results Between January 2015 and April 2016, 13 patients were randomized. The trial was stopped in June 2016 for poor accrual. The average loss of hearing over all frequencies was 1.3 dB less for treated ears compared to control ears. Although not statistically ( p = 0.61) nor clinically significant, the difference was in favor of the treated ears for all frequencies between 3 and 10 kHz. Conclusions Our trial suggests that STS deposited on the round window was safe for the middle and inner ears. More work is needed to improve the efficacy of trans-tympanic injections of cisplatin antidotes. Trial registration ClinicalTrials.gov, NTC02281006 , Registered 3 November 2014.
Innovation in Education Research: Creation of an Education Research Core
Authors: Schwengel Deborah A. , Toy Serkan 
Published: January 2019

Within academic medical centers, there is increasing interest among physicians to pursue education as a promotion pathway. Many medical schools and universities offer professional development opportunities for these individuals such as workshops and certificate and advanced degree programs. However, there exists a need for a more personalized support for clinician-educators to be successful in educational scholarship in the health care setting. In 2017, a departmental level educational research community was established within Anesthesiology and Critical Care Medicine at Johns Hopkins University to support faculty, staff, and trainees in creating, completing, and publishing educational scholarship. The research infrastructure includes administrative and institutional review board submission assistance, internal grant support, database management, statistical analysis, and consultation with professional educators. Also, integral to the education core is monthly education lab meetings that allow an opportunity for education researchers to present work in progress, conceive new projects, discuss relevant literature, and cultivate and sustain a community of educational scholars.
This innovation in education demonstrates feasibility at a departmental level to successfully support educational research. We have initiated education meetings with a cohort of core education faculty who are interested in an educational promotion track. We present several metrics that can be used to evaluate the effectiveness of the programs similar to this innovation.
The Effects of Postoperative Residual Neuromuscular Blockade on Hospital Costs and Intensive Care Unit Admission: A Population-Based Cohort Study
Authors: Grabitz Stephanie D. , Rajaratnam Nishan , Chhagani Khushi , Thevathasan Tharusan , Teja Bijan J. , Deng Hao , Eikermann Matthias , Kelly Barry J. 
Published: January 2019

BACKGROUND:
Postoperative residual neuromuscular blockade continues to be a frequent occurrence with a reported incidence rate of up to 64%. However, the effect of postoperative residual neuromuscular blockade on health care utilization remains unclear. We conducted a retrospective cohort study to investigate the effects of postoperative residual neuromuscular blockade on hospital costs (primary outcome), intensive care unit admission rate, and hospital length of stay (secondary outcomes).

METHODS:
We performed a prespecified secondary analysis of data obtained in 2233 adult patients undergoing surgery under general anesthesia. Postoperative residual neuromuscular blockade was defined as a train-of-four ratio <0.9 in the postanesthesia care unit (PACU). Our confounder model adjusted for a variety of patient, surgical, and anesthesia-related factors. We fitted truncated negative binomial regression models for hospital cost and hospital length of stay analyses and a logistic regression model for our intensive care unit admission analysis.

RESULTS:
Overall, 457 (20.5%) patients in our cohort had residual neuromuscular blockade on admission to the PACU. Postoperative residual neuromuscular blockade was not independently associated with increased hospital costs (adjusted incidence rate ratio, 1.04, CI, 0.98–1.11; P = .22). There were significantly higher odds of intensive care unit admission in those with postoperative residual neuromuscular blockade compared to those without (adjusted odds ratio, 3.03, CI, 1.33–6.87; P < .01). Further, we found a trend toward increased hospital length of stay in patients with postoperative residual neuromuscular blockade (adjusted incidence rate ratio, 1.09; P = .06). Sensitivity analysis using the same model in the day of surgery admissions and ambulatory surgery confirmed our findings.

CONCLUSIONS:
Postoperative residual neuromuscular blockade at PACU admission was not significantly associated with increased hospital costs, but was associated with higher rates of intensive care unit admission. These findings support the view that clinicians should continue to work to reduce the rate of postoperative residual neuromuscular blockade.
Analisis Prediksi Kebangkrutan dan Rasio Keuangan Bank Umum Syariah dengan Metode Altman Z-Score pada Tahun 2011-2015
Authors: Muharrami Rais Sani , Sinta Sinta 
Published: January 2019

The purpose of this research is to perform a comparative analysis of bankruptcy prediction and financial ratio related to Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa. This research applied Altman model on Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa to explain its bankruptcy prediction., while Mann Withney test is used to show a comparative analysis on its financial ratio related to bankruptcy. Data was use in this research is time series data, the data from 2011 up to 2015. The data is obtained from publication in Otoritas Jasa Keuangan (OJK) and publication in each bank’s website. The sampling techniques using purposive sampling methods. This research can be concluding that there is no difference between Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa on Bankruptcy prediction with Altman model. In financial ratios related to bankrupty exposure such as liquidity, Profitability, and Productivity has not significant difference to. While insolvency ratio at Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa foundto have differences. For bankruptcy prediction at Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa is found not difference. So, we can conclude that the difference in bankruptcy perdiction on Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa caused by the absence of dirrerences in the financial ratios with regard to bankruptcy unless insolvency.
Focando as lentes: Criminologia Cultural e a Imagem
Authors: Hayward Keith J. 
Published: January 2019

O presente estudo busca analisar o crescente papel/uso da imagem em relação às condições contemporâneas da sociedade na modernidade tardia e, particularmente, as representações visuais (significados) extraídas da imagem do crime e do controle social enquanto produtos culturais carregados de sentido, de interpretações, de tensões, etc., o poder dessas imagens e desses múltiplos visuais (estilos), de que forma podemos focalizar as lentes (imagens) da transgressão e das agências de controle, e as maneiras pelas quais essas lentes são manipuladas pelos meios de comunicação, a fim de gerarem uma cultura estilizada e espetacularizada em torno dessas questões. Para a concreção dessa intenção de pesquisa, a Criminologia Cultural procura compreender, tanto metodológica quanto teoricamente, o impacto simbólico e cultural dessas condições da sociedade moderna frente às instituições de controle, e ao próprio significado circular dos termos crime e controle social, no sentido de desafiar a Criminologia, fazendo girar o seu caleidoscópio para além das análises econômicas e sociais da Criminologia ortodoxa, para focalizar ou melhor identificar o lado impreciso da imagem do crime e do controle social vistas em cada aspecto de nossa existência, e projetadas por uma cultura de estilo, que festeja e promove o seu lado sedutor. Palavras-chave: Imagem; Crime e Controle social; Criminologia Cultural; Representações visuais.