bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Sports-Related Subconcussive Injuries in Soccer Players
Authors: Salvatore Anthony , Díaz-Rodríguez Yarimar 
Published: January 2019

AbstractSports-related subconcussive impacts to the head are receiving increased interest. Recent evidence indicates that subconcussive impacts will have greater relevance across time because of the number of repetitive impacts. Soccer players are at risk of receiving at least one impact during a soccer game. The authors review the cognitive-communication functioning following subconcussive head injuries in youth and recommendations for baseline assessments and cognitive-communication dysfunctions after subconcussive impacts in youth. The review is followed by a description and discussion of a study that assessed the cognitive-communicative dysfunction in young soccer players prior to and following a series of soccer matches and recommendations for monitoring recovery of cognitive-communication.
Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients—A 12-Year Perspective
Authors: Wolfson Theodore S. , Novikov David , Chen Kevin K. , Kim Kelvin Y. , Anoushiravani Afshin A. , Deshmukh Ajit J. , Lajam Claudette M. 
Published: January 2019

AbstractDespite the evolution of blood management protocols, total knee arthroplasty (TKA) occasionally requires allogeneic blood transfusion. This poses a particular challenge for Jehovah's Witnesses (JW) who believe that the Bible strictly prohibits the use of blood products. The aim of this study was to compare JW and a matched-control cohort of non-JW candidates undergoing TKA to assess the safety using modern blood management protocols. Fifty-five JW patients (63 knees) who underwent TKA at our institution between 2005 and 2017 were matched to 63 non-JW patients (63 knees). Patient demographics, intraoperative details, and postoperative complications including in-hospital complications, revisions, and 90-day readmissions were collected and compared between the groups. Additionally, subgroup analysis was performed comparing JW patients who were administered tranexamic acid (TXA) between the two groups. Baseline demographics did not vary significantly between the study cohorts. The mean follow-up was 3.1 years in both the JW and non-JW cohorts. Postoperative complications, including in-hospital complications (7.9 vs. 4.8%; p = 0.47), revision TKA (1.6 vs. 1.6%; p = 1.00), and 90-day readmission (1.6 vs. 4.8%; p = 0.31) were not significantly different between the JW and non-JW groups. Subgroup analysis demonstrated JW patients who received TXA had a significantly lower decline in postoperative hemoglobin (Hgb) (8.6 vs. 14.0%; p < 0.01). At a follow-up of up to 12 years, JW patients who underwent TKA have outcomes equivalent to non-JW patients without the need for transfusion. Our findings support that surgeons are more likely to optimize JW patients preoperatively with iron and folate supplementation. Despite these variations in preoperative optimization efforts, no significant difference with regard to Hgb or hematocrit levels was demonstrated. Level of evidence is III, retrospective observational study.
Knee Cell-Based Cartilage Restoration
Authors: Hensley Dana , Pickett Adam 
Published: January 2019

AbstractAs our patients become more physically active at all ages, the incidence of injuries to articular cartilage is increasing causing significant pain and disability. The intrinsic healing response of articular cartilage is poor because of its limited vascular supply and capacity for chondrocyte division. Nonsurgical management for the focal cartilage lesion is successful in the majority of patients. Those patients who fail conservative management may be candidates for a cartilage reparative or reconstructive procedure. The type of treatment available depends on a multitude of lesion-specific and patient-specific variables. First-line therapies for isolated cartilage lesions have demonstrated good clinical results in the correct patient, but typically repair cartilage with fibrocartilage, which has inferior stiffness, inferior resilience, and poorer wear characteristics. Advances in cell-based cartilage restoration have provided the surgeon a means to address focal cartilage lesions utilizing mesenchymal stem cells, chondrocytes, and biomimetic scaffolds to restore hyaline cartilage.
Rehabilitation for Femoroacetabular Impingement: Conservative Care and Postoperative Practice
Authors: Westermann Robert , Lynch T. , Rosneck James , Hagen Mia 
Published: January 2019

AbstractThe understanding of femoroacetabular impingement (FAI) has increased over the past 10 years, with advancements in diagnosis and surgical techniques. Controversy remains regarding the ideal regimen of conservative care. Additionally, there is wide variety in postoperative clinical practice after hip arthroscopy. This review is a synthesis of resources on rehabilitation as a stand-alone treatment for FAI as well rehabilitation following surgery. Best evidence regarding conservative care is presented followed by postoperative debates on weight-bearing, range of motion, and physical therapy. In most cases, such as use of bracing and continuous passive motion, there are limited experimental studies to rely on. Higher quality evidence is required to support today's rehabilitation practices which are based mostly on theory and individual experience.
Clinical Assessments of Balance in Adults with Concussion: An Update
Authors: Reed-Jones Rebecca , Szekely Brian , Powell Douglas , Murray Nicholas 
Published: January 2019

AbstractPostural instability is a cardinal indicator of concussion. Assessments of the postural control system range from clinical to laboratory tests that assess the balance of the individual. In a previous article regarding clinical assessment of balance in adults with concussion, we reviewed the importance of balance as a component in concussion evaluations. The purpose of this review article is to update the information previously published in 2014. Since 2014, research has provided evidence for the incorporation of dynamic methods for evaluating balance postconcussion with particular emphasis on sensory system integration and dual tasking. Therefore, this review will examine the current state of knowledge on how concussion injuries affect postural control, advancements in evaluating balance postconcussion, such as novel eye-tracking techniques, and current recommendations for best practices for balance assessment.
A Unique Factor XIII Mutation in Southeastern Iran with an Unexpectedly High Prevalence: Khash Factor XIII
Authors: Dorgalaleh Akbar , Tabibian Shadi , Shams Mahmood , Majid Golbahar , Naderi Majid , Casini Alessandro , Tavasoli Behnaz , Gheidishiran Maryam , Daneshi Maryam , Safa Majid 
Published: January 2019

AbstractCongenital factor XIII (FXIII) deficiency is an extremely rare hemorrhagic disorder characterized by a deficiency of FXIII and associated with a high rate of morbidity and mortality. The disorder is more frequent in Iran, especially in Khash, a city in the southeast of the country. As identified in the current report, the prevalence of FXIII deficiency in this city is 1 homozygote per approximately 500 population (which is ∼4,000 times higher than the worldwide prevalence) with 3.5% heterozygotes. The disorder is accompanied by a high rate of mortality in rural areas of Khash, given an averaged observed rate of approximately three deaths per each family with FXIII deficiency, mostly due to late-diagnosis and/or misdiagnosis, and fetal consequences of both umbilical cord and central nervous system bleeding. Almost all patients with FXIII deficiency in the southeast Iran have a unique mutation in F13A gene (Trp187Arg), which leads to a severe FXIII deficiency. This mutation is used for pre-marriage and prenatal diagnosis, as well as for carrier detection and diagnostic confirmation. Fibrogammin P has been used worldwide for about one decade, along with different therapeutic regimens for prophylaxis treatment, major and minor surgeries, and successful delivery. Due to the rapid increase in the number of patients identified to have congenital FXIII deficiency, and the high rate of related morbidity and mortality, a comprehensive regional preventive program is necessary to prevent further expansion of this condition and decrease the burden on the health care system. The area of Khash city provides novel insights into severe FXIII deficiency due to its high prevalence in this region. This report also provides a review of FXIII deficiency, its diagnosis, prevalence, molecular basis, clinical manifestations, management, and treatment, with a particular focus on Iran, representing a hotspot for this disorder.
Immune Modulation in Pediatric Sepsis
Authors: Hall Mark 
Published: January 2019

AbstractThe initial host immune response to sepsis in children is characterized by a proinflammatory surge that can be associated with fever, capillary leak, and organ dysfunction. There is, however, a concurrent anti-inflammatory response that results in hyporesponsiveness of innate and adaptive immune cells. When severe, this response is termed immunoparalysis and is known to be associated with prolonged organ dysfunction, increased risk for nosocomial infection, and death in septic adults and children. Sepsis-induced immune suppression can be defined in the laboratory by reduced whole blood ex vivo-stimulated cytokine production capacities, reduced expression of human leukocyte antigen (HLA)-DR on circulating monocytes, and reduced absolute cell counts. While anti-inflammatory therapies have largely been unsuccessful at improving outcomes from adult and pediatric sepsis, the use of immunostimulatory therapies such as granulocyte macrophage colony-stimulating factor (GM-CSF) in patients with sepsis-induced immunoparalysis shows promise. A greater understanding of the risk factors for immunoparalysis along with the development and execution of immunophenotype-specific clinical trials of strategies to optimize innate and adaptive immune function are needed to further improve outcomes in septic children.
Plasma Protein Oxidation as a Determinant of Impaired Fibrinolysis in Type 2 Diabetes
Authors: Bryk Agata , Konieczynska Malgorzata , Rostoff Pawel , Broniatowska Elzbieta , Hohendorff Jerzy , Malecki Maciej , Undas Anetta 
Published: January 2019

Objective We investigated clinical and laboratory determinants of plasma protein oxidation and its associations with clot fibrinolysis in type 2 diabetes patients.
Materials and Methods Our cross-sectional study consisted of 246 type 2 diabetic patients, 143 (58%) with concomitant cardiovascular disease (CVD), including 41 (17%) with previous myocardial infarction (MI). We measured total protein carbonylation (PC), thiobarbituric acid reactive substances (TBARS) and total antioxidant capacity (TAC) along with clot lysis time (CLT) and clot permeation (Ks
), fibrinogen, plasminogen, α-2-antiplasmin, plasminogen activator inhibitor-1 (PAI-1), thrombin activatable fibrinolysis inhibitor (TAFI) and thrombomodulin.
Results Total PC correlated positively, while TAC correlated inversely with glycated haemoglobin and diabetes duration (all p < 0.05). Diabetic patients with CVD had higher total PC, TBARS and lower TAC compared with the remainder (all p < 0.001). Among correlations of total PC with Ks
, PAI-1, thrombomodulin and TAFI, the strongest was with CLT (r = 0.687, all p < 0.01). High total PC, defined as ≥ 3.45 nmol/mg, was predicted by time since diabetes diagnosis ≥ 5 years (odds ratio [OR]: 3.0, 95% confidence interval [CI]: 1.36–6.63) and previous MI (OR: 11.31, 95% CI: 4.37–29.32). After adjustment for potential confounders, total PC accounted for 34.9% of the total variance in CLT. Total PC at a cut-off of 3.44 nmol/mg showed high discriminatory power for identifying patients with prolonged CLT (area under the curve: 0.845, 95% CI: 0.792–0.898, p < 0.001).
Conclusion Elevated plasma PC, largely driven by a long history of diabetes and concomitant CVD, is an important determinant of hypofibrinolysis in type 2 diabetes.
The Current Role of Dual Mobility Articulations in Total Hip Arthroplasty
Authors: Parvataneni Hari , Pulido Luis , Prieto Hernan , Silverberg Arnold 
Published: January 2019

AbstractThe concept of dual mobility (DM) bearings in total hip arthroplasty was first introduced by Professors Gilles Bousquet and Andre Rambert in France in 1974 with the goal of enhancing hip stability. Although DM did not receive U.S. Food and Drug Administration approval for commercial use in the United States until 2009, there has been a surge in popularity of DM implants over the past several years, evidenced by the American Joint Replacement Registry data. The enthusiasm for DM stems from a growing body of literature that supports its use across a range of patient populations, most notably revision hip arthroplasty and high-risk primary scenarios. DM has been shown to effectively reduce the risk of dislocation while also exhibiting excellent survivorship. DM does incur some unique risks, namely, intraprosthetic dissociation, but many of the early concerns with DM have not been realized in the literature and do not seem to negatively impact its long-term survivorship. The exact indications for DM have yet to be defined and remain a matter of debate. It should be considered as an alternative for any primary or revision hip arthroplasty at high risk for postoperative instability. In this article, the authors review the current literature regarding the clinical success of DM implants for a variety of indications, all of which predispose to hip instability. The history, basic biomechanics, modern designs, and unique complications are also discussed.
Indwelling Pleural Catheter Placement for Nonmalignant Pleural Effusions
Authors: DeBiasi Erin , Puchalski Jonathan , Bramley Kyle 
Published: January 2019

AbstractPleural effusions account for significant symptoms and morbidity. Recent studies demonstrate a high mortality in patients with “benign” pleural effusions, now better characterized as nonmalignant pleural effusions (NMPEs) based on their prognosis. The most common nonmalignant clinical conditions with recurrent pleural effusions are congestive heart failure and hepatic hydrothorax, although many other diseases exist in isolation or as comorbid conditions. When conventional therapy fails, thoracentesis is often performed for relief of dyspnea. Many times, however, the effusions recur despite maximal medical therapy. Placement of tunneled or indwelling pleural catheters provides an effective therapeutic strategy for recurrent NMPEs when other medical therapy fails.
Results of Graft Removal and Negative Pressure Wound Therapy in Management of Graft Infection
Authors: Miyake Keisuke , Kitabayashi Katsukiyo , Sakagoshi Nobuo 
Published: January 2019

AbstractGraft infections are a challenging complication in lower extremity bypass surgery with poor outcome, even when treated with graft removal (Gr-R) as a gold standard therapy. The efficacy of negative pressure wound therapy (NPWT) for graft infections has been reported recently, but it is still controversial. The purpose of this study was to assess the efficacy of NPWT and Gr-R for treating graft infections. Twelve consecutive patients with graft infections from 2008 to 2014, treated with Gr-R or NPWT, were enrolled. Those procedures were assessed in complete wound healing, reinfection, amputation, and mortality rate. Five grafts were treated with Gr-R, and seven grafts with NPWT. The initial indications for bypass surgery were claudication, in five grafts treated with Gr-R and three grafts treated with NPWT, and critical limb ischemia in four grafts treated with NPWT. The median time until healing in Gr-R and NPWT was 12 and 59 days, with complete healing seen in 100 and 85.7%, respectively. The major amputation rate was 20 and 14.3%, and reinfection rate was 20 and 14.3%, respectively. There was no perioperative mortality. Gr-R did not show devastating outcome when applied for grafts without limb-threatening ischemia. NPWT showed a low level of invasiveness with excellent results, except for anastomosis site infections. To achieve optimal results, a tailored treatment strategy should be considered.
Functional Validation of microRNA-126-3p as a Platelet Reactivity Regulator Using Human Haematopoietic Stem Cells
Authors: Garcia Alix , Dunoyer-Geindre Sylvie , Zapilko Veronika , Nolli Séverine , Reny Jean-Luc , Fontana Pierre 
Published: January 2019

Background Platelets are an abundant source of micro-ribonucleic acids (miRNAs) that may play a role in the regulation of platelet function. Some miRNAs, such as miR-126-3p, have been noted as potential biomarkers of platelet reactivity and the recurrence of cardiovascular events. However, the biological relevance of these associations remains uncertain, and the functional validation of candidate miRNAs on human-derived cells is lacking.
Objective This article functionally validates miR-126-3p as a regulator of platelet reactivity in platelet-like structures (PLS) derived from human haematopoietic stem cells.
Materials and Methods CD34+-derived megakaryocytes were transfected with miR-126-3p and differentiated in PLS. PLS reactivity was assessed using perfusion in a fibrinogen-coated flow chamber. miR-126-3p's selected gene targets were validated using quantitative polymerase chain reaction, protein quantification and a reporter gene assay.
Results CD34+-derived megakaryocytes transfected with miR-126-3p generated PLS exhibiting 156% more reactivity than the control. These functional data were in line with those obtained analysing CD62P expression. Moreover, miR-126-3p transfection was associated with the down-regulation of a disintegrin and metalloproteinase-9 (ADAM9) messenger RNA (mRNA), a validated target of miR-126-3p, and of Plexin B2 (PLXNB2) mRNA and protein, an actin dynamics regulator. Silencing PLXNB2 led to similar functional results to miR-126-3p transfection. Finally, using a reporter gene assay, we validated PLXNB2 as a direct target of miR-126-3p.
Conclusion We functionally validated miR-126-3p as a regulator of platelet reactivity in PLS derived from human haematopoietic stem cells. Moreover, PLXNB2 was validated as a new gene target of miR-126-3p in human cells, suggesting that miR-126-3p mediates its effect on platelets, at least in part, through actin dynamics regulation.
New Strategies of Pulmonary Protection of Preterm Infants in the Delivery Room with the Respiratory Function Monitoring
Authors: Zeballos Sarrato Gonzalo , Sánchez Luna Manuel , Zeballos Sarrato Susana , Pérez Pérez Alba , Pescador Chamorro Isabel , Bellón Cano Jose María 
Published: January 2019

Objective To investigate if the use of a visible respiratory function monitor (RFM) to use lower tidal volumes (Vts) during positive pressure ventilation (PPV) in the delivery room (DR) reduces the need of surfactant administration and invasive mechanical ventilation during the first 72 hours after birth of preterm infants <32 weeks' gestational age (GA).
Study Design Infants <32 weeks' GA (n = 106) requiring noninvasive PPV were monitored with a RFM at birth and randomized to visible (n = 54) or masked (n = 52) display on RFM. Pulmonary data were recorded during the first 10 minutes after birth. Secondary analysis stratified patients by GA (<28, 28–29+6, or ≥30 weeks).
Results Median expiratory Vts during inflations were greater in the masked group (7 mL/kg) than in the visible group (5.8 mL/kg; p = 0.001) same as peak inflation pressure (PIP) administered (21.5 vs. 19.7 cmH2O; p < 0.001). Consequently, minute volumes were greater in the masked group (256 vs. 214 mL/kg/min; p < 0.001), with no differences in respiratory rate. These differences were higher in those <30 weeks' GA. There was no difference in the need of surfactant administration or intubation during the first 72 hours of age.
Conclusion Using a RFM in the DR prevents the use of large Vt and PIP during respiratory support inflations, mostly in the more immature newborn infants, but with no other short-term benefits.
Antepartum Contraceptive Counseling in Women with Preterm Birth
Authors: Toscano Marika , Li Dongmei , Dye Timothy , Olson-Chen Courtney 
Published: January 2019

Objective To compare rates of antepartum contraceptive counseling among women with preterm birth (PTB) and term birth.
Study Design This is a retrospective cohort study of patients with completed delivery records in New York from January 1, 2004, to December 31, 2014. Exposure was determined based on the timing of delivery. Exposed women delivered at <37 weeks, and nonexposed women delivered at ≥37 weeks. Primary outcome was patient response to questions regarding receipt of prenatal contraceptive counseling (PCC) by a health care provider. Secondary outcome was receipt of interpregnancy interval counseling. Chi-square tests and multivariate logistic regression were used for analysis.
Results Of 724,723 delivery records, PTB rate was 7.9%. Women with PTB < 37 weeks were significantly less likely to receive PCC (odds ratio [OR]: 0.9; 95% confidence interval [CI]: 0.89–0.93) or interpregnancy interval counseling (OR: 0.95; 95% CI: 0.94–0.97). The primary outcome remained significant after adjusting for confounders (adjusted OR: 0.91; 95% CI: 0.89–0.93). PTB < 34 weeks was associated with even lower odds of receiving contraceptive counseling (OR: 0.79; 95% CI: 0.76–0.83).
Conclusion Postpartum contraception is an important tool for the prevention of recurrent PTB. Antepartum contraception counseling increases postpartum contraceptive uptake. Women with PTB have less exposure to antepartum contraceptive counseling. Lack of adequate counseling and decreased uptake of postpartum contraception may impact future pregnancy outcomes.
Hospital Charge Variability across New York State: Sociodemographic Factors in Pituitary Surgery
Authors: Kidwai Sarah M. , Yang Anthony , Gray Mingyang L. , McKee Sean , Iloreta Alfred Marc , Shrivastava Raj , Govindaraj Satish 
Published: January 2019

Introduction Significant charge disparities exist across New York State (NYS). Race and income are associated with increased charges. To determine risk factor, we correlate hospital charges for pituitary surgery with socioeconomic factors. Additionally, we identify patients at risk for increased hospital charges and provide insight into cost-effective practices.
Methods Retrospective cohort study of the Statewide Planning and Research Cooperative System (SPARCS) database from the NYS Department of Health was conducted. The SPARCS database was reviewed. Patients who underwent transsphenoidal pituitary surgery from 1995 to 2015 were identified. Income and urban status were referenced from U.S. census data. Linear regression was performed to analyze the effect of sociodemographic factors, comorbidities, and complications on hospital charges while controlling for length of stay.
Results A total of 9,373 patients were identified. Black (10.8%, p < 0.001) and Asian (14.5%, p < 0.001) had higher hospital charges. Patients from nonurban cities (13.4%, p < 0.001), Medicaid (13.8%, p < 0.001), and those from the 0 to 25th (9.1%, p < 0.001) and 25 to 50th (11.7%, p < 0.001) income quartile had lower hospital charges. Patients with postoperative cerebrospinal fluid leak (24.0%, p < 0.001), diabetes insipidus (22.1%, p < 0.001), smoking history (11.8%, p < 0.001), hypertension (7.4%, p < 0.001), and hypothyroidism (6.9%, p < 0.001) had higher hospital charges.
Conclusion Patients incurring higher chargers were more likely to have a smoking history, hypertension, hypothyroidism, and comorbidities. The determinants of this analysis may provide insight into barriers to patient access and cost improvement strategies. In addition, this emphasizes the need for future studies to create a risk stratification model, similar to those in other fields.