bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acetabular Debridement Demonstrates Similar Outcomes and Survival to Microfracture in Hip Arthroscopy: A Multi-Center Analysis
Authors: Hevesi Mario , Bernard Christopher D. , Hartigan David Edward , Levy Bruce A. , Domb Benjamin G. , Krych Aaron John 
Published: July 2019

Objectives: Hip arthroscopy is becoming more advanced and commonly performed. However, significant controversy exists regarding whether high grade acetabular cartilage lesions should be treated with debridement or microfracture. In addition, patients treated with microfracture are subject to extended partial weight-bearing rehabilitation in order to mitigate risk of subchondral plate fracture and protect fibrocartilage tissue formation. The purpose of this study was to determine the mid-term patient-reported outcomes and failure rate and patient-reported outcomes of Grade 3 and 4 acetabulum labrum articular disruption (ALAD) lesions managed with microfracture or debridement. Methods: Primary arthroscopic labral repair cases at two centers from November 2008 to April 2016 were reviewed in patients aged < 55 years with unipolar ALAD Grade 3 and 4 pathology. Patients undergoing microfracture and debridement were compared using visual analog pain scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score - Sports Specific Subscale (HOS-SSS) to determine predictors of outcomes and failure. Results: 127 hips in 123 patients (47 M, 76 F, mean age 34.7 ± 11.1) undergoing debridement (n = 95) or microfracture (n = 32) were followed for a mean of 4.9 years (range 2.0 - 8.5). Patients undergoing debridement achieved 3.5 point mean improvements in VAS (p < 0.01), 20.9 point improvements in mHHS (p < 0.01), and 25.5 point improvements in HOS-SSS (p < 0.01), which was statistically similar to that observed in microfracture patients (p ≥ 0.19). Five-year survival free of revision surgery was 83.0% in the debridement group and 85.6% in the microfracture group (p = 0.85). Cartilage treatment technique was found not to be predictive of revision risk during both univariate (p = 0.84) and multivariate (p = 0.84) analysis. Conclusion: Patients undergoing debridement of high grade unipolar acetabular cartilage lesions demonstrate similar patient reported outcome scores and revision rates compared to patients undergoing microfracture. These outcomes support debridement of acetabular lesions in order to optimize recovery while maintaining established positive outcomes following hip arthroscopy. [Table: see text]
Role of the Long Head of the Biceps During Active Pitching in Healthy Collegiate Athletes: An Electromyographic Evaluation
Authors: Gowd Anirudh K. , Luchetti Timothy , Birlingmair Jacob , Verma Nikhil N. , Romeo Anthony A. , Zaferiou Antonia 
Published: July 2019

Objectives: Supraphysiologic forces placed on the glenohumeral joint during pitching leads to a high incidence of bicipital-labral pathology in competitive pitchers. Heavy debate in operative management between biceps tenodesis, labral repair, and debridement warrants further study in the role of the biceps during pitching. The purpose of this study was to evaluate the recruitment of the long and short heads of the biceps utilizing electromyographic evaluation and correlate activity with pitch velocity. Methods: Seventeen healthy, competitive, pitchers were recruited and consented to pitch in a controlled laboratory setting, under electromyographic observation. Surface electromyography (sEMG) was performed via electrodes placed on either head of the biceps, deltoid, infraspinatus, and latissimus dorsi, band pass filtered between 10-500 Hz and sampled at a rate of 1500 Hz during the pitching motion. sEMG was normalized to maximal volumetric isometric contraction (MVIC) via manual muscle testing (MMT). Pitch velocity was measured using a Speedster III radar gun, and then correlated to sEMG readings. Results: Average age of recruited subjects was 19.8 ± 1.4 years old. Average number of years pitched was 10.3 ± 3.6 years. Fourteen players reported their highest level of play was college, while two reported semi-professional, and one reported high-school. Average pitch velocity from included pitches was 70.6 ± 4.0 (range: 61 - 79). sEMG signals were interpreted in three modalities: median signal, integral sum of all signals, and time spent (ms) above 10% MVIC. Pitch velocity did not correlate to any sEMG analysis (p>0.05) by bivariate linear regression. Coefficient of variation was greater between pitchers than within pitchers. Greater than 80% of pitchers demonstrated statistically different activation of the long head of biceps muscle (LHBM) versus short head of biceps muscle (SHBM) (Figure 1). Three players had significantly greater short head activation, while 12 players had significantly greater long head activation. Conclusion: The long and short heads of the biceps are consistently activated during pitching, suggested they have a role during the late cocking and deceleration phase of pitching, although not correlated to ball acceleration. Preferential recruitment of either long or short head biceps suggest variability in fast ball pitching styles, that warrant further research for clinical implications. [Figure: see text]
Little Leaguer’s Shoulder Caused Severe Humeral Retroversion: Ultrasonographic Analysis
Authors: Mihata Teruhisa , Neo Masashi 
Published: July 2019

Objectives: The increased humeral retroversion on the dominant side in throwing athletes is thought to result from repetitive throwing motion. In the previous studies, the degree of increased humeral retroversion was various, suggesting that other factors may affect humeral retroversion. Little Leaguer’s shoulder, which is rotational stress fracture of the proximal humeral epiphyseal plate, may change humeral retroversion. The purpose of this study was to investigate effect of Little Leaguer’s shoulder on humeral retroversion. Methods: Ten high-school baseball players (average, 16.6 years; range, 16 to 18 years), who had had Little Leaguer’s shoulder during elementary or junior high schools (average, 12.6 years; range, 11 to 15 years), were enrolled in the study. As a control group, 22 high-school baseball players (average, 16.9 years; range, 16 to 18 years), who have never had shoulder or elbow pain, were included in this study. Humeral retroversion was ultrasonographically measured on the dominant and non-dominant sides. Humeral retroversion was compared between dominant and non-dominant shoulders with paired t-test. Side-to-side difference in humeral retroversion was compared between Little Leaguer’s shoulders and control group with unpaired t-test. Results: Humeral retroversion was significantly greater on the dominant side than on the non-dominant side in both Little Leaguer’s shoulder (Dominant, 104°±8°; Non-dominant, 84°±12°; P < .001) and control groups (Dominant, 91°±13°; Non-dominant, 81°±10°; P < .001). The side-to-side difference in humeral retroversion in Little Leaguer’s shoulder group (20°±10°) was significantly greater than that in control group (10°±10°, P = .02). Conclusion: Humeral retroversion was increased with repetitive throwing motion without any symptom in the shoulder and elbow joint. Additional increase in humeral retroversion was made when the players had had Little Leaguer’s shoulder in elementary or junior high school.
Central retinal vein occlusion associated with platelet activation
Authors: Citirik Mehmet 
Published: July 2019

Purpose: The aim of this article is to determine and compare the platelet activation by three main platelet activation parameters: mean platelet volume, platelet distribution width, and plateletcrit in patients with central retinal vein occlusion and control subjects. Methods: This study included 30 patients with nonischemic central retinal vein occlusion and 30 control subjects. The levels of mean platelet volume, platelet distribution width, and plateletcrit were measured in all groups. Results: The mean serum level of mean platelet volume was 10.01 ± 0.89 fl in central retinal vein occlusion group and 8.74 ± 1.45 fl in control group. The mean serum level of platelet distribution width was 14.31 ± 1.49% and 11.65 ± 1.81% in central retinal vein occlusion group and control group, respectively. Mean serum plateletcrit value was 0.27 ± 0.07% in central retinal vein occlusion group and 0.23 ± 0.07% in control group. Mean platelet volume, platelet distribution width, and plateletcrit levels were significantly higher in central retinal vein occlusion patients than controls ( p < 0.05). Conclusion: Subclinical platelet activation reflected by mean platelet volume, platelet distribution width, and plateletcrit may have an impact on the genesis of vessel occlusion in central retinal vein occlusion. The results may be important for the clinical management of patients with central retinal vein occlusion.
Premature Ejaculation: Do We Need to Address the Issue Differently?
Authors: M. Shivalingaiah , S. Anuradha , Bhat Gajanan S. 
Published: July 2019

Introduction: Premature ejaculation is a complex condition with controversial management modalities. We decided to assess the treatment-seeking behavior of affected couples, which is an indirect indicator of the efficacy of the present management modalities of premature ejaculation. Materials and Methods: Couples, who reported premature ejaculation at our outpatient clinics between January 2015 and December 2016, were enrolled in the study. Patients with acquired causes for premature ejaculation were excluded. Both the partners were administered premature ejaculation diagnostic tool (PEDT) questionnaire separately at the time of initiation of the study and after 1 month. They were asked to report intravaginal ejaculatory latency time (IELT) and their treatment-seeking behavior at these time intervals. The couples were counselled regarding their diagnosis and offered treatment with dapoxetine 30 mg as and when required. Results: A total of 117 couples with an average married life of 5.4 years were enrolled for the study. Among these, 68 had premature ejaculation (PE), 30 had probable PE and 19 had no PE as estimated on PEDT. Post treatment, 55% of couples with PE, 47% of couples with probable PE and 55% of couples without PE wanted to continue treatment seeking despite improvement. Female partners had the desire to seek treatment despite the male partner reporting otherwise. Conclusion: The treatment seeking behavior of the affected couple indicates the inefficacy of the present management modalities of PE. As specialized health care providers, we need to address these concerns to provide a comprehensive solution to their problems.
Polycystic Ovary Syndrome (PCOS) and Sexual Dysfunctions
Authors: Koneru Amulya , S Priyanka 
Published: July 2019

Objectives: Polycystic ovary syndrome (PCOS) is a very common endocrine disorder affecting 5% to 10% of women in reproductive age all over the world. Many comorbidities have been associated with PCOS including infertility, obesity, depression, anxiety, hirsutism, alopecia, and sexu al dysfunctions. In this paper, we have reviewed the available Indian and international literature regarding psychiatric and sexual comorbidities of PCOS. Methods: PubMed, Cochrane, Google Scholar, and other databases were used to conduct the search. Research published in English was included. We searched the databases using the terms ‘polycystic ovary syndrome’, ‘PCOS’, ‘infertility and PCOS’, ‘sexual dysfunctions and PCOS’, etc. Results: For this review, we could find about 90 papers pertaining to the subject. Most of them focused on the effect of infertility and symptoms of PCOS such as hirsutism on body image and sexual dysfunctions. Meta-analyses showed that women with PCOS had poor rates of sexual desire, orgasm, and lubrication. Body image often had a negative impact on sexual thoughts and fantasies. Conclusion: Focus on sexual dysfunctions in PCOS has been emphasized only recently after high rates of its prevalence have been found. Hence, management of PCOS involves a multidisciplinary approach where proper assessment and management of sexual dysfunctions should be given its due importance.
A randomised controlled trial to investigate the use of high-frequency airway oscillations as training to improve dyspnoea in COPD
Authors: Daynes Enya , Greening Neil , Siddiqui Salman , Singh Sally 
Published: July 2019

IntroductionChronic obstructive pulmonary disease (COPD) is characterised by expiratory flow limitation resulting in symptomatic dyspnoea, sputum retention and ventilation heterogeneity. Changes in breathing mechanics affect the ability of respiratory muscles to respond to the ventilatory demands, increasing the sensation of dyspnoea. A high-frequency airway oscillating device has been developed to combine respiratory muscle training and oscillations to improve dyspnoea and sputum retention within COPD.Methods and analysisPatients with symptomatic COPD (Medical Research Council Breathlessness scale grade ≥2) will be recruited to a double-blind, randomised, sham-controlled trial. Both groups will follow an 8-week intervention phase using the device three times per day for 5 min at a time. This will be recorded in a self-reported diary. The device applies a flow resistive load and oscillations for combined training. Those receiving the sham device will follow the same protocol; however, the mechanism of action will be removed from the device. Improvements in the Chronic Respiratory Questionnaire-Dyspnoea domain will be the primary outcome measure. Secondary outcomes will explore respiratory muscle function, health-related quality of life, exercise capacity and physical activity. The Lung Clearance Index will be an exploratory outcome. Outcomes will be explored using the most appropriate statistical test, dependent on the sample distribution. Focus groups will be an exploratory outcome and analysed by thematic analysis.Ethics and disseminationEthical approval has been obtained from the East Midlands-Leicester South Research Ethics Committee and the trial has been registered through the ISRCTN Registry. The study results will be disseminated to the appropriate stakeholders through presentations, conferences and peer-reviewed journals.
Home-based tuberculosis contact investigation in Uganda: a household randomised trial
Authors: Davis J. Lucian , Turimumahoro Patricia , Meyer Amanda J. , Ayakaka Irene , Ochom Emma , Ggita Joseph , Mark David , Babirye Diana , Okello Daniel Ayen , Mugabe Frank , Fair Elizabeth , Vittinghoff Eric , Armstrong-Hough Mari , Dowdy David , Cattamanchi Adithya , Haberer Jessica E. , Katamba Achilles 
Published: July 2019

IntroductionThe World Health Organization (WHO) recommends household tuberculosis (TB) contact investigation in low-income countries, but most contacts do not complete a full clinical and laboratory evaluation.MethodsWe performed a randomised trial of home-based, SMS-facilitated, household TB contact investigation in Kampala, Uganda. Community health workers (CHWs) visited homes of index patients with pulmonary TB to screen household contacts for TB. Entire households were randomly allocated to clinic (standard-of-care) or home (intervention) evaluation. In the intervention arm, CHWs offered HIV testing to adults; collected sputum from symptomatic contacts and persons living with HIV (PLWHs) if ≥5 years; and transported sputum for microbiologic testing. CHWs referred PLWHs, children <5 years, and anyone unable to complete sputum testing to clinic. Sputum testing results and/or follow-up instructions were returned by automated SMS texts. The primary outcome was completion of a full TB evaluation within 14 days; secondary outcomes were TB and HIV diagnoses and treatments among screened contacts.ResultsThere were 471 contacts of 190 index patients allocated to the intervention and 448 contacts of 182 index patients allocated to the standard-of-care. CHWs identified 190/471 (40%) intervention and 213/448 (48%) standard-of-care contacts requiring TB evaluation. In the intervention arm, CHWs obtained sputum from 35/91 (39%) of sputum-eligible contacts and SMSs were sent to 95/190 (50%). Completion of TB evaluation in the intervention and standard-of-care arms at 14 days (14%versus15%; difference −1%, 95% CI −9% to 7%, p=0.81) and yields of confirmed TB (1.5%versus1.1%, p=0.62) and new HIV (2.0%versus1.8%, p=0.90) diagnoses were similar.ConclusionsHome-based, SMS-facilitated evaluation did not improve completion or yield of household TB contact investigation, likely due to challenges delivering the intervention components.
Low dose chloroquine decreases insulin resistance in human metabolic syndrome but does not reduce carotid intima-media thickness
Authors: McGill Janet B. , Johnson Mariko , Hurst Stacy , Cade William T. , Yarasheski Kevin E. , Ostlund Richard E. , Schechtman Kenneth B. , Razani Babak , Kastan Michael B. , McClain Donald A. , de las Fuentes Lisa , Davila-Roman Victor G. , Ory Daniel S. , Wickline Samuel A. , Semenkovich Clay F. 
Published: July 2019

Abstract
Background
Metabolic syndrome, an obesity-related condition associated with insulin resistance and low-grade inflammation, leads to diabetes, cardiovascular diseases, cancer, osteoarthritis, and other disorders. Optimal therapy is unknown. The antimalarial drug chloroquine activates the kinase ataxia telangiectasia mutated (ATM), improves metabolic syndrome and reduces atherosclerosis in mice. To translate this observation to humans, we conducted two clinical trials of chloroquine in people with the metabolic syndrome.

Methods
Eligibility included adults with at least 3 criteria of metabolic syndrome but who did not have diabetes. Subjects were studied in the setting of a single academic health center. The specific hypothesis: chloroquine improves insulin sensitivity and decreases atherosclerosis. In Trial 1, the intervention was chloroquine dose escalations in 3-week intervals followed by hyperinsulinemic euglycemic clamps. Trial 2 was a parallel design randomized clinical trial, and the intervention was chloroquine, 80 mg/day, or placebo for 1 year. The primary outcomes were clamp determined-insulin sensitivity for Trial 1, and carotid intima-media thickness (CIMT) for Trial 2. For Trial 2, subjects were allocated based on a randomization sequence using a protocol in blocks of 8. Participants, care givers, and those assessing outcomes were blinded to group assignment.

Results
For Trial 1, 25 patients were studied. Chloroquine increased hepatic insulin sensitivity without affecting glucose disposal, and improved serum lipids. For Trial 2, 116 patients were randomized, 59 to chloroquine (56 analyzed) and 57 to placebo (51 analyzed). Chloroquine had no effect on CIMT or carotid contrast enhancement by MRI, a pre-specified secondary outcome. The pre-specified secondary outcomes of blood pressure, lipids, and activation of JNK (a stress kinase implicated in diabetes and atherosclerosis) were decreased by chloroquine. Adverse events were similar between groups.

Conclusions
These findings suggest that low dose chloroquine, which improves the metabolic syndrome through ATM-dependent mechanisms in mice, modestly improves components of the metabolic syndrome in humans but is unlikely to be clinically useful in this setting.
Trial registration ClinicalTrials.gov (NCT00455325, NCT00455403), both posted 03 April 2007
The middle fossa approach with self-drilling screws: A novel technique for BONEBRIDGE implantation
Authors: You Peng , Siegel Lauren H. , Kassam Zahra , Hebb Matthew , Parnes Lorne , Ladak Hanif M. , Agrawal Sumit Kishore 
Published: July 2019

Background Bone conduction implants can be used in the treatment of conductive or mixed hearing loss. The BONEBRIDGE bone conduction implant (BB-BCI) is an active, transcutaneous device. BB-BCI implantation can be performed through either the transmastoid or retrosigmoid approach with their respective limitations. Here, we present a third, novel approach for BB-BCI implantation. Objective Describe the detailed surgical technique of BB-BCI implantation through a middle fossa approach with self-drilling screws and present preliminary audiometric outcome data following this approach. Methods A single institution, retrospective chart review was completed for patients implanted with the BB-BCI via the middle fossa approach. Preoperative planning and modelling were performed using 3D Slicer. Audiological testing was performed pre- and post-operatively following standard audiometric techniques. Results Forty patients underwent BB-BCI implantation using the middle fossa approach. Modelling techniques allowed for implantation through the use of external landmarks, obviating the need for intraoperative image guidance. The surgical technique was refined over time through experience and adaptation. Mean follow-up was 29 months (range 3–71 months) with no surgical complications, favourable cosmesis, and expected audiometric outcomes. An average functional gain of 39.6 dB (± 14.7 SD) was found. Conclusion The middle fossa technique with self-drilling screws is a safe and effective option for BONEBRIDGE implantation. As a reference for other groups considering this approach, an annotated video has been included as a supplement to the study.
Epoxidized methyl ricinoleate bio-plasticizer with a pendant acetate ester for PVC artificial material: circumventing existing limit on achievable migration resistance
Authors: Pan Siyu , Hou Delong , Yang Gaofu , Xie Qiuping , Yan Sunxian , Zeng Qi , Wang Zhonghui , Chen Yi , Fan Haojun 
Published: July 2019

AbstractProcessing polyvinyl chloride (PVC) artificial material requires plasticizer that softens the PVC coating. Currently, utilizing unsaturated fatty acid methyl esters to obtain epoxidized fatty acid methyl ester (EFAME) bio-plasticizers constitutes an environmentally responsible solution to substitute conventional ortho-phthalates that are endocrine disruptors or probable carcinogens. However, commercial EFAMEs, even with the highest epoxy value (ca. 5.5–5.8%) so far, still suffer from fast leaching from the PVC matrix, burdening the environment and shortening lifespan of the artificial material. Here, we report a proof-of-principle demonstration of a new strategy to obtain migration-resistant EFAME that harnesses the midchain hydroxyl of methyl ricinoleate and covalently attachment of a pendant acetate ester. Despite a low epoxy value (3.0%), the engineered bio-plasticizer displays significantly suppressed migration in multiple scenarios compared with one conventional EFAME with much higher epoxy value (5.8%). Circumventing the limit confronting previous strategy that highlights the sole contribution of epoxy value to achievable migration resistance, the rationale herein may provide guidance for designing new EFAMEs with comparable performance to ortho-phthalates, thus bringing the old and oft-maligned PVC artificial material industry one step closer to sustainability.
Parkinson Disease
Authors: Zesiewicz Theresa A. 
Published: July 2019

ABSTRACT

PURPOSE OF REVIEW
Parkinson disease is a common neurodegenerative disorder that affects millions of people worldwide. Important advances in the treatment, etiology, and the pathogenesis of Parkinson disease have been made in the past 50 years. This article provides a review of the current understanding of Parkinson disease, including the epidemiology, phenomenology, and treatment options of the disease.

RECENT FINDINGS
Parkinson disease is now recognized to be a heterogeneous condition marked by both motor and nonmotor symptoms. It is composed of preclinical, prodromal, and clinical phases. New medications with improved ease of administration have been approved for its treatment. Innovative surgical therapies for Parkinson disease may be used when motor symptoms persist despite optimal medical management.

SUMMARY
Parkinson disease is a complex, heterogeneous neurodegenerative disorder. Considerable progress has been made in its treatment modalities, both pharmacologic and surgical. While its cure remains elusive, exciting new research advances are on the horizon.