bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seventeen-Year Follow-up After Meniscal Repair With Concomitant Anterior Cruciate Ligament Reconstruction in a Pediatric and Adolescent Population
Authors: Tagliero Adam J. , Desai Vishal S. , Kennedy Nicholas I. , Camp Christopher L. , Stuart Michael J. , Levy Bruce A. , Dahm Diane L. , Krych Aaron J. 
Published: November 2018

Background: Studies have shown good and excellent clinical and radiographic results after meniscal repair. Limited published information exists on the long-term outcomes, however, especially in a pediatric and adolescent population. Purpose: To determine long-term results of meniscal repair and concomitant anterior cruciate ligament (ACL) reconstruction in a pediatric and adolescent population. Specifically, the aims were to determine the clinical success rate of meniscal repair with concomitant ACL reconstruction, compare results with midterm outcomes, and analyze risk factors for failure. Study Design: Case series; Level of evidence, 4. Methods: Cases of meniscal repair with concomitant ACL reconstruction between 1990 and 2005 were reviewed among patients aged ≤18 years. Patient demographics, injury history, and surgical details were recorded, and risk factors for failure were analyzed. Physical examination findings and clinical outcomes at latest available follow-up were collected. Subjective knee outcomes were compared with midterm results. Descriptive statistics and univariate analysis were used to evaluate the available data. Results: Forty-seven patients (30 females, 17 males) with a mean age of 16 years (SD, 1.37) and a mean follow-up of 16.6 years (SD, 3.57) were included in this study. Overall, 13 patients (28%) failed meniscal repair and required repeat surgery at the time of final follow-up. Of the 13 failures, 9 underwent a subsequent meniscectomy; 2, meniscectomy and revision ACL reconstruction; 1, meniscal repair and revision ACL reconstruction; and 1, meniscal repair and subsequent meniscectomy. Mean International Knee Documentation Committee scores improved from 47.9 preoperatively to 87.7 postoperatively ( P < .01), and the mean score at long-term follow-up (87.7) did not significantly differ from that at the midterm follow-up (88.5) at a mean 7.4 years ( P = .97). Mean Tegner Activity Scale scores improved from 1.9 preoperatively to 6.3 postoperatively ( P < .01) and decreased from 8.3 at preinjury to 6.3 at final long-term follow-up ( P < .01). Conclusion: In conclusion, the long-term overall clinical success rate (failure-free survival) was 72% for repair of pediatric and adolescent meniscal tears in the setting of concomitant ACL reconstruction. Patients reported excellent knee subjective outcome scores that remained favorable when compared with midterm follow-up.
Bone Marrow–Harvesting Technique Influences Functional Heterogeneity of Mesenchymal Stem/Stromal Cells and Cartilage Regeneration
Authors: Sivasubramaniyan Kavitha , Ilas Dragos C. , Harichandan Abhishek , Bos Pieter K. , Santos Diego L. , de Zwart Peter , Koevoet Wendy J.L.M. , Owston Heather , Bühring Hans-Jörg , Jones Elena , van Osch Gerjo J.V.M. 
Published: November 2018

Background: Connective tissue progenitors (CTPs) from native bone marrow (BM) or their culture-expanded progeny, often referred to as mesenchymal stem/stromal cells, represents a promising strategy for treatment of cartilage injuries. But the cartilage regeneration capacity of these cells remains unpredictable because of cell heterogeneity. Hypothesis: The harvest technique of BM may highly influence stem cell heterogeneity and, thus, cartilage formation because these cells have distinct spatial localization within BM from the same bone. Study Design: Controlled laboratory study. Methods: CTPs obtained from the femur of patients undergoing total hip replacement by 2 harvest techniques—BM aspiration and BM collection—after bone rasping were immunophenotyped by flow cytometry and evaluated for chondrogenic ability. The spatial localization of different CTP subsets in BM was verified by immunohistochemistry. Results: Cells from the BM after rasping were significantly more chondrogenic than the donor-matched aspirate, whereas no notable difference in their osteogenic or adipogenic potential was observed. The authors then assessed whether distinct immunophenotypically defined CTP subsets were responsible for the different chondrogenic capacity. Cells directly isolated from BM after rasping contained a higher percentage (mean, 7.2-fold) of CD45–CD271+CD56+ CTPs as compared with BM aspirates. The presence of this subset in the harvested BM strongly correlated with chondrogenic ability, showing that CD271+CD56+ cells are enriched in chondroprogenitors. Furthermore, evaluation of these CTP subsets in BM revealed that CD271+CD56+ cells were localized in the bone-lining regions whereas CD271+CD56– cells were found in the perivascular regions. Since the iliac crest remains a frequent site of BM harvest for musculoskeletal regeneration, the authors also compared the spatial distribution of these subsets in trabeculae of femoral head and iliac crest and found CD271+CD56+ bone-lining cells in both tissues. Conclusion: Chondrogenically distinct CTP subsets have distinct spatial localization in BM; hence, the harvest technique of BM determines the efficiency of cartilage formation. Clinical Relevance: The harvest technique of BM may be of major importance in determining the clinical success of BM mesenchymal stem/stromal cells in cartilage repair.
Chemioprofilassi endovescicale del carcinoma uroteliale superficiale. Studio su mitomicina ed epirubicina in differenti dosaggi
Authors: Pastorello M. , Molon A. , Poluzzi M. , Venturi F. , Siggillino I. 
Published: November 2018

Superficial transitional cell carcinomas (TCC) of the bladder have a high recurrence rate and a potential for progressive disease. The intravesical use of chemotherapeutic agents to prevent recurrences has achieved varying success. We report our experience in the prevention of superficial TCC recurrences using topical Mitomycin C or Epirubicin (in two different doses). After complete transurethral resection (TURB) and histological confirmation of stage pTa or pT1 disease, 80 patients were assigned to group A (Mitomycin 40 mg in 40 ml); 80 pts to group B (Epirubicin 50 mg in 50 ml); 40 pts were enrolled in group C (Epirubicin 80 mg in 50 ml saline). Median follow-up is 43.4 months for group A, 42.1 months for gr. B, 21.1 months for gr. C. 183 pts could be evaluated. Results: 28/74 pts had recurrences in gr. A, 26/73 in gr. B, 11/36 in gr. C; the recurrence index/100 pt-months is 1.21 in gr. A, 1.23 in gr. B, 2.10 in gr. C. Tumour progression was registered in 13/74 pts in gr. A, in 11/73 in gr. B, in 5/36 in gr. C. pT1-tumours showed a recurrence rate of 69% (average of the three groups) versus 13% of pTa-tumours; a very high recurrence rate was also observed in multiple neoplasms.
Overactive bladder symptom bother and health-related quality of life in patients with systemic lupus erythematosus and primary Sjögren syndrome
Authors: Pereira e Silva R , Romão V C , Neves M , Garcia R , Oliveira S , Brites J , Ramos F Oliveira , Canhão H , Palma dos Reis J , Pereira da Silva J A , Lopes T 
Published: November 2018

Objective The objective of this paper is to assess overactive bladder (OAB) symptom bother (SB) and health-related quality of life (HRQL) among patients with systemic lupus erythematosus (SLE) and primary Sjögren syndrome (pSS). Methods We recruited adult SLE and pSS patients and two groups of age- and sex-matched controls. We applied the OAB questionnaire-short form (OABq-SF) to all participants to assess SB and HRQL and collected clinical information relevant for OAB. We compared the OABq-SF scores for SB and HRQL between patients and controls using univariate and multivariate linear regression analysis. Results We recruited 95 rheumatic patients (68 SLE, 27 pSS) and 231 controls. Compared to controls SLE patients showed higher OABq-SF SB scores (22.6 ± 20.4 vs 14.7 ± 17.0, p = 0.004) and lower HRQL scores (89.8 ± 15.8 vs 93.8 ± 11.4, p = 0.044). On multivariate analysis SLE was significantly associated with a higher SB score (ß-coefficient 7.13, p = 0.008) and tended to be associated with worse HRQL values (ß-coefficient –3.53, p = 0.055). Patients with pSS had numerically higher mean SB scores (22.8 ± 22.5 vs 16.2 ± 18.0, respectively, p = 0.107) and lower HRQL scores (91.0 ± 10.7 vs 93.2 ± 11.6, respectively, p = 0.369), although these differences were not statistically significant. Diagnosis of pSS was not significantly associated with SB or HRQL scores on univariate or multivariate analysis. Conclusions Patients with SLE have significantly worse OAB-SB and poorer HRQL compared to controls. A similar trend was seen for pSS patients, especially for SB. These findings suggest that clinically subtle OAB symptoms may be present in rheumatic patients for whom, later on, bladder pain syndrome may occur.
Paved with good intentions: Misdirected idealism in the lead-up to 2008’s GFC
Authors: Gould Anthony M , Lokrou Milène R 
Published: November 2018

AbstractIrresponsible lending practices on the part of financial institutions and proliferation of tradable derivatives were key causal agents of the 2008 financial crisis. However, it is less clear why, historically, loose credit arrangements were so widespread. Somewhat misleadingly, much conjecture has laid blame at the feet of financial institutions themselves. While it is true that duplicitous and even corrupt lending practices were consequential antecedents of the crisis, a legacy commitment to certain – laudable – elements of New-Dealism created context for these elements to become established. To understand really what went wrong, it is necessary to look back before the 2000s and appreciate the interaction that was occurring between a long-term policy commitment to neoliberalism and piecemeal/fragmented application of approaches that aimed to assist financially disadvantaged people. Using the analogy of heart-attack pathology to guide some of its analysis, this essay argues for better policy-integration.
De-Escalation of Antiplatelet Therapy in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Clinical Trials
Authors: Kheiri Babikir , Osman Mohammed , Abdalla Ahmed , Chahine Adam , Ahmed Sahar , Osman Khansa , Bachuwa Ghassan , Hassan Mustafa , Bhatt Deepak L. 
Published: November 2018

Aims: Patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI) are recommended to be placed on potent P2Y12 blockade. However, the long-term bleeding risk is high. Therefore, despite no definitive evidence, switching to clopidogrel beyond the acute phase is common. We aimed to evaluate the clinical outcomes of antiplatelet de-escalation compared with continuation in patients treated with PCI. Methods: We searched databases for randomized clinical trials (RCTs) that evaluated the safety and efficacy of antiplatelet de-escalation compared with continuation in patients treated with PCI. Pooled summary estimates were calculated. Results: We included 3 RCTs with 3391 patients (median follow-up: 12 months). Compared with the continued group, the net clinical outcome (composite of bleeding or thrombotic events) was significantly reduced in the group switched to clopidogrel (8.7% vs 12.1%; risk ratio [RR]: 0.64; 95% confidence interval [CI]: 0.43-0.97; P = .03). However, there were similar clinical outcomes between groups for major adverse cardiovascular events (MACE; RR: 0.78; 95% CI: 0.55-1.11; P = .17), all Bleeding Academic Research Consortium (BARC) types bleeding (RR: 0.61; 95% CI: 0.33-1.11; P = .10), or BARC types ≥2 bleeding (RR: 0.49; 95% CI: 0.19-1.26; P = .14). Conclusions: Our results suggest a net clinical benefit of de-escalation therapy shortly after PCI, without increased risk of MACE. Larger randomized trials will be necessary to confirm these findings.
Clinical significance of proximal interphalangeal joint pain in patients with trigger fingers
Authors: Young Kim Jin , Jin Choi Gook , Mo Kang Dong 
Published: November 2018

We investigated incidence, clinical features and surgical outcomes of trigger finger accompanied by proximal interphalangeal joint pain. One-hundred and seventy-nine consecutive patients with trigger finger who had A1 pulley release were recruited. Forty-two patients (24%) complained of proximal interphalangeal joint pain at the time of surgery. Symptom duration was investigated, and tenderness at the proximal interphalangeal joint was palpated. Range of motion and pain score of the affected finger were measured pre- and post-operatively. Bone scan was performed to identify joint lesions. A comparison of the results between the proximal interphalangeal joint pain group and the non-proximal interphalangeal joint pain group shows that the proximal interphalangeal joint pain seemed to result from long symptom duration and consequent joint pathology. The proximal interphalangeal joint pain was incompletely resolved after A1 pulley release. Thus, the surgical outcomes might be worse than expected in spite of resolution of painful clicking, especially when there was additional joint tenderness on palpation. Level of evidence: IV
Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real‐world US database
Authors: Studer Sean , Hull Michael , Pruett Janis , Koep Eleena , Tsang Yuen , Drake William 
Published: November 2018

Several new medications for pulmonary arterial hypertension (PAH) have recently been introduced; however, current real‐world data regarding US patients with PAH are limited. We conducted a retrospective administrative claims study to examine PAH treatment patterns and summarize healthcare utilization and costs among patients with newly diagnosed PAH treated in US clinical practice. Patients newly treated for PAH from 1 January 2010 to 31 March 2015 were followed for ≥12 months. Patient characteristics, treatment patterns, healthcare resource utilization, and costs were described. Adherence (proportion of days covered), persistence (months until therapy discontinuation/modification), and the probability of continuing the index regimen were analyzed by index regimen cohort (monotherapy versus combination therapy). Of 1637 eligible patients, 93.8% initiated treatment with monotherapy and 6.2% with combination therapy. The most common index regimen was phosphodiesterase type 5 inhibitor (PDE‐5I) monotherapy (70.0% of patients). A total of 581 patients (35.5%) modified their index regimen during the study. Most patients (55.4%) who began combination therapy did so on or within six months of the index date. Endothelin receptor agonists (ERAs) and combination therapies were associated with higher adherence than PDE‐5Is and monotherapies, respectively. Healthcare utilization was substantial across the study population, with costs in the combination therapy cohort more than doubling from baseline to follow‐up. The majority of patients were treated with monotherapies (most often, PDE‐5Is), despite combination therapies and ERAs being associated with higher medication adherence. Index regimen adjustments occurred early and in a substantial proportion of patients, suggesting that inadequate clinical response to monotherapies may not be uncommon.
Activity of eltrombopag in severe aplastic anemia
Authors: Scheinberg Phillip 
Published: November 2018

AbstractSince the approval of horse antithymocyte globulin (ATG) decades ago, there was a long hiatus in therapies with activity in severe aplastic anemia (SAA). This scenario changed in 2014 when eltrombopag, a thrombopoietin receptor agonist, was approved for SAA after an insufficient response to initial immunosuppressive therapy (IST). The basis for this approval was the observation of single-agent activity of eltrombopag in this patient population, where 40% to 50% recovered blood counts at times involving &gt;1 lineage. The achievement of transfusion independence confirmed the clinical benefit of this approach. Increase in marrow cellularity and CD34+ cells suggested a recovery to a more functioning bone marrow. Further in its development, eltrombopag was associated with standard horse ATG plus cyclosporine in first line, producing increases in overall (at about 90%) and complete response rates (at about 40%) and leading to transfusion independence and excellent survival. Interestingly, best results were observed when all drugs were started simultaneously. The cumulative incidence of clonal cytogenetic abnormalities to date has compared favorably with the vast experience with IST alone in SAA. Longer follow-up will help in define these long-term risks. In this review, the development of eltrombopag in SAA will be discussed.
Failing to notice? Uneven teachers’ attention to boys and girls in the classroom
Authors: Bassi Marina , Mateo Díaz Mercedes , Blumberg Rae Lesser , Reynoso Ana 
Published: November 2018

Abstract
This paper analyzes whether teachers’ attention to boys and girls differs in low-performing schools in Chile, where large gender gaps in test scores are also observed. We coded 237 videotaped classes of fourth graders, identifying specific behaviors of teachers toward boys and girls. The results show a general imbalance in teachers’ attention and interactions favoring boys. Gender attention gap is correlated with lower scores in math for girls on Chile’s national standardized test (SIMCE). The gender attention gap was also greater in general in classrooms in which teachers had overall worse interactions with students, as measured by the Classroom Assessment Scoring System (CLASS). The evidence in this paper contributes to the discussion about whether traditional measures of teacher–student interactions really capture all that matters for learning.

JEL Classification
O12, J16, I2
An adaptive model for the autonomous monitoring and management of water end use
Authors: Nguyen Khoi A. , Stewart Rodney A. , Zhang Hong , Sahin Oz 
Published: November 2018

AbstractMost pattern classification systems are usually developed based on the training of historical data, and as a result, the performance of these models relies heavily on the amount of collected information. However, in many cases, such data collection process is relatively costly, which eventually limits the efficiency as well as the widespread implementation of the final developed model. In this context, the paper focuses on presenting an advanced universal water management system, which could interface with both water consumers and utilities via smart phone and web application. Originally, Autoflow©, a prototype tool that is used to disaggregate total water consumption into each end-use category was developed, which achieved an accuracy ranging from 74 to 94%. However, a drawback of this model was that it was trained with data collected from only Australia; therefore, accuracy reductions would likely be observed when this system is implemented in different countries having very different water using appliances and behaviour patterns. To avoid the costly data collection process for model calibration when operating in new regions, this research study introduces an enhanced model, namely AutoflowU (i.e. U stands for Universal). This new tool can be applied in residential properties globally to autonomously disaggregate water consumption into the seven main water end-use categories, namely: shower, toilet, tap, clothes washer, dishwasher, evaporative air cooler and irrigation, without the need for collecting new regional end-use data for model calibration. In order to develop this new tool, Decision Trees, Dynamic Time Warping (DTW), Self Organising Map (SOM) and Hidden Markov Model (HMM) techniques were utilised. The test results obtained from 230 properties in both Australia and the US showed that the AutoflowU achieved 72–93% accuracy.
Optimizing Cardiovascular Care in Children With Acute Myeloid Leukemia to Improve Cancer-Related Outcomes
Authors: Armenian Saro H. , Ehrhardt Matthew J. 
Published: November 2018

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 14-year-old African American female presented with fatigue, easy bruising, and fever. On examination, she had scattered bruising, lymphadenopathy, and hepatosplenomegaly. Laboratory evaluation revealed pancytopenia with peripheral blasts, and acute myeloid leukemia (AML; French-American-British M2, t[8;21][q22;q22.1]) was diagnosed on bone marrow biopsy. A baseline echocardiogram revealed normal left ventricular (LV) systolic function (ejection fraction [EF], 60%; shortening fraction [SF], 32%), and conventional chemotherapy was initiated that consisted of two cycles of remission induction (cytarabine, etoposide, and daunorubicin [50 mg/m2 × 3 days per cycle]) followed by intensification 1 (high-dose cytarabine and etoposide), intensification 2 (high-dose cytarabine and mitoxantrone [12 mg/m2/dose daily; four total doses]), and intensification 3 (high-dose cytarabine and l-asparaginase). Of note, an echocardiogram was not repeated before the start of intensification 1. During intensification 1, the patient developed Streptococcus viridans sepsis, which required 4 days in the intensive care unit with antimicrobial and inotropic support. Repeat echocardiogram after recovery from the sepsis episode demonstrated low-normal LV systolic function (EF, 53%; SF, 27%), and she subsequently began intensification 2. On day 3 of intensification 2, the patient developed afebrile tachypnea, tachycardia, and an increasing oxygen requirement. Chest x-ray revealed cardiomegaly and pulmonary vascular congestion. Cardiac troponins were normal, whereas N-terminal pro B-type natriuretic peptide was 10 times the upper limit of normal. Repeat echocardiogram showed an enlarged LV with moderate to severely depressed LV function (EF, 28%; SF, 14%). Day 4 mitoxantrone was omitted and a cardiology consult obtained.
VERIFYING NUCLEAR WASTE TILE-HOLES USING GAMMA RADIATION SCANNING
Authors: Johnston James , Yue Shuwei , Stewart Jeremy 
Published: November 2018

Nuclear waste management facilities at Chalk River Laboratories (CRL) use below-ground “tile-holes” to store solid waste from various activities such as medical isotope production. After long periods of isotopic decay, some of the waste has decayed down to low activities and can be transferred to low-level waste storage facilities. This paper presents a method to verify the radiation level of the waste inside tile-holes by performing gamma radiation scans along the depth of waste storage tile-holes. Such measurements allow for noninvasive verification of tile-hole contents and provide input to the assessment of radiological risk associated with removal of the waste. Using the radiation profile system, the radiation level of the radioactive waste may be identified based on the radiation profile. This information will support planning for possible transfer of this waste to a licensed waste storage facility designed for low-level waste, thus freeing storage space for possible tile-hole re-use for more highly radioactive waste.CRL-developed small diode-based gamma radiation sensors have been used in these radiation scans. The diode sensors were deployed into verification tubes adjacent to the tile-holes to measure the radiation profile. Over 10 tile-holes have been scanned using this technique since 2009.