bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between avulsion fracture of the distal fibula and recurrent sprain in children with ankle sprain
Authors: Yamaguchi Satoshi , Nakagawa Ryosuke 
Published: September 2018

Category: Sports Introduction/Purpose: The incidence of ankle sprain is higher in children than in adolescents and adults. Avulsion fractures of the distal fibula, where the anterior tibiofibular ligament attaches, commonly occur with lateral ankle sprain in children. If the avulsion fracture remains ununited, it will become a subfibular ossicle (Figure), and can cause pain, instability, and recurrent sprain. However, the incidence and radiographic result of avulsion fracture, as well as the impact of the fracture on clinical outcomes, are not well-studied. The purposes of this study were 1) to clarify the incidence and union rate of distal fibular avulsion fracture with lateral ankle sprain in children, and 2) to assess the association between avulsion fracture and recurrent sprain. Methods: Patients who presented to four orthopaedic clinics were prospectively examined. Patients with a first-time inversion ankle sprain, aged from 6 to 12 years, and visiting the clinics within 48 hours after injury, were included. Patients underwent anteroposterior and lateral radiographs, and the ATFL view (Figure) at the first visit, and the incidence of avulsion fracture was assessed. The patients with avulsion fractures underwent follow-up radiographs after 8 weeks, and fracture union was assessed. Treatment was not standardized, and ranged from an elastic bandage to a non-weightbearing cast for 6 weeks. Recurrent sprain of the ipsilateral ankle was surveyed by a review of the medical record and the questionnaire that was sent to the patients regularly. Furthermore, patients were divided into 3 groups: patients with no avulsion fracture, fracture union, and fracture nonunion. The rates of recurrent sprain were compared among the groups using the chi-square test and multiple comparisons. Results: From April 2014 to August 2015, 144 ankles of 144 patients (53 female and 91 male) with a mean age of 8.8 years underwent the radiographs at the first visit. Recurrent sprain was assessed in 105 (73%) patients with a mean follow-up of 23months. The incidence of distal fibular avulsion fracture was 62% (89/144 patients). The union rate of avulsion fracture was only 17%. The overall rate of recurrent sprain was 32% (34/105 patients). The rates were 45% (5/11) in patients with fracture union and 39% (20/51) in patients with nonunion. These rates were significantly higher than that in patients with no avulsion fracture (21%, 9/43) (P=0.02). However, the rates were similar between patients with fracture union and nonunion. Conclusion: Avulsion fractures of the distal fibula were surprisingly common with ankle sprain in children, and the most of the fractures remained ununited. The rate of recurrent sprain was relatively high at a 23 month follow-up. The presence of avulsion fracture was associated with a higher risk of recurrent sprain, however achieving fracture union did not reduce the risk.
First metatarsophalangeal arthrodesis for treatment of hallux valgus with metatarsus adductus
Authors: Zhu Yuan 
Published: September 2018

Category: Bunion Introduction/Purpose: The surgical treatment of hallux valgus with severe metatarsus adductus deformity can be challenging. This study aims to investigate the clinical and radiologic outcomes of first metatarsophalangeal arthrodesis in treating this complex deformity. Methods: Between Jun 2009 and Jun 2015, 15 consecutive cases of hallux valgus with severe metatarsus adductus [metatarsus adductus angle, MAA>25°(modified Sgarlato method)] received first metatarsophalangeal arthrodesis for correction with a dorsal plate and a lag screw. The clinical outcome of these patients (average age of 63.1 years) was evaluated by means of the American Orthopaedic Foot & Ankle Society (AOFAS) Hallux MTP-IP Scale and ankle pain on the visual analogue scale (VAS). Radiological imaging included hallux valgus angle (HVA) and 1st intermetatarsal angle (IMA). Results: All these 15 patients were available for follow-up at a mean of 12.7 months. The average postoperative AOFAS Hallux MTP-IP Scale 12 months after surgery was 88.6 (compare with 60.8 preoperatively). The mean visual analog scale score decreased from 5.51 ± 1.53 preoperatively to 0.98 ± 0.98 at the latest follow-up. All the metatarsophalangeal joints got complete fused without delayed fusion. The HVA improved from 45.2°preoperatively in average to 17.3°postoperatively. No deformity recurrence was observed by the time of the latest follow-up. Conclusion: First metatarsophalangeal arthrodesis is a simple, reasonable and reliable option for the treatment of hallux valgus with severe metatarsus adductus deformity, especially for elderly patients with degenerated symptomatic metatarsophalangeal joint.
Spending on Antineoplastic Agents in the United States, 2011 to 2016
Authors: Hong Samuel J. , Li Edward C. , Matusiak Linda M. , Schumock Glen T. 
Published: September 2018

Purpose: Recent cancer drug approvals are lauded as being more effective with relatively fewer adverse effects, but these treatments come with a great cost to the US health care system. There is little information on recent trends in actual antineoplastic expenditures representative of the whole US health care system or by sector. Therefore, the objective of this study was to describe antineoplastic expenditures in the United States by year and sector. Methods: This was a retrospective, cross-sectional study of IQVIA (formerly QuintilesIMS) National Sales Perspective data for the period of January 1, 2011, to December 31, 2016. Actual expenditures were totaled by health care sector and calendar year, then adjusted for medical-cost inflation to 2016 dollars. Growth was calculated as the percentage increase from the previous year. Results: Total expenditures of antineoplastic agents across all channels grew from $26.8 billion in 2011 to $42.1 billion in 2016. Antineoplastic spending increased 12.2% in 2016 (compared with the previous year), followed by 15.6% in 2015, 13.4% in 2014, 6.3% in 2013, and 0.4% in 2012. Throughout the study period, 96.5% of total antineoplastic expenditures occurred within clinics, mail-order pharmacies, nonfederal hospitals, and retail pharmacies. Conclusion: Antineoplastic expenditures are expected to increase because of continuing development and approval of costly targeted cancer therapies. Cost containment and utilization management strategies must be balanced so as not to restrict access or disrupt innovation. Future policies should focus on ensuring safe and appropriate use of antineoplastics while balancing long-term drug costs.
Reducing Glucokinase Activity Restores Endogenous Pulsatility and Enhances Insulin Secretion in Islets From db/db Mice
Authors: Jahan Ishrat , Corbin Kathryn L , Bogart Avery M , Whitticar Nicholas B , Waters Christopher D , Schildmeyer Cara , Vann Nicholas W , West Hannah L , Law Nathan C , Wiseman Jeffrey S , Nunemaker Craig S 
Published: September 2018

AbstractAn early sign of islet failure in type 2 diabetes (T2D) is the loss of normal patterns of pulsatile insulin release. Disruptions in pulsatility are associated with a left shift in glucose sensing that can cause excessive insulin release in low glucose (relative hyperinsulinemia, a hallmark of early T2D) and β-cell exhaustion, leading to inadequate insulin release during hyperglycemia. Our hypothesis was that reducing excessive glucokinase activity in diabetic islets would improve their function. Isolated mouse islets were exposed to glucose and varying concentrations of the glucokinase inhibitor d-mannoheptulose (MH) to examine changes in intracellular calcium ([Ca2+]i) and insulin secretion. Acutely exposing islets from control CD-1 mice to MH in high glucose (20 mM) dose dependently reduced the size of [Ca2+]i oscillations detected by fura-2 acetoxymethyl. Glucokinase activation in low glucose (3 mM) had the opposite effect. We then treated islets from male and female db/db mice (age, 4 to 8 weeks) and heterozygous controls overnight with 0 to 10 mM MH to determine that 1 mM MH produced optimal oscillations. We then used 1 mM MH overnight to measure [Ca2+]i and insulin simultaneously in db/db islets. MH restored oscillations and increased insulin secretion. Insulin secretion rates correlated with MH-induced increases in amplitude of [Ca2+]i oscillations (R2 = 0.57, P &lt; 0.01, n = 10) but not with mean [Ca2+]i levels in islets (R2 = 0.05, not significant). Our findings show that correcting glucose sensing can restore proper pulsatility to diabetic islets and improved pulsatility correlates with enhanced insulin secretion.
Optical Switching between Liquid-Crystalline Assemblies with Different Structural Symmetries and Molecular Orders
Authors: Nagai Aya , Kondo Hideaki , Miwa Yohei , Kondo Tomonori , Kutsumizu Shoichi , Yamamura Yasuhisa , Saito Kazuya 
Published: September 2018

Abstract
Optical switching between one-dimensionally ordered layered smectic C (SmC) and three-dimensionally periodic bicontinuous cubic (Cubbi) liquid-crystalline (LC) phases is a fascinating challenge because of the dramatic changes of structural symmetries and orders as well as physical properties. In this work, we have developed a new light-driven Cubbi phase system consisting of 4′-n-hexadecyloxy-3′-cyanobiphenyl-4-carboxylic acid (ACBC-16) and a structurally analogous azo compound (Azo-2). The employment of the CN side-group in the host compound brought about outstanding responsiveness under ultraviolet (UV) light in the mixtures containing 11 and 19 mol % Azo-2, leading to a UV response time of ∼5 s and excellent repeatability of on-off switching for the conversion between the two LC phases. The modification also enabled us to quantitatively analyze the mechanism of the light-induced transformation between the two LC phases. The evaluation revealed that the presence of ∼4% of bent molecules in the system under UV light destabilizes the SmC layered structure originally constructed by rod-shaped molecules, causing formation of the Cubbi phase at temperatures 10–35 K below the temperature range of the thermally-stable Cubbi phase.
A Strategy for in Silico Prediction of the Membrane Permeability of Drugs
Authors: Fujii Yu , Yoshida Erina , Osakai Toshiyuki 
Published: September 2018

Abstract
Parallel artificial membrane permeation assay (PAMPA) was performed for nine amine drugs and their permeability coefficient (log Ppampa) was determined at different pHs. The previously developed digital simulation method was successfully used to reproduce the sigmoid-like pH dependence of log Ppampa, and the distribution coefficient (log KD,M) to the lipid-containing dodecane membrane could be determined for all the amine drugs studied. The thus determined log KD,M values showed a linear free-energy relationship with the standard ion-transfer potential ($\Delta _{\text{O}}^{\text{W}}\phi ^{ \circ }$; R2 = 0.754) and the distribution coefficient (log KD; R2 = 0.891), which were previously determined by ion-transfer voltammetry with the 1,2-dichloroethane|water interface. On the other side, we can predict $\Delta _{\text{O}}^{\text{W}}\phi ^{ \circ }$ very accurately by a previously proposed solvation model called the “non-Bornian” model. These findings suggest a possible strategy for perfect in silico prediction of the membrane permeability of drugs.
Market penetration of Xpert MTB/RIF in high tuberculosis burden countries: A trend analysis from 2014 - 2016
Authors: Cazabon Danielle , Pande Tripti , Kik Sandra , Van Gemert Wayne , Sohn Hojoon , Denkinger Claudia , Qin Zhi Zhen , Waning Brenda , Pai Madhukar 
Published: September 2018

Background: Xpert® MTB/RIF, a rapid tuberculosis (TB) molecular test, was endorsed by the World Health Organization in 2010. Since then, 34.4 million cartridges have been procured under concessional pricing. Although the roll out of this diagnostic is promising, previous studies showed low market penetration. Methods: To assess 3-year trends of market penetration of Xpert MTB/RIF in the public sector, smear and Xpert MTB/RIF volumes for the year 2016 were evaluated and policies from 2014-2016 within 22 high-burden countries (HBCs) were studied. A structured questionnaire was sent to representatives of 22 HBCs. The questionnaires assessed the total smear and Xpert MTB/RIF volumes, number of modules and days of operation of GeneXpert machines in National TB Programs (NTPs). Data regarding the use of NTP GeneXpert machines for other diseases and GeneXpert procurement by other disease control programs were collected. Market penetration was estimated by the ratio of total sputum smear volume for initial diagnosis divided by the number of Xpert MTB/RIF tests procured in the public sector. Results: The survey response rate was 21/22 (95%). Smear/Xpert ratios decreased in 17/21 countries and increased in four countries, since 2014. The median ratio decreased from 32.6 (IQR: 44.6) in 2014 to 6.0 (IQR: 15.4) in 2016. In 2016, the median GeneXpert utilization was 20%, however seven countries (7/19; 37%) were running tests for other diseases on their NTP-procured GeneXpert systems in 2017, such as HIV, hepatitis-C virus (HCV), Chlamydia trachomatis, and Neisseria gonorrhoeae. Five (5/15; 33%) countries reported GeneXpert procurement by HIV or HCV programs in 2016 and/or 2017. Conclusions: Our results show a positive trend for Xpert MTB/RIF market penetration in 21 HBC public sectors. However, GeneXpert machines were under-utilized for TB, and inadequately exploited as a multi disease technology.
Advanced care planning in end-of-life care: the key role of ambulance services
Authors: Kirk Andrew 
Published: September 2018

Overview Effective communication and coordination between individual care providers is vitally important to ensure that patients' wishes are respected throughout their care and when they die, as well as that families and loved ones are supported following the patient's death. Ambulance services play an increasingly key role in end-of-life care and this is especially true in terms of transfer of the dying patient ( NEoLCP, 2012 ). This month's continuing professional development (CPD) article will explore advanced care planning and, in particular, it will focus on do-not-attempt cardiopulmonary resuscitation (DNACPR) orders, advanced decisions to refuse treatment (ADRTs) and rapid discharge transfers.
A versatile perfusion bioreactor and endothelializable photo cross-linked tubes of gelatin methacryloyl as promising tools in tissue engineering
Authors: Huber Birgit , Hoch Eva , Calderon Iván , Borchers Kirsten , Kluger Petra J. 
Published: September 2018

Abstract
Size and function of bioartificial tissue models are still limited due to the lack of blood vessels and dynamic perfusion for nutrient supply. In this study, we evaluated the use of cytocompatible methacryl-modified gelatin for the fabrication of a hydrogel-based tube by dip-coating and subsequent photo-initiated cross-linking. The wall thickness of the tubes and the diameter were tuned by the degree of gelatin methacryl-modification and the number of dipping cycles. The dipping temperature of the gelatin solution was adjusted to achieve low viscous fluids of approximately 0.1 Pa s and was different for gelatin derivatives with different modification degrees. A versatile perfusion bioreactor for the supply of surrounding tissue models was developed, which can be adapted to several geometries and sizes of blood-vessel mimicking tubes. The manufactured bendable gelatin tubes were permeable for water and dissolved substances, like Nile Blue and serum albumin. As a proof of concept, human fibroblasts in a three-dimensional collagen tissue model were successfully supplied with nutrients via the central gelatin tube under dynamic conditions for 2 days. Moreover, the tubes could be used as scaffolds to build-up a functional and viable endothelial layer. Hence, the presented tools can contribute to solving current challenges in tissue engineering.
Evaluation of serum alkaline phosphatase measurement through the 4-year trueness verification program in China
Authors: Wang Jing , Wang Yufei , Zhang Tianjiao , Zeng Jie , Zhao Haijian , Guo Qi , Yan Ying , Zhang Jiangtao , Zhou Weiyan , Chen Wenxiang , Zhang Chuanbao 
Published: September 2018

AbstractBackgroundAlkaline phosphatase (ALP) is critical for various diseases. The International Federation of Clinical Chemistry and Laboratory Medicine had recommended the new reference procedure in 2011, but many manufacturers did not trace results to the higher procedure. Since 2012, the National Center for Clinical Laboratories (NCCL) in China has organized the trueness verification program (TV) with commutable materials. The present study summarizes the 4-year TV program to give an overview of the measurement standardization for ALP results.MethodsCommutable serum-based materials with different concentrations were prepared and sent to participating laboratories. The target values were assigned by the reference lab network.ResultsThe analytical performance was evaluated according to three indexes: trueness (bias), imprecision (CV) and accuracy (total error [TE]). The number of participating laboratories increased from 115 in 2012 to 287 in 2016. The pass rates of precision for homogeneous and heterogeneous systems were all above 85% over the 4 years; however, the pass rates of bias were much lower (<50%). Among the homogeneous systems, Roche Cobas/Modular had an obvious negative bias, whereas the mean positive bias for Beckman AU was prominent. As to the heterogeneous systems, the pass rates of bias for Sichuan Maccura (57.1%–78.6%) were higher than Roche Cobas/Modular (4.4%–33.9%) and Beckman AU (35.7%–64.8%).ConclusionsThe PT/EQA program with commutable materials can be used to assess the trueness against target values assigned by reference procedures. For ALP, homogeneous systems did not perform better than heterogeneous systems. The bias for ALP performance was notable and was the main obstacle to its standardization in China.
A comparison of complete blood count reference intervals in healthy elderly vs. younger Korean adults: a large population study
Authors: Lee Eun Jin , Kim Miyoung , Lee Eunyup , Jeon Kibum , Lee Jiwon , Lee Jee-Soo , Kim Han-Sung , Kang Hee Jung , Lee Young Kyung 
Published: September 2018

Abstract

Background
The use of laboratory reference intervals based on younger populations is of questionable validity in older populations. We established reference intervals for 16 complete blood count (CBC) parameters in healthy elderly Koreans aged ≥60 years and compared them to those of individuals aged 20–59 years.

Methods
Among 64,532 individuals (39,609 men and 24,923 women) aged ≥20 years who underwent medical checkups, 8151 healthy subjects (12.6%, 5270 men and 2881 women, including 675 and 511, respectively, who were ≥60 years of age) were enrolled based on stringent criteria including laboratory, imaging and endoscopy results; previous medical history; and medication history. CBC parameters were measured using an Advia2120i instrument.

Results
Overall, healthy individuals aged ≥60 years did not require separate reference intervals from those aged <60 years except for red cell distribution width (RDW) and mean corpuscular hemoglobin (MCH) in women. However, subjects aged ≥60 years still required sex-specific reference intervals for red blood cell count, hemoglobin, hematocrit, MCH, monocytes and eosinophils. Separate reference intervals were required for MCH, eosinophils and basophils for certain age subgroups of men aged ≥60 years, and for MCH and RDW in certain age subgroups of women aged ≥60 years, compared to counterparts <60 years of age.

Conclusions
Healthy elderly Koreans can use the same reference intervals as younger populations. Thus, abnormal CBC results may not necessarily be attributable to physiologic changes but possible underlying diseases that should be investigated.
Propensity Score Estimation Using Classification and Regression Trees in the Presence of Missing Covariate Data
Authors: Penning de Vries Bas B.L. , van Smeden Maarten , Groenwold Rolf H.H. 
Published: September 2018

Abstract
Data mining and machine learning techniques such as classification and regression trees (CART) represent a promising alternative to conventional logistic regression for propensity score estimation. Whereas incomplete data preclude the fitting of a logistic regression on all subjects, CART is appealing in part because some implementations allow for incomplete records to be incorporated in the tree fitting and provide propensity score estimates for all subjects. Based on theoretical considerations, we argue that the automatic handling of missing data by CART may however not be appropriate. Using a series of simulation experiments, we examined the performance of different approaches to handling missing covariate data; (i) applying the CART algorithm directly to the (partially) incomplete data, (ii) complete case analysis, and (iii) multiple imputation. Performance was assessed in terms of bias in estimating exposure-outcome effects among the exposed, standard error, mean squared error and coverage. Applying the CART algorithm directly to incomplete data resulted in bias, even in scenarios where data were missing completely at random. Overall, multiple imputation followed by CART resulted in the best performance. Our study showed that automatic handling of missing data in CART can cause serious bias and does not outperform multiple imputation as a means to account for missing data.
Dilatancy as a measure of fracturing development in the process of rock damage
Authors: Cieślik Jerzy 
Published: September 2018

Abstract
Dilatancy understood as inelastic volume changes of rock under conditions of differential stress not only foreshadows brittle rock failure [1, 2, 3], preceding such phenomena as earthquakes or mining-induced rockbursts, but also defines the kinematics of rock deformation [4, 5]. This article shows that there is a quantitative relationship between the dilatancy occurring at different levels of rock load and the development of fracturing that accompanies the process of rock degradation. Based on the mechanical laboratory test results of Wustenzelleer fine-grained sandstone, the article presents analyses of plastic volume changes in rock samples and a certain measure of fracture development accompanying the process of their degradation. Thanks to the characteristics obtained through mechanical tests with unloading, the inelastic volumetric strain of the samples was established, and the scalar damage variable (CDM - continuum damage mechanics approach) was determined at various load levels. These results demonstrated the relationship between dilatancy and rock stiffness changes describing the development of fracturing. Three load intervals were determined, in which the nature of the analysed phenomena, i.e. dilatancy and damage describing the development of cracks, undergoes significant changes. The highest intensity of both phenomena was obtained in the post-critical load range, between the ultimate strength limit and the residual strength of the samples, in which rock samples undergo the process of degradation the most. Obtained dependencies allow the correlation to be taken into account in damage mechanics models describing the variable stiffness of rocks in the loading process.