bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Cross-Sectional Analysis of the BC Children’s Hospital Cleft Palate Program Waitlist
Authors: Leung Leslie Tze Fung , Loock Christine A. , Courtemanche Rebecca , Courtemanche Douglas J. 
Published: September 2019

Objective: A 2016 review of the BC Children’s Hospital Cleft Palate - Craniofacial Program (CPP) revealed that one-third of patients met the program’s care recommendations and half met the American Cleft Palate-Craniofacial Association guidelines. This study reviews patients on the CPP waitlist and determines median wait times and missed clinical assessments as well as identifies how wait times are influenced by medical complexity, specialized speech service needs, vulnerability, and distance from clinic. Design: Cross-sectional. Setting: BC Children’s Hospital Cleft Palate—Craniofacial Program. Patients: Five hundred seventy-six waitlisted patients. Main Outcome Measures: Additional wait time after recommended appointment date. Correlation of additional wait time with diagnosis, number of specialists required, speech services needed, vulnerability, and distance from the clinic. Missed plastic surgery, speech, and orthodontic assessments according to CPP team recommendations and ACPA guidelines. Results: Patients had a median additional wait time of 11 months (interquartile range: 5-27). Longer additional wait times were associated with a craniofacial diagnosis ( P = .019), a need for formal speech assessments or evaluations ( P < .001), or a requirement to see multiple specialists ( P < .001). Vulnerability and distance from clinic did not affect wait times. Plastic surgery assessments were not available at the preschool and preteen time points for 45 (8%) patients, 355 (62%) patients were unable to access speech assessments, and 120 (21%) were unable to complete an orthodontic assessment. Conclusion: Patients wait up to an additional year to be seen by the CPP and miss speech, orthodontic, and surgical assessments at key developmental milestones. Additional resources are required to address these concerns.
Different Suture Materials for Arthroscopic Transtibial Pull-out Repair of Medial Meniscal Posterior Root Tears: A Human Biomechanical Study
Authors: Nakama Gilberto Y. , Aman Zachary S. , Storaci Hunter W. , Kuczmarski Alexander S. , Krob Joseph J. , Strauss Marc J. 
Published: October 2019

Background: Transtibial pull-out repair of the medial meniscal posterior root (MMPR) has been largely assessed through biomechanical studies. Biomechanically comparing different suture types would further optimize MMPR fixation and affect clinical care. Purpose/Hypothesis: The purpose of this study was to determine the optimal suture material for MMPR fixation. It was hypothesized that ultra high–molecular weight polyethylene (UHMWPE) suture tape would be biomechanically superior to UHMWPE suture and standard suture. Study Design: Controlled laboratory study. Methods: The MMPR attachment was divided in 24 human cadaveric knees and randomly assigned to 3 repair groups: UHMWPE suture tape, UHMWPE suture, and standard suture. Specimens were dissected down to the medial meniscus, and the posterior root attachments were sectioned off the tibia. Two-tunnel transtibial pull-out repair with 2 sutures, as determined by the testing group, was performed. The repair constructs were cyclically loaded between 10 and 30 N at 0.5 Hz for 1000 cycles to mimic the forces experienced on the medial meniscus during postoperative rehabilitation. Displacement was recorded at 1, 50, 100, 500, and 1000 cycles. Ultimate failure load, displacement at failure, and load at 3 mm of displacement (clinical failure) were also recorded. Results: UHMWPE suture tape had significantly less displacement of the medial meniscus when compared with standard suture at 1 (–0.22 mm [95% CI, –0.41 to –0.02]; P = .025) and 50 (–0.35 mm [95% CI, –0.67 to –0.03]; P = .029) cycles. There were no other significant differences observed in displacement between groups at any number of cycles. UHMWPE suture tape had significantly less displacement at the time of failure than standard suture (–3.71 mm [95% CI, –7.17 to –0.24]; P = .034). UHMWPE suture tape had a significantly higher load to reach the clinical failure displacement of 3 mm than UHMWPE suture (15.64 N [95% CI, 0.02 to 31.26]; P = .05). There were no significant differences in ultimate failure load between groups. Conclusion: The meniscal root repair construct with UHMWPE suture tape may be stronger and less prone to displacement than that with standard suture or UHMWPE suture. Clinical Relevance: UHMWPE suture tape may provide better clinical results compared with UHMWPE suture and standard suture.
Increase coherence, cooperation and cross-compliance of regulations on chemicals and water quality
Authors: Munthe John , Lexén Jenny , Skårman Tina , Posthuma Leo , Brack Werner , Altenburger Rolf , Brorström-Lundén Eva , Bunke Dirk , Faust Michael , Rahmberg Magnus , Sleeuwaert Frank , Slobodnik Jaroslav , van Gils Jos , van Wezel Annemarie 
Published: October 2019

Abstract
An analysis of existing regulatory frameworks for chemicals reveals a fragmented situation with a number of regulatory frameworks designed for specific groups of chemicals; for protection of different end-points and covering different parts of the chemicals´ life cycle stages. Lack of- and fragmented information on chemicals (properties, use, emissions as well as fate, occurrence and effects in the environment) limit the ability for assessment and early action, and existing legislation would benefit from more transparency and openness of information and knowledge. To achieve harmonisation of existing legislation and an efficient control of chemical contamination of European waters, a solution-focused approach is proposed including increased ambitions (in monitoring, modelling, and risk assessment), cooperation and dialogue. More holistic and efficient development and implementation of existing legislation can be achieved by better cooperation, harmonisation and information exchange between different regulatory frameworks and by improved science–policy interactions. The introduction of an organisational structure and incentives for cooperation are proposed. Cooperation should focus on harmonisation of advanced monitoring activities, modelling, prioritisation, risk assessment and assessment of risk prevention (‘safe by design’) and minimisation options. A process for dialogue and information exchange between existing policy frameworks and with stakeholders (industry, NGO´s, etc.) should be included to identify feasible options for mitigation as well as regulatory gaps—on local and EU-scales. There is also a need to increase international cooperation and strengthen global agreements to cover the full life cycle of chemicals (produced and consumed globally) and for exchanging knowledge and experiences to allow early action. This recommended action would also provide knowledge and a framework for a shift towards a sustainable chemistry approach for chemical safety based on a “safe by design” concept.
Mixtures of chemicals are important drivers of impacts on ecological status in European surface waters
Authors: Posthuma Leo , Brack Werner , van Gils Jos , Focks Andreas , Müller Christin , de Zwart Dick , Birk Sebastian 
Published: October 2019

Abstract
The ecological status of European surface waters may be affected by multiple stressors including exposure to chemical mixtures. Currently, two different approaches are used separately to inform water quality management: the diagnosis of the deterioration of aquatic ecosystems caused by nutrient loads and habitat quality, and assessment of chemical pollution based on a small set of chemicals. As integrated assessments would improve the basis for sound water quality management, it is recommended to apply a holistic approach to integrated water quality status assessment and management. This allows for estimating the relative contributions of exposure to mixtures of the chemicals present and of other stressors to impaired ecological status of European water bodies. Improved component- and effect-based methods for chemicals are available to support this. By applying those methods, it was shown that a holistic diagnostic approach is feasible, and that chemical pollution acts as a limiting factor for the ecological status of European surface waters. In a case study on Dutch surface waters, the impact on ecological status could be traced back to chemical pollution affecting individual species. The results are also useful as calibration of the outcomes of component-based mixture assessment (risk quotients or mixture toxic pressures) on ecological impacts. These novel findings provide a basis for a causal and integrated analysis of water quality and improved methods for the identification of the most important stressor groups, including chemical mixtures, to support integrated knowledge-guided management decisions on water quality.
Random fixed point theorems in Banach spaces applied to a random nonlinear integral equation of the Hammerstein type
Authors: Okeke Godwin Amechi , Bishop Sheila Amina , Akewe Hudson 
Published: October 2019

Abstract
The purpose of this paper is to define a new random operator called the generalized ϕ-weakly contraction of the rational type. This new random operator includes those studied by Khan et al. (Filomat 31(12):3611–3626, 2017) and Zhang et al. (Appl. Math. Mech. 32(6):805–810, 2011) as special cases. We prove some convergence, existence, and stability results in separable Banach spaces. Moreover, we produce some numerical examples to demonstrate the applicability of our analytical results. Furthermore, we apply our results in proving the existence of a solution of a nonlinear integral equation of the Hammerstein type.
Risk of Major Complications After Perioperative Norepinephrine Infusion Through Peripheral Intravenous Lines in a Multicenter Study
Authors: Pancaro Carlo , Shah Nirav , Pasma Wietze , Saager Leif , Cassidy Ruth , van Klei Wilton , Kooij Fabian , Vittali Dave , Hollmann Markus W. , Kheterpal Sachin , Lirk Philipp 
Published: September 2019

BACKGROUND:
Continuous infusions of norepinephrine to treat perioperative hypotension are typically administered through a central venous line rather than a peripheral venous catheter to avoid the risk of localized tissue necrosis in case of drug extravasation. There is limited literature to estimate the risk of skin necrosis when peripheral norepinephrine is used to counteract anesthesia-associated hypotension in elective surgical cases. This study aimed to estimate the rate of occurrence of drug-related adverse effects, including skin necrosis requiring surgical management when norepinephrine peripheral extravasation occurs.

METHODS:
This retrospective cohort study used the perioperative databases of the University Hospitals in Amsterdam and Utrecht, the Netherlands, to identify surgical patients who received norepinephrine peripheral intravenous infusions (20 µg/mL) between 2012 and 2016. The risk of drug-related adverse effects, including skin necrosis, was estimated. Particular care was taken to identify patients who needed plastic surgical or medical attention secondary to extravasation of dilute, peripheral norepinephrine.

RESULTS:
A total of 14,385 patients who received norepinephrine peripheral continuous infusions were identified. Drug extravasation was observed in 5 patients (5/14,385 = 0.035%). The 95% confidence interval (CI) for infusion extravasation was 0.011%–0.081%, indicating an estimated risk of 1–8 events per every 10,000 patients. There were zero related complications requiring surgical or medical intervention, resulting in a 95% CI of 0%–0.021% and indicating a risk of approximately 0–2 events per 10,000 patients.

CONCLUSIONS:
In the current database analysis, no significant association was found between the use of peripheral intravenous norepinephrine infusions and adverse events.
Automedicação entre acadêmicos de medicina de Fernandópolis – São Paulo
Authors: Tognoli Thais do Amaral , Tavares Vinicius de Oliveira , Ramos Ana Paula Domingos , Batigalia Fernando , De Godoy José Maria Pereira , Ramos Rogério Rodrigo 
Published: September 2019

Objetivos: buscou-se investigar a automedicação por acadêmicos de curso de graduação em Medicina de instituição privada e analisar possíveis variáveis relacionadas. Métodos: trata-se de um estudo transversal realizado com 320 discentes dos quatro primeiros anos do curso de Medicina da Universidade Brasil, campus Fernandópolis-SP. Foi aplicado questionário validado com variáveis sociais e de consumo de medicamentos, seguido de análise estatística por regressão linear simples. Resultado: como resultado, a automedicação foi considerada uma opção em 309 dos participantes, a maioria deles do sexo feminino, idade entre 21 a 23 anos, solteiros, sem curso superior prévio, com convênio médico e conscientes de eventuais riscos à Saúde, mesmo após acesso a bulas ou a pesquisas on-line. O quadro clínico precedente à automedicação incluiu, principalmente, cefaleia e mialgia. Houve preferência por fármacos anteriormente utilizados com consumo médio (por 1 a 2 dias), principalmente de analgésicos e anti-inflamatórios. Estar mais próximo ao término do curso (p = 0,006) e possuir convênio médico (p = 0,046) se relacionaram com automedicação. Conclusão: o hábito da automedicação aumenta, gradativamente, ao decorrer da graduação, com isso, sugere-se implementação de proposta pedagógica educativa sobre esse assunto em grade curricular de cursos de Medicina.
Αρμογή σπαραγμάτων. Νεότερα για τη βιβλιοθήκη Νικολάου και Κωνσταντίνου Καρατζά
Authors: Αποστολόπουλος Δημήτρης Γ. 
Published: September 2019

In the General State Archives, in Athens, specifically in the “Giannis Vlachogiannis” archive collection, there is a file containing seventeen fragments, that are one-sheet, two-sheet, four-sheet and, one among them, five-sheet. Vlachogiannis does not mention anything about their origin; in order to describe, however, the contents of this file, he wrote: “Χειρογράφων αποσπάσματα (βιογραφικά λογίων και κληρικών)” (excerpts from manuscripts (biographical information of scholars and clergymen)). This study aimed initially at tracing the philological identity and origin of these fragments.The identification of two scribes, who have written the majority of the fragments (fifteen out of seventeen), has given the first clue: Nikolaos Karatzas, a scholar, collector and manuscript scribe all together, owner of one of the biggest libraries in Constantinople in the 18th century, has written eleven texts; in the remaining four, we recognize the handwriting of his son and inheritor of his library, Konstantinos Karatzas. The second piece of information arose from the discovery of the fact that the fragments are not actually fifteen, as textual evidence demonstrated their coherence of content: in fact they form six sections.But are they indeed excerpts, fragments from “manuscripts”, as Vlachogiannis had assumed?Evidence from various sources brought forward in this study demonstrate the fact that the fragments were fascicules incorporated into printed books that once belonged to Karatzas' library, probably until the beginning of the second decade of the 19th century.The printed books in question are the following: Meletios Pegas, Ὑπὲρ τῆς χριστιανῶν εὐσεβείας πρὸς Ἰουδαίους ἀπολογία, Léopol 1593.Gregorios Palamas, Λόγοι ἀποδεικτικοὶ… [London 1626-1626].Ioannes Karyophylles, Ἐγχειρίδιον περί τινων ἀποριῶν…, Monastery of Synagovou 1697.Johann Michael Lange, Philologiae Barbaro-Græcæ, Noribergae 1707-1708.Ioannes Komnenos, Προσκυνητάριον τοῦ ἁγίου Ὄρους…, Venice 1745.Gabriel Severos, Συνταγμάτιον περὶ… μυστηρίων, Venice 1791. How were these fragments found in Athens, although they originated from printed books located in Constantinople? The answer to this plausible question is that they followed a labyrinthine path: the books that included them were bought by Lord Guilford and were donated to the Ionian Academy, the School he had established in 1824 on Corfu. After Guilford's death, when the books of his library were to be given back to the heirs of the donor, the librarian on Corfu, who was claiming his unpaid salaries, detached the fragments. They remained in the hands of A. Papadopoulos-Vretos and when his archive was sold to the General State Archives in 1920, Vlachogiannis put them aside in order to study them. It should be noted that most of the printed books from which the fragments were detached were bought by the British Museum in an auction, and are today located in the British Library.DIMITRIS G. APOSTOLOPOULOS
Postoperative weightbearing following ankle arthrodesis
Authors: Potter Matt J. , Freeman Richard 
Published: September 2019

Aims Postoperative rehabilitation regimens following ankle arthrodesis vary considerably. A systematic review was conducted to determine the evidence for weightbearing recommendations following ankle arthrodesis, and to compare outcomes between different regimens. Patients and Methods MEDLINE, Web of Science, Embase, and Scopus databases were searched for studies reporting outcomes following ankle arthrodesis, in which standardized postoperative rehabilitation regimens were employed. Eligible studies were grouped according to duration of postoperative nonweightbearing: zero to one weeks (group A), two to three weeks (group B), four to five weeks (group C), or six weeks or more (group D). Outcome data were pooled and compared between groups. Outcomes analyzed included union rates, time to union, clinical scores, and complication rates. Results A total of 60 studies (2426 ankles) were included. Mean union rates for groups A to D were 93.2%, 95.5%, 93.0%, and 93.0%, respectively. Mean time to union was 10.4 weeks, 14.5 weeks, 12.4 weeks, and 14.4 weeks for groups A to D, respectively. Mean complication rates were 22.3%, 23.0%, 27.1%, and 28.7% for groups A to D, respectively. Reporting of outcome scores was insufficient to conduct meaningful analysis. Conclusion Outcomes following ankle arthrodesis appear to be similar regardless of the duration of postoperative nonweightbearing, although the existing literature is insufficient to make definitive conclusions. Cite this article: Bone Joint J 2019;101-B:1256–1262
Periprosthetic atypical femoral fractures exist and are associated with duration of bisphosphonate therapy
Authors: MacKenzie Samuel A. , Ng Richard T. , Snowden Gorden , Powell-Bowns Matilda F. R. , Duckworth Andrew D. , Scott Chloe E. H. 
Published: September 2019

Aims Currently, periprosthetic fractures are excluded from the American Society for Bone and Mineral Research (ASBMR) definition of atypical femoral fracture (AFFs). This study aims to report on a series of periprosthetic femoral fractures (PFFs) that otherwise meet the criteria for AFFs. Secondary aims were to identify predictors of periprosthetic atypical femoral fractures (PAFFs) and quantify the complications of treatment. Patients and Methods This was a retrospective case control study of consecutive patients with periprosthetic femoral fractures between 2007 and 2017. Two observers identified 16 PAFF cases (mean age 73.9 years (44 to 88), 14 female patients) and 17 typical periprosthetic fractures in patients on bisphosphonate therapy as controls (mean age 80.7 years (60 to 86, 13 female patients). Univariate and multivariate analysis was performed to identify predictors of PAFF. Management and complications were recorded. Results Interobserver agreement for the PAFF classification was excellent (kappa = 0.944; p < 0.001). On univariate analysis compared with controls, patients with PAFFs had higher mean body mass indices (28.6 kg/m2 (sd 8.9) vs 21.5 kg/m2 (sd 3.3); p = 0.009), longer durations of bisphosphonate therapy (median 5.5 years (IQR 3.2 to 10.6) vs 2.4 years (IQR 1.0 to 6.4); p = 0.04), and were less likely to be on alendronate (50% vs 94%; p = 0.02) with an indication of secondary osteoporosis (19% vs 0%; p = 0.049). Duration of bisphosphonate therapy was an independent predictor of PAFF on multivariate analysis (R2 = 0.733; p = 0.05). Following primary fracture management, complication rates were higher in PAFFs (9/16, 56%) than controls (5/17, 29%; p = 0.178) with a relative risk of any complication following PAFF of 1.71 (95% confidence interval (CI) 0.77 to 3.8) and of reoperation 2.56 (95% CI 1.3 to 5.2). Conclusion AFFs do occur in association with prostheses. Longer duration of bisphosphonate therapy is an independent predictor of PAFF. Complication rates are higher following PAFFs compared with typical PFFs, particularly of reoperation and infection. Cite this article: Bone Joint J 2019;101-B:1285–1291
Detection of Stimulated Erythropoiesis by the RNA-Based 5'-Aminolevulinate Synthase 2 Biomarker in Dried Blood Spot Samples
Authors: Salamin Olivier , Gottardo Emeric , Schobinger Céline , Reverter-Branchat Gemma , Segura Jordi , Saugy Martial , Kuuranne Tiia , Tissot Jean-Daniel , Favrat Bernard , Leuenberger Nicolas 
Published: September 2019

AbstractBACKGROUNDDespite implementation of the Athlete Biological Passport 10 years ago, blood doping remains difficult to detect. Thus, there is a need for new biomarkers to increase the sensitivity of the adaptive model. Transcriptomic biomarkers originating from immature reticulocytes may be reliable indicators of blood manipulations. Furthermore, the use of dried blood spots (DBSs) for antidoping purposes constitutes a complementary approach to venous blood collection. Here, we developed a method of quantifying the RNA-based 5′-aminolevulinate synthase 2 (ALAS2) biomarker in DBS.MATERIALSThe technical, interindividual, and intraindividual variabilities of the method, and the effects of storage conditions on the production levels of ALAS2 RNA were assessed. The method was used to monitor erythropoiesis stimulated endogenously (blood withdrawal) or exogenously (injection of recombinant human erythropoietin).RESULTSWhen measured over a 7-week period, the intra- and interindividual variabilities of ALAS2 expression in DBS were 12.5%–42.4% and 49%, respectively. Following withdrawal of 1 unit of blood, the ALAS2 RNA in DBS increased significantly for up to 15 days. Variations in the expression level of this biomarker in DBS samples were more marked than those of the conventional hematological parameters, reticulocyte percentage and immature reticulocyte fraction. After exogenous stimulation of erythropoiesis via recombinant human erythropoietin injection, ALAS2 expression in DBS increased by a mean 8-fold.CONCLUSIONSMonitoring of transcriptomic biomarkers in DBS could complement the measurement of hematological parameters in the Athlete Biological Passport and aid the detection of blood manipulations.
Combination of Sjogren’s disease with autoimmune thyroiditis: A case history
Authors: Sycheva Ye A , Khein Ts S 
Published: October 2019

Therapists, including rheumatologists, often forget that many autoimmune diseases are combined with endocrine pathology, in particular with thyroid pathology.
These cases, according to the classification of N. Smith and A. Steinberg, belong to the 5th class - class E of autoimmune diseases, which includes conditions that manifest several autoimmune diseases, both organ-specific and organ-specific.
In the literature, cases of combinations of endocrine diseases with non-endocrine autoimmune are described. It was noted that they are most often found in young women, which are associated with the X chromosome.
We give our own observation of a patient with Sjogren's disease in combination with thyroid pathology.