bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical Comparison of the Influences of 2 Proximal Metatarsal Osteotomies on First Ray Articular Contact Characteristics
Authors: Reddy Sudheer C. , Li Jihui , Cuttica Daniel J. , Thiess Mark 
Published: September 2019

Background: An understudied area of proximal first metatarsal osteotomies is the effect on articular contact properties following the surgeries. Potential long-term risks include altered joint mechanics and possible arthritic progression. A biomechanical comparison of articular characteristics of the proximal opening wedge and Ludloff osteotomies was performed in this study. It was hypothesized that the proximal opening wedge osteotomy (POWO) would lead to greater alterations in articular contact properties along the first ray. Methods: Seven paired fresh-frozen below-knee cadaveric limbs with hallux valgus were selected. Specimens in each pair were tested in the intact state and then randomized to receive either a Ludloff or POWO. A 4-mm opening wedge osteotomy was used in all cases. Loading of the flexor hallucis longus was to 100 N using an instrumented tensioner. A 28-N load was added at the distal phalanx to simulate the ground reaction force. First metatarsophalangeal (MTP) and tarsometatarsal (TMT) articular properties were recorded simultaneously using 2 pressure sensors. For each state, a pressure map was generated and contact area, peak pressure, and center of pressure were calculated. Wilcoxon signed-rank test was used to assess statistical significance. Results: Average peak pressure was noted to be elevated at the MTP (4.6 vs 6.9 mPa, P = .04) and TMT (3.3 mPa vs 5.1 mPa, P = .30) joints when comparing the Ludloff and the POWO, respectively. Contact area was also noted to be lower in the POWO relative to the Ludloff for the MTP (86.6 vs 69.1 mm2, P = .30) but not the TMT joints (89.1 vs 88.5 mm2, P = .97). There was a slight plantar-lateral and dorsomedial shift in pressure at the MTP and TMT articulations, respectively, of the POWO relative to the Ludloff. A trend toward decreased contact force within the TMT joint was noted following opening wedge osteotomy relative to the intact state (103.8 vs 113.9 N, P = .31), while forces were elevated at the MTP joint (104.3 vs 96.0 N, P = .63), although not statistically significant. Smaller increases in TMT and MTP joint forces were noted following the Ludloff when compared to the intact state (95.6 vs 93.3 N at TMT and 109.2 vs 103.2 N at MTP). Conclusion: POWO can potentially change articular contact characteristics along the TMT and MTP articulations of the first ray. This could possibly lead to altered loading patterns and possible long-term damage vs other osteotomies. Clinical Relevance: While it is unlikely that the changes observed with the sizes of the osteotomy commonly used would lead to long-term significant clinical consequences, further study with larger group sizes would be beneficial.
Lightly Embalmed Cadavers in Sonography Education: A Novel Approach to Improving Students’ Perceived Competence in Renal Biopsy Procedures
Authors: Wampler Kathryn , Bartenhagen Lisa , Sayles Harlan , Michael Kimberly 
Published: September 2019

Objective: To determine if a simulation lab using lightly embalmed cadavers would improve diagnostic medical sonography (DMS) students’ perceived competence in ultrasound-guided native renal biopsy examinations. Methods: Subjects included DMS students (n = 49) enrolled in academic years 2012 to 2018. Each DMS student performed a native renal biopsy with a nephrology fellow. Skills practiced included machine setup, inferior renal pole localization, biopsy guide preparation, needle visualization, and communication skills. Pre- and postlab surveys assessed DMS students’ perceived competence. Results: Prelab, 12% (n = 6) of students felt competent to assist in the procedure. Postlab, 61% (n = 35) of students felt competent, a statistically significant ( P < .001) change. All students viewed the lab as a valuable experience. Hands-on experience (53%), student/physician collaboration (33%), and low-stress environment (13%) were reported themes. Additional resources (50%) and scheduling (22%) were areas for improvement. Conclusion: A renal biopsy simulation lab using lightly embalmed cadavers is an effective method to improve DMS students’ perceived competence in this procedure.
MBEC Versus MBIC: the Lack of Differentiation between Biofilm Reducing and Inhibitory Effects as a Current Problem in Biofilm Methodology
Authors: Thieme Lara , Hartung Anita , Tramm Kristina , Klinger-Strobel Mareike , Jandt Klaus D. , Makarewicz Oliwia , Pletz Mathias W. 
Published: September 2019

Abstract

Background
Biofilms are communities of aggregated, matrix-embedded microbial cells showing a high tolerance to an in principle adequate antibiotic therapy, often resulting in treatment failure. A major challenge in the management of biofilm-associated infections is the development of adequate, standardized biofilm susceptibility testing assays that are clinically meaningful, i.e. that their results correlate with treatment outcome. Different biofilm susceptibility endpoint parameters like the minimal biofilm eradication concentration (MBEC) or the minimal biofilm inhibitory concentration (MBIC) have been suggested as a guide for treatment of biofilm-associated infections, however with inconsistent perception and use among biofilm researchers, leading to confusion and contradictions among different anti-biofilm component studies and clinical trials.

Findings
Evaluation of anti-biofilm effects is mostly based on the untreated reference growth control biofilm measured at the same endpoint as the treated biofilm, neglecting the possible change of the untreated reference biofilm from the time point of pre-antimicrobial exposure to the measured endpoint. In this commentary, we point out the importance of individual quantification of mature, established biofilms before antimicrobial treatment for each biofilm model in order to draw conclusions on the measured biofilm effect size, i.e. biofilm reducing (MBEC) or biofilm inhibitory (MBIC) effects.

Conclusion
The assessment of pre-treatment biofilms contributes to a standardized use of biofilm susceptibility endpoint parameters, which is urgently needed to improve the clinical validity of future anti-biofilm assays.
Microbial community structure and the relationship with soil carbon and nitrogen in an original Korean pine forest of Changbai Mountain, China
Authors: Liu Minghui , Sui Xin , Hu Yanbo , Feng Fujuan 
Published: September 2019

Abstract

Background
The broad-leaved Korean pine mixed forest is an important and typical component of a global temperate forest. Soil microbes are the main driver of biogeochemical cycling in this forest ecosystem and have complex interactions with carbon (C) and nitrogen (N) components in the soil.

Results
We investigated the vertical soil microbial community structure in a primary Korean pine-broadleaved mixed forest in Changbai Mountain (from 699 to 1177 m) and analyzed the relationship between the microbial community and both C and N components in the soil. The results showed that the total phospholipid fatty acid (PLFA) of soil microbes and Gram-negative bacteria (G-), Gram-positive bacteria (G+), fungi (F), arbuscular mycorrhizal fungi (AMF), and Actinomycetes varied significantly (p < 0.05) at different sites (elevations). The ratio of fungal PLFAs to bacterial PLFAs (F/B) was higher at site H1, and H2. The relationship between microbial community composition and geographic distance did not show a distance-decay pattern. The coefficients of variation for bacteria were maximum among different sites (elevations). Total soil organic carbon (TOC), total nitrogen (TN), soil water content (W), and the ratio of breast-height basal area of coniferous trees to that of broad-leaved tree species (RBA) were the main contributors to the variation observed in each subgroup of microbial PLFAs. The structure equation model showed that TOC had a significant direct effect on bacterial biomass and an indirect effect upon bacterial and fungal biomass via soil readily oxidized organic carbon (ROC). No significant relationship was observed between soil N fraction and the biomass of fungi and bacteria.

Conclusion
The total PLFAs (tPLFA) and PLFAs of soil microbes, including G-, G+, F, AMF, and Actinomycetes, were significantly affected by elevation. Bacteria were more sensitive to changes in elevation than other microbes. Environmental heterogeneity was the main factor affecting the geographical distribution pattern of microbial community structure. TOC, TN, W and RBA were the main driving factors for the change in soil microbial biomass. C fraction was the main factor affecting the biomass of fungi and bacteria and ROC was one of the main sources of the microbial-derived C pool.
Peripheral arterial disease and systematic detection of circulating tumor cells: rationale and design of the DETECTOR prospective cohort study
Authors: Yannoutsos Alexandra , Fontaine Manon , Galloula Alexandre , Damotte Diane , Chatellier Gilles , Paterlini-Bréchot Patrizia , Meyer Guy , Pastre Jean , Duchatelle Véronique , Marini Valéria , Schwering Karl-Léo , Lazareth Isabelle , Ghaffari Parinaz , Stansal Audrey , Sanson Hélène , Labrousse Cécile , Beaussier Hélène , Nasr Nesrine Ben , Zins Marc , Salmeron Sergio , Messas Emmanuel , Lajonchère Jean-Patrick , Emmerich Joseph , Priollet Pascal , Trédaniel Jean 
Published: September 2019

Abstract

Background
Smoking is a strong risk factor for cancer and atherosclerosis. Cancer mortality, especially from lung cancer, overtakes cardiovascular (CV) death rate in patients with peripheral arterial disease (PAD). Only a few patients with lung cancer after PAD management may benefit from surgical excision. Circulating tumor cells (CTC) associated with low-dose chest CT (LDCT) may improve early cancer detection. This study focuses on a screening strategy that can address not only lung cancer but all tobacco-related cancers in this high-risk population.

Methods
DETECTOR Project is a prospective cohort study in two French University hospitals. Participants are smokers or former smokers (≥30 pack-years, quitted ≤15 years), aged ≥55 to 80 years, with atherosclerotic PAD or abdominal aortic aneurysm. After the first screening round combining LDCT and CTC search on a blood sample, two other screening rounds will be performed at one-year interval. Incidental lung nodule volume, volume doubling time and presence of CTC will be taken into consideration for adapted diagnostic management. In case of negative LDCT and presence of CTC, a contrast enhanced whole-body PET/CT will be performed for extra-pulmonary malignancy screening. Psychological impact of this screening strategy will be evaluated in population study using a qualitative methodology. Assuming 10% prevalence of smoking-associated cancer in the studied population, a total of at least 300 participants will be enrolled.

Discussion
Epidemiological data underline an increase incidence in cancer and related death in the follow-up of patients with PAD, compared with the general population, particularly for tobacco-related cancers. The clinical benefit of a special workup for neoplasms in patients with PAD and a history of cigarette smoking has never been investigated. By considering CTCs detection in this very high-risk selected PAD population for tobacco-induced cancer, we expect to detect earlier pulmonary and extra-pulmonary malignancies, at a potentially curable stage.

Trial registration
The study was registered in the French National Agency for Medicines and Health Products Safety (No N° EUDRACT_ID RCB: 2016-A00657–44) and was approved by the ethics Committee for Persons Protection (IRB number 1072 and n° initial agreement 2016-08-02; ClinicalTrials.gov identifier NCT02849041).
Measuring the palpable pulsatility length as a physical examination test in defining the severity of inflow stenosis for hemodialysis fistulas
Authors: Chen Matt Chiung-Yu , Weng Mei-Jui , Wu Misoso Yi-Wen , Liu Yi-Chun , Chi Wen-Che 
Published: September 2019

Abstract

Background
Pulsatility is an important property of hemodialysis arteriovenous fistulas (AVF) and can be perceived by the fingers as a gradual decrease in strength downstream from the anastomosis along the main trunk of the fistula. The distance from the point at which the pulse becomes imperceptible to the anastomosis is termed the palpable pulsatility length (PPL); we considered this length may play a role in assessing the severity of inflow stenosis for hemodialysis fistulas.

Methods
This study was performed by retrospective analysis of routinely collected data. Physical examinations and fistula measurements were performed in a selected population of 76 hemodialysis patients with mature fistulas during half a year. Fistula measurements included the PPL before and after treatment and the distance between the anastomosis and the arterial cannulation site (aPump length). The aPump index (API) was calculated by dividing the PPL by the aPump length. Angiograms were reviewed to determine the location and severity of stenosis. PPL and API were used to detect the critical inflow stenosis, which indicates severe inflow stenosis of an AVF.

Results
Receiver operating characteristic analysis showed that the area under the curve was 0.895 for API and 0.878 for PPL. A cutoff value of API < 1.29 and PPL < 11.0 cm were selected to detect the critical inflow stenosis. The sensitivity was 96.0% versus 80.0% and specificity was 84.31% versus 84.31% for API and PPL, respectively.

Conclusions
PPL and API are useful tools in defining the severity of pure inflow stenosis for mature AVFs in the hands of trained examiners with high sensitivity and specificity.
A transplantable tumor model allowing investigation of NY-BR-1-specific T cell responses in HLA-DRB1*0401 transgenic mice
Authors: Das Krishna , Eisel David , Vormehr Mathias , Müller-Decker Karin , Hommertgen Adriane , Jäger Dirk , Zörnig Inka , Feuerer Markus , Kopp-Schneider Annette , Osen Wolfram , Eichmüller Stefan B. 
Published: September 2019

AbstractBackgroundNY-BR-1 has been described as a breast cancer associated differentiation antigen with intrinsic immunogenicity giving rise to endogenous T and B cell responses. The current study presents the first murine tumor model allowing functional investigation of NY-BR-1-specific immune responses in vivo.MethodsA NY-BR-1 expressing tumor model was established in DR4tg mice based on heterotopic transplantation of stable transfectant clones derived from the murine H2 compatible breast cancer cell line EO771. Composition and phenotype of tumor infiltrating immune cells were analyzed by qPCR and FACS. MHC I binding affinity of candidate CTL epitopes predicted in silico was determined by FACS using the mutant cell line RMA-S. Frequencies of NY-BR-1 specific CTLs among splenocytes of immunized mice were quantified by FACS with an epitope loaded Db-dextramer. Functional CTL activity was determined by IFNγ catch or IFNγ ELISpot assays and statistical analysis was done applying the Mann Whitney test. Tumor protection experiments were performed by immunization of DR4tg mice with replication deficient recombinant adenovirus followed by s.c. challenge with NY-BR-1 expressing breast cancer cells.ResultsOur results show spontaneous accumulation of CD8+T cells and F4/80+myeloid cells preferentially in NY-BR-1 expressing tumors. Upon NY-BR-1-specific immunization experiments combined with in silico prediction and in vitro binding assays, the first NY-BR-1-specific H2-Db-restricted T cell epitope could be identified. Consequently, flow cytometric analysis with fluorochrome conjugated multimers showed enhanced frequencies of CD8+T cells specific for the newly identified epitope in spleens of immunized mice. Moreover, immunization with Ad.NY-BR-1 resulted in partial protection against outgrowth of NY-BR-1 expressing tumors and promoted intratumoral accumulation of macrophages.ConclusionThis study introduces the first H2-Db-resctricted CD8+T cell epitope-specific for the human breast cancer associated tumor antigen NY-BR-1. Our novel, partially humanized tumor model enables investigation of the interplay between HLA-DR4-restricted T cell responses and CTLs within their joint attack of NY-BR-1 expressing tumors.
Early prediction of spontaneous Patent Ductus Arteriosus (PDA) closure and PDA-associated outcomes: a prospective cohort investigation
Authors: Slaughter Jonathan L. , Cua Clifford L. , Notestine Jennifer L. , Rivera Brian K. , Marzec Laura , Hade Erinn M. , Maitre Nathalie L. , Klebanoff Mark A. , Ilgenfritz Megan , Le Vi T. , Lewandowski Dennis J. , Backes Carl H. 
Published: September 2019

AbstractBackgroundPatent ductus arteriosus (PDA), the most commonly diagnosed cardiovascular condition in preterm infants, is associated with increased mortality and harmful long-term outcomes (chronic lung disease, neurodevelopmental delay). Although pharmacologic and/or interventional treatments to close PDA likely benefit some infants, widespread routine treatment of all preterm infants with PDA may not improve outcomes. Most PDAs close spontaneously by 44-weeks postmenstrual age; treatment is increasingly controversial, varying markedly between institutions and providers. Because treatment detriments may outweigh benefits, especially in infants destined for early, spontaneous PDA closure, the relevant unanswered clinical question is not whether to treat all preterm infants with PDA, but whom to treat (and when). Clinicians cannot currently predict in the first month which infants are at highest risk for persistent PDA, nor which combination of clinical risk factors, echocardiographic measurements, and biomarkers best predict PDA-associated harm.MethodsProspective cohort of untreated infants with PDA (n=450) will be used to predict spontaneous ductal closure timing. Clinical measures, serum (brain natriuretic peptide, N-terminal pro-brain natriuretic peptide) and urine (neutrophil gelatinase-associated lipocalin, heart-type fatty acid-binding protein) biomarkers, and echocardiographic variables collected during each of first 4 postnatal weeks will be analyzed to identify those associated with long-term impairment. Myocardial deformation imaging and tissue Doppler imaging, innovative echocardiographic techniques, will facilitate quantitative evaluation of myocardial performance. Aim1 will estimate probability of spontaneous PDA closure and predict timing of ductal closure using echocardiographic, biomarker, and clinical predictors. Aim2 will specify which echocardiographic predictors and biomarkers are associated with mortality and respiratory illness severity at 36-weeks postmenstrual age. Aim3 will identify which echocardiographic predictors and biomarkers are associated with 22 to 26-month neurodevelopmental delay. Models will be validated in a separate cohort of infants (n=225) enrolled subsequent to primary study cohort.DiscussionThe current study will make significant contributions to scientific knowledge and effective PDA management. Study results will reduce unnecessary and harmful overtreatment of infants with a high probability of early spontaneous PDA closure and facilitate development of outcomes-focused trials to examine effectiveness of PDA closure in “high-risk” infants most likely to receive benefit.Trial registrationClinicalTrials.govNCT03782610. Registered 20 December 2018.
Surgical configurations of the pectoralis major flap for reconstruction of sternoclavicular defects: a systematic review and new classification of described techniques
Authors: Opoku-Agyeman Jude , Matera David , Simone Jamee 
Published: September 2019

Abstract

Objectives
The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. We also provide an algorithm for the selection of these flap variants for sternoclavicular defect reconstruction.

Methods
EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to August of 2019. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures.

Results
The study included 6 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the thoracoacromial artery (type 3a) or the deltoid branch of the thoracoacromial artery (type 3b).

Conclusion
There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system, the Opoku Classification will help surgeons select the appropriate configuration of the pectoralis major flap for sternoclavicular joint defect reconstruction based on size of defect, the status of the vascular anatomy, and acceptability of upper extremity disability. It will also help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.