bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Obesity on Achilles Rupture Repair
Authors: Hillam Jeffery S. , Mohile Neil , Smyth Niall , Kaplan Jonathan , Aiyer Amiethab 
Published: December 2018

Introduction. Obesity is an increasingly common comorbidity that may negatively affect outcomes following orthopaedic surgery. It is valuable to determine whether obese patients are vulnerable for postoperative complications. The purpose of this study was to analyze data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to determine the effect of obesity on surgical treatment of Achilles tendon ruptures. Methods. Patients who underwent a surgical repair of the Achilles tendon were retrospectively identified through the ACS NSQIP. The patients were divided into 2 cohorts (obese and nonobese), then perioperative and postoperative factors were evaluated for association with obesity. Results. A total of 2128 patients were identified, of whom 887 (41.7%) were classified as obese. Obesity correlated with an increased operative time, 60.9 versus 56.1 minutes. The only postoperative complication associated with obesity was wound dehiscence. Logistic regression adjusted for comorbid conditions demonstrated that obesity was not associated with an increased risk of wound dehiscence. Conclusion. A large segment of the patient population undergoing Achilles tendon repair is obese. Obesity was found to have an increased association with wound dehiscence, likely related to comorbid conditions, following Achilles tendon repair. Obesity was not significantly associated with any other complication. Levels of Evidence: III, Retrospective Cohort Study
Micro-Particle Curcumin for the Treatment of Chronic Kidney Disease-1: Study Protocol for a Multicenter Clinical Trial
Authors: Weir Matthew A. , Walsh Michael , Cuerden Meaghan S. , Sontrop Jessica M. , Chambers Laura C. , Garg Amit X. 
Published: December 2018

Background: The progression to end-stage renal disease (ESRD) is the most important complication of chronic kidney disease (CKD). Patients with ESRD require dialysis or transplantation to survive, incur numerous complications, and have high mortality rates. Slowing the progression of CKD is an important goal. Unfortunately, even when current treatments are appropriately applied, patients with CKD still progress to ESRD. Current treatments do not address the inflammation and fibrosis that mediate progression to ESRD, but micro-particle curcumin, a natural health product, has both anti-inflammatory and anti-fibrotic properties and may be an effective treatment for patients with CKD. Objective: Micro-particle curcumin for the treatment of CKD-1 (MPAC-CKD-1) will measure the effect of micro-particle curcumin on 2 important markers of CKD progression: albuminuria and estimated glomerular filtration rate (eGFR). Efficacy in either of these markers will justify a larger, international trial to investigate micro-particle curcumin’s ability to lower the risk of ESRD in patients with CKD. Design: MPAC-CKD-1 is a multicenter, double-blind prospective randomized controlled trial. Setting: Four kidney disease clinics in Ontario, Canada (3 in London and 1 in Hamilton). Patients: We will enroll patients with CKD, defined by an eGFR between 15 and 60 mL/min/1.73 m2 and a daily albumin excretion of more than 300 mg (or a random urine sample albumin-to-creatinine ratio more than 30 mg/mmol). Measurements: We will measure changes in the co-primary outcomes of urinary albumin-to-creatinine ratio and eGFR at 3 months and 6 months. We will also measure compliance, safety parameters, and changes in health-related quality of life. Methods: Participants will be randomly assigned to receive micro-particle curcumin 90 mg once daily or matching placebo for 6 months. We will enroll at least 500 patients to exclude clinically meaningful 6-month changes in these 2 co-primary outcomes (16% difference in albuminuria, and a 2.3 mL/min/1.73 m2 between-group difference in the 6-month change in eGFR, at a two-tailed alpha of 0.025, power of 0.80). Results: Patient enrollment began on October 1, 2015, with 414 participants randomized as of July 2018. We expect to report the results in 2020. Limitations: MPAC-CKD-1 is not powered to assess outcomes such as the need for renal replacement therapy or death. Conclusions: MPAC-CKD-1 is a multicenter, double-blind prospective randomized controlled trial designed to test whether micro-particle curcumin reduces albuminuria and slows eGFR decline in patients with albuminuric CKD. MPAC-CKD-1 will also test the feasibility of this intervention and inform the need for a future larger scale trial (MPAC-CKD-2). Trial registration: MPAC-CKD-1 is registered with U.S. National Institutes of Health at clinicaltrials.gov (NCT02369549). Protocol version 2.0, December 6, 2014.
The DOWN Questionnaire: A Novel Screening Tool for Cervical Spondylotic Myelopathy
Authors: Barkoh Kaku , Ohiorhenuan Ifije E. , Lee Larry , Lucas Joshua , Arakelyan Anush , Ornelas Christopher , Buser Zorica , Hsieh Patrick , Acosta Frank , Liu John , Wang Jeffrey C. , Hah Raymond 
Published: December 2018

Study Design: Case-control study. Objectives: Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord injury in adults aged over 55 years. However, since the onset is typically insidious, accurately diagnosing CSM can be challenging, often requiring referral to a subspecialist and advanced imaging. To help identify patients at risk for CSM, this case-control study compared responses to a series of 4 questions (DOWN questionnaire) in myelopathic and non-myelopathic patients. Methods: Ninety-two patients, 46 with and 46 without myelopathy, were recruited for the study. Each patient answered 4 questions encompassing common symptoms associated with CSM. Responses between patient groups were compared, and Cohen’s κ was used to assess for agreement between responses and the diagnosis of myelopathy. Results: We found a sensitivity of 91% and a κ of 0.54 to 3 positive responses and a sensitivity of 72% and a κ of 0.61 to 4 positive responses. Conclusions: Positive responses to 3 or more DOWN questions has high sensitivity and moderate agreement with the diagnosis of myelopathy based on history, physical exam, and review of advanced imaging by an orthopedic or neurological surgeon. The DOWN questionnaire is a potentially useful screening tool to identify patients at risk for CSM.
The morphology of the femur in elderly Japanese females: Analysis using 3D-CT
Authors: Maehara Takashi , Kiyono Masahiro , Noda Tomoyuki , Sato Ryozo , Kadota Hiroaki , Hori Tadahiro , Koga Yoichi , Hidaka Yoshihisa , Joko Ryoji , Muraoka Sosuke , Ozaki Toshifumi 
Published: December 2018

Background: While various implants are currently used for the treatment of femoral trochanteric fractures in Japan, ‘mismatches’ have been known to occur between patient and implant type. The purpose of this study is to identify morphological characteristics of elderly Japanese females, both in terms of the shape of proximal femur and its anterior curvature in order to evaluate the suitability of implants for treatment of femoral trochanteric fractures using 3D-computed tomography (CT) scanning. Methods: This study used CT scan data taken from 50 elderly females (aged 70 years or older). Neck–shaft (NS) angle and height of the greater trochanter (GT) were measured under defined conditions (TPI: theoretical plane to place implant). Anterior curvature of the femoral shaft was also measured. Results: On average, the NS angle was found to be 128.1° and GT height was 62.4 mm. Average curvature radius was 1040 mm. As for the NS angle, the centrum-collum-diaphysis angles of existing implants (125° or 130°) are reasonable. In elderly Japanese patients, the proximal femur shows specific characteristics. As GT height is very short, the implant may easily interfere with the lateral cortex. Additionally, the curvature radius calculated (1040 mm) was smaller than that of past reports, indicating strong curvature in the Japanese elderly. Conclusion: Our measurement results are potentially useful in the avoidance of intraoperative trouble caused by mismatch of implants.
Knowledge, Attitudes, and Practices of Women Toward Prenatal Genetic Testing
Authors: Abdo Nour , Ibraheem Nadia , Obeidat Nail , Graboski-Bauer Ashley , Batieha Anwar , Altamimi Nada , Khatatbih Moawia 
Published: December 2018

Objectives: We aim to address public knowledge, attitudes, and practices relative to prenatal genetic testing as a starting point for policy development in Jordan. Study design: We conducted a cross-sectional prenatal genetic testing knowledge, attitudes, and practices survey with 1111 women recruited at obstetrics and gynecology clinics nationwide. Data were analyzed using a variety of descriptive and inferential statistical tests. Results: The overwhelming majority (>94%) of participants considered prenatal genetic testing, particularly non-invasive prenatal genetic screening, procedures to be good, comfortable, and reasonable, even when the non-diagnostic nature of non-invasive prenatal genetic screening was explained. Likewise, 95% encouraged the implementation of non-invasive prenatal genetic screening within the Jordanian health system, but most preferred it to remain optional. However, women in higher-risk age brackets, in consanguineous marriages, and with less education were significantly less interested in learning about non-invasive prenatal genetic screening. Only 60% of women interviewed were satisfied with the services provided by their obstetric/gynecologist. The more satisfied the women were, the more they are likely to adapt non-invasive prenatal genetic screening. Conclusions: In sum, although the data support the receptivity of Jordanian women to national implementation of non-invasive prenatal genetic screening, such policies should be accompanied by health education to increase the genetic literacy of the population and to engage high-risk populations. Thus, this offers rare insight into the readiness of 1 particular Arab population to adapt non-invasive prenatal genetic screening technologies.
Robust adaptive immune response against Babesia microti infection marked by low parasitemia in a murine model of sickle cell disease
Authors: Yi Woelsung , Bao Weili , Rodriguez Marilis , Liu Yunfeng , Singh Manpreet , Ramlall Vijendra , Cursino-Santos Jeny R. , Zhong Hui , Elton Catherine M. , Wright Gavin J. , Mendelson Avital , An Xiuli , Lobo Cheryl A. , Yazdanbakhsh Karina 
Published: December 2018

Abstract
The intraerythrocytic parasite Babesia microti is the number 1 cause of transfusion-transmitted infection and can induce serious, often life-threatening complications in immunocompromised individuals including transfusion-dependent patients with sickle cell disease (SCD). Despite the existence of strong long-lasting immunological protection against a second infection in mouse models, little is known about the cell types or the kinetics of protective adaptive immunity mounted following Babesia infection, especially in infection-prone SCD that are thought to have an impaired immune system. Here, we show, using a mouse B microti infection model, that infected wild-type (WT) mice mount a very strong adaptive immune response, characterized by (1) coordinated induction of a robust germinal center (GC) reaction; (2) development of follicular helper T (TFH) cells that comprise ∼30% of splenic CD4+ T cells at peak expansion by 10 days postinfection; and (3) high levels of effector T-cell cytokines, including interleukin 21 and interferon γ, with an increase in the secretion of antigen (Ag)-specific antibodies (Abs). Strikingly, the Townes SCD mouse model had significantly lower levels of parasitemia. Despite a highly disorganized splenic architecture before infection, these mice elicited a surprisingly robust adaptive immune response (including comparable levels of GC B cells, TFH cells, and effector cytokines as control and sickle trait mice), but higher immunoglobulin G responses against 2 Babesia-specific proteins, which may contain potential immunogenic epitopes. Together, these studies establish the robust emergence of adaptive immunity to Babesia even in immunologically compromised SCD mice. Identification of potentially immunogenic epitopes has implications to identify long-term carriers, and aid Ag-specific vaccine development.
Carfilzomib-induced aHUS responds to early eculizumab and may be associated with heterozygous CFHR3-CFHR1 deletion
Authors: Portuguese Andrew Jay , Lipe Brea 
Published: December 2018

Key Points
Rapid initiation of eculizumab mitigates progression of carfilzomib-induced aHUS. Development of carfilzomib-induced aHUS may be associated with heterozygous CFHR3-CFHR1 deletion.
Invited commentary on… Continuity of care in the community for people with severe mental illness: does it matter?
Authors: Holloway Frank 
Published: December 2018

SummaryIn this issue, MacDonald et al have used data from the South London and Maudsley NHS Foundation Trust electronic patient record to investigate the relationship between service change, routine outcome data and ‘continuity of care’. The period they have looked at was one of huge change in the configuration of services and the background to this is explored here.Declaration of interestF.H. was a clinical director of South London and Maudsley NHS Foundation Trust and its predecessor organisations from 1991 to 2010.
Fetal Leydig cells dedifferentiate and serve as adult Leydig stem cells
Authors: Shima Yuichi , Miyabayashi Kanako , Sato Tetsuya , Suyama Mikita , Ohkawa Yasuyuki , Doi Masao , Okamura Hitoshi , Suzuki Kentaro 
Published: December 2018

ABSTRACT
Previous studies have established that fetal Leydig cells (FLCs) and adult Leydig cells (ALCs) show distinct functional characteristics. However, the lineage relationship between FLCs and ALCs has not been clarified yet. Here, we reveal that a subset of FLCs dedifferentiate at fetal stages to give rise to ALCs at the pubertal stage. Moreover, the dedifferentiated cells contribute to the peritubular myoid cell and vascular pericyte populations in the neonatal testis, and these non-steroidogenic cells serve as potential ALC stem cells. We generated FLC lineage-specific Nr5a1 (Ad4BP/SF-1) gene-disrupted mice and mice lacking the fetal Leydig enhancer (FLE) of the Nr5a1 gene. Phenotypes of these mice support the conclusion that most of the ALCs arise from dedifferentiated FLCs, and that the FLE of the Nr5a1 gene is essential for both initial FLC differentiation and pubertal ALC redifferentiation.
ETNOEDUCACIÓN, ETNIZACIÓN AFROCOLOMBIANA Y FORCEJEOS DECOLONIALES
Authors: Arboleda Quiñonez Santiago 
Published: December 2018

Aquí se discute la etnoeducación como campo de gestión y producción de alteridad, al tiempo que de auto representación positiva, en el de trámite de un proyecto de transformación y hasta cierto punto de ruptura con el paradigma monocultural, imperante en la educación colombiana y en general en nuestros países latinoamericanos. Se postula que el proyecto etnoeducativo fija propósitos abiertamente decoloniales y liberadores, que parten de la experiencia y el pensamiento de los pueblos indígenas y afrocolombianos.
Managing gestational diabetes mellitus: Audit data of outcomes for women and neonates
Authors: Brown Anna-Maria , Rajeswari Devannas , Williams Peter , Lowndes Alison 
Published: December 2018

Background Literature on the management of gestational diabetes mellitus (GDM) and other pre-existing diabetic conditions in pregnancy suggest treatments that may ameliorate outcomes for both mother and neonates. Aims To examine the effects of GDM on outcomes for mothers and neonates and the effects of maternal age, body mass index and gestational age at birth with or without induction of labour for women with GDM. Methods Audit data of outcomes for GDM groups were analysed against outcomes for the general population of women giving birth in this unit. Descriptive statistics organised the data and inferential statistics determined the significant differences between frequencies. Findings Most of the results were predictive when comparing women with and without GDM for mode of birth and outcomes for mothers and neonates. This included significant differences for hospital birth, induction of labour and caesarean section. Conclusion Good glycaemic control and healthy lifestyle measures are advised to minimise development of obesity in women with GDM and diverse outcomes for both mothers and neonates.
Does preceptorship support newly qualified midwives to become confident practitioners?
Authors: Black Sophie Emma 
Published: December 2018

Background Preceptorship is as a period of time whereby a newly qualified registrant is supported and guided to make the transition from student to competent practitioner. Aim To analyse the literature and answer whether preceptorship for newly qualified midwives supports them to become competent and confident practitioners. Methods Literature was searched using an inclusion/exclusion criteria and six pieces of relevant literature met the inclusion criteria. Themes were derived from the chosen pieces of literature and analysed thematically. Results The themes consisted of two main themes and three subthemes. There were also some additional comments that could not be classed as themes but were important to note. Conclusion There is an evident lack of primary research into newly qualified midwives, preceptorship, and gaining competence and confidence. More primary research is needed to assess this notion. In addition, preceptors also need to be trained to ensure they have the right attributes to adequately support, teach and assess junior midwives.
Clinical Microbiology Is Growing Up: The Total Laboratory Automation Revolution
Authors: Bailey Adam L , Ledeboer Nathan , Burnham Carey-Ann D 
Published: December 2018

AbstractBACKGROUNDHistorically, culture-based microbiology laboratory testing has relied on manual methods, and automated methods (such as those that have revolutionized clinical chemistry and hematology over the past several decades) were largely absent from the clinical microbiology laboratory. However, an increased demand for microbiology testing and standardization of sample-collection devices for microbiology culture, as well as a dwindling supply of microbiology technologists, has driven the adoption of automated methods for culture-based laboratory testing in clinical microbiology.CONTENTWe describe systems currently enabling total laboratory automation (TLA) for culture-based microbiology testing. We describe the general components of a microbiology automation system and the various functions of these instruments. We then introduce the 2 most widely used systems currently on the market: Becton Dickinson's Kiestra TLA and Copan's WASPLab. We discuss the impact of TLA on metrics such as turnaround time and recovery of microorganisms, providing a review of the current literature and perspectives from laboratory directors, managers, and technical staff. Finally, we provide an outlook for future advances in TLA for microbiology with a focus on artificial intelligence for automated culture interpretation.SUMMARYTLA is playing an increasingly important role in clinical microbiology. Although challenges remain, TLA has great potential to affect laboratory efficiency, turnaround time, and the overall quality of culture-based microbiology testing.
Impact of Hormone Therapy on Laboratory Values in Transgender Patients
Authors: SoRelle Jeffrey A , Jiao Rhoda , Gao Emily , Veazey Jonas , Frame Ithiel , Quinn Andrew M , Day Philip , Pagels Patti , Gimpel Nora , Patel Khushbu 
Published: December 2018

Abstract

BACKGROUND
For transgender individuals taking hormone therapy (HT), data on laboratory values are limited, and the effects on laboratory values cannot be easily predicted. We evaluated the impact on common laboratory analytes in transgender individuals before and after initiation of HT.

METHODS
We conducted a retrospective chart review of transgender patients identified at transgender-specific clinics at an urban county hospital and community clinic. Laboratory data were collected on hormone concentrations, hematologic parameters, electrolytes, lipids, and liver and renal markers before and after initiation of HT.

RESULTS
We identified 183 transgender women (TW) and 119 transgender men (TM) for whom laboratory data were available. In all, 87 TW and 62 TM had baseline laboratory data, and data were also available for 133 TW and 89 TM on HT for &gt;6 months. The most significant changes were seen in red blood cell count, hemoglobin concentration, hematocrit, and creatinine levels after &gt;6 months of HT, which increased in TM and decreased in TW after HT (P &lt; 0.005; d index &gt; 0.6). Alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase levels increased in TM; however, the effect size was small (d index &lt; 0.5). Calcium, albumin, and alkaline phosphatase levels significantly decreased in TW (P &lt; 0.001; d &gt; 0.6). Additionally, TM were found to have increased triglycerides and decreased HDL levels (P &lt; 0.005; d &gt; 0.6).

CONCLUSIONS
Changes occur in several common laboratory parameters for patients on HT. Some laboratory values changed to match the gender identity, whereas others remained unchanged or were intermediate from the baseline values. These findings will help guide interpretation of laboratory test results in transgender patients taking HT.
Adding the Team into T1 Translational Research: A Case Study of Multidisciplinary Team Science in the Evaluation of Biomarkers of Prostate Cancer Risk and Prognosis
Authors: Marrone Michael T , Joshu Corinne E , Peskoe Sarah B , De Marzo Angelo M , Heaphy Christopher M , Lupold Shawn E , Meeker Alan K , Platz Elizabeth A 
Published: December 2018

Abstract

BACKGROUND
Given translational research challenges, multidisciplinary team science is promoted to increase the likelihood of moving from discovery to health effect. We present a case study documenting the utility of multidisciplinary team science in prostate cancer tissue biomarker validation.

METHODS
We used primary data generated by a team consisting of a pathologist, cancer biologists, a biostatistician, and epidemiologists. We examined their contributions by phase of biomarker evaluation to identify when, through the practice of team science, threats to internal validity were recognized and solved. Next, we quantified the extent of bias avoided in evaluating the association of Ki67 (immunohistochemistry), stromal cell telomere length (fluorescence in situ hybridization), and microRNA (miRNA) (miR-21, miR-141, miR-221; quantitative RT-PCR) with prostate cancer risk or recurrence in nested case–control studies.

RESULTS
Threats to validity were tissue storage time (Ki67, miRNA) and laboratory equipment maintenance (telomeres). Solutions were all in the data analysis phase and involved using tissue storage-time specific cutpoints and/or batch-specific cutpoints. Bias in the regression coefficient for quantiles of each biomarker ranged from 24% to 423%, and the coefficient for the test for trend ranged from 15% to 910%. The interpretation of the associations changed as follows: Ki67, null to positive; stromal cell telomere length, null to positive; miR-21 and miR-141 remained null; miR-221, weak to moderate inverse.

CONCLUSIONS
In this case study, we documented the inferential benefits of multidisciplinary team science when the team's collaboration and coordination led to the identification of threats to validity and the implementation of appropriate solutions.