bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Molecular-Weight Heparin for the Prevention of Venous Thromboembolism in Patients Undergoing Knee Arthroscopic Surgery and Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Randomized Controlled Trials
Authors: Zhu Jing , Jiang Hai , Marshall Brandon , Li Jian , Tang Xin 
Published: August 2018

Background: Low-molecular-weight heparin (LMWH) thromboprophylaxis is widely used for reducing the risk of thrombosis after major orthopaedic surgery. However, the effect and safety on knee arthroscopic surgery are still controversial. Purpose: To assess the efficacy and safety of LMWH for the prevention of symptomatic venous thromboembolism (VTE) after knee arthroscopic surgery and anterior cruciate ligament reconstruction (ACLR) by conducting a meta-analysis of randomized controlled trials (RCTs). Study Design: Meta-analysis. Methods: The authors searched the electronic databases of MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov , and Web of Science for all studies from inception to June 30, 2017. All selected studies were categorized into 2 subgroups: simple knee arthroscopic surgery and ACLR. The primary effect and safety endpoint were the incidence of major VTE and major bleeding events (BEs), respectively. The secondary effect and safety endpoint were the incidence of all VTE and all BEs, respectively. Relative risks (RRs) with 95% CIs were calculated using Review Manager 5.3. Results: Eight RCTs with 4113 patients were included. For patients undergoing simple knee arthroscopic surgery, LMWH prophylaxis did not bring a significant reduction in the risk of major VTE (RR, 1.00 [95% CI, 0.37-2.67]; P > .99) and all VTE (RR, 0.63 [95% CI, 0.31-1.29]; P = .21) and did not increase the risk of major BEs (RR, 0.98 [95% CI, 0.06-15.72]; P = .99) but did have a higher risk of all BEs (RR, 1.64 [95% CI, 1.18-2.28]; P = .003) in comparison with non-LMWH prophylaxis. For patients undergoing ACLR, LMWH prophylaxis was associated with a significantly lower rate of major VTE (RR, 0.23 [95% CI, 0.12-0.43]; P < .001) and all VTE (RR, 0.22 [95% CI, 0.06-0.73]; P = .01) but no increase in major BEs (RR, 1.80 [95% CI, 0.19-17.25]; P = .61) and all BEs (RR, 1.12 [95% CI, 0.72-1.74]; P = .61) in comparison with non-LMWH prophylaxis. Conclusion: Compared with non-LMWH treatment, LMWH had no significant efficacy in preventing VTE in patients undergoing simple knee arthroscopic surgery but increased the risk of BEs. However, LMWH had significant efficacy in preventing VTE for patients mainly undergoing ACLR and did not increase the risk of BEs.
Can “Becoming Breastfeeding Friendly” Impact Breastfeeding Protection, Promotion, and Support in Mexico? A Qualitative Study
Authors: Safon Cara , Buccini Gabriela , Ferré Isabel , de Cosío Teresita González , Pérez-Escamilla Rafael 
Published: August 2018

Background: The Becoming Breastfeeding Friendly (BBF) initiative includes a guide that helps countries worldwide assess their readiness to scale up national breastfeeding programs. Country committees of breastfeeding experts across government, academia, and civil society engage with BBF by applying the BBF toolbox that includes (1) the BBF Index (BBFI) to measure and score a country’s breastfeeding environment, (2) case studies that illustrate how countries have created enabling environments for breastfeeding, and (3) a 5-meeting process, during which country committees develop policy recommendations intended to improve breastfeeding outcomes based on the BBFI scores. Objective: This study seeks to understand how the application of the BBF toolbox impacted plans to improve the enabling environment for breastfeeding in Mexico. Methods: Semi-structured interviews were conducted with Mexico’s 11 BBF country committee members about the 5-meeting process between May and June 2017. Audio recordings were transcribed and were coded and analyzed using a grounded theory approach. Results: Three major themes emerged: (1) the unique enabling environment for breastfeeding consisted of obstacles and opportunities for improvement, (2) favorable country committee member dynamics positively affected the utility of the BBF toolbox, and (3) BBF revealed and shaped country committee members’ shared vision of change that laid the foundation for a shared public policy agenda. Conclusions: Becoming Breastfeeding Friendly can generate multisectoral breastfeeding champions who can advance the public policy agenda to improve breastfeeding outcomes at the national level both in Mexico and elsewhere.
Acute Kidney Injury Following Methimazole Initiation: A Case Report
Authors: Shell Abigail , Sullivan Joshua W. 
Published: August 2018

Objective: Nephritis has been rarely associated with methimazole, primarily in the development of nephrotic syndrome. We describe a case of acute kidney injury without evidence of nephrotic syndrome following methimazole initiation. Methods: We present the relevant history, laboratory data, and nuclear medicine data and review relevant documentation from the literature. Results: A 72-year-old male recently diagnosed with new-onset atrial fibrillation was found to have suppressed thyroid-stimulating hormone (TSH) levels; elevated free T3, T4, and thyroid-stimulating immunoglobulin (TSI) levels; and a nonnodular thyroid gland with normal iodine uptake. He was diagnosed with Graves’ disease and treated with propylthiouracil (PTU) for 5 years. When his poor compliance with PTU was impeding his antithyroid treatment, he was converted to methimazole. Within 1 month following methimazole initiation, his serum creatinine (SCr) had risen to 1.6× baseline in the absence of other contributing nephrotoxins. SCr returned to baseline within 2 weeks of methimazole discontinuation, and the patient was subsequently managed on PTU. Conclusion: Acute kidney injury with or without the presence of nephrotic syndrome may occur during treatment with methimazole. Renal function should be closely monitored after the initiation of methimazole to prevent progressive renal dysfunction.
An imbalance in the T-helper phenotypes displayed by senescent CD4+CD28null T cells is associated with erosive arthritis (rhupus syndrome) in systemic lupus erythematosus
Authors: Lozada-Navarro A C , Castillo-Martínez D , Moreno-Ramírez M , Acosta-Peña G , Páez A , Massó F , Márquez-Velasco R , Amezcua-Guerra L M 
Published: August 2018

Objective The objective was to assess the proportion of Th1, Th2 and Th17 phenotypes in senescent CD4+CD28null cells from patients with systemic lupus erythematosus (SLE) and its association with the pattern of joint involvement. Methods This cross-sectional study was performed in SLE patients with erosive arthritis (rhupus) or nondeforming, nonerosive arthritis. Total CD4+CD28null cells as well as the proportion of these cells expressing T-bet, GATA3 or RORγt were analyzed by color-flow cytometry. Serum osteopontin levels were measured by ELISA. Results Eighteen SLE patients (nine with rhupus and nine with nonerosive arthritis) were studied. The percentage of CD4+CD28null/CD4+ cells (17.7%, 10.3–25.0% versus 9.4%, 8.1–22.4%; P = 0.386) as well as the osteopontin levels (5800, 5,134–5995 pg/ml versus 5578, 5171–5717 pg/ml; P > 0.05) were similar in both groups. A higher percentage of CD4+CD28nullT-bet+ cells (42.8%, 33.5–53.4% versus 30.0%, 23.3–34.2%) but a lower percentage of CD4+CD28nullGATA3+ cells (3.1%, 1.7–5.6% versus 6.2%, 2.6–18.4%) was observed in patients with rhupus than in their counterparts ( P = 0.016). The frequency of CD4+CD28nullRORγt+ cells was similar between groups. Conclusions In patients with rhupus, senescent CD4+CD28null cells are preferentially polarized to a Th1 phenotype, whereas this is partial towards Th2 in lupus patients with a nonerosive arthritis pattern.
What Can We Learn from Global and Regional Rankings of Countries?
Authors: Aytug Huseyin , Law Siong Hook , Singh Nirvikar 
Published: August 2018

We use principal component analysis (PCA) to extract the essential information contained in 10 different country rankings, measuring different country characteristics such as GDP per capita, human development, quality of governance, environmental quality and business environment. Globally, the first principal component accounts for about 82 per cent of the variation across countries, and the first three principal components account for over 92 per cent. The percentages are similar for regions such as Europe, North America and Asia, but lower for South America and Africa, but even in the last of these regions, the first three principal components account for 86 per cent of the variation. Excluding GDP per capita does not change our results appreciably. The analysis suggests that various different indices may add relatively little new information to more basic measures of development. Regional comparisons suggest that Asia’s economic structures, as implied by the rankings, may be closer to those of Europe and North America than South America and Africa. JEL Codes: C38, O1, O57
The association between post-traumatic stress disorder and coronary artery disease: a meta-analysis
Authors: Akosile Wole , Colquhoun David , Young Ross , Lawford Bruce , Voisey Joanne 
Published: August 2018

Objectives: There are some psychosocial factors that have similar importance to biological factors in the genesis of coronary diseases. However, reasons for high rates of coronary heart disease in individuals with post-traumatic stress disorder (PTSD) are yet to be fully elucidated. Using a meta-analysis, we investigated the longitudinal relationship between PTSD and coronary heart disease (CHD) as an independent factor in the aetiology of CHD. Methods: The databases of Medline, EBSCOhost and Psychoinfo were electronically searched for relevant articles. Results: The pooled hazard ratio (HR) for the magnitude of the relationship between PTSD and CHD was an HR of 1.61, and p-value of p < 0.0005, 95% confidence interval (CI) [1.46–1.77] before adjustment for depression in nine studies ( N = 151,144) that met inclusion criteria. The HR estimates for the seven depression-adjusted estimates was 1.46, and a p-value of p < 0.0005, 95% CI[0.26–1.69]. Conclusions: This study demonstrates an association between CHD and PTSD.
Amino Acid Profile of Synovial Fluid Following Intra-articular Ankle Fracture
Authors: Leimer Elizabeth M. , Tanenbaum Laura M. , Nettles Dana L. , Bell Richard D. , Easley Mark E. , Setton Lori A. , Adams Samuel B. 
Published: August 2018

Background: Post-traumatic osteoarthritis (PTOA) is a frequent complication in patients with a previous traumatic joint injury, and the pathophysiology is not well understood. The goal of this study was to characterize the biochemical signature of amino acids, peptides, and amino acid metabolites in ankle synovial fluid following intra-articular fracture. Methods: Synovial fluid from both the injured and contralateral ankles of 19 patients with an intra-articular ankle fracture was obtained and analyzed via metabolic profiling. Follow-up analysis was performed after 6 months in 7 of these patients. Results: Statistical comparisons between injured and contralateral ankles revealed that 19 of the 66 measured amino acids, peptides, and amino acid metabolites were significantly elevated at time of fracture. Metabolites associated with glutathione metabolism exhibited the most elevated mean-fold changes, indicating a possible role for oxidative stress in fractured ankles. None of the metabolites elevated at baseline were significantly elevated after 6 months, but 6 metabolites had mean-fold changes greater than 2.1 at this time point. Multiple metabolites also exhibited significant correlations ( r > 0.575) with matrix metalloproteinase-1 and -9. Conclusion: These results indicate the presence of amino acid metabolic products in the setting of ankle fracture and suggest that these changes in amino acid metabolism may be chronic and indicate a role for inflammation and collagen degradation in disease progression. Clinical Relevance: Changes in amino acid metabolism following intra-articular fracture may contribute to the progression to PTOA. This knowledge may allow for the identification and early treatment of patients at risk of developing PTOA. Level of Evidence: Level III, comparative series.
Safety and tolerability of lifitegrast ophthalmic solution 5.0%: Pooled analysis of five randomized controlled trials in dry eye disease
Authors: Nichols Kelly K , Donnenfeld Eric D , Karpecki Paul M , Hovanesian John A , Raychaudhuri Aparna , Shojaei Amir , Zhang Steven 
Published: August 2018

Purpose: Characterize the safety and tolerability of lifitegrast ophthalmic solution 5.0% for the treatment of dry eye disease. Methods: Pooled data from five randomized controlled trials were analyzed. Key inclusion criteria were adults with dry eye disease (Schirmer tear test score ⩾1 and ⩽10 mm, eye dryness score ⩾40 (visual analog scale 0–100), corneal staining score ⩾2.0 (0–4 scale)). Participants were randomized to lifitegrast ophthalmic solution 5.0% or placebo twice daily for 84 or 360 days. Treatment-emergent adverse events and drop comfort scores were assessed. Results: Overall, 2464 participants (lifitegrast, n = 1287; placebo, n = 1177) were included. Ocular treatment-emergent adverse events occurring in >5% in either group were instillation site irritation (lifitegrast, 15.2%; placebo, 2.8%), instillation site reaction (lifitegrast, 12.3%; placebo, 2.3%), and instillation site pain (lifitegrast, 9.8%; placebo, 2.1%); the most common (> 5%) nonocular treatment-emergent adverse event was dysgeusia (lifitegrast, 14.5%; placebo, 0.3%). The majority of treatment-emergent adverse events were mild to moderate in severity. Discontinuation due to treatment-emergent adverse events occurred in 7.0% (lifitegrast) versus 2.6% (placebo) of participants (ocular: 5.5% vs 1.5%; nonocular: 1.9% vs 1.1%). Drop comfort scores with lifitegrast improved within 3 min of instillation and the score at 3 min improved across visits (12-week trials (both eyes, day 84 vs 0): 2.0 vs 3.3; SONATA (day 360 vs 0): right eye, 1.2 vs 1.7; left eye, 1.2 vs 1.8). Conclusion: Lifitegrast ophthalmic solution 5.0% appeared to be safe and well tolerated for the treatment of dry eye disease. Drop comfort with lifitegrast improved within 3 min of instillation.
Nurse performed peripheral intravenous catheter first time insertion success in pediatric patients in Bhutan: An observational study
Authors: Choden Jigme , Carr Peter J , Brock Aleisha R , Esterman Adrian 
Published: August 2018

Introduction: Peripheral intravenous catheter insertion is a clinical procedure commonly performed by nurses for pediatric patients in Bhutan. This study describes peripheral intravenous catheter first attempt success and factors associated with such insertions. Methods: A cross-sectional survey was conducted from October 2016 to March 2017, comprised of a national sample of the Bhutan pediatric patient population (0–12 years). We collected data on peripheral intravenous catheter first time insertion success rate of admitted pediatric patients, to identify predictors of a successful first time attempt. Clustered log binomial generalized linear models were used to obtain the prevalence of first time attempt success and predictors of success. Results: The prevalence rate of successful first time attempt adjusted for clustering was 64% (95% confidence interval: 51%–80%). Predictors of a successful first time attempt were older patient age, lighter skin color, the vein being visible with a tourniquet, and the left hand being used for insertion. A transilluminator was used in 52 patients, and the peripheral intravenous catheter was eventually successfully placed in 82% of the patients. Discussion: Our first time successful cannulation rate is substantially lower than that found in similar studies in other countries. Considering the impact a peripheral intravenous catheter has on patients’ clinical outcomes and cost implications, reducing the number of failed attempts should be of high importance. Better education and simulation, combined with the adoption of vessel locating technology, are required to improve insertion practice in Bhutan. This could lead to greater efficiency of the health facilities in Bhutan.
Lack of short-chain fatty acids and overgrowth of opportunistic pathogens define dysbiosis of neuromyelitis optica spectrum disorders: A Chinese pilot study
Authors: Gong Junli , Qiu Wei , Zeng Qin , Liu Xiyuan , Sun Xiaobo , Li Huijuan , Yang Yu , Wu Aimin , Bao Jian , Wang Yuge , Shu Yaqing , Hu Xueqiang , Bellanti Joseph A , Zheng Song Guo , Lu Yongjun , Lu Zhengqi 
Published: August 2018

Background: Intestinal microbiota is an important environmental factor in the initiation and progression of autoimmune diseases. However, investigations on the gut microbiome in neuromyelitis optica spectrum disorders (NMOSD) are relatively insufficient, especially for that of the Asia population. Objectives: To evaluate whether or not the intestinal microbiota of NMOSD patients had specific microbial signatures. Methods: Next-generation sequencing and gas chromatography were employed to compare the fecal microbial composition and short-chain fatty acids (SCFAs) spectrum between patients with NMOSD ( n = 84) and healthy controls ( n = 54). Results: The gut microbial composition of NMOSD distinguished from healthy individuals. Streptococcus, significantly increased in NMOSD, is positively correlated with disease severities ( p < 0.05). The use of immunosuppressants results in a decrease of Streptococcus, suggesting that Streptococcus might play a significant role in the pathogenesis of NMOSD. A striking depletion of fecal SCFAs was observed in NMOSD patients ( p < 0.0001), with acetate and butyrate showing significantly negative correlation with disease severities ( p < 0.05). Conclusion: The fecal organismal structures and SCFAs level of patients with NMOSD were distinctive from healthy individuals. These findings not only could be critical events driving the aberrant immune response responsible for the pathogenesis of these disorders but could also provide suggestions for disease therapy.
A nationwide epidemiological study on the prevalence of multiple sclerosis and neuromyelitis optica spectrum disorder with important multi-ethnic differences in Malaysia
Authors: Viswanathan Shanthi , Wah Lee Mei 
Published: August 2018

Objectives: This study looked at observed crude prevalence/incidence of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) in Malaysia and identified any inter-ethnic differences for MS/NMOSD. Methods: This was a nationwide tertiary hospital–based retrospective cross-sectional study using the capture–recapture method. It looked at the estimated crude prevalence of confirmed MS and NMOSD and annual incidence on 29 December 2017. Recapture of data was done between February and March 2018 on 1 March 2018. Public and referring private institutions were accessed. Results: The survey identified 767 MS and 545 NMOSD subjects, with crude prevalence rates of 2.73 per 100,000 (95% confidence interval (CI): 2.53; 2.92 per 100,000 population) and 1.94 per 100,000 (95% CI: 1.77; 2.10 per 100,000 population) with observed crude annual incidence of 0.55 (95% CI: 0.43; 0.58) for MS and 0.39 per 100,000 (95% CI: 0.35; 0.47) for NMOSD. The MS:NMOSD ratios were 1.4:1.0. The capture–recapture method revealed 913 MS (95% CI: 910; 915.9) and 580 (95% CI: 578.8; 581.2) NMOSD with prevalence per 100,000 of 3.26 (95% CI: 3.05; 3.47) and 2.07 (95% CI: 1.90; 2.24), respectively. In the MS group, 59.4% were Malay, 16.6% Chinese, 20.5% Indian, and 3.5% were from indigenous groups. In the NMOSD group, 47.3% were Malay, 46.9% Chinese, 3.5% Indian, and 2.3% were from other indigenous groups. The ratio of NMOSD to MS among the Chinese was 2:1, but the ratio of MS to NMOSD among the Malays was 1.8:1, and that in Indians was 8.3:1. Conclusion: There is a modest increase in the prevalence of MS and NMOSD in Malaysia with inter-ethnic differences for MS/NMOSD.
Prognostic value of cerebrospinal fluid neurofilament light chain and chitinase-3-like-1 in newly diagnosed patients with multiple sclerosis
Authors: Sellebjerg Finn , Royen Lydia , Soelberg Sørensen Per , Oturai Annette Bang , Jensen Poul Erik Hyldgaard 
Published: August 2018

Background: Neurofilament light chain (NFL) and chitinase-3-like-1 (CHI3L1) concentrations in cerebrospinal fluid (CSF) may have prognostic value in clinically isolated syndromes (CIS) and relapsing–remitting multiple sclerosis (RRMS). Objectives: To compare the prognostic value of CSF concentrations of NFL and CHI3L1 in newly diagnosed CIS and RRMS patients. Methods: NFL and CHI3L1 were measured in CSF in 177 newly diagnosed patients with CIS or RRMS who were followed clinically for a mean of 5.7 years. Results: At baseline CSF concentrations of NFL correlated with CSF concentrations of CHI3L1, relapses in the previous year, time from last relapse, and the Expanded Disability Status Scale (EDSS) score. CSF concentrations of NFL and CHI3L1 were both associated with increased relapse risk during the first 2 years in univariate analyses, but only the CSF concentration of NFL was independently associated with relapse risk in a multivariable analysis. There was no relationship between CSF concentrations of NFL or CHI3L1 and risk of conversion to secondary progressive MS or development of disability. Conclusion: CSF concentrations of NFL are associated with 2-year relapse risk but not with disease progression or clinical worsening in newly diagnosed CIS and RRMS patients. This may be due to confounding by the effect of disease-modifying therapies.
Morton’s Neuroma Excision: What Are We Really Doing? Which Retractor Is Superior?
Authors: Pinter Zachariah , Odom Christopher , McGee Andrew , Paul Kyle , Huntley Samuel , Johnson John L. , Shah Ashish 
Published: August 2018

Background: When using a dorsal approach for Morton’s neuroma excision, the most common complication is recurrent Morton’s neuroma. The present cadaveric study demonstrates how far proximally the nerve is resected during a dorsal approach and examines both the laminar spreader and Gelpiretractor to determine which instrument facilitates maximal proximal resection of the nerve. Methods: This study involved 12 fresh-frozen cadaver specimens, each of which underwent a dorsal approach to the interdigital nerve with proximal resection. Either a laminar spreader or a Gelpi retractor was used to improve visualization of the intermetatarsal space. The interdigital nerve was then resected, and the lengths of the cut nerves were compared based on the retractor employed. Results: The mean length of proximal resection in the second intermetatarsal space was 2.42 cm when using the laminar spreader and 1.93 cm when using the Gelpi retractor (P = .252). In the third intermetatarsal space, the mean length of proximal resection was 2.14 cm when using the Laminar spreader and 1.48 cm when using the Gelpi retractor (P = .166). Conclusion: This study demonstrates how far proximal the interdigital nerve is resected during a dorsal approach to Morton’s neuroma and shows no statistically significant difference between the Laminar spreader and the Gelpi retractor. Levels of Evidence: Level V: Cadaver study