bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical topographical anatomy of the gastro-oesophageal junction in the cat
Authors: Voutsinou Agni , Papazoglou Lysimachos G , Antonopoulos Ioannis , Rallis Timoleon S 
Published: May 2017

Objectives The purpose of the present study was to describe histologically the gastro-oesophageal junction in the cat and interrelationships of this region. Our hypothesis was that cats are devoid of abdominal oesophagus. Methods Three centimetres of the terminal oesophagus, the phreno-oesophageal membrane with 1–2 cm margins of the diaphragmatic crural muscle and the proximal 3 cm of the gastric cardia were obtained from nine domestic shorthair cats and one domestic longhair cat that were euthanased for reasons other than digestive tract pathology. Longitudinal samples were examined histologically. Evaluated parameters included the location of the phreno-oesophageal membrane with reference to the transition between the oesophageal and gastric mucosa, the thickness of the circumferential smooth muscle of the muscular layer of the distal oesophagus at points 3 mm and 6 mm cranial to the mucosa transition, and the thickness of the circumferential smooth muscle layer at the mucosa transition level. Median differences in the thickness of the smooth muscle layer were compared by performing non-parametric statistical analysis using the Mann–Whitney U-test. Results The transition of the oesophageal to gastric mucosa was abrupt and corresponded to the point of insertion of the phreno-oesophageal membrane at the diaphragm level in all cats. The mean thickness of the circumferential smooth muscle layer at the point of oesophageal to gastric mucosa transition was significantly greater than the mean thickness of the oesophageal circumferential smooth muscle layer at 3 mm and 6 mm cranial to the mucosa transition ( P ⩽0.05). The increased muscle thickness at the gastro-oesophageal junction correlates with the accepted location of the high-pressure zone, reflecting the caudal oesophageal sphincter. It seems that the whole oesophagus was situated within the thoracic rather than the abdominal cavity. Conclusions and relevance No distinct abdominal oesophagus was observed in nine domestic shorthair cats and one domestic longhair cat. These findings might have implications for the pathophysiology of hiatal hernia in cats.
The Plasminogen Activator Inhibitor 1 4G/5G Polymorphism and the Risk of Alzheimer’s Disease
Authors: Fekih-Mrissa Najiba , Mansour Malek , Sayeh Aicha , Bedoui Ines , Mrad Meriem , Riahi Anis , Mrissa Ridha , Nsiri Brahim 
Published: May 2017

Objective:The aim of this study was to determine whether plasminogen activator inhibitor 1 (PAI-1) is associated with the risk of Alzheimer’s disease (AD) in Tunisian patients.Design and Methods:We analyzed the genotype and allele frequency distribution of the PAI-1 polymorphism in 60 Tunisian patients with AD and 120 healthy controls.Results:The results show a significantly increased risk of AD in carriers of the 4G/4G and 4G/5G genotypes versus the wild-type 5G/5G genotype (4G/4G: 28.33% in patients vs 10.0% in controls; P < 10−3; OR = 8.78; 4G/5G: 55.0% in patients vs 38.33% in controls; OR = 4.45; P < 10−3). The 4G allele was also more frequently found in patients compared with controls; P < 10−3; OR = 3.07. For all participants and by gender, homozygotic carriers (4G/4G) were at an increased risk of AD over heterozygotes and women were at an increased risk over their male genotype counterparts. The odds ratio for AD among 4G/4G carriers for any group was approximately twice that of heterozygotes in the same group. Women homozygotes ranked highest for AD risk (OR = 20.8) and, in fact, women heterozygotes (OR = 9.03) ranked higher for risk than male homozygotes (OR = 6.12).Conclusion:These preliminary exploratory results should be confirmed in a larger study.
Seven-year survival analysis of the Global® CAP® (Conservative Anatomic Prosthesis) shoulder resurfacing
Authors: Ingoe Helen , Holland Philip , Tindall Emma , Liow Raymond , Mcvie James L , Rangan Amar 
Published: May 2017

Background Shoulder resurfacings represent approximately one-third of shoulder arthroplasties and have the highest revision rates of any shoulder arthroplasty. We present a survival analysis of the Global CAP hemi-resurfacing implanted by multiple surgeons with up to 10 years of follow-up. Methods A life-table survival analysis of the Global CAP hemi-resurfacing was undertaken in a single site with multiple surgeons. Two survival analyses were performed; first, where failure was defined as component exchange and, second, where failure was defined as re-operation for any reason. Postoperative functional outcome was quantified using the Quick Disability Arm Hand and Shoulder Score (Quick DASH) and Oxford Shoulder Score (OSS). Results Eighty-seven Global CAPs were implanted in 75 patients. At a mean (SD) follow-up of 5.4 years (2.5 years) (range 0.9 years to 10 years), five patients had revision surgery and three patients underwent a reoperation for any reason. Survival at year 7 with component exchange as the endpoint was 80% (95% confidence interval = 93 to 65) and survival with re-operation for any reason as the end point was 62% (95% confidence interval = 82 to 50). The mean OSS and Quick DASH were 35 and 27.6, respectively. Conclusions The Global CAP has similar survivorship in the short to medium term and produces similar clinical outcomes compared to other shoulder resurfacings.
Can we improve the outcome of hydrodilatation for adhesive capsulitis?
Authors: Haughton David N. , Barton Simon , Meenan Erin , Mehan Rakesh , Wykes Philip , Warner James , Mulgrew Emma 
Published: May 2017

Background Hydrodilatation (HD) has been shown to improve pain and function in patients with adhesive capsulitis (AC). There is no consensus concerning how HD should be performed or what volume should be injected. It has distinct advantages compared to surgery; however, it is a painful procedure and is often poorly tolerated. Methods We retrospectively reviewed all patients referred for HD over a 2.5-year period aiming to assess whether volume injected influences outcome. Results There were 107 patients treated with HD; of these, 76 (43 female, 32 male) had full data for analysis. The majority were classified as primary AC ( n = 57) with an average age of 55.5 years. The mean improvement in Oxford Shoulder Score (OSS) was 12.1, with females (13.9) and post-traumatic cases of AC (14.1) demonstrating the best outcome. No complications were observed during the HD process. There was a negative correlation observed between volume injected and OSS improvement. Only two patients experienced a poor outcome and required further treatment with manipulation +/– arthroscopic arthrolysis. Conclusions The present study supports the use of HD as a first line treatment for AC regardless of the underlying cause, and also demonstrates that the volume injected does appear to influence the outcome.
Dose Unit Establishment for a New Basal Insulin Using Joint Modeling of Insulin Dose and Glycemic Response
Authors: Qu Yongming , Luo Junxiang , Garhyan Parag , Antalis Caryl J. , Chang Annette M. , Jacober Scott J. 
Published: May 2017

Background: For new insulin analogs with properties that vary from human insulin, defining activity in units of human insulin based on glycemic lowering efficacy may be challenging. Here we present a new method that can be used to quantify a unit dose of an experimental insulin when the traditional euglycemic clamp method is not adequate. Methods: Joint modeling of insulin dose and the glycemic outcome variable hemoglobin A1c (HbA1c), where both were response variables, was used to evaluate insulin unit potency for basal insulin peglispro (BIL). The data were from the Phase 3 program for BIL, which included greater than 5500 patients with type 1 or type 2 diabetes who were treated for 26 or 52 weeks with BIL or a comparator insulin. Both basal-bolus and basal insulin only studies were included, and some type 2 diabetes patients were insulin-naïve. Results: The analysis showed that 1 unit of BIL, composed of 9 nmol of active ingredient, had similar or slightly greater potency compared to 1 unit insulin glargine or NPH insulin for all populations. Conclusions: Despite some limitations, the joint modeling of HbA1c and insulin dose provides a reasonable approach to estimate the relative potency of a new basal insulin versus an established basal insulin.
Etiological factors of short stature in children and adolescents: experience at a tertiary care hospital in Egypt
Authors: Hussein Almontaser , Farghaly Hekma , Askar Eman , Metwalley Kotb , Saad Khaled , Zahran Asmaa , Othman Hisham A. 
Published: May 2017

Background: Accurate anthropometric measurements and critical analysis of growth data allow the clinician to promptly recognize children with short stature. The aim of this study was to determine the frequency of etiological factors causing short stature among children referred to the pediatric endocrinology clinic of Assiut University Children’s Hospital, the main tertiary care center in Upper Egypt. Methods: We conducted this descriptive observational study from May 2012 to December 2015, to analyze 637 children (boys 354, girls 283) with short stature. Evaluation included: detailed medical history, physical examination, laboratory tests, bone age and chromosomal analysis. Results: Endocrinological causes accounted for 26% of short stature [of them, 11.8% had growth hormone deficiency (GHD)], 63.6% had normal variants of growth [of them, 42% had familial short stature (FSS), 15.8% had constitutional growth delay (CGD) and 5.5% a combination of both]. Interestingly, celiac disease (CD) constituted 6.6% of children with short stature in our cohort. Conclusions: Although potentially treatable causes such as GHD, hypothyroidism and CD accounted for a considerable percentage of short stature in our study, the majority of short stature in children had normal variations of growth. Growth hormone treatment in children, however, should be promptly initiated with specific clinical indications. CD is a not uncommon cause of short stature.
Accounting for adjuvant-induced artifacts in the characterization of vaccine formulations by polyacrylamide gel electrophoresis
Authors: Jakob Virginie , Brunner Livia , Barnier-Quer Christophe , Blust Molly , Collin Nicolas , Carter Lauren , Carter Darrick , Rausch Kelly M. , Fox Christopher B. 
Published: May 2017

Objectives: Several vaccine adjuvants comprise complex nano- or micro-particle formulations, such as oil-in-water emulsions. In order to characterize interactions and compatibility of oil-in-water emulsion adjuvants with protein antigens in vaccines, effective protein characterization methods that can accommodate potential interference from high concentrations of lipid-based particles are needed. Methods: Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) is a standard protein characterization technique which is affected by the presence of adjuvants such as oil-in-water emulsions. In this article, we investigate variations in SDS-PAGE methods that result in a reduction of adjuvant-induced staining artifacts. We have investigated whether the SDS method or the adjuvant composition were the reason for these artifacts and succeeded in reducing the artifacts with a modified sample preparation and different staining procedures. Results: The best results were obtained by using gold staining or silver staining instead of a Coomassie Blue staining procedure. Moreover, the replacement of the dilution buffer (20% SDS to disrupt emulsion) by alternative detergents such as Tween® 80 and Triton® X-100 removed adjuvant-induced streaking artifacts at the top of the gel. Conclusions: These methods may be useful for improving characterization approaches of antigen–adjuvant mixtures by SDS-PAGE.
A Cost-Effectiveness Analysis of Surgical Treatment Modalities for Chondral Lesions of the Knee: Microfracture, Osteochondral Autograft Transplantation, and Autologous Chondrocyte Implantation
Authors: Schrock John B. , Kraeutler Matthew J. , Houck Darby A. , McQueen Matthew B. , McCarty Eric C. 
Published: May 2017

Background: Numerous surgical options exist to treat chondral lesions in the knee, including microfracture (MFx), osteochondral autograft transplantation (OAT), first-generation autologous chondrocyte implantation (ACI-1), and next-generation ACI (ACI-2). Purpose: To compare the cost-effectiveness of MFx, OAT, and ACI-1. The secondary purpose of this study was to compare the functional outcomes of MFx, OAT, ACI-1, and ACI-2. Study Design: Systematic review; Level of evidence, 2. Methods: Two independent reviewers conducted an online literature search of 2 databases for level 1 and 2 studies using the Lysholm, International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), and/or Hospital for Special Surgery (HSS) Knee Score. A weighted mean difference in pre- to postoperative functional outcome score was calculated for each treatment. The mean per-patient costs associated with MFx, OAT, and ACI-1 were determined from a recent publication based on review of a national private insurance database. The cost for each procedure was then divided by the weighted mean difference in functional outcome score to give the cost-per-point change in outcome score. Results: A total of 12 studies (6 level 1, 6 level 2) met the inclusion criteria for the functional outcome analysis, including 730 knees (MFx, n = 300; OAT, n = 90; ACI-1, n = 68; ACI-2, n = 272). The mean follow-up was not significantly different between groups (MFx, 29.4 months; OAT, 38.3 months; ACI-1, 19.0 months; ACI-2, 26.7 months). The mean increase in functional outcome score was 23 for MFx, 19 for OAT, 20 for ACI-1, and 35 for ACI-2. The change in functional outcome score was significantly greater for ACI-2 when compared with all other treatments ( P < .0001). The cost-per-point change in functional outcome score was $200.59 for MFx, $313.84 for OAT, and $536.59 for ACI-1. Conclusion: MFx, OAT, ACI-1, and ACI-2 are effective surgical procedures for the treatment of cartilage defects in the knee. All 4 treatments led to an increase in functional outcome scores postoperatively with a short-term follow-up. ACI-2 had a statistically greater improvement in functional outcome scores as compared with the other 3 procedures. MFx was found to be the most cost-effective treatment option and ACI-1 the least cost-effective.
A Pilot Study for Linking Adolescent Patients to an Interactive Tobacco Prevention Program
Authors: Calabro Karen S. , Marani Salma K. , Le Thuan A. , Khalil Georges E. , Tami-Maury Irene M. , Prokhorov Alexander V. 
Published: May 2017

Context: The American Academy of Pediatrics and professional guidelines recommend intervening with adolescents about avoiding tobacco use in the health-care setting. Barriers in the clinical setting limit consistent provision of this critical service. Objectives: This pilot study compared 2 approaches for referring adolescents to an evidence-based tobacco prevention and cessation program in the outpatient setting. Secondary aims assessed tobacco use, knowledge, and program evaluation. Design, Setting, and Participants: The study setting was a medical and dental clinic. Participants aged 13 to 18 received tobacco advice and instructions to work through “A Smoking Prevention Interactive Experience.” The program addresses health concerns of adolescents about tobacco use and is founded on behavioral change theories. The link to access it is featured on the website of the National Cancer Institute’s Research-Tested Interventions. Participants (N = 197) were randomized to 1 of 2 approaches (ie, a program link via e-mail or referral by a printed card). Results: The program was accessed by 57% (112 of 197) of participants. Both referral approaches were equally effective. Non-Hispanics were twice as likely to access the program as Hispanics (adjusted odds ratio = 2.1, 95% confidence interval = 1.2-3.8, P < .05). Over 95% of participants identified themselves as nonusers of tobacco and evaluated the program as beneficial in increasing knowledge and motivation to remain tobacco-free. Conclusion: Linking adolescent patients to an evidence-based tobacco prevention/cessation program at a community health clinic was highly promising and feasible. We present conclusions for future research.
Exploring Failure of Total Shoulder Arthroplasty Systems Through Implant Retrieval, Radiographic, and Clinical Data Analyses
Authors: Moore Drew D , Moravek James E , Baker Erin A , Salisbury Meagan R , Baker Kevin C , Wiater J Michael 
Published: May 2017

Background Retrieved clinically failed anatomic total shoulder arthroplasty (TSA) components as well as associated radiographs and medical records were analyzed in order to investigate the origins of clinical failure(s) of TSA components. Methods Fifty TSA systems were retrieved from 48 patients including 27 females and 21 males; components were implanted for an average of 68 months (range, 2–267). Data obtained through radiographic analysis, medical records review, and damage mode analysis of each component were performed and statistically analyzed. Results Significant correlations were found between glenoid loosening and preoperative pain ( r = 1.00, P < .001), humeral stem scratching and humeral loosening (Zone 1: r = .60, P < .01; Zone 2: r = .45, P = .03; Zone 3: r = .45, P = .03) , as well as glenoid damage and rotator cuff tears ( r = .36, P = .02). Discussion Wear and damage of the glenoid and humeral components, which may result from rotator cuff tearing, may lead to accelerated loosening, clinical failure, and early revision arthroplasty. Improved implant design and/or surgical indications may improve implant performance, thereby reducing the incidence of implant damage and wear, and result in improved clinical outcomes.
Invariant NKT cells contribute to chronic lymphocytic leukemia surveillance and prognosis
Authors: Gorini Francesca , Azzimonti Laura , Delfanti Gloria , Scarfò Lydia , Scielzo Cristina , Bertilaccio Maria Teresa , Ranghetti Pamela , Gulino Alessandro , Doglioni Claudio , Di Napoli Arianna , Capri Miriam , Franceschi Claudio , Caligaris-Cappio Federico , Ghia Paolo , Bellone Matteo , Dellabona Paolo , Casorati Giulia , de Lalla Claudia 
Published: May 2017

Key Points
iNKT cells control CLL progression in both mice and patients and this inversely correlates with CD1d expression by leukemia cells. Human iNKT cells indirectly hinder CLL survival by restraining proleukemia monocyte-derived nurse-like cells.
Endogenous hepcidin and its agonist mediate resistance to selected infections by clearing non–transferrin-bound iron
Authors: Stefanova Deborah , Raychev Antoan , Arezes Joao , Ruchala Piotr , Gabayan Victoria , Skurnik Mikael , Dillon Barbara J. , Horwitz Marcus A. , Ganz Tomas , Bulut Yonca , Nemeth Elizabeta 
Published: May 2017

Key PointsIn mouse models, hepcidin participates in innate immunity by controlling NTBI. NTBI-dependent infections can be treated with hepcidin agonists in mouse models of hereditary hemochromatosis or parenteral iron overload.
Cognitive impairment in COPD: should cognitive evaluation be part of respiratory assessment?
Authors: Andrianopoulos Vasileios , Gloeckl Rainer , Vogiatzis Ioannis , Kenn Klaus 
Published: May 2017

Cognitive impairment is highly prevalent in patients with COPD and demonstrates multiple detrimental effects on many aspects of patient state and therapeutic outcomes. It is attributed to several overlapping pathophysiological factors, with the most common being the low level of oxygen saturation due to respiratory insufficiency. Despite the impact of cognitive impairment on clinical outcomes, the screening for coexisting cognitive deficits which may interfere with the successful progress of respiratory treatment is yet neglected. There is a special consideration that cognitive deficits should be taken into account when developing respiratory therapy plans. Cognitively impaired patients are likely to require more support and have need of an individualised respiratory care plan which can also be beneficial for their cognitive deficits. Pulmonary rehabilitation as a multidisciplinary approach could be prioritised for COPD patients with cognitive impairment.Educational aimsTo illustrate the common signs of cognitive impairment and define potential associations between lung and cognitive dysfunction.To illustrate the potential influence of cognitive deficits on the optimal progress of respiratory therapy.To illustrate the importance of cognitive evaluation as part of a comprehensive clinical assessment for patients suspected of suffering cognitive impairment.
Long-Term Follow-Up of the Intergroup Exemestane Study
Authors: Morden James P. , Alvarez Isabel , Bertelli Gianfilippo , Coates Alan S. , Coleman Robert , Fallowfield Lesley , Jassem Jacek , Jones Stephen , Kilburn Lucy , Lønning Per E. , Ortmann Olaf , Snowdon Claire , van de Velde Cornelis , Andersen Jørn , Del Mastro Lucia , Dodwell David , Holmberg Stig , Nicholas Hanna , Paridaens Robert , Bliss Judith M. , Coombes R. Charles 
Published: May 2017

Purpose The Intergroup Exemestane Study, an investigator-led study of 4,724 postmenopausal patients with early breast cancer (clinical trial information: ISRCTN11883920), has previously demonstrated that a switch from adjuvant endocrine therapy after 2 to 3 years of tamoxifen to exemestane was associated with clinically relevant improvements in efficacy. Here, we report the final efficacy analyses of this cohort. Patients and Methods Patients who remained disease free after 2 to 3 years of adjuvant tamoxifen were randomly assigned to continue tamoxifen or switch to exemestane to complete a total of 5 years of adjuvant endocrine therapy. Given the large number of non–breast cancer–related deaths now reported, breast cancer–free survival (BCFS), with censorship of intercurrent deaths, was the primary survival end point of interest. Analyses focus on patients with estrogen receptor-positive or unknown tumors (n = 4,599). Results At the time of the data snapshot, median follow-up was 120 months. In the population that was estrogen receptor positive or had unknown estrogen receptor status, 1,111 BCFS events were observed with 508 (22.1%) of 2,294 patients in the exemestane group and 603 (26.2%) of 2,305 patients in the tamoxifen group. The data corresponded to an absolute difference (between exemestane and tamoxifen) at 10 years of 4.0% (95% CI, 1.2% to 6.7%), and the hazard ratio (HR) of 0.81 (95% CI, 0.72 to 0.92) favored exemestane. This difference remained in multivariable analysis that was adjusted for nodal status, prior use of hormone replacement therapy, and prior chemotherapy (HR, 0.80; 95% CI, 0.71 to 0.90; P < .001). A modest improvement in overall survival was seen with exemestane; the absolute difference (between exemestane and tamoxifen) at 10 years in the population that was estrogen receptor positive or had unknown estrogen receptor status was 2.1% (95% CI, −0.5% to 4.6%), and the HR was 0.89 (95% CI, 0.78 to 1.01; P = .08). For the intention-to-treat population, the absolute difference was 1.6% (95% CI, −0.9% to 4.1%); the HR was 0.91 (95% CI, 0.80 to 1.03, P = .15). No statistically significant difference was observed in the proportion of patients who reported a fracture event in the post-treatment period. Conclusion The Intergroup Exemestane Study and contemporaneous studies have established that a strategy of switching to an aromatase inhibitor after 2 to 3 years of tamoxifen can lead to sustained benefits in terms of reduction of disease recurrence and breast cancer mortality.