bluuebunny/crossref_metadata_2025_split huggingface dataset:
Return to Sport and Performance After Anterior Cruciate Ligament Reconstruction in National Football League Linemen
Authors: Cinque Mark E. , Hannon Charles P. , Bohl Daniel D. , Erickson Brandon J. , Verma Nikhil N. , Cole Brian J. , Bach Bernard R. 
Published: June 2017

Background: Tears of the anterior cruciate ligament (ACL) are common in the National Football League (NFL). The impact of these injuries on the careers of NFL linemen is unknown. Purpose: To define the percentage of NFL linemen who return to sport (RTS) after ACL reconstruction, the mean time to RTS, and the impact on performance compared with matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: Data on NFL offensive and defensive linemen who sustained an ACL tear and underwent ACL reconstruction between 1980 and 2015 were analyzed. Players were identified through NFL team websites, publicly available injury reports, player profiles, and press releases. Demographics and mean in-game performance data preinjury and post–ACL reconstruction were recorded. A player was deemed to have returned to sport if he played in at least 1 NFL game after his ACL reconstruction. A healthy control group was selected to compare in-game performance data and was matched with the study group on several parameters. Results: Overall, 73 NFL linemen met the inclusion criteria; 47 (64.3%) returned to play after ACL reconstruction (62.5% of offensive linemen, 65.9% of defensive linemen). All offensive linemen successfully returned to play the season after injury. No difference existed in number of seasons, total number of games played, mean number of games played, or mean number of games started per season when offensive linemen who RTS after ACL reconstruction were compared with matched controls (all P > .05). Among defensive linemen who RTS, most returned the season after injury (88.9%). There was no difference between defensive linemen who RTS after ACL reconstruction and matched controls in any performance metrics as an average over the remainder of their career (all P > .05). However, NFL defensive linemen who tore their ACL played fewer total seasons than matched controls ( P = .020). Conclusion: Overall, 64.3% of NFL offensive and defensive linemen who undergo ACL reconstruction returned to play. Linemen who RTS do so at a high level, with no difference in in-game performance or career duration when compared with matched controls.
Critical elements in non-sulfide Zn deposits: a reanalysis of the Kabwe Zn-Pb ores (central Zambia)
Authors: Mondillo N. , Herrington R. , Boyce A. J. , Wilkinson C. , Santoro L. , Rumsey M. 
Published: June 2017

ABSTRACTThe Kabwe Zn-Pb deposit (central Zambia) consists of a cluster of mixed sulfide and non-sulfide orebodies. The sulfide ores comprise sphalerite, galena, pyrite, chalcopyrite and accessory Ge-sulfides (±Ga and In). The non-sulfide ores comprise: (1) willemite-dominated zones encasing massive sulfide orebodies and (2) oxide-dominated alteration bands, overlying both the sulfide and Zn-silicate orebodies. This study focuses on the Ge, In and Ga distribution in the non-sulfide mineralization, and was carried out on a suite of Kabwe specimens, housed in the Natural History Museum Ore Collection (London). Petrography confirmed that the original sulfides were overprinted by at least two contrasting oxidation stages dominated by the formation of willemite (W1 and W2), and a further event characterized by weathering-related processes. Oxygen isotopic analyses have shown that W1 and W2 are unrelated genetically and furthermore not related to supergene Zn-Pb-carbonates in the oxide-dominated assemblage. The δ18O composition of 13.9–15.7‰ V-SMOW strongly supports a hydrothermal origin for W1. The δ18O composition of W2 (−3.5‰ to 0‰ V-SMOW) indicates that it precipitated from groundwaters of meteoric origin in either a supergene or a low-T hydrothermal environment. Gallium and Ge show a diversity of distribution among the range of Zn-bearing minerals. Gallium has been detected at the ppm level in W1, sphalerite, goethite and hematite. Germanium occurs at ppm levels in W1 and W2, and in scarcely detectable amounts in hemimorphite, goethite and hematite. Indium has low concentrations in goethite and hematite. These different deportments among the various phases are probably due to the different initial Ga, In and Ge abundances in the mineralization, to the different solubilities of the three elements at different temperatures and pH values, and finally to their variable affinities with the various minerals formed.
GATA2 haploinsufficiency accelerates EVI1-driven leukemogenesis
Authors: Katayama Saori , Suzuki Mikiko , Yamaoka Ayaka , Keleku-Lukwete Nadine , Katsuoka Fumiki , Otsuki Akihito , Kure Shigeo , Engel James Douglas , Yamamoto Masayuki 
Published: June 2017

Key Points
Leukemic cells in an inv(3)(q21q26) EVI1 misexpression mouse model are able to differentiate toward myeloid lineage. Gata2 heterozygous deletion accelerates EVI1 misexpression leukemia by inducing a proliferation and differentiation defect in leukemia cells.
A novel recombinant human thrombopoietin therapy for the management of immune thrombocytopenia in pregnancy
Authors: Kong Zhangyuan , Qin Ping , Xiao Shan , Zhou Hai , Li Hong , Yang Renchi , Liu Xiaofan , Luo Jianmin , Li Zhichun , Ji Guochao , Cui Zhongguang , Bai Yusheng , Wu Yuxia , Shao Linlin , Peng Jun , Ma Jun , Hou Ming 
Published: June 2017

Key PointsrhTPO is a potentially effective and safe treatment option for ITP during pregnancy.
The impact of blood glucose on community-acquired pneumonia: a retrospective cohort study
Authors: Jensen Andreas Vestergaard , Egelund Gertrud Baunbæk , Andersen Stine Bang , Trier Petersen Pelle , Benfield Thomas , Faurholt-Jepsen Daniel , Rohde Gernot , Ravn Pernille 
Published: June 2017

Hyperglycaemia is common in patients with community-acquired pneumonia (CAP) and is a predictor of severe outcomes. Data are scarce regarding whether this association is affected by diabetes mellitus (DM) and also regarding its importance for severe outcomes in hospital. We determined the impact of blood glucose on severe outcomes of CAP in hospital.We studied 1318 adult CAP patients hospitalised at three Danish hospitals. The association between blood glucose and DM status and severe clinical outcome (admission to an intensive care unit (ICU) and/or in-hospital mortality) was assessed by logistic regression. Models were adjusted for CURB-65 score and comorbidities.12% of patients had DM. In patients without DM an increase in admission blood glucose was associated with risk for ICU admittance (OR 1.25, 95% CI 1.13–1.39), but not significantly associated with in-hospital mortality (OR 1.10, 95% CI 0.99–1.23). In patients with DM an increase in admission blood glucose was not associated with ICU admittance (OR 1.05, 95% CI 1.00–1.12) or in-hospital mortality (OR 1.05, 95% CI 0.99–1.12).An increase in admission blood glucose (only in patients without DM) was associated with a higher risk for ICU admittance and a trend towards higher in-hospital mortality. DM was not associated with a more severe outcome of CAP.
Corticosteroid-resistant inflammatory signalling inPseudomonas-infected bronchial cells
Authors: Mizutani Mirai , Bérubé Julie , Ahlgren Heather G. , Bernier Joanie , Matouk Elias , Nguyen Dao , Rousseau Simon 
Published: June 2017

Decreasing the inflammatory response that leads to tissue damage during cystic fibrosis (CF) lung disease has been a long-standing goal of CF therapy. While corticosteroids are widely used anti-inflammatory drugs, their efficacy in CF lung disease remains debated. The complex interaction between the colonising bacteria and the host environment may impact corticosteroid responsiveness.In this study, sputum samples from adult CF patients were collected at baseline and during pulmonary exacerbation episodes. Lung function measurements and sputum microbiological analyses were performed. In parallel, the inflammatory response and corticosteroid sensitivity of airway epithelial cells toPseudomonas-derived exoproducts was investigated.We report that adult CF patients colonised with mucoidPseudomonas aeruginosahave higher levels of baseline inflammation, more frequent exacerbations and worse lung function compared with patients colonised with nonmucoidP. aeruginosa. Moreover, mucoidP. aeruginosaactivates NF-κBviaToll-like receptor (TLR) 2, which acts in an additive manner to TLR5 to drive inflammation in airway epithelial cells. Furthermore, TLR2-mediated intracellular signalling is more resistant to the anti-inflammatory effects of corticosteroid when compared with other TLR signalling pathways.Overall, these results suggest that airway inflammation triggered by mucoidP. aeruginosais less responsive to the anti-inflammatory action of corticosteroids. Whether this translates into a diminished response of CF patients to corticosteroid therapy should be examined in future clinical studies.
Up-regulation of EP2 and EP3 receptors in human tolerogenic dendritic cells boosts the immunosuppressive activity of PGE2
Authors: Flórez-Grau Georgina , Cabezón Raquel , Borgman Kyra J E , España Carolina , Lozano Juan Jose , Garcia-Parajo Maria F , Benítez-Ribas Daniel 
Published: June 2017

Abstract
Dendritic cells (DCs) are APCs essential in regulating the immune response. PGE2, produced during inflammation, has a pivotal role in the maturation of DCs and, therefore, is vital for the immune response. The large variety of biologic functions governed by PGE2 is mediated by its signaling through 4 distinct E-type prostanoid (EP) receptors. Immunogenic DCs express EP2 and EP4, which mediate the PGE2 signaling. However, the expression and function of EP receptors in human tolerogenic DCs (tol-DCs), which present an inhibitory phenotype, have not yet, to our knowledge, been assessed. To clarify the role of EP receptors in tol-DCs, we examined the expression of different EP receptors and their effect using selective agonists in human cells. We find that EP2 and EP3 expression are up-regulated in in vitro–generated tol-DCs compared with mature DCs (mDCs). Activation of EP2–EP4 has a direct effect on the surface expression of costimulatory molecules and maturation receptors, such as CD80, CD83, and CD86 or MHCII and CCR7 in tol-DCs, the latter being exclusively modulated by PGE2–EP4 signaling. Importantly, we find that EP2 and EP3 receptors are involved in tolerance induction through IL-10 production by tol-DCs. These results are in sharp contrast with the inflammatory role of EP4. Moreover, we show that DCs generated in the presence of agonists for EP receptors, induce naive T cell differentiation toward polarized Th1/Th17 cells. Given the differential effects of EP receptors, our results suggest that EP receptor agonist/antagonists might become relevant novel drug templates to modulate immune response.
Supporting carers of people with dementia: What is effective?
Authors: Jackson Graham A. , Browne Debbie 
Published: June 2017

Carer stress is well documented, especially in those caring for individuals with dementia. A recommendation of all national dementia strategies is to provide excellent support and information to informal carers of people with dementia. NICE guidance suggests that a range of tailored interventions, including psychological input, psychoeducation and training courses, should be offered to reduce caregiver burden and stress, although good-quality outcome-based evidence is lacking. On the basis of a narrative review of the literature, we describe individual and multicomponent carer support packages and discuss their evidence base, reflecting on outcomes for carers. Multicomponent interventions have the best evidence for effectiveness.Learning Objectives• Consider the risks of both physical and psychological harm experienced by carers of people with dementia (often referred to as carer burden or caregiver burden)• Be aware of the interventions available for the support of carers of people with dementia• Consider the evidence for the effectiveness of these interventions and be aware of the limitations of the evidence
Malingering mental disorders: Clinical assessment
Authors: Tracy Derek K. , Rix Keith J. B. 
Published: June 2017

SummaryMalingering is the dishonest and intentional production of symptoms. It can cause considerable difficulty as assessment runs counter to normal practice, and it may expose clinicians to testing medicolegal situations. In this first part of a two-article review, we explore types of psychiatric malingering and their occurrence across a range of common and challenging scenarios, discussing presentations that may help delineate true from feigned illness. A framework is provided for undertaking an assessment where malingering is suspected, including recommendations on clinician approach, the use of collateral information, and self-evaluation of biases. The uses, and limitations, of psychometric tests are discussed, including ‘general’, malingering-specific and ‘symptom validity’ scales.Learning Objectives• Understand the challenges of determining ‘real’ from ‘malingered’ symptomatology across a range of psychiatric conditions• Have a rational strategy for approaching a clinical assessment where malingering is suspected• Appreciate the role and limitations of various psychometric tests that can be used in such assessments
Statutory wills: Doing the right thing under the Mental Capacity Act 2005
Authors: Milward Kathryn , Curtice Martin , Harding Rosie 
Published: June 2017

SummaryStatutory wills are made under the Mental Capacity Act 2005 (MCA) for persons who lack testamentary capacity. Mental health practitioners are likely to be familiar with many of the provisions of the MCA and the test for testamentary capacity. However, they may not have encountered statutory wills. This article explains the procedure for applying for a statutory will, including the role of medical practitioners. Salient legal cases are summarised to highlight the difficulties in applying a best interests framework for decision-making in the context of statutory wills. Finally, this article considers how the United Nations Convention on the Rights of Persons with Disabilities (CRPD) might affect not only on statutory wills, but also the wider provisions of the MCA.Learning Objectives• Be able to explain statutory wills and the application procedure to a patient or carer• Understand the differences between the test for testamentary capacity (as established inBanks v Goodfellow(1870)) and assessing capacity under the MCA• Appreciate how the CRPD might affect the decision-making process, not only for statutory wills but for all decisions made under the MCA
Hospital-Based Acute Care Within 7 Days of Discharge After Outpatient Arthroscopic Shoulder Surgery
Authors: Liu Jiabin , Flynn David N. , Liu Wai-Man , Fleisher Lee A. , Elkassabany Nabil M. 
Published: June 2017

BACKGROUND:
The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood.

METHODS:
We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database. ER visits and IP admissions within 7 days of surgery were identified by cross-matching 2 independent Healthcare Cost and Utilization Project databases.

RESULTS:
The final cohort included 103,476 subjects. We identified 1867 (1.80%, 95% confidence interval [CI], 1.72%–1.89%) events, and the majority of these encounters were ER visits (1643, or 1.59%, 95% CI, 1.51%–1.66%). Direct IP admission after discharged was uncommon (224, or 0.22%, 95% CI, 0.19%–0.24%). The most common reasons for seeking acute care were musculoskeletal pain (23.78% of all events). Nearly half of all events (43.49%) occurred on the day of surgery or on postoperative day 1. Operative time exceeding 2 hours was associated with higher odds of requiring acute care (odds ratio [OR], 1.28; 99% CI, 1.08–1.51). High-volume surgical centers (OR, 0.67; 99% CI, 0.58–0.78) and regional anesthesia (OR, 0.72; 99% CI, 0.56–0.92) were associated with lower odds of requiring acute care.

CONCLUSIONS:
The rate of hospital-based acute care after outpatient shoulder arthroscopy was low (1.80%). Complications driving acute care visits often occurred within 1 day of surgery. Many of the events were likely related to surgery and anesthesia (eg, inadequate analgesia), suggesting that anesthesiologists may play a central role in preventing acute care visits after surgery.
Amodiaquine resistance in Plasmodium berghei is associated with PbCRT His95Pro mutation, loss of chloroquine, artemisinin and primaquine sensitivity, and high transcript levels of key transporters
Authors: Ndung'u Loise , Langat Benard , Magiri Esther , Ng'ang'a Joseph , Irungu Beatrice , Nzila Alexis , Kiboi Daniel 
Published: June 2017

Background: The human malaria parasite Plasmodium falciparum has evolved complex drug evasion mechanisms to all available antimalarials. To date, the combination of amodiaquine-artesunate is among the drug of choice for treatment of uncomplicated malaria. In this combination, a short acting, artesunate is partnered with long acting, amodiaquine for which resistance may emerge rapidly especially in high transmission settings. Here, we used a rodent malaria parasite Plasmodium berghei ANKA as a surrogate of P. falciparum to investigate the mechanisms of amodiaquine resistance. Methods: We used serial technique to select amodiaquine resistance by submitting the parasites to continuous amodiaquine pressure. We then employed the 4-Day Suppressive Test to monitor emergence of resistance and determine the cross-resistance profiles. Finally, we genotyped the resistant parasite by PCR amplification, sequencing and relative quantitation of mRNA transcript of targeted genes. Results: Submission of P. berghei ANKA to amodiaquine pressure yielded resistant parasite within thirty-six passages. The effective dosage that reduced 90% of parasitaemia (ED90) of sensitive line and resistant line were 4.29mg/kg and 19.13mg/kg, respectively. After freezing at -80ºC for one month, the resistant parasite remained stable with an ED90 of 18.22mg/kg. Amodiaquine resistant parasites are also resistant to chloroquine (6fold), artemether (10fold), primaquine (5fold), piperaquine (2fold) and lumefantrine (3fold). Sequence analysis of Plasmodium berghei chloroquine resistant transporter revealed His95Pro mutation. No variation was identified in Plasmodium berghei multidrug resistance gene-1 (Pbmdr1), Plasmodium berghei deubiquitinating enzyme-1 or Plasmodium berghei Kelch13 domain nucleotide sequences. Amodiaquine resistance is also accompanied by high mRNA transcripts of key transporters; Pbmdr1, V-type/H+ pumping pyrophosphatase-2 and sodium hydrogen ion exchanger-1 and Ca2+/H+ antiporter. Conclusions: Selection of amodiaquine resistance yielded stable “multidrug-resistant’’ parasites and thus may be used to study common resistance mechanisms associated with other antimalarial drugs. Genome wide studies may elucidate other functionally important genes controlling AQ resistance in P. berghei.
Impact of Sex on Cardiac Troponin Concentrations—A Critical Appraisal
Authors: Eggers Kai M , Lindahl Bertil 
Published: June 2017

Abstract

BACKGROUND
The use of sex-specific cutoffs for cardiac troponin (cTn) is currently debated. Although endorsed by scientific working groups, concerns have been raised that sex-specific cutoffs may have only a small clinical effect at the cost of increased complexity in decision-making.

METHODS
We reviewed studies investigating the interrelations between high-sensitivity (hs) cTn results and sex, diagnoses, and outcome. Investigated populations included community-dwelling subjects and patients with stable angina, congestive heart failure, or acute chest pain including those with acute coronary syndromes.

RESULTS
Men usually have higher hs-cTn concentrations compared with women, regardless of the assessed population or the applied assay. The distribution and prognostic implications of hs-cTn concentrations indicate that women have a broader cardiovascular risk panorama compared with men, particularly at lower hs-cTn concentrations. At higher concentrations, particularly above the 99th percentile, this variation is often attenuated. Sex-specific hs-cTn 99th percentiles have so far shown clinical net benefit in only 1 study assessing patients with chest pain. However, several methodological aspects need to be considered when interpreting study results, e.g., issues related to the determination of the 99th percentiles, the selection bias, and the lack of prospective and sufficiently powered analyses.

CONCLUSIONS
Available studies do not show a consistent clinical superiority of sex-specific hs-cTn 99th percentiles. This may reflect methodological aspects. However, from a pathobiological perspective, the use of sex-specific hs-cTn 99th percentiles makes sense for the ruling in of myocardial infarction. We propose a new approach to hs-cTn 99th cutoffs taking into account the analytical properties of the used assays.
Polylactic acid biocomposites: approaches to a completely green flame retarded polymer
Authors: Sypaseuth Fanni D. , Gallo Emanuela , Çiftci Serhat , Schartel Bernhard 
Published: June 2017

AbstractBasic paths towards fully green flame retarded kenaf fiber reinforced polylactic acid (K-PLA) biocomposites are compared. Multicomponent flame retardant systems are investigated using an amount of 20 wt% such as Mg(OH)2 (MH), ammonium polyphosphate (APP) and expandable graphite (EG), and combinations with silicon dioxide or layered silicate (LS) nanofillers. Adding kenaf fibers and flame retardants increases the E modulus up to a factor 2, although no compatibilizer was used at all. Thus, in particular adding EG and MH decreases the strength at maximum elongation, and kenaf fibers, MH, and EG are crucial for reducing the elongation to break. The oxygen index is improved by up to 33 vol% compared to 17 vol% for K-PLA. The HB classification of K-PLA in the UL 94 test is outperformed. All flame retarded biocomposites show somewhat lower thermal stability and increased amounts of residue. MH decreases the fire load significantly, and the greatest reduction in peak heat release rate is obtained for K-PLA/15MH/5LS. Synergistic effects are observed between EG and APP (ratio 2:1) in flammability and fire properties. Synergistic multicomponent systems containing EG and APP, or MH with adjuvants offer a promising route to green flame retarded natural fiber reinforced PLA biocomposites.
Quality Enhancement of Tapioca Starch Gel using Sucrose and Xanthan Gum
Authors: Tunnarut Duenchay , Pongsawatmanit Rungnaphar 
Published: June 2017

Abstract
The quality of starch gel could be enhanced by sugar and hydrocolloid. Sucrose (0, 10 % and 20 %) and xanthan gum (Xan) (0.3125 %) were added in the tapioca starch (TS) gels (25 %w/w TS and TS/Xan gels) for quality investigation. Sucrose increased gelatinization temperatures of starch mixtures. Moisture content and water activity decreased with increasing sucrose content and Xan addition. Freeze–thaw stability of TS and TS/Xan gels with and without sucrose was evaluated. Sucrose and Xan decreased water separation from repeated freeze–thaw cycles. A regression model for predicting water separation from Xan, sucrose and selected freeze–thaw cycle was developed and showed a good predictability. After keeping the TS and TS/Xan gels at 5 °C for 7 and 14 days, the hardness of TS and TS/Xan gels increased with increasing sucrose content but was retarded by adding Xan (p<0.05), suggesting Xan impeded the structure formation contributed from amylose molecule association during cold storage.