bluuebunny/crossref_metadata_2025_split huggingface dataset:
TUNNEL POSITIONING IN REMNANT SPARING DOUBLE BUNDLE ACL RECONSTRUCTION — A 2-YEAR STUDY OF MRI TUNNEL POSITIONS, CLINICAL OUTCOMES AND TUNNEL CONFLUENCE
Authors: Falconer Travis M. , Gohil Satyen , Tusak Louise , Breidahl William H. , Annear Peter T. 
Published: August 2016

Purpose: The purpose of this study is to examine the outcomes of a cohort of patients who have undergone a new surgical technique for anterior cruciate ligament (ACL) tunnel targeting using the footprint of the torn ACL as soft tissue markers. This is in the setting of anatomical ACLR with remnant preservation. Methods: This retrospective single center cohort study was conducted on patients undergoing a primary ACLR between August 2008 and February 2013. A total of 103 patients underwent ACLR with a remnant sparing technique with non-radiological soft tissue targeting of femoral and tibial tunnels. Exclusion criteria included skeletal immaturity, concomitant meniscal repair or ligament surgery, knee malalignment, delayed presentation ([Formula: see text]6 months post injury) and incomplete medical insurance. At 2 years all patients had gadolinium MRI scan, plain film X-ray, and a clinical assessment including KT-1000 arthrometry, and the following outcome scores; Tegner, IKDC (subjective/objective), Lysholm, Cincinnati and ACL Quality of Life. Results: A total of 44 patients (18 males, 26 females; mean age 30.9 years [Formula: see text]/[Formula: see text]11.8) were enrolled within the study. About 93.2% of the participants achieved an IKDC objective rating of A or B. The mean scores for outcome measures were; IKDC Subjective (84.9[Formula: see text][Formula: see text]/[Formula: see text][Formula: see text]11), Tegner (6.1[Formula: see text][Formula: see text]/[Formula: see text][Formula: see text]2), Lysholm (87.2[Formula: see text][Formula: see text]/[Formula: see text][Formula: see text]11.3), Cincinnati (358.1[Formula: see text][Formula: see text]/[Formula: see text][Formula: see text]40.8) and ACL Quality of Life (75.4[Formula: see text][Formula: see text]/[Formula: see text][Formula: see text]19). There were no graft failures at follow up. No patients had a loss of full extension [Formula: see text]. All tunnels were positioned satisfactorily. Almost half of all femoral tunnels (47.8%) and 30.4% of tibial tunnels were confluent at the joint surface. Conclusions: This series demonstrates that anatomical double tunnel ACLR using non-radiological guided remnant retention technique, provides satisfactory 2-year clinical outcomes and is a safe and effective option. Targeting tunnels to be within the native remnant leads to high rates of tunnel confluence.
Polyphosphate delays fibrin polymerisation and alters the mechanical properties of the fibrin network
Authors: Whyte Claire S. , Chernysh Irina N. , Domingues Marco M. , Connell Simon , Weisel John W. , Ariens Robert A. S. , Mutch Nicola J. 
Published: August 2016

SummaryPolyphosphate (polyP) binds to fibrin(ogen) and alters fibrin structure, generating a heterogeneous network composed of ‘knots’ interspersed by large pores. Here we show platelet-derived polyP elicits similar structural changes in fibrin and examine the mechanism by which polyP alters fibrin structure. Polymerisation of fibrinogen with thrombin and CaCl2 was studied using spinning disk confocal (SDC) microscopy. PolyP delayed fibrin polymerisation generating shorter protofibrils emanating from a nucleus-type structure. Consistent with this, cascade blue-polyP accumulated in fibrin ‘knots’. Protofibril formation was visualized by atomic force microscopy (AFM) ± polyP. In the presence of polyP abundant monomers of longer length were visualised by AFM, suggesting that polyP binds to monomeric fibrin. Shorter oligomers form in the presence of polyP, consistent with the stunted protofibrils visualised by SDC microscopy. We examined whether these structural changes induced by polyP alter fibrin’s viscoelastic properties by rheometry. PolyP reduced the stiffness (G’) and ability of the fibrin network to deform plastically G”, but to different extents. Consequently, the relative plastic component (loss tangent (G”/G’)) was 61 % higher implying that networks containing polyP are less stiff and more plastic. Local rheological measurements, performed using magnetic tweezers, indicate that the fibrin dense knots are stiffer and more plastic, reflecting the heterogeneity of the network. Our data show that polyP impedes fibrin polymerisation, stunting protofibril growth producing ‘knotted’ regions, which are rich in fibrin and polyP. Consequently, the mechanical properties of the fibrin network are altered resulting in clots with overall reduced stiffness and increased ability to deform plastically.Supplementary Material to this article is available online at www.thrombosis-online.com.
Late‐Onset Asthma Predicts Cardiovascular Disease Events: The Wisconsin Sleep Cohort
Authors: Tattersall Matthew C. , Barnet Jodi H. , Korcarz Claudia E. , Hagen Erika W. , Peppard Paul E. , Stein James H. 
Published: August 2016

Background
Asthma is a heterogeneous syndrome with different clinical subtypes that is associated with an increased risk for cardiovascular disease (CVD). We hypothesized that the late‐onset subtype of asthma is associated with a higher risk of incident CVD.

Methods and Results

Participants from the Wisconsin Sleep Cohort free of CVD at baseline were followed for a mean (SD) of 13.9 (5.9) years for development of CVD (myocardial infarction, angina, stroke, coronary revascularization, heart failure, or CVD death). Late‐onset asthma was defined as physician‐diagnosed asthma at age ≥18 years. Multivariable Cox regression models adjusted for age, sex, and CVD risk factors were used to assess associations of late‐onset asthma and incident CVD. The 1269 participants were 47.3 (8.0) years old; 166 participants had asthma (111 late‐onset, 55 early‐onset). Participants with late‐onset asthma compared to nonasthmatics were more likely to be female (67% versus 44%) and to have a higher body‐mass index (32.2 versus 29.4 kg/m
2
) (
P
<0.05). Mean age of asthma diagnosis in the late‐onset group was 39.5 (9.6) years versus 8.9 (5.7) years in the early‐onset group (
P
<0.0001). Late‐onset asthmatics had a higher adjusted risk of incident CVD than nonasthmatics (hazard ratio 1.57, 95% CI 1.01–2.45,
P
=0.045). There was no interaction between body‐mass index and age of asthma diagnosis on incident CVD (
P
=0.83).

Conclusions
In a large cohort study of adults followed prospectively for over a decade, late‐onset asthmatics had an increased risk of incident CVD events that persisted after adjustment for age, sex, and CVD risk factors.
Numerical Weather Forecasts at Kilometer Scale in the French Alps: Evaluation and Application for Snowpack Modeling
Authors: Vionnet Vincent , Dombrowski-Etchevers Ingrid , Lafaysse Matthieu , Quéno Louis , Seity Yann , Bazile Eric 
Published: August 2016

Abstract
Numerical weather prediction (NWP) systems operating at kilometer scale in mountainous terrain offer appealing prospects for forecasting the state of snowpack in support of avalanche hazard warning, water resources assessment, and flood forecasting. In this study, daily forecasts of the NWP system Applications of Research to Operations at Mesoscale (AROME) at 2.5-km grid spacing over the French Alps were considered for four consecutive winters (from 2010/11 to 2013/14). AROME forecasts were first evaluated against ground-based measurements of air temperature, humidity, wind speed, incoming radiation, and precipitation. This evaluation shows a cold bias at high altitude partially related to an underestimation of cloud cover influencing incoming radiative fluxes. AROME seasonal snowfall was also compared against output from the Système d’Analyse Fournissant des Renseignements Atmosphériques à la Neige (SAFRAN) specially developed for alpine terrain. This comparison reveals that there are regions of significant difference between the two, especially at high elevation, and possible causes for these differences are discussed. Finally, AROME forecasts and SAFRAN reanalysis have been used to drive the snowpack model Surface Externalisée (SURFEX)/Crocus (SC) and to simulate the snowpack evolution over a 2.5-km grid covering the French Alps during four winters. When evaluated at the experimental site of Col de Porte, both simulations show good agreement with measurements of snow depth and snow water equivalent. At the scale of the French Alps, AROME-SC exhibits an overall positive bias, with the largest positive bias found in the northern and central French Alps. This study constitutes the first step toward the development of a distributed snowpack forecasting system using AROME.
Microphysics Regime Impacts on the Relationship between Orographic Rain and Orographic Forcing in the Coastal Mountains of Northern California
Authors: Kingsmill David E. , Neiman Paul J. , White Allen B. 
Published: August 2016

Abstract
This study examines the impact of microphysics regime on the relationship between orographic forcing and orographic rain in the coastal mountains of Northern California using &gt;4000 h of data from profiling Doppler radars, rain gauges, and a GPS receiver collected over 10 cool seasons. Orographic forcing is documented by hourly upslope flow, integrated water vapor (IWV), and IWV flux observed along the coast at Bodega Bay (BBY; 15 m MSL). Microphysics regime is inferred in the coastal mountains at Cazadero (CZC; 478 m MSL), where hourly periods of brightband (BB) and nonbrightband (NBB) rain are designated. BB rain is associated with a microphysics regime dominated by the seeder–feeder process while NBB rain is associated with a microphysics regime dominated by the warm-rain process. Mean BBY upslope flow, IWV, and IWV flux are ~16%, ~5%, and ~19% larger, respectively, for NBB rain compared to BB rain, while mean CZC rain rate is ~33% larger for BB rain compared to NBB rain. The orographic enhancement ratio of CZC to BBY rain rate is 3.7 during NBB rain and 2.7 during BB rain. Rain rate at CZC increases as orographic forcing at BBY increases. For a given amount of BBY orographic forcing, mean CZC rain rates are larger for BB rain compared to NBB rain. Correlation coefficients associated with the relationship between CZC rain rate and BBY orographic forcing are smaller for NBB rain relative to BB rain, but these differences are not statistically significant.
Konkan Railway Corporation Limited
Authors: Banerjee Bibek , Raghuram G , Rangaraj Narayan 
Published: August 2016

Mr Rajaram, Managing Director of Konkan Railway Corporation (KRC), is concerned about the mounting debt burden of KRC. He is in the process of formulating an overall marketing strategy for KRC in the freight sector, in order to break even. He is also considering the appropriate marketing organization to serve the target market(s). Readers are invited to send their responses on the case to Vikalpa office.
The impact on clinical practice of the 2015 reforms to the New South Wales Mental Health Act
Authors: Ryan Christopher James , Callaghan Sascha 
Published: August 2016

Objectives: The Mental Health Act 2007 (NSW) ( MHA) was recently reformed in light of the recovery movement and the United Nations Convention on the Rights of Persons with Disabilities. We analyse the changes and describe the impact that these reforms should have upon clinical practice. Conclusions: The principles of care and treatment added to the MHA place a strong onus on clinicians to monitor patients’ decision-making capacity, institute a supported decision-making model and obtain consent to any treatment proposed. Patients competently refusing treatment should only be subject to involuntary treatment in extraordinary circumstances. Even when patients incompetently refuse treatment, clinicians must make every effort reasonably practicable to tailor management plans to take account of any views and preferences expressed by them or made known via friends, family or advance statements.
Geometry Classrooms With Simulation/Games. Research Results and Future Developments
Authors: Piu Angela , Fregola Cesare , Barbieri Barbara 
Published: August 2016

Background. As revealed by national surveys and comparisons with other countries, Italian students may have difficulties in learning mathematical content, and geometry in particular. Aim. This research aimed at ascertaining if, with respect to traditional methods, the structural characteristics of simulation games designed on the basis of specific theoretical and methodological choices can: (a) facilitate comprehension and improve the retention of geometric concepts; (b) increase pupils’ motivation to learn geometry; (c) affect perceived social and scholastic self-efficacy. Method. This mixed method research included an experimental and a control group and a qualitative analysis of an open-ended examination. Results. Our research with Y4 primary pupils (n=104) indicates that students who learned geometrical concepts via the simulation game had a higher level of both content retention and level of abstraction compared with those in the control group. Conclusions. The results of this study highlight the didactic effectiveness of simulation games with reference to the cognitive aspects of the learning process and indicate the need to develop design models for geometry-based simulations.
A Comparison of the Regional Circulation in the Feet between Dialysis and Non-Dialysis Patients using Indocyanine Green Angiography
Authors: Nishizawa M. , Igari K. , Kudo T. , Toyofuku T. , Inoue Y. , Uetake H. 
Published: August 2016

Background and Aims: Peripheral artery disease in dialysis cases is more prone to critical limb ischemia compared to non-dialysis cases, with a significantly high rate of major amputation of the lower limbs. Lesions are distributed on the more distal side in dialysis critical limb ischemia cases. The aim of this study was to investigate the usefulness of indocyanine green angiography to determine differences in the regional circulation in the foot between dialysis and non-dialysis patients. Materials and Methods: The subjects included 62 cases, among which 20 were dialysis patients and 42 were non-dialysis patients. We compared the indocyanine green angiography parameters for regions of interest in the dialysis and non-dialysis groups, which included the magnitude of intensity from indocyanine green onset to maximum intensity (Imax), the time from indocyanine green onset to maximum intensity (Tmax), the time elapsed from the fluorescence onset to half the maximum intensity (T1/2), and the time from maximum intensity to declining to 90% of the maximum intensity (Td90%). These indocyanine green angiography parameters were measured at region of interest 1 (the Chopart joint), region of interest 2 (the Lisfranc joint), and region of interest 3 (the distal region of the first metatarsal bone). Results: In the comparison between the dialysis and non-dialysis groups, a significant difference was observed regarding Tmax, T1/2, and Td90%, especially in region of interest 3. Conclusion: In this study, we show that regional tissue perfusion is more deteriorated in dialysis patients compared with non-dialysis patients using indocyanine green angiography. Tmax, T1/2, and Td90% could be useful clinical parameters to compare ischemic severity of the lower limb between dialysis and non-dialysis patients.
A Multicenter Evaluation of the Performance and Usability of a Novel Glucose Monitoring System in Chinese Adults With Diabetes
Authors: Ji Linong , Guo Xiaohui , Guo Lixin , Ren Qian , Yu Nan , Zhang Jie 
Published: August 2016

Objective: Flash glucose monitoring is a new glucose sensing technique that measures interstitial glucose levels for up to 14 days and does not require any calibration. The aim of this study is to evaluate the performance of the new system in Chinese patients with diabetes. Methods: A multicenter, prospective, masked study was performed in a total of 45 subjects with diabetes. Subjects wore 2 sensors at the same time, for up to 14 days. The accuracy was evaluated against capillary blood glucose (BG) and venous Yellow Springs Instrument (YSI; Yellow Springs, OH) measurements. During all 14 days, subjects were asked to perform at least 8 capillary BG tests per day. Each subject attended 3 days of 8-hour clinic sessions to measure YSI and sensor readings every 15 minutes. Results: Forty subjects had evaluable glucose readings, with 6687 of 6696 (99.9%) sensor and capillary BG pairs within consensus error grid zones A and B, including 5824 (87.0%) in zone A. The 6969 sensor and venous YSI pairs resulted in 6965 (99.9%) pairs within zones A and B, including 5755 (82.6%) in zone A. The sensor pairs with BG and YSI result in mean absolute relative difference (MARD) of 10.0% and 10.7%, respectively. Overall between-sensor coefficient of variation (CV) was 8.0%, and the mean lag time was 3.1 (95% confidence interval 2.54 to 4.29) minutes. Conclusions: The system works well for people with diabetes in China, and it is easy to wear and use.
Clinical and Laboratory Evaluation of a New Specific Point-of-Care Test for Intact Proinsulin
Authors: Pfützner Andreas , Pfützner Anke H. , Kann Peter H. , Burgard Gunther 
Published: August 2016

Background: Intact proinsulin is a biomarker for pancreatic ß-cell dysfunction. In large prospective studies in nondiabetic subjects, elevated intact proinsulin predicted development of type 2 diabetes and/or macrovascular events up to 7 years in advance. This study was performed to evaluate a new semiquantitative lateral flow-based point-of-care rapid test (POCT) for elevated intact proinsulin (cutoff: 15 pmol/L). The test requires 10 µL of capillary whole blood, with visual readout after 5 minutes. It is best applied at 2 hours after a glucose challenge or a meal. Methods: POCT results were obtained by health care professionals from 60 patients and healthy subject (33 female, 27 male, 28 type 2 diabetes, age: 53.6 ± 12.3 years). An additional venous blood sample was obtained from all participants for measurement of intact proinsulin by means of a quantitative ELISA reference method (TecoMedical, Sissach, Switzerland). Results: Elevated intact proinsulin levels (>15 pmol/L) were determined by the reference method in 26 participants, of whom 22 were also positive with the POCT (sensitivity: 85%). All 34 subjects with low intact proinsulin levels were tested negative by the POCT (specificity: 100%). Conclusions: The test successfully detected elevated postprandial intact proinsulin levels in 85% of the tested subjects and no false positive test result occurred. This POCT can therefore serve as a simple screening tool for identification of patients with prevalent ß-cell dysfunction, who are at high risk for development of type 2 diabetes and/or macrovascular events within the next 5-7 years.
Magnesium/Calcium Ratio in Serum Predicts Periodontitis and Tooth Loss in a 5-Year Follow-up
Authors: Meisel P. , Pink C. , Nauck M. , Jablonowski L. , Voelzke H. , Kocher T. 
Published: August 2016

In the cross-sectional Study of Health in Pomerania (SHIP-0), subjects with an adequate magnesium supply had a lower risk of periodontal disease and more teeth than those with low magnesium levels. The authors analyzed 5-y follow-up data (SHIP-1) to determine whether the baseline magnesium levels had a long-term effect on attachment level and number of teeth lost. Of the participants examined dentally in the baseline study, 3,300 (75%) were examined for progression or recession of periodontal attachment level after 5 y. For 2,432 subjects, the authors related the outcome variables of periodontal attachment level and tooth loss to baseline characteristics, especially serum magnesium and calcium concentrations, as well as systemic markers of inflammation. The progression of periodontitis was associated with the magnesium/calcium (Mg/Ca) ratio at baseline in a dose-dependent manner. Progression of mean attachment loss was prevented in the upper quartile of the Mg/Ca ratio ( P < 0.001) with antagonistic effects of magnesium and calcium irrespective of inflammatory state. With respect to tooth loss, Mg/Ca exerted dimorphic effects. In inflammatory states as indicated by high C-reactive protein (>3 mg/L), tooth loss was prevented in subjects with high Mg/Ca ratio (incidence rate ratio = 0.60, 95% confidence interval: 0.45 to 0.80, P = 0.001), but the contrary was observed in subjects with low C-reactive protein levels (incidence rate ratio = 1.14, 95% confidence interval: 0.97 to 1.34, NS). Similar results were observed with stratifying the regression on tooth loss by interleukin 6 or fibrinogen threshold. An adequate magnesium serum level and Mg/Ca balance may prevent progression of attachment level and tooth loss, especially in inflammatory states. Knowledge Transfer Statement: The results of this study present evidence that an adequate magnesium supply may be important in the prevention of periodontal diseases and future tooth loss. A diet high in magnesium could improve periodontal health, notwithstanding its beneficial effects on systemic disease. In populations with a high prevalence of hypomagnesemia, additional intake of supplements is advisable.
How I treat essential thrombocythemia
Authors: Rumi Elisa , Cazzola Mario 
Published: August 2016

Abstract
Essential thrombocythemia (ET) is an indolent myeloproliferative neoplasm that may be complicated by vascular events, including both thrombosis and bleeding. This disorder may also transform into more aggressive myeloid neoplasms, in particular into myelofibrosis. The identification of somatic mutations of JAK2, CALR, or MPL, found in about 90% of patients, has considerably improved the diagnostic approach to this disorder. Genomic profiling also holds the potential to improve prognostication and, more generally, clinical decision-making because the different driver mutations are associated with distinct clinical features. Prevention of vascular events has been so far the main objective of therapy, and continues to be extremely important in the management of patients with ET. Low-dose aspirin and cytoreductive drugs can be administered to this purpose, with cytoreductive treatment being primarily given to patients at high risk of vascular complications. Currently used cytoreductive drugs include hydroxyurea, mainly used in older patients, and interferon α, primarily given to younger patients. There is a need for disease-modifying drugs that can eradicate clonal hematopoiesis and/or prevent progression to more aggressive myeloid neoplasms, especially in younger patients. In this article, we use a case-based discussion format to illustrate our approach to diagnosis and treatment of ET.