bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salivary calculi
Authors: Haq Jahrad , McGurk Mark 
Published: April 2016

Abstract
The aetiology of salivary gland stones is still not fully understood. The prevalence of symptomatic salivary gland stones in the UK is 5.9 per 100,000 and represents the majority of salivary gland pathology in middle-aged patients. The submandibular is the most common site, followed by the parotid and sublingual glands. We present a case involving a 50-year-old patient with a three-month history of recurrent left parotid swelling. This was discussed in a multidisciplinary one-stop salivary gland clinic. The patient was subsequently diagnosed with a stone in the left parotid duct. Evidence is presented pertaining to both surgical and non-surgical management and this case discusses a combination of these approaches to render the patient symptom-free.
Paediatric maxillofacial trauma
Authors: Ujam Atheer , Thomas Suraj , Holmes Simon 
Published: April 2016

Abstract
Maxillofacial trauma in children is markedly different to their adult counterparts. The facial skeleton contains significant growth potential with inherent elasticity at this stage. There is also a differing cranial to facial bone ratio with 0.5:0.5 in infants changing to 0.33:0.67 in adults. The sinuses in small children are also at a rudimentary stage and developing tooth buds are also present. We present two cases in this chapter. The first is a six-year old attending with a left orbital floor fracture in a state of physiological compromise. The second is an 11-year-old with bilateral displaced condyles as part of a ‘guardsman’s fracture’ of the mandible. The treatment of both is discussed at length taking the difficulties in examination, consent and treatment for this cohort of patients into consideration.
Friedmann–Robertson–Walker models do not require zero active mass
Authors: Kim Do Young , Lasenby Anthony N. , Hobson Michael P. 
Published: April 2016

Abstract
The Rh = ct cosmological model has received considerable attention in recent years owing to claims that it is favoured over the standard Λ cold dark mater (ΛCDM) model by most observational data. A key feature of the Rh = ct model is that the zero active mass condition ρ + 3p = 0 holds at all epochs. Most recently, Melia has claimed that this condition is a requirement of the symmetries of the Friedmann–Robertson–Walker spacetime. We demonstrate that this claim is false and results from a flaw in the logic of Melia's argument.
MicroRNA-183-96-182 Cluster Regulates Bovine Granulosa Cell Proliferation and Cell Cycle Transition by Coordinately Targeting FOXO11
Authors: Gebremedhn Samuel , Salilew-Wondim Dessie , Hoelker Michael , Rings Franca , Neuhoff Christiane , Tholen Ernst , Schellander Karl , Tesfaye Dawit 
Published: April 2016

Abstract
Large-scale expression profiling of micro-RNAs (miRNAs) in bovine granulosa cells from dominant and subordinate follicles on Day 19 of the estrous cycle revealed enriched micro-RNA-183-96-182 cluster miRNAs in preovulatory dominant follicles that coordinately regulate the forkhead box protein O1 (FOXO1) gene. However, little is known about the role of this cluster in bovine granulosa cell function. We used an in vitro granulosa cell culture model to investigate this role. Granulosa cells aspirated from small growing follicles (3–5 mm in diameter) were cultured in Dulbecco modified Eagle medium/F-12 medium supplemented with fetal bovine serum and transfected with locked nucleic acid-based miRNA mimics, inhibitors, and corresponding negative controls. Overexpression of the miRNA cluster resulted in suppression of FOXO1 mRNA and protein, whereas inhibition of the cluster increased expression of FOXO1 mRNA. Overexpression also increased the relative rate of cell proliferation, whereas inhibition slowed it down. Similarly, the proportion of cells under G0/G1 arrest declined, whereas the ratio of cells in S phase increased in response to miR-183-96-182 overexpression. Selective knockdown of FOXO1 mRNA using anti-FOXO1 small interfering RNA increased the rate of granulosa cell proliferation, decreased the proportion of cells under G0/G1 arrest, and increased the proportion of cells in the S phase of cell cycle. Our data suggest that miR-183-96-182 cluster miRNAs promote proliferation and G1/S transition of bovine granulosa cells by coordinately targeting FOXO1, suggesting a critical role in granulosa cell function. MicroRNA-183-96-182 cluster regulates bovine granulosa cell function by targeting FOXO1 gene.
Association Between Tibial Malunion Deformity Parameters and Degenerative Hip and Knee Disease
Authors: Weinberg Douglas S. , Park Paul J. , Liu Raymond W. 
Published: April 2016

Objectives:
Tibia fractures are the most common long bone fracture. Criteria for closed and open reduction are based on the amount of fracture shortening, angulation, and rotation, with high success rates achieved if acceptable alignment is maintained. However, there exists limited data available regarding the long-term consequences of specific deformation patterns.

Methods:
The tibiae of 2898 cadaveric skeletons were manually inspected for evidence of fracture. Specimens with midshaft fractures were identified as candidates for study; intraarticular fractures were excluded. Fracture shortening, location, angulation, rotation (torsion), and translation were measured using previously described techniques. Degenerative joint disease of the knee and hip was graded from 0 to 3 in fracture specimens using a previously published system. Correlations between fracture characteristic and osteoarthritis were evaluated.

Results:
Thirty-seven tibia fractures were present in 36 skeletons. In patients with tibia fractures, ipsilateral knee arthritis was greater than that of the contralateral side (P < 0.001). Knee arthritis was greater in fractures with coronal plane deformity greater than 5 degrees (P = 0.006) and with rotational deformity greater than 10 degrees (P = 0.004). There were no differences in knee arthritis based on laterality, shortening, sagittal deformity, fracture type, or translation in any plane (P > 0.05 for all). There were no differences in hip arthritis on the ipsilateral side compared with the contralateral side (P = 0.149). However, tibiae that were shortened by more than 10 mm had higher grades of ipsilateral hip arthritis (P = 0.009).

Conclusions:
The results of this study suggest that coronal and axial plane malalignment and shortening are of the greatest consequence following tibia fracture. These conclusions strengthen the recommendations of authors who have emphasized restoring tibial length following fracture, and providing anatomic restoration in the coronal and axial planes.
Membrane Induced Osteogenesis in the Management of Posttraumatic Bone Defects
Authors: Azi Matheus L. , Teixeira Armando Augusto de A. , Cotias Ricardo B. , Joeris Alexander , Kfuri Mauricio 
Published: April 2016

Objective:
To evaluate the union rate of posttraumatic bone defects treated with the induced membrane technique.

Design:
Single-center retrospective case series.

Setting:
Level I trauma center.

Patients/Participants:
Thirty-three patients who sustained 34 posttraumatic bone defects (19 tibia, 15 femur).

Intervention:
Staged management using the induced membrane technique described by Masquelet. After extensive debridement at the fracture site, a polymethylmethacrylate (PMMA) spacer was inserted into the resulting void. After soft tissue recovery, the spacer was removed, and the void, now enveloped by an induced membrane, was filled with an autologous iliac crest bone graft.

Main Outcome Measures:
Bone union rate, time to achieve bone union, length of hospital stay, number of surgeries, infection resolution, range of motion, musculoskeletal tumor society system functional score, and limb shortening.

Results:
The mean defect size was 6.7 cm, and infection was present in 23 (68%) of the bone defects. Bone union was evident in 91% of cases (31/34). The average time to union was 8.5 months. In 7 of 23 (30%) of infected cases, the infection recurred, and in 3 of them, the graft was resorbed, resulting in treatment failure.

Conclusion:
The induced membrane technique was effective for managing posttraumatic bone defects. A recurrence of infection was associated with treatment failure.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Curcumin Lowers Serum Lipids and Uric Acid in Subjects With Nonalcoholic Fatty Liver Disease: A Randomized Controlled Trial
Authors: Panahi Yunes , Kianpour Parisa , Mohtashami Reza , Jafari Ramezan , Simental-Mendía Luis E. , Sahebkar Amirhossein 
Published: April 2016

Background:
Nonalcoholic fatty liver disease (NAFLD) is one of the most common hepatic diseases in the general adult population. Dyslipidemia, hyperuricemia, and insulin resistance are common risk factors and accompanying features of NAFLD. Curcumin is a dietary natural product with beneficial metabolic effects relevant to the treatment of NAFLD.

Aim:
To assess the effects of curcumin on metabolic profile in subjects with NAFLD.

Methods:
Patients diagnosed with NAFLD (grades 1–3; according to liver sonography) were randomly assigned to curcumin (1000 mg/d in 2 divided doses) (n = 50) or control (n = 52) group for a period of 8 weeks. All patients received dietary and lifestyle advises before the start of trial. Anthropometric measurements, lipid profile, glucose, insulin, glycated hemoglobin, and uric acid concentrations were measured at baseline and after 8 weeks of follow-up.

Results:
Eighty-seven subjects (n = 44 and 43 in the curcumin and control group, respectively) completed the trial. Supplementation with curcumin was associated with a reduction in serum levels of total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.001), triglycerides (P < 0.001), non–high-density lipoprotein cholesterol (P < 0.001), and uric acid (P < 0.001), whereas serum levels of high-density lipoprotein cholesterol and glucose control parameters remained unaltered. Curcumin was safe and well tolerated during this study.

Conclusion:
Results of the present trial suggest that curcumin supplementation reduces serum lipids and uric acid concentrations in patients with NAFLD.
Patients With Celiac Disease Reported Higher Consumption of Added Sugar and Total Fat Than Healthy Individuals
Authors: Babio Nancy , Alcázar Mireia , Castillejo Gemma , Recasens Miriam , Martínez‐Cerezo Francesc , Gutiérrez‐Pensado Vanessa , Masip Guiomar , Vaqué Cristina , Vila‐Martí Anna , Torres‐Moreno Miriam , Sánchez Enric , Salas‐Salvadó Jordi 
Published: April 2016

ABSTRACTObjectives:The aim of the study was to compare the dietary pattern between subjects with celiac disease (CD) (cases) and subjects without (healthy controls) CD.Methods:A case‐control design study was conducted. A total of 98 subjects with CD (age 10–23 years) were matched by age, sex, and body mass index with 98 nonceliac participants. A nonconsecutive 3‐day food record was completed to assess energy, nutrient, and food intake and evaluate the participant's adherence to recommendations. Differences in energy, nutrients, food consumption, and compliance with general recommendations between cases and control groups were assessed by Student t test. Pearson chi‐squared test was used to compare categorical variables. Sociodemographic, personal, and family history data were collected.Results:Compared with the control group, the cases with CD reported a significantly higher consumption of added sugar (P < 0.001) and total fat (P < 0.017). Mean fiber consumption was below the nutritional recommendations in both groups. Participants with CD consumed significantly lower amounts of foods rich in starch (P < 0.001) and higher amounts of foods rich in protein such as meat, fish, and eggs (P = 0.007). Subjects with CD showed a significantly lower percentage of adherence to recommendations for folic acid (53.2 vs 70.5; P < 0.001), calcium (49.0 vs 56.3; P = 0.025), iron (57.4 vs 78.0; P < 0.001), and magnesium (50.0 vs 63.9; P < 0.001).Conclusions:The subjects with CD showed a more unbalanced diet than controls in terms of added sugars, total fat, and micronutrient consumption.
Effects of Surfactant Lavage Combined With Intratracheal Budesonide Instillation on Meconium-Injured Piglet Lungs
Authors: Lin Chih-Hsueh , Jeng Mei-Jy , Kuo Benjamin Ing-Tiau , Kou Yu Ru 
Published: April 2016

Objectives:
To evaluate the combined effects of surfactant lavage and intratracheally instillation of budesonide on meconium-injured piglet lungs.

Design:
A prospective, randomized, animal model study.

Setting:
An experimental laboratory.

Subjects:
Twenty-four anesthetized and mechanically ventilated newborn piglets.

Interventions:
Human meconium slurry was intratracheally instilled into piglet lungs to induce lung injury. The injured piglets were randomly assigned to either the sham treatment group (control) or one of the three therapeutic groups: the intratracheally instilled budesonide (Bud) group, the bronchoalveolar lavage with diluted surfactant (dsBAL) group, and the combination therapy of Bud and dsBAL (dsBAL + Bud) group.

Measurements and Main Results:
Cardiopulmonary profiles were measured hourly. Proinflammatory cytokine (interleukin-1β, interleukin-6, and interleukin-8) levels in bronchoalveolar lavage fluid were measured. Finally, the pulmonary histology of the experimental subjects was examined at the end of experiments. Both of the lavaged groups (dsBAL and dsBAL + Bud) showed significantly better oxygenation than those that had not undergone lavage (control and Bud) (p < 0.05). The dsBAL + Bud group showed a significantly higher lung compliance and required a significantly lower peak inspiratory pressure during the experimental periods than the other three groups (p < 0.05). All treatment groups had significantly lower concentrations of interleukin-1β concentration in the bronchoalveolar lavage fluid than the control group (p < 0.05). The dsBAL + Bud group also had a significantly lower interleukin-6 concentration in the bronchoalveolar lavage fluid (p< 0.05), as well as a significantly lower lung injury score based on pulmonary histology than the control group (p < 0.05).

Conclusions:
Therapeutic bronchoalveolar lavage with diluted surfactant followed by intratracheal instillation of budesonide has a synergistic and beneficial effect when treating severe meconium-injured newborn piglet lungs.
Procalcitonin in the Early Course Post Pediatric Cardiac Surgery
Authors: Zant Robert , Stocker Christian , Schlapbach Luregn Jan , Mayfield Sara , Karl Tom , Schibler Andreas 
Published: April 2016

Objective:
Procalcitonin has emerged as a promising infection marker, but previous reports from small-sized studies suggest nonspecific elevation of procalcitonin after pediatric heart surgery. As procalcitonin is increasingly used as a marker for infection in the PICU, the aim of this study was to identify factors associated with postoperative procalcitonin elevation and to investigate the role of procalcitonin as an early marker of outcome after cardiac surgery.

Design:
Prospective observational study.

Setting:
Single, tertiary referral PICU.

Patients:
Patients aged 0–16 years following cardiac surgery with or without cardiopulmonary bypass.

Interventions:
Procalcitonin was measured in all patients at admission to PICU, and on postoperative day 1 and 2. Outcome variables included major adverse event, length of stay in PICU, postoperative renal failure requiring temporary dialysis, duration of mechanical ventilation and duration of inotropic support. A major adverse event was defined as cardiac arrest, need for postoperative extracorporeal life support or death within 3 months of cardiac surgery.

Measurements and Main Results:
In 221 included patients who underwent 232 operations, procalcitonin at admission to PICU was significantly associated with mechanical ventilation prior to surgery (p = 0.001), preoperative myocardial dysfunction (p = 0.002), duration of cardiopulmonary bypass (p < 0.001), intraoperative cross-clamp time (p = 0.015), and serum lactate at admission (p < 0.001). Patients suffering a major adverse event and patients with postoperative renal failure had significantly higher procalcitonin levels at admission to PICU (p = 0.04 and 0.01, respectively). Furthermore, procalcitonin levels at admission correlated significantly with the length of stay in the PICU (p = 0.005), time on mechanical ventilation (p = 0.03), and duration of inotropic support (p = 0.02).

Conclusions:
Elevated levels of procalcitonin in the early phase after pediatric cardiac surgery are a marker for increased risk for major adverse events and postoperative renal failure and increased postoperative morbidity.
Comparison of Pediatric Severe Sepsis Managed in U.S. and European ICUs*
Authors: Giuliano John S. , Markovitz Barry P. , Brierley Joe , Levin Richard , Williams Gary , Lum Lucy Chai See , Dorofaeff Tavey , Cruces Pablo , Bush Jenny L. , Keele Luke , Nadkarni Vinay M. , Thomas Neal J. , Fitzgerald Julie C. , Weiss Scott L. 
Published: April 2016

Objectives:
Pediatric severe sepsis remains a significant global health problem without new therapies despite many multicenter clinical trials. We compared children managed with severe sepsis in European and U.S. PICUs to identify geographic variation, which may improve the design of future international studies.

Design:
We conducted a secondary analysis of the Sepsis PRevalence, OUtcomes, and Therapies study. Data about PICU characteristics, patient demographics, therapies, and outcomes were compared. Multivariable regression models were used to determine adjusted differences in morbidity and mortality.

Setting:
European and U.S. PICUs.

Patients:
Children with severe sepsis managed in European and U.S. PICUs enrolled in the Sepsis PRevalence, OUtcomes, and Therapies study.

Interventions:
None.

Measurements and Main Results:
European PICUs had fewer beds (median, 11 vs 24; p < 0.001). European patients were younger (median, 1 vs 6 yr; p < 0.001), had higher severity of illness (median Pediatric Index of Mortality-3, 5.0 vs 3.8; p = 0.02), and were more often admitted from the ward (37% vs 24%). Invasive mechanical ventilation, central venous access, and vasoactive infusions were used more frequently in European patients (85% vs 68%, p = 0.002; 91% vs 82%, p = 0.05; and 71% vs 50%; p < 0.001, respectively). Raw morbidity and mortality outcomes were worse for European compared with U.S. patients, but after adjusting for patient characteristics, there were no significant differences in mortality, multiple organ dysfunction, disability at discharge, length of stay, or ventilator/vasoactive-free days.

Conclusions:
Children with severe sepsis admitted to European PICUs have higher severity of illness, are more likely to be admitted from hospital wards, and receive more intensive care therapies than in the United States. The lack of significant differences in morbidity and mortality after adjusting for patient characteristics suggests that the approach to care between regions, perhaps related to PICU bed availability, needs to be considered in the design of future international clinical trials in pediatric severe sepsis.
An Algorithmic Approach to the Surgical Treatment of Chronic Ischemia of the Hand: A Systematic Review of the Literature
Authors: Thibaudeau Stephanie , Serebrakian Arman T. , Gerety Patrick A. , Levin L. Scott 
Published: April 2016

Background:
Chronic ischemia of the hand can lead to intractable pain, cold intolerance, and digital necrosis, affecting up to 4.8 percent of patients undergoing vascular surgery. Treatment of patients suffering from chronic hand ischemia, in particular, the subset of patients with a nonreconstructible distal arterial tree, can be a significant challenge for hand surgeons. The purpose of this systematic review is to analyze the outcomes of surgical therapies in an effort to define the efficacy of each intervention. The authors also revisit the treatment algorithm for nontraumatic chronic hand ischemia.

Methods:
A systematic search of the literature published since 1990 in the PubMed/MEDLINE database was performed using keywords. Articles were eligible if they described clinical studies of human patients with nontraumatic chronic hand ischemia who underwent sympathectomy, arterial bypass, or venous arterialization. Pain improvement, wound healing, and new ulcerations were primary outcome measures. Primary patency rates and limb salvage data were also collected as primary outcome measures in the bypass and arterialization study arms.

Results:
For sympathectomy, arterial bypass, and venous arterialization, pain relief was achieved in 89, 100, and 100 percent of patients, respectively; whereas wound healing occurred in 74, 93, and 75 percent, respectively. Postoperative ulcerations were 0, 3, and 8 percent, respectively. No secondary amputations were reported in these 33 studies. Complication rates were moderately high (2.1 to 30.8 percent).

Conclusion:
This systematic review confirms that sympathectomy, arterial bypass, and venous arterialization are efficacious treatments, and allows for an algorithmic approach to the surgical treatment of chronic hand ischemia.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Correction of Pectus Excavatum by Custom-Made Silicone Implants: Contribution of Computer-Aided Design Reconstruction. A 20-Year Experience and 401 Cases
Authors: Chavoin Jean-Pierre , Grolleau Jean-Louis , Moreno Benjamin , Brunello Jérémie , André Aymeric , Dahan Marcel , Garrido Ignacio , Chaput Benoit 
Published: April 2016

Background:
In the absence of demonstrable functional impairment, pectus excavatum is merely a congenital deformity, albeit with a marked psychological impact. Many patients do not wish to undergo thoracic remodeling operations, which are invasive and do not clearly result in respiratory or cardiac improvement.

Methods:
From 1993 to 2015, the authors designed 401 custom-made silicone implants to treat funnel chests. Before 2007, implants were made from plaster chest molds. Beginning in 2007, three-dimensional reconstructions were made from computed tomographic scans by computer-aided design. The authors prospectively recorded all assessments and follow-up data since 1993. Preoperative and postoperative photographs of two random groups of 50 patients were analyzed, in a blinded manner, by two surgeons independently. Intraoperative and postoperative complications, clinical outcomes, patient satisfaction, and quality of life were evaluated.

Results:
One infection and three hematomas were recorded. Periprosthetic seroma was evident in all cases. Patients rated the cosmetic outcomes of computer-aided design implants significantly higher than those of the earlier implants made using plaster molds (p = 0.030). Malformations were better corrected in the computer-aided design group (86 percent) than in the plaster group (72 percent) (p = 0.038). Patient satisfaction was higher in the former group (p = 0.011). Medical Outcomes Study 36-Item Short-Form Health Survey scores revealed significant improvements, both socially and emotionally.

Conclusions:
Correction of pectus excavatum using a computer-aided design silicone implant fulfils aesthetic and psychological demands. The technique is simple and reliable and yields high-quality results. In the medium term, the approach may render invasive techniques obsolete. These operations remain risky and of doubtful functional utility.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.