bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ACL Graft Has Different Cross-sectional Dimensions Compared With the Native ACL
Authors: Thein Ran , Spitzer Elad , Doyle John , Khamaisy Saker , Nawabi Danyal H. , Chawla Harshvardhan , Lipman Joseph D. , Pearle Andrew D. 
Published: May 2016

Background: Impingement of anterior cruciate ligament (ACL) grafts against the femoral notch and the posterior cruciate ligament (PCL) is thought to be influenced primarily by tunnel position and graft orientation. Recent data have implied that the native ACL is ribbon-shaped. Purpose: To evaluate the 3-dimensional shape and cross-sectional area of the native ACL versus the ACL graft and to compare the degree of impingement against the femoral notch and PCL. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Bilateral knee magnetic resonance images were analyzed for 27 patients with unilateral bone–patellar tendon–bone (BPTB) ACL reconstruction performed via transtibial or anteromedial portal femoral tunneling techniques. Three-dimensional models of the ACL, PCL, femur, and tibia were digitally rendered. The cross-sectional area and dimensions of the native ACL and the reconstructed graft were determined at 3 equally spaced locations and compared via Wilcoxon-Mann-Whitney and Kruskal-Wallis tests. In addition, impingement of the ACL on the PCL and femoral notch was graded in 3 groups. Chi-square or Fisher exact tests were used to compare the proportional differences of impingement of the native and reconstructed ACL on the PCL and femoral notch, respectively. All analyses were performed using 2-sided hypothesis testing, with statistical significance at P < .05. Results: Cross-sectional areas at all 3 points on the ACL graft were significantly greater than those of the native ACL ( P < .001). The long- to short-axis ratio for the native ACL was significantly greater at each location compared with the corresponding locations along the ACL graft ( P < .001), implying that the native ACL is “flatter” than is an ACL graft. There were 19 operated knees (70%) with contact or impingement between the ACL graft and the femoral notch compared with zero knees with a native ACL ( P < .001). In addition, 22 operated knees (81%) showed contact or impingement between the ACL graft and the PCL, compared with 7 knees (26%) with a native ACL ( P < .001). No significant differences in impingement frequency were noted between the transtibial and anteromedial tunneling techniques for ACL graft specimens ( P > .05). Conclusion: Native ACLs have a smaller cross-sectional area, are “flatter,” and experience less incidence of impingement compared with anatomically placed BPTB ACL grafts.
Secular Trends in Heights and Weights in Boys and Girls Over 3 Decades in Rural India
Authors: Mamidi Raja Sriswan , Rajkumar Hemalatha , Radhakrishna K. V. , Babu J. J. 
Published: May 2016

Background: Secular trends in height reported from developing countries are few and scarce. Objective: To assess secular trends in linear growth in boys and girls from birth to 18 years of life in rural households of India based on periodical cross-sectional surveys conducted over a period of 35 years. Materials and Methods: The present study uses data from baseline and final surveys of National Nutrition Monitoring Bureau from 1975 to 1979 (N = 6043) to 2012 to 2013 (N = 11 910) on anthropometry from birth to 18 years from 7 states in households of rural India. Results: The overall improvement in 18+ boys and girls was 3.1 and 1.0 cm, respectively, over a period of 35 years. The increments in height of 18+ were highest for both boys (7.4 cm) and girls (4.8 cm) in the state of Kerala followed by Tamil Nadu (boys, 7.3 cm and girls, 3.8 cm). Under-5 stunting rates reduced from 82% in the baseline survey to 45.7% in the final survey at 1.35% per year in the pooled states and was similar in both boys and girls. The recovery in stunting was highest in Tamil Nadu (1.63% per year) followed by Kerala (1.46% per year). Conclusion: The pattern of secular trends in height in rural India seen over 3 decades was strikingly similar to that of developed countries. The phenomenal improvement in linear growth in Kerala and Tamil Nadu in children younger than 5 years and adolescents suggests that growth potential for Indians is similar to that of developed countries.
Clinical and MRI Donor Site Outcomes Following Autologous Osteochondral Transplantation for Talar Osteochondral Lesions
Authors: Fraser Ethan J. , Savage-Elliott Ian , Yasui Youichi , Ackermann Jakob , Watson Geoffrey , Ross Keir A. , Deyer Timothy , Kennedy John G. 
Published: May 2016

Background: Autologous osteochondral transplantation (AOT) has an inherent risk of donor site morbidity (DSM). The reported rates of DSM vary from 0% to 50%, with few studies reporting clinical or imaging outcomes at the donor site as a primary outcome and even fewer report these outcomes when a biosynthetic plug backfill is employed. Although TruFit (Smith & Nephew, Andover, MA) plugs have been removed from the market for regulatory purposes, biphasic plugs (including TruFit plugs) have been used for several years and the evaluation of these is therefore pertinent. Methods: Thirty-nine patients who underwent forty AOT procedures of the talus, with the donor graft being taken from the ipsilateral knee, were included. Postoperative magnetic resonance imaging (MRI) was used to assess the donor site graded with magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Lysholm scores were collected preoperatively, at the time of magnetic resonance imaging (MRI), and again at 24 months and at final follow-up to assess clinical outcomes. Statistical analysis was performed to establish if there was any correlation between MRI assessment of the donor site and clinical outcomes. The mean patient age was 36.2 ± 15.7 years with a mean follow-up of 41.8 ± 16.7 months. Results: All patient donor site defects were filled with OBI TruFit biphasic plugs. DSM was encountered in 12.5% of the patient cohort at 24 months, and in these patients, the Lysholm score was a mean 87.2 ± 5.0. At final follow-up, DSM was reduced to 5%. Lysholm scores for the entire cohort were 98.4 ± 4.6 and 99.4 ± 3.1 at 24 months and final follow-up, respectively. MRI of the donor sites were taken at an average of 18.1 ± 13.5 (range, 3-48) months postoperatively and the mean MOCART score was 60.0 ± 13.5. No correlation was found between the MOCART score and Lysholm outcomes at the donor knee ( P = .43, r = 0.13). Conclusion: Low incidence of DSM and good functional outcomes were achieved with AOT. Additionally, MRI findings did not predict clinical outcomes in our study. Level of Evidence: Level IV, retrospective case series.
Relationship and Classification of Plantar Heel Spurs in Patients With Plantar Fasciitis
Authors: Ahmad Jamal , Karim Ammar , Daniel Joseph N. 
Published: May 2016

Background: This study classified plantar heel spurs and their relationship to plantar fasciitis. Methods: Patients included those with plantar fasciitis who were treated from 2012 through 2013. Plantar heel spur shape and size were assessed radiographically and correlated to function and pain before and after treatment. Function and pain were scored with the Foot and Ankle Ability Measures and a visual analog scale, respectively. This study included 109 patients with plantar fasciitis. Results: The plantar heel spur shape was classified as 0/absent in 26 patients, 1/horizontal in 66 patients, 2/vertical in 4 patients, and 3/hooked in 13 patients. The plantar heel spur size was less than 5 mm in 75 patients, 5-10 mm in 28 patients, and greater than 10 mm in 6 patients. Initially, patients with any shape or size to their spur had no difference in function and pain. With treatment, patients with horizontal and hooked spurs had the greatest improvement in function and pain ( P < .05). With treatment, patients with larger spurs had the greatest improvement in function and pain ( P < .05). Conclusion: Plantar heel spurs can be classified by shape and size in patients with plantar fasciitis. Before treatment, neither the spur shape nor size significantly correlated with symptoms. After treatment, patients with larger horizontal or hooked spurs had the greatest improvement in function and pain. These findings may be important when educating patients about the role of heel spurs with plantar fasciitis and the effect of nonsurgical treatment with certain spurs. Level of Evidence: Level III, comparative series.
Efficacy and Safety of Fondaparinux in Patients With Suspected Heparin-Induced Thrombocytopenia
Authors: Snodgrass Megan N. , Shields Jenna , Rai Hema 
Published: May 2016

Objective: Heparin-induced thrombocytopenia (HIT) occurs in up to 5% of patients exposed to unfractionated heparin for 5 or more days. Direct thrombin inhibitors (DTIs) are currently the only Food and Drug Administration (FDA)-approved agents for the treatment of HIT. The purpose of this study is to determine whether fondaparinux is an appropriate first-line alternative anticoagulant in patients with suspected or confirmed HIT. Methods: A retrospective study was conducted by identifying all patients who received a DTI or fondaparinux during a 5 year period, August 2009-August 2014. Patients were included if they had a HIT panel/serotonin-release assay analysis (regardless of the result) and were initiated on a DTI or fondaparinux for alternative anticoagulation. The primary outcome was new, recurrent, or progressive thromboembolic event. Secondary outcomes included bleeding events, platelet count recovery, and hospital stay. Results: A total of 1022 patients were evaluated, and 47 patients met the inclusion criteria. Twelve patients were HIT positive and 35 were HIT negative. Seven (14.9%) of the 47 patients experienced a new thrombosis, none of whom were on fondaparinux only (FONDA). There were 4 new minor bleeds, with 1 bleed as a result of being on fondaparinux. FONDA treatment resulted in a slightly shorter median duration of hospital stay compared to the DTI-only group and the DTI followed by fondaparinux group. There is a potential for cost savings with fondaparinux due to the ease of administration and availability to be given in the outpatient setting. Conclusion: In this small retrospective review, fondaparinux appeared similarly efficacious and safe compared to DTIs for the treatment of suspected HIT.
The use of telehealth (text messaging and video communications) in patients with cystic fibrosis: A pilot study
Authors: Gur Michal , Nir Vered , Teleshov Anna , Bar-Yoseph Ronen , Manor Eynav , Diab Gizelle , Bentur Lea 
Published: May 2016

Background Poor communications between cystic fibrosis (CF) patients and health-care providers may result in gaps in knowledge and misconceptions about medication usage, and can lead to poor adherence. We aimed to assess the feasibility of using WhatsApp and Skype to improve communications. Methods This single-centre pilot study included CF patients who were older than eight years of age assigned to two groups: one without intervention (control group), and one with intervention. Each patient from the intervention group received Skype-based online video chats and WhatsApp messages from members of the multidisciplinary CF team. CF questionnaires, revised (CFQ-R) scores, knowledge and adherence based on CF My Way and patients satisfaction were evaluated before and after three months. Feasibility was assessed by session attendance, acceptability and satisfaction survey. Descriptive analysis and paired and non-paired t-tests were used as applicable. Results Eighteen patients were recruited to this feasibility study (nine in each group). Each intervention group participant had between four and six Skype video chats and received 22–45 WhatsApp messages. In this small study, CFQ-R scores, knowledge, adherence and patient satisfaction were similar in both groups before and after the three-month intervention. Conclusions A telehealth-based approach, using Skype video chats and WhatsApp messages, was feasible and acceptable in this pilot study. A larger and longer multi-centre study is warranted to examine the efficacy of these interventions to improve knowledge, adherence and communication.
Youth unemployment: Implications for social work practice
Authors: Liang Jianqiang , Ng Guat Tin , Tsui Ming-sum , Yan Miu Chung , Lam Ching Man 
Published: May 2016

Summary This article discusses a missing but emergent role of social work with unemployed young people. The authors highlight the transitional and structural factors of youth unemployment. Using a social work lens, the “Youth Employment Network” (YEN) is discussed and the International Labour Organization’s “4Es” (employability, equal opportunity, employment creation, entrepreneurship) framework is elaborated. This article adds a fifth “E” (Ecological connection) and proposes a “5Es” model for social workers to support unemployed young people to overcome transitional and structure barriers for employment. Findings Limited social work programs, studies, or evaluations are targeted for unemployed young people despite historical concern with employment conditions of workers and suggest the instrumental role in research, policy and practice concerning the unemployed young people. Applications Recommendations are provided in terms of how to implement the 5Es in policy, education, training, and direct practice of social work in youth employment.
Agonism Reloaded: Potentia, Renewal and Radical Democracy
Authors: Tambakaki Paulina 
Published: May 2016

This article focuses on the agonistic account of renewal and discusses its place within the broader horizon of radical democracy. It suggests that while the emphasis which agonistic theorists place on difference and popular struggles (particularly social movement politics) ensures some common ground with other theories of radical democracy, their account of renewal also displays some marked differences. The article explores these differences and discusses whether agonism is sufficient to address the limits of the current neoliberal order. Honig B (2013) Antigone, Interrupted. Cambridge: Cambridge University Press Wenman M (2013) Agonistic Democracy: Constituent Power in the Era of Globalisation. Cambridge: Cambridge University Press Nichols R and Singh J (eds) (2014) Freedom and Democracy in an Imperial Context – Dialogues with James Tully. Abingdon, New York: Routledge Mouffe C (2013) Agonistics. London: Verso. Tully J (ed.) (2014) On Global Citizenship: James Tully in Dialogue. London; New York: Bloomsbury Academics.
Amino acid metabolism reflecting arginase activity is increased in patients with type 2 diabetes and associated with endothelial dysfunction
Authors: Kövamees Oskar , Shemyakin Alexey , Pernow John 
Published: May 2016

Background: Endothelial dysfunction contributes to the development of vascular complication in diabetes. Arginase has emerged as a key mechanism behind endothelial dysfunction by its reciprocal regulation of nitric oxide production by substrate competition. We hypothesized that increased arginase activity in patients with type 2 diabetes shifts the metabolism of l-arginine from nitric oxide synthase to arginase resulting in an increase in the plasma ratio of ornithine/citrulline, and that this ratio is associated with endothelial dysfunction. Methods: Forearm endothelium-dependent vasodilatation and endothelium-independent vasodilatation were determined in 15 patients with type 2 diabetes and 10 healthy controls and related to amino acids reflecting arginase and nitric oxide synthase activity. Results: Compared to healthy controls, patients with diabetes had impaired endothelium-dependent vasodilatation and endothelium-independent vasodilatation. The ratios of ornithine/citrulline and proline/citrulline were 60% and 95% higher, respectively, in patients with diabetes than in controls ( p < 0.001). The plasma ornithine/arginine ratio was 36% higher in patients with diabetes, indicating increased arginase activity. These ratios were inversely correlated to endothelium-dependent vasodilatation and endothelium-independent vasodilatation. Conclusion: Patients with diabetes and macrovascular complications have increased amino acid ratios reflecting a shift in arginine metabolism due to arginase activation. These changes are inversely related to endothelial function supporting that arginase activity contributes to endothelial dysfunction.
Statistical lessons learned for designing cluster randomized pragmatic clinical trials from the NIH Health Care Systems Collaboratory Biostatistics and Design Core
Authors: Cook Andrea J , Delong Elizabeth , Murray David M , Vollmer William M , Heagerty Patrick J 
Published: May 2016

Background/aims: Pragmatic clinical trials embedded within health care systems provide an important opportunity to evaluate new interventions and treatments. Networks have recently been developed to support practical and efficient studies. Pragmatic trials will lead to improvements in how we deliver health care and promise to more rapidly translate research findings into practice. Methods: The National Institutes of Health (NIH) Health Care Systems Collaboratory was formed to conduct pragmatic clinical trials and to cultivate collaboration across research areas and disciplines to develop best practices for future studies. Through a two-stage grant process including a pilot phase (UH2) and a main trial phase (UH3), investigators across the Collaboratory had the opportunity to work together to improve all aspects of these trials before they were launched and to address new issues that arose during implementation. Seven Cores were created to address the various considerations, including Electronic Health Records; Phenotypes, Data Standards, and Data Quality; Biostatistics and Design Core; Patient-Reported Outcomes; Health Care Systems Interactions; Regulatory/Ethics; and Stakeholder Engagement. The goal of this article is to summarize the Biostatistics and Design Core’s lessons learned during the initial pilot phase with seven pragmatic clinical trials conducted between 2012 and 2014. Results: Methodological issues arose from the five cluster-randomized trials, also called group-randomized trials, including consideration of crossover and stepped wedge designs. We outlined general themes and challenges and proposed solutions from the pilot phase including topics such as study design, unit of randomization, sample size, and statistical analysis. Our findings are applicable to other pragmatic clinical trials conducted within health care systems. Conclusion: Pragmatic clinical trials using the UH2/UH3 funding mechanism provide an opportunity to ensure that all relevant design issues have been fully considered in order to reliably and efficiently evaluate new interventions and treatments. The integrity and generalizability of trial results can only be ensured if rigorous designs and appropriate analysis choices are an essential part of their research protocols.
Diffuse traumatic brain injury induces prolonged immune dysregulation and potentiates hyperalgesia following a peripheral immune challenge
Authors: Rowe Rachel K , Ellis Gavin I , Harrison Jordan L , Bachstetter Adam D , Corder Gregory F , Van Eldik Linda J , Taylor Bradley K , Marti Francesc , Lifshitz Jonathan 
Published: May 2016

Background Nociceptive and neuropathic pain occurs as part of the disease process after traumatic brain injury (TBI) in humans. Central and peripheral inflammation, a major secondary injury process initiated by the traumatic brain injury event, has been implicated in the potentiation of peripheral nociceptive pain. We hypothesized that the inflammatory response to diffuse traumatic brain injury potentiates persistent pain through prolonged immune dysregulation. Results To test this, adult, male C57BL/6 mice were subjected to midline fluid percussion brain injury or to sham procedure. One cohort of mice was analyzed for inflammation-related cytokine levels in cortical biopsies and serum along an acute time course. In a second cohort, peripheral inflammation was induced seven days after surgery/injury with an intraplantar injection of carrageenan. This was followed by measurement of mechanical hyperalgesia, glial fibrillary acidic protein and Iba1 immunohistochemical analysis of neuroinflammation in the brain, and flow cytometric analysis of T-cell differentiation in mucosal lymph. Traumatic brain injury increased interleukin-6 and chemokine ligand 1 levels in the cortex and serum that peaked within 1–9 h and then resolved. Intraplantar carrageenan produced mechanical hyperalgesia that was potentiated by traumatic brain injury. Further, mucosal T cells from brain-injured mice showed a distinct deficiency in the ability to differentiate into inflammation-suppressing regulatory T cells (Tregs). Conclusions We conclude that traumatic brain injury increased the inflammatory pain associated with cutaneous inflammation by contributing to systemic immune dysregulation. Regulatory T cells are immune suppressors and failure of T cells to differentiate into regulatory T cells leads to unregulated cytokine production which may contribute to the potentiation of peripheral pain through the excitation of peripheral sensory neurons. In addition, regulatory T cells are identified as a potential target for therapeutic rebalancing of peripheral immune homeostasis to improve functional outcome and decrease the incidence of peripheral inflammatory pain following traumatic brain injury.
Efficacy of a hospital-wide environmental cleaning protocol on hospital-acquired methicillin-resistant Staphylococcus aureus rates
Authors: Watson Paul Andrew , Watson Luke Robert , Torress-Cook Alfonso 
Published: May 2016

Background: Environmental contamination has been associated with over half of methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in hospitals. We explored if a hospital-wide environmental and patient cleaning protocol would lower hospital acquired MRSA rates and associated costs. Objective: This study evaluates the impact of implementing a hospital-wide environmental and patient cleaning protocol on the rate of MRSA infection and the potential cost benefit of the intervention. Methods: A retrospective, pre-post interventional study design was used. The intervention comprised a combination of enhanced environmental cleaning of high touch surfaces, daily washing of patients with benzalkonium chloride, and targeted isolation of patients with active infection. The rate of MRSA infection per 1000 patient days (PD) was compared with the rate after the intervention (Steiros Algorithm®) was implemented. A cost–benefit analysis based on the number of MRSA infections avoided was conducted. Results: The MRSA rates decreased by 96% from 3.04 per 1000 PD to 0.11 per 1000 PD ( P <0.0001). This reduction in MRSA infections, avoided an estimated $1,655,143 in healthcare costs. Discussion: Implementation of this hospital-wide protocol appears to be associated with a reduction in the rate of MRSA infection and therefore a reduction in associated healthcare costs.
Limited privacy protection and poor sensitivity
Authors: Randall Sean M , Ferrante Anna M , Boyd James H , Brown Adrian P , Semmens James B 
Published: May 2016

Background: The statistical linkage key (SLK-581) is a common tool for record linkage in Australia, due to its ability to provide some privacy protection. However, newer privacy-preserving approaches may provide greater privacy protection, while allowing high-quality linkage. Objective: To evaluate the standard SLK-581, encrypted SLK-581 and a newer privacy-preserving approach using Bloom filters, in terms of both privacy and linkage quality. Method: Linkage quality was compared by conducting linkages on Australian health datasets using these three techniques and examining results. Privacy was compared qualitatively in relation to a series of scenarios where privacy breaches may occur. Results: The Bloom filter technique offered greater privacy protection and linkage quality compared to the SLK-based method commonly used in Australia. Conclusion: The adoption of new privacy-preserving methods would allow both greater confidence in research results, while significantly improving privacy protection.