bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modification of the use of the extensor retinaculum for reducible distal radioulnar joint instability: technique and results
Authors: Filius A. , Zuidam J. M. , Jaquet J. B. , Slijper H. P. , Coert J. H. 
Published: June 2017

Different surgical techniques have been described for chronic distal radioulnar joint instability: they are often complicated, quite invasive and may not be recommended for bidirectional instability. We describe a procedure using a radial-based extensor retinaculum strip and a capsular plication. This is a simple technique and less invasive than ‘anatomic’ radioulnar ligament reconstructions. We report the results of 38 patients (38 wrists) who we treated. After a minimum of 8 months we quantified the outcomes of the patients objectively by assessing ranges of motion, grip strength and clinical assessment of stability, and subjectively using questionnaires. Overall, 36 out of 38 patients were stable after surgery. The operated forearm and wrist had approximately 3° less range of motion in all planes and 3 kgf less grip strength compared with the unoperated side. The median Mayo modified wrist score was 90; the median visual analogue scale score was 2. This surgical technique appears to successfully treat patients with chronic reducible distal radioulnar joint instability. Anatomic reconstruction of both radioulnar ligaments is not always necessary. Level of evidence: IV
Cartilage Regeneration in Full-Thickness Patellar Chondral Defects Treated with Particulated Juvenile Articular Allograft Cartilage: An MRI Analysis
Authors: Grawe Brian , Burge Alissa , Nguyen Joseph , Strickland Sabrina , Warren Russell , Rodeo Scott , Shubin Stein Beth 
Published: June 2017

Background Full-thickness cartilage lesions of the patella represent a common source of pain and dysfunction. Previously reported surgical treatment options include marrow stimulation, cell-based treatments, and osteochondral transfer. Minced juvenile allograft cartilage is a novel treatment option that allows for a single stage approach for these lesions. Hypothesis Particulated juvenile allograft cartilage (PJAC) for the treatment of chondral defects of the patella would offer acceptable lesion fill rates, mature over time, and not be associated with any negative biologic effects on the surrounding tissue. Methods A retrospective chart review of prospectively collected data was conducted to identify consecutive patients who were treated with PJAC for a full thickness symptomatic cartilage lesion. Qualitative (fast spin echo) and quantitative (T2 mapping) magnetic resonance imaging (MRI) was undertaken at the 6-, 12-, and 24-month postoperative mark. Numerous patient, lesion, and graft specific factors were assessed against MRI scores and percent defect fill of the graft. Graft maturation over time was also assessed. Results Forty-five patients total were included in the study. Average age at the time of surgery was 26.5 years (range 13-45 years), average lesion size was 208 mm2 (range 4-500 mm2), and average donor age was 49.5 months (range 3-120 months). Sixty percent of the patients were female, while 93% of all patients underwent a concomitant procedure at the time of the index operation. Six-month MRI findings revealed that no patient-, graft-, or donor-specific factors correlated with MR scores, and 82% of the knees demonstrated good to excellent fill. Twelve-month MRI findings revealed that T2 relaxation times of deep graft demonstrated negative correlation with patient age ( P = 0.049) and donor age ( P = 0.006), the integration zone showed a negative correlation with donor age ( P = 0.026). In all, 85% of patients at 12 months displayed good to moderate fill of the graft. At 24 months, patient age demonstrated negative correlation with average T2 relaxation times of the deep and superficial graft ( P = 0.005; P = 0.0029) and positive correlation with the superficial zone of the adjacent cartilage ( P = 0.001). Donor age showed negative correlation with grayscale score ( P = 0.004) and T2 relaxation times at deep integration zone ( P = 0.018). T2 relaxation times of deep and superficial graft and integration zone improved over time ( P < 0.001) and between each time point. Conclusions Particulated juvenile allograft tissue appears to be an acceptable reconstructive option for full-thickness cartilage lesions of the patella, offering satisfactory tissue defect fill at 6, 12, and 24 months after surgery. Imaging of the repaired cartilage demonstrates progressive graft maturation over time.
The anticoagulant effects of warfarin and the bleeding risk associated with its use in patients with chronic thromboembolic pulmonary hypertension at a specialist center in Japan: a retrospective cohort study
Authors: Jujo‐Sanada Takayuki , Tanabe Nobuhiro , Sakao Seiichiro , Sugiura Toshihiko , Sekine Ayumi , Nishimura Rintaro , Suda Rika , Naito Akira , Miwa Hideki , Yamamoto Keiko , Sasaki Akane , Matsumura Akane , Ema Ryogo , Kasai Hajime , Kato Fumiaki , Tatsumi Koichiro 
Published: June 2017

Patients with chronic thromboembolic pulmonary hypertension (CTEPH) require lifelong anticoagulation therapy. However, the bleeding risk and recurrence of venous thromboembolism (VTE) in CTEPH patients who are administered warfarin have not been adequately evaluated. The purpose of this study was to evaluate the risk of clinically relevant bleeding, recurrent VTE, and clinical worsening in patients with CTEPH who were administered warfarin.The clinical records of 72 patients with CTEPH who regularly visited our institution and were administered warfarin were retrospectively reviewed between 1 January 2011 and 31 December 2015. We investigated the incidence of clinically relevant bleeding events, recurrent VTE, and hospitalization for the deterioration of pulmonary hypertension or right heart failure (RHF) during the observation period.The mean observation period for the 72 patients was 3.60 ± 1.60 person‐years. Clinically relevant bleeding, RHF, and recurrent VTE occurred in 21 (29.2%), eight (11.1%), and three (4.2%) of 72 patients, respectively, and the incidence rates for these events were 8.1%/person‐year, 3.1%/person‐year, and 1.2%/person‐year, respectively. The incidence rates for the major and non‐major bleeding events were 5.0%/person‐year and 3.9%/person‐year, respectively. The incidence of clinically relevant bleeding events was 20.8%/person‐year during medical treatment with a soluble guanylate cyclase stimulator. One of 35 patients (2.9%) during the post‐pulmonary endarterectomy period experienced hemoptysis during observation period (> 6 months after pulmonary endarterectomy). No bleeding events occurred during the post‐balloon pulmonary angioplasty period.In conclusion, warfarin effectively prevents VTE recurrence in CTEPH patients, but its effects may be associated with a considerable bleeding risk.
Loss of thymic innate lymphoid cells leads to impaired thymopoiesis in experimental graft-versus-host disease
Authors: Dudakov Jarrod A. , Mertelsmann Anna M. , O’Connor Margaret H. , Jenq Robert R. , Velardi Enrico , Young Lauren F. , Smith Odette M. , Boyd Richard L. , van den Brink Marcel R. M. , Hanash Alan M. 
Published: June 2017

Key Points
Thymic ILCs and their production of IL-22 are reduced in mice with GVHD; IL-22 deficiency worsens thymic epithelial damage in GVHD. Administration of IL-22 posttransplant can enhance thymopoiesis after experimental allogeneic bone marrow transplant.
Early Response–Based Therapy Stratification Improves Survival in Adult Early Thymic Precursor Acute Lymphoblastic Leukemia: A Group for Research on Adult Acute Lymphoblastic Leukemia Study
Authors: Bond Jonathan , Graux Carlos , Lhermitte Ludovic , Lara Diane , Cluzeau Thomas , Leguay Thibaut , Cieslak Agata , Trinquand Amélie , Pastoret Cedric , Belhocine Mohamed , Spicuglia Salvatore , Lheritier Véronique , Leprêtre Stéphane , Thomas Xavier , Huguet Françoise , Ifrah Norbert , Dombret Hervé , Macintyre Elizabeth , Boissel Nicolas , Asnafi Vahid 
Published: June 2017

Purpose Early thymic precursor (ETP) acute lymphoblastic leukemia (ALL) is an immunophenotypically defined subgroup of T-cell ALL (T-ALL) associated with high rates of intrinsic treatment resistance. Studies in children have shown that the negative prognostic impact of chemotherapy resistance is abrogated by the implementation of early response–based intensification strategies. Comparable data in adults are lacking. Patients and Methods We performed comprehensive clinicobiologic, genetic, and survival analyses of a large cohort of 213 adult patients with T-ALL, including 47 patients with ETP-ALL, treated in the GRAALL (Group for Research on Adult Acute Lymphoblastic Leukemia) -2003 and -2005 studies. Results Targeted next-generation sequencing revealed that the genotype of immunophenotypically defined adult T-ALL is similar to the pediatric equivalent, with high rates of mutations in factors involved in cytokine receptor and RAS signaling (62.2%), hematopoietic development (29.7%), and chemical modification of histones (48.6%). In contrast to pediatric cases, mutations in DNA methylation factor genes were also common (32.4%). We found that despite expected high levels of early bone marrow chemotherapy resistance (87%), the overall prognosis for adults with ETP-ALL treated using the GRAALL protocols was not inferior to that of the non–ETP-ALL group (5-year overall survival: ETP, 59.6%; 95% CI, 44.2% to 72.0% v non-ETP, 66.5%; 95% CI, 58.7% to 73.2%; P = 0.33) and that allogeneic stem-cell transplantation had a beneficial effect in a large proportion of patients with ETP-ALL. Conclusion Our results suggest that the use of response-based risk stratification and therapy intensification abrogates the poor prognosis of adult ETP-ALL.
Building a Network of Health Professionals for Breast and Cervical Cancer Control in the Andean Region
Authors: Mendoza-Cervantes Diana , Otero Isabel , Zujewski Jo Anne , Ferrandiz Salazar Jorge , López Córdova Gabriela , Muha Cathy , Stevens Lisa 
Published: June 2017

Purpose Cancer mortality is approximately twice as high in Latin American countries than in more developed countries. In particular, the countries of the high Andean region of Latin America carry a double burden of breast and cervical cancers. In these countries, there are disproportionately higher mortality to incidence ratios compared with other regions in Latin America. The US National Cancer Institute’s Center for Global Health, the Pan American Health Organization, and the Ministry of Health in Peru collaborated to design and execute an education and advocacy workshop in Lima, Peru. The workshop was convened to discuss regional challenges and practices, as well as to support the implementation of Plan Esperanza, Peru’s national cancer control plan. Methods Workshop participants included local and international experts to present the state of the science, health practitioners, and advocacy groups to discuss unique barriers that women in the region experience. Results Inequalities in access to and distribution of medical expertise, lack of continuity of cancer control plans, and the need for sustained public buy-in emerged as obstacles. Conclusion The workshop provided a forum to discuss key issues regarding breast and cervical cancer control among health professionals and advocates in Peru and the region. This article outlines the resulting recommendations.
Platelet distribution width, mean platelet volume and haematological parameters in patients with uncomplicated plasmodium falciparum and P. vivax malaria
Authors: A. Ali Elrazi , M. Abdalla Tajeldin , Adam Ishag 
Published: June 2017

Background: The association between the haematological profile (including abnormal platelets) and malaria is not completely understood. There are few published data on haematological profiles of malaria patients in areas with unstable malaria transmission. The current study was conducted to investigate if the haematological parameters, including platelet indices, were reliable predictors for microscopically-diagnosed malaria infection. Methods: A case-control study with a total of 324 participants (162 in each arm) was conducted at the out-patient clinic of New Halfa hospital during the rainy and post rainy season (August 2014 through to January 2015). The cases were patients with uncomplicated Plasmodium falciparum (107; 66.9%) and P. vivax malaria (55, 34.0%) infections. The controls were aparasitemic individuals. The haematological parameters were investigated using an automated hemo-analyser. Results: There was no significant difference in the mean (±SD) age between the study groups; however, compared to the controls, patients with uncomplicated malaria had significantly lower haemoglobin, leucocyte and platelet counts, and significantly higher red cell distribution width (RDW), platelet distribution width (PDW) and mean platelet volume (MPV). Conclusions: The study revealed that among the haematological indices, PDW and MPV were the main predictors for uncomplicated P. falciparum and P. vivax malaria infection. Abbreviations: OR: odds ratio.
Overinterpretation of Research Findings: Evidence of “Spin” in Systematic Reviews of Diagnostic Accuracy Studies
Authors: McGrath Trevor A , McInnes Matthew D F , van Es Nick , Leeflang Mariska M G , Korevaar Daniël A , Bossuyt Patrick M M 
Published: June 2017

Abstract

BACKGROUND
We wished to assess the frequency of overinterpretation in systematic reviews of diagnostic accuracy studies.

METHODS
MEDLINE was searched through PubMed from December 2015 to January 2016. Systematic reviews of diagnostic accuracy studies in English were included if they reported one or more metaanalyses of accuracy estimates. We built and piloted a list of 10 items that represent actual overinterpretation in the abstract and/or full-text conclusion, and a list of 9 items that represent potential overinterpretation. Two investigators independently used the items to score each included systematic review, with disagreements resolved by consensus.

RESULTS
We included 112 systematic reviews. The majority had a positive conclusion regarding the accuracy or clinical usefulness of the investigated test in the abstract (n = 83; 74%) and full-text (n = 83; 74%). Of the 112 reviews, 81 (72%) contained at least 1 actual form of overinterpretation in the abstract, and 77 (69%) in the full-text. This was most often a “positive conclusion, not reflecting the reported summary accuracy estimates,” in 55 (49%) abstracts and 56 (50%) full-texts and a “positive conclusion, not taking high risk of bias and/or applicability concerns into account,” in 47 abstracts (42%) and 26 full-texts (23%). Of these 112 reviews, 107 (96%) contained a form of potential overinterpretation, most frequently “nonrecommended statistical methods for metaanalysis performed” (n = 57; 51%).

CONCLUSIONS
Most recent systematic reviews of diagnostic accuracy studies present positive conclusions and a majority contain a form of overinterpretation. This may lead to unjustified optimism about test performance and erroneous clinical decisions and recommendations.
EVALUACIÓN DEL IMPACTO SOBRE EL MARGEN BRUTO DE UN CONJUNTO DE ESTRATEGIAS DE MANEJO EN LA ACTIVIDAD LECHERA
Authors: ROSSLER N. , GIUSIANO J. , BLANGETTI D. 
Published: June 2017

Utilizando la metodología de estudio de caso se comparó el margen bruto de un tambo ubicado al oeste de la provincia de Córdoba, con su manejo habitual versus una situación hipotética mejorada del mismo. El objetivo fue evaluar el impacto económico de algunas estrategias de manejo que mejoran los indicadores productivos y reproductivos del sistema.Los problemas identifi cados están vinculados a cuestiones de manejo del rodeo en particular y del sistema en general: elevado porcentaje de rechazo y muerte de animales, bajas carga animal, relación VO/VT y producción individual de leche, venta de animales en categorías regulares, elevado nivel de Gastos sanitarios. La solución de estos problemas mediante la implementación de estrategias de manejo debajo o nulo costo repercutió de manera positiva en el margen bruto, principalmente por un incrementoen los ingresos. El margen bruto de la situación mejorada duplicó al margen bruto de la situación actual.
MITIGACIÓN DEL ESTRÉS CALÓRICO DURANTE EL PREPARTO EN VACAS LECHERAS
Authors: TOFFOLI G. D. , LEVA P. E. , SOSA J. L. , GHIANO J. E. J. , FERNANDEZ G. B. , GARCIA M. S. , TAVERNA M. , WALTER E. 
Published: June 2017

Se utilizaron 30 vacas en preparto que se alojaron en un corral seco con acceso a sombra artificial durante el verano. Las vacas fueron distribuidas en dos grupos: sin refrescado (TS) y con refrescado (TR) en el sector comedero. El peso corporal y la condición corporal fueron evaluadas al inicio y a los 25 días. La frecuencia respiratoria se realizó dos veces por semana en cuatro momentos del día. El registro de comportamiento dos veces a la semana. Los datos de analizaron con t Student y χ2. El peso y condición corporal no presentaron diferencia signifi cativa. Se observó un efecto del tratamiento en el día y horario para la frecuencia respiratoria (p<0,0001). La conducta de parado a la sombra fue al que dedicaron mayor tiempo en ambos tratamientos 27 % en TS y 29 % en TR. No hubo diferencias en la producción lechera entre TS y TR: 31,4 l/v/d y 30,6 l/v/d respectivamente.
Women as Public Scientists in the Atomic Age
Authors: Richmond Marsha L. 
Published: June 2017

With the onset of the atomic age in 1945, geneticists increasingly spoke out about how nuclear fallout and radiation impacted heredity and reproduction. The scholarship discussing post–World War II activism focuses almost exclusively on males, with little attention given to women who served as public scientists or the role gender played in gaining public trust and influencing policy makers. This paper examines two women, both trained in genetics, who became activists in the 1950s and 1960s to educate the public about the dangers radiation and wartime chemicals posed to the human germ plasm. In Genetics in the Atomic Age (1956), Charlotte Auerbach (1899–1994) described basic genetic principles to explain why radiation-induced mutations could be harmful. In Silent Spring (1962), Rachel Carson (1907–1964) drew on genetics to warn about the possible mutagenic properties of DDT along with other concerns. Both women fostered scientific literacy to empower an informed citizenry that could influence public policy. They appealed both to men and to the growing cadre of middle-class educated women, encouraging an expanded role for maternal responsibility: not only protecting families but also the well-being of all humankind.
This essay is part of a special issue entitled THE BONDS OF HISTORY edited by Anita Guerrini.
Exploring Interprofessional, Interagency Multimorbidity Care: Case Study Based Observational Research
Authors: McKinlay Eileen M. , Morgan Sonya J. , Gray Ben V. , Macdonald Lindsay M. , Pullon Susan R.H. 
Published: June 2017

Background The increase in multimorbidity or co-occurring chronic illnesses is a leading healthcare concern. Patients with multimorbidity require ongoing care from many different professionals and agencies, and often report a lack of integrated care. Objective To explore the daily help-seeking behaviours of patients with multimorbidity, including which health professionals they seek help from, how professionals work together, and perceptions and characteristics of effective interprofessional, interagency multimorbidity care. Design Using a case study observational research design, multiple data sources were assembled for four patients with multimorbidity, identified by two general practitioners in New Zealand. In this paper, two case studies are presented, including the recorded instances of contact and communication between patients and professionals, and between professionals. Professional interactions were categorized as consultation, coordination, or collaboration. Results The two case studies illustrated two female patients with likely similar educational levels, but with different profiles of multimorbidity, social circumstances, and personal capabilities, involving various professionals and agencies. Engagement between professionals showed varying levels of interaction and a lack of clarity about leadership or care coordination. The majority of interactions were one-to-one consultations and rarely involved coordination and collaboration. Patients were rarely included in communications between professionals. Conclusion Cases constructed from multiple data sources illustrate the complexity of day-to-day, interprofessional, interagency multimorbidity care. While consultation is the most frequent mode of professional interaction, targeted coordinated and collaborative interactions (including the patient) are highly effective activities. Greater attention should be given to developing and facilitating these interactions and determining who should lead them.
Early Sign Language Exposure and Cochlear Implantation Benefits
Authors: Geers Ann E. , Mitchell Christine M. , Warner-Czyz Andrea , Wang Nae-Yuh , Eisenberg Laurie S. ,   the CDaCI Investigative Team
Published: June 2017

BACKGROUND:
Most children with hearing loss who receive cochlear implants (CI) learn spoken language, and parents must choose early on whether to use sign language to accompany speech at home. We address whether parents’ use of sign language before and after CI positively influences auditory-only speech recognition, speech intelligibility, spoken language, and reading outcomes.

METHODS:
Three groups of children with CIs from a nationwide database who differed in the duration of early sign language exposure provided in their homes were compared in their progress through elementary grades. The groups did not differ in demographic, auditory, or linguistic characteristics before implantation.

RESULTS:
Children without early sign language exposure achieved better speech recognition skills over the first 3 years postimplant and exhibited a statistically significant advantage in spoken language and reading near the end of elementary grades over children exposed to sign language. Over 70% of children without sign language exposure achieved age-appropriate spoken language compared with only 39% of those exposed for 3 or more years. Early speech perception predicted speech intelligibility in middle elementary grades. Children without sign language exposure produced speech that was more intelligible (mean = 70%) than those exposed to sign language (mean = 51%).

CONCLUSIONS:
This study provides the most compelling support yet available in CI literature for the benefits of spoken language input for promoting verbal development in children implanted by 3 years of age. Contrary to earlier published assertions, there was no advantage to parents’ use of sign language either before or after CI.