bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chinese Ethnicity Is Associated With Concomitant Cartilage Injuries in Anterior Cruciate Ligament Tears
Authors: Chan Chloe Xiaoyun , Wong Keng Lin , Toh Shi Jie , Krishna Lingaraj 
Published: January 2018

Background: Chinese ethnicity is associated with the presence of knee osteoarthritis. This raises the possibility that it may similarly be associated with concomitant meniscus and cartilage injuries in patients with anterior cruciate ligament (ACL) tears. There are currently no published data on the effect of Chinese ethnicity in this regard. Purpose: The primary aim was to determine whether Chinese ethnicity is associated with concomitant intra-articular injuries in patients with ACL tears and to verify the correlation of age, sex, body mass index, mechanism of injury, cause of injury, and presence of bone contusions on magnetic resonance imaging with such injuries. A secondary purpose was to determine the optimal time frame for surgical reconstruction in patients with identified risk factors for concomitant injuries. Study Design: Cohort study; Level of evidence, 3. Methods: The medical records of 696 patients from a multiethnic population who underwent ACL reconstruction from January 2013 to August 2016 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify patient factors that were associated with medial meniscus tears, lateral meniscus tears, and cartilage injuries. Further univariate analysis was conducted to determine the earliest time point for surgery, after which the rate of concomitant injuries was significantly higher. Results: Over half (69.1%, n = 481) of our study population sustained at least 1 other concomitant knee injury. Meniscus tears were most frequently associated with ACL tears (24.1% medial, 25.6% lateral, and 15.5% medial and lateral meniscus tears). Cartilage injuries were present in 18.4% of our cohort. Chinese ethnicity was associated with concomitant cartilage injuries. Increased age (≥30 years) was significantly associated with cartilage injuries and male sex with medial and lateral meniscus tears. Among patients with these factors, significantly fewer medial meniscus tears and cartilage injuries were noted when surgery was carried out within 12 months of the index trauma. Conclusion: This is one of the first studies to have identified an association between Chinese ethnicity and concomitant cartilage injuries in ACL tears. This study also found an association between increased age and an increased prevalence of cartilage injuries. Male sex was associated with both medial and lateral meniscus tears. Definitive surgery should be performed within 12 months of the index injury to minimize further intra-articular injuries.
Creating Naptime
Authors: Knauert Melissa P , Redeker Nancy S , Yaggi Henry K , Bennick Michael , Pisani Margaret A 
Published: January 2018

Introduction: Patients in the intensive care unit (ICU) have significantly disrupted sleep. Sleep disruption is believed to contribute to ICU delirium, and ICU delirium is associated with increased mortality. Experts recommend sleep promotion as a means of preventing or shortening the duration of delirium. ICU Sleep promotion protocols are highly complex and difficult to implement. Our objective is to describe the development, pilot implementation, and revision of a medical ICU sleep promotion protocol. Methods: Naptime is a clustered-care intervention that provides a rest period between 00:00 and 04:00. We used literature review, medical chart review, and stakeholder interviews to identify sources of overnight patient disturbance. With stakeholder input, we developed an initial protocol that we piloted on a small scale. Then, using protocol monitoring and stakeholder feedback, we revised Naptime and adapted it for unitwide implementation. Results: We identified sound, patient care, and patient anxiety as important sources of overnight disturbance. The pilot protocol altered the timing of routine care with a focus on medications and laboratory draws. During the pilot, there were frequent protocol violations for laboratory draws and for urgent care. Stakeholder feedback supported revision of the protocol with a focus on providing 60- to 120-minute rest periods interrupted by brief clusters of care between 00:00 and 04:00. Discussion: Four-hour blocks of rest may not be possible for all medical ICU patients, but interruptions can be minimized to a significant degree. Involvement of all stakeholders and frequent protocol reevaluation are needed for successful adoption of an overnight rest period.
Willingness to Pay for Teledermoscopy Services at a University Health Center
Authors: Raghu T S , Yiannias James , Sharma Nita , Markus Allan L 
Published: January 2018

Background: The study objective was to investigate the willingness to pay (WTP) for teledermoscopy services among students at a university health center. The hypothesis was that WTP for teledermoscopy among students would exceed the costs for traditional consultation. Methods: Between November 2013 and May 2014, students at a university health center were surveyed for their perceptions of teledermoscopy. One set of responses was collected from students visiting the health center for any reason (anonymous sample). An additional set of responses was collected from students visiting for dermatologic lesions (in-person sample). A contingent valuation method with a maximum likelihood estimation procedure was used to estimate the WTP distribution. Results: A total of 214 surveys were collected for the anonymous sample and 41 responses for the in-person sample. The mean (standard deviation [SD]) WTP for the anonymous sample was $55.27 ($39.11; 95% confidence interval [CI]: $49.99-$60.55). The mean (SD) WTP for the in-person sample was $52.37 ($26.56; 95% CI: $43.99-$60.75). Median WTP for the 2 samples was similar: $48.84 and $48.01. Conclusions: We conclude that students would be willing to pay for teledermoscopy services that would provide the potential for significant system cost savings. This may be especially true in college health or similar settings where dermatology services may not be available.
Disrupting CD147-RAP2 interaction abrogates erythrocyte invasion by Plasmodium falciparum
Authors: Zhang Meng-Yao , Zhang Yang , Wu Xiao-Dong , Zhang Kun , Lin Peng , Bian Hui-Jie , Qin Min-Min , Huang Wan , Wei Ding , Zhang Zhao , Wu Jiao , Chen Ruo , Feng Fei , Wang Bin , Nan Gang , Zhu Ping , Chen Zhi-Nan 
Published: January 2018

Key PointsThe CD147-RAP2 interaction is essential for erythrocyte invasion by P falciparum and is independent from the known interactions involved. HP6H8, which specifically interrupts the CD147-RAP2 pair, is capable of complete elimination and prevention of P falciparum infection in humanized mice.
Persistently elevated exhaled nitric oxide fraction is associated with increased risk of exacerbation in COPD
Authors: Alcázar-Navarrete Bernardino , Ruiz Rodríguez Oliverio , Conde Baena Pablo , Romero Palacios Pedro José , Agusti Alvar 
Published: January 2018

Preventing the occurrence of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is a major therapeutic goal. We hypothesise that persistently increased levels of exhaled nitric oxide (FeNO) during follow-up can identify a group of COPD patients at higher risk of AECOPD.To test this hypothesis, we measuredFeNOlevels (HypAirFeNO®, Medisoft; Sorinnes, Belgium) prospectively in 226 clinically stable COPD outpatients at recruitment and during follow-up (at 6 and 12 months). Patients were stratified according to the number of visits withFeNO≥20 ppb.FeNOwas <20 ppb in all three visits in 44.2% of patients, 29.6% in visit 1 and 26.1% in visit 2 or 3. These three groups suffered progressively higher AECOPD rates during follow-up (0.67, 0.91 and 1.42, respectively, p<0.001). After adjusting for potential confounding variables (log-rank test), the hazard ratio for AECOPD was higher in the latter group (1.579 (95% CI 1.049–2.378), p=0.029). Likewise, time to first moderate and severe AECOPD was shorter in these patients. Finally, there was no relationship betweenFeNOlevels and circulating eosinophils.PersistentFeNOlevels ≥20 ppb in clinically stable COPD outpatients are associated with a significantly higher risk of AECOPD.
Intensity of exposure to pulmonary tuberculosis determines risk of tuberculosis infection and disease
Authors: Acuña-Villaorduña Carlos , Jones-López Edward C. , Fregona Geisa , Marques-Rodrigues Patricia , Gaeddert Mary , Geadas Carolina , Hadad David Jamil , White Laura F. , Pereira Dutra Molina Lucilia , Vinhas Solange , Ribeiro-Rodrigues Rodrigo , Salgame Padmini , Palaci Moises , Alland David , Ellner Jerrold J. , Dietze Reynaldo 
Published: January 2018

Household contacts of pulmonary tuberculosis (TB) patients are at increased risk of TB infection and disease. However, their risk in relation to the intensity of exposure remains unknown.We studied smear-positive TB cases and their household contacts in Vitória, Brazil. We collected clinical, demographic and radiographic information from TB cases, and obtained tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT) results from household contacts. We measured intensity of exposure using a proximity score and sleep location in relation to the TB index case and defined infection by TST ≥10 mm or QFT ≥0.35 UI·mL−1. We ascertained secondary TB cases by reviewing local and nationwide case registries.We included 160 TB index cases and 894 household contacts. 464 (65%) had TB infection and 23 (2.6%) developed TB disease. Risk of TB infection and disease increased with more intense exposures. In an adjusted analysis, the proximity score was associated with TB disease (OR 1.61, 95% CI 1.25–2.08; p<0.000); however, its diagnostic performance was only moderate.Intensity of exposure increased risk of TB infection and disease among household contacts; however, its diagnostic performance was still suboptimal. A biomarker to target preventive therapy is urgently needed in this at-risk population.
Neurophysiological mechanisms of exertional dyspnoea in fibrotic interstitial lung disease
Authors: Schaeffer Michele R. , Ryerson Christopher J. , Ramsook Andrew H. , Molgat-Seon Yannick , Wilkie Sabrina S. , Dhillon Satvir S. , Mitchell Reid A. , Sheel A. William , Khalil Nasreen , Camp Pat G. , Guenette Jordan A. 
Published: January 2018

Our understanding of the mechanisms of dyspnoea in fibrotic interstitial lung disease (ILD) is incomplete. The aims of this study were two-fold: 1) to determine whether dyspnoea intensity is better predicted by neural respiratory drive (NRD) or neuromechanical uncoupling (NMU) of the respiratory system in fibrotic ILD, and 2) to examine the effect of breathing 60% oxygen on NRD, NMU and dyspnoea ratings.Fourteen patients with fibrotic ILD were included. Visit 1 comprised a familiarisation incremental cycle exercise test, Visit 2 comprised a normoxic incremental cycling test to address Aim 1, and Visits 3 and 4 consisted of constant-load cycling while breathing room air or 60% oxygen to address Aim 2. Diaphragmatic electromyography (EMGdi) was used as a surrogate of NRD. NMU was calculated as the ratio between EMGdi (%max) and tidal volume (%vital capacity).On adjusted analysis, NMU and its constituents were all significantly associated with dyspnoea ratings during incremental cycling, with EMGdi having the strongest correlation. The between-treatment change in dyspnoea ratings during constant load cycling was only correlated with change in exercise endurance time and NMU.Dyspnoea more strongly reflected the level of EMGdi than NMU in fibrotic ILD. However, the improvement in dyspnoea with 60% oxygen was better predicted by improvements in NMU.
Efficacy of intravenous plus intrathecal/intracerebral ventricle injection of polymyxin B for post-neurosurgical intracranial infections due to MDR/XDR Acinectobacter baumannii: a retrospective cohort study
Authors: Pan Sijun , Huang Xiaofang , Wang Yesong , Li Li , Zhao Changyun , Yao Zhongxiang , Cui Wei , Zhang Gensheng 
Published: January 2018

Abstract
Background
Post-neurosurgical intracranial infections caused by multidrug-resistant or extensively drug-resistant Acinetobacter baumannii are difficult to treat and associated with high mortality. In this study, we analyzed the therapeutic efficacy of intravenous combined with intrathecal/intracerebral ventricle injection of polymyxin B for this type of intracranial infection.

Methods
This retrospective study was conducted from January 2013 to September 2017 at the Second Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou,China) and included 61 cases for which cerebrospinal fluid (CSF) cultures were positive for multidrug-resistant or extensively drug-resistant A. baumannii after a neurosurgical operation. Patients treated with intravenous and intrathecal/intracerebral ventricle injection of polymyxin B were assigned to the intrathecal/intracerebral group, and patients treated with other antibiotics without intrathecal/intracerebral injection were assigned to the intravenous group. Data for general information, treatment history, and the results of routine tests and biochemistry indicators in CSF, clinical efficiency, microbiological clearance rate, and the 28-day mortality were collected and analyzed.

Results
The rate of multidrug-resistant or extensively drug-resistant A. baumannii infection among patients who experienced an intracranial infection after a neurosurgical operation was 33.64% in our hospital. The isolated A. baumannii were resistant to various antibiotics, and most seriously to carbapenems (100.00% resistance rate to imipenem and meropenem), cephalosporins (resistance rates of 98.38% to cefazolin, 100.00% to ceftazidime, 100.00% to cefatriaxone, and 98.39% to cefepime). However, the isolated A. baumannii were completely sensitive to polymyxin B (sensitivity rate of 100.00%), followed by tigecycline (60.66%) and amikacin (49.18%). No significant differences in basic clinical data were observed between the two groups. Compared with the intravenous group, the intrathecal/intracerebral group had a significantly lower 28-day mortality (55.26% vs. 8.70%, P = 0.01) and higher rates of clinical efficacy and microbiological clearance (95.65% vs. 23.68%, P < 0.001; 91.30% vs. 18.42%, P < 0.001, respectively).

Conclusions
Intravenous plus intrathecal/intracerebral ventricle injection of polymyxin B is an effective regimen for treating intracranial infections caused by multidrug-resistant or extensively drug-resistant A. baumannii.
Retrospective Survival Analysis of Patients With Advanced Pancreatic Ductal Adenocarcinoma and Germline BRCA or PALB2 Mutations
Authors: Reiss Kim A. , Yu Shun , Judy Renae , Symecko Heather , Nathanson Katherine L. , Domchek Susan M. 
Published: January 2018

Purpose Germline mutations in the homologous recombination (HR) genes BRCA1, BRCA2, and PALB2 confer an increased risk for pancreatic ductal adenocarcinoma (PDAC). Tumors associated with mutations in HR genes are sensitive to DNA-damaging agents, such as platinum chemotherapies. We hypothesized that patients with PDAC with germline BRCA1, BRCA2, or PALB2 mutations may benefit preferentially from platinum-based chemotherapy. Materials and Methods Twenty-nine individuals with deleterious germline mutations in BRCA1, BRCA2, or PALB2 and a diagnosis of advanced PDAC (mut-positive) were matched 2:1 to patients who were noncarrier or untested (control) by age at diagnosis, year of diagnosis, stage, and sex. Patients were identified via one of two available databases at the University of Pennsylvania: the Basser Center for BRCA Registry or the University of Pennsylvania Electronic Medical Patient Record. Treatment history, including exposure to platinum-based chemotherapy, was ascertained. Primary objective was overall survival (OS). Results Patients who were mut-positive had an OS of 21.8 months; control patients had an OS of 8.1 months (hazard ratio [HR], 0.35; 95% CI, 0.2 to 0.62; P < .001). With platinum exposure, patients who were mut-positive had an undefined OS (median follow-up, 20.1 months), versus an OS of 15.5 months in the control patients (HR, 0.25; 95% CI, 0.1 to 0.61; P = .002). In patients not treated with platinum, there was no significant difference in OS between groups (HR, 0.54; 95% CI, 0.25 to 1.17; P = .12). When treated with platinum therapy, patients who were mut-positive had a 1-year OS of 94%, compared with a 1-year OS of 60% in control patients. Conclusion Platinum-based therapy may confer a survival benefit in patients with advanced PDAC who carry a deleterious germline BRCA1, BRCA2, or PALB2 mutation.
TCF7L1 suppresses primitive streak gene expression to support human embryonic stem cell pluripotency
Authors: Sierra Robert A. , Hoverter Nathan P. , Ramirez Ricardo N. , Vuong Linh M. , Mortazavi Ali , Merrill Bradley J. , Waterman Marian L. , Donovan Peter J. 
Published: January 2018

ABSTRACT
Human embryonic stem cells (hESCs) are exquisitely sensitive to WNT ligands, which rapidly cause differentiation. Therefore, hESC self-renewal requires robust mechanisms to keep the cells in a WNT inactive but responsive state. How they achieve this is largely unknown. We explored the role of transcriptional regulators of WNT signaling, the TCF/LEFs. As in mouse ESCs, TCF7L1 is the predominant family member expressed in hESCs. Genome-wide, it binds a gene cohort involved in primitive streak formation at gastrulation, including NODAL, BMP4 and WNT3. Comparing TCF7L1-bound sites with those bound by the WNT signaling effector β-catenin indicates that TCF7L1 acts largely on the WNT signaling pathway. TCF7L1 overlaps less with the pluripotency regulators OCT4 and NANOG than in mouse ESCs. Gain- and loss-of-function studies indicate that TCF7L1 suppresses gene cohorts expressed in the primitive streak. Interestingly, we find that BMP4, another driver of hESC differentiation, downregulates TCF7L1, providing a mechanism of BMP and WNT pathway intersection. Together, our studies indicate that TCF7L1 plays a major role in maintaining hESC pluripotency, which has implications for human development during gastrulation.
Informational Shocks, Off-Label Prescribing, and the Effects of Physician Detailing
Authors: Shapiro Bradley T. 
Published: January 2018

The relationship between pharmaceutical detailing and prescriptions for non-FDA-approved (off-label) use has been the subject of regulatory scrutiny, with more than $12 billion in regulatory settlements for off-label promotion since 2004. Using the case of AstraZeneca’s antipsychotic drug, Seroquel, I study the extent to which off-label prescriptions are caused by detailing. Using a physician panel that connects detailing exposure to medical charts, I exploit within-physician variation to identify detailing effects. I find the effect of detailing on off-label prescriptions is small in both absolute and relative terms. Detailing on net tilts the prescribing distribution toward on-label. This paper was accepted by Eric Anderson, marketing.
Preliminary results of an anteverting triple periacetabular osteotomy for the treatment of hip instability in down syndrome
Authors: Maranho D. A. , Kim Y.-J. , Williams K. A. , Novais E. N. 
Published: January 2018

Purpose To investigate the outcomes of an anteverting triple periacetabular osteotomy for the treatment of hip instability in skeletally immature patients with Down syndrome. Methods We evaluated 16 patients (21 hips) with Down syndrome and hip instability who underwent an anteverting triple periacetabular osteotomy between 2007 and 2016. There were nine females and seven males with an average age of 7.4 years SD 2.0. We assessed the level of hip pain, gait ability and clinical stability at a minimum of one year after surgery. Radiographic evaluation included pre- and postoperative lateral centre-edge angle (LCEA), Tönnis acetabular angle and extrusion index. Result After an average follow-up of 4.1 years SD 2.6, 20 of 21 hips (95%) remained clinically stable. In all, 12 of 16 (75%) patients had a full gait without a major limp, but three patients (19%) had a persistent limp. Of the 21 procedures, one hip (5%) was considered a failure due to persistent instability. There was a mean increase of 18.3º SD 15.3º of the LCEA (p < 0.001); a mean decrease of 15.2º SD 11.6º (p < 0.001) for the Tönnis angle and the extrusion index had a mean decrease of 0.27 SD 0.20 (p < 0.001). The most common complications were minor and included nonunion of the pubis or ischium (24%) and stress fractures of the pubis and ischium (14%). Only one patient required unplanned surgery for the treatment of an infection; which was considered a major complication. Conclusion The anteverting triple periacetabular osteotomy provided global deformity correction and achieved hip stability in 95% of the hips after a mean follow-up of 4.1 years. Level of Evidence Therapeutic level IV.
Practicing Multicultural Education through Religiously Affiliated Schools and Its Implications for Social Change
Authors: Rohman Miftahur , Lessy Zulkipli 
Published: January 2018

Abstract
Having varied ethnics, cultures, religions, or faiths, Indonesia is considered a multicultural nation in today’s world. This equity can be dangerous; but also can be advantageous if myriad interests of citizens are able to be nurtured through education, including religious schools. The research was conducted to explore multicultural practices in the State-owned Islamic High School (MAN) 3 and the Catholic High School (SMA) Stella Duce 2 in Yogyakarta Indonesia. Data was gathered via qualitative method by means of comparative study, aiming at seeking similarities and differences on promoting multicultural education values. Findings show similarities of teachers’ attitudes and characteristics as facilitator, accommodator, or assimilator whereas the differences include their leadership role in intrareligious dialog at MAN 3 and dialog leaders at SMA Stella Duce 2. Other issues include diverse understandings of religion and its perceived violence. The research formulates two categories of teacher as being multicultural-intrareligious pluralist and multicultural-intrareligious humanist. It also discusses implications on social change as a result of cultural interchange at those schools.
Keywords: Multiculturalism, Education, Madrasah, Boarding, Social Change
Abstrak
Memiliki variasi etnik, budaya, agama, atau kepercayaan, Indonesia kini dianggap sebagai negara multikultural. Kekayaan ini dapat menjadi bahaya; tetapi juga menjadi keuntungan bilamana perbedaan kepentingan dan kecenderungan ini dapat dipelihara melalui sekolah, termasuk yang bernafaskan agama. Penelitian ini dilakukan untuk menggali praktek multikultur di MAN 3 dan SMA Stella Duce 2 Yogyakarta Indonesia. Pengumpulan data dilakukan melalui metode kualitatif dengan cara perbandingan, bertujuan mencari kesamaan dan perbedaan dalam rangka promosi nilai-nilai pendidikan multikultural. Temuan menunjukkan kesamaan sikap dan karakteristik para guru berperan sebagai fasilitator, akomodator, atau asimilator sementara perbedaan mencakup peran mereka sebagai pemandu dialog seagama khususnya di MAN 3 dan pemandu dialog antaragama di SMA Stella Duce 2. Isu-isu lain termasuk beragam pemahaman tentang agama dan agama dipersepsikan sumber kekerasan. Penelitian ini menandai dua kategori guru sebagai pluralis multikultur-seagama dan humanis multikultur-antaragama. Penelitian ini juga mendiskusikan implikasi bagi perubahan sosial sebagai akibat dari pertukaran budaya yang terjadi di kedua sekolah tersebut.

Kata Kunci: Multikulturalisme, Pendidikan, Madrasah, Asrama, Perubahan Sosial