bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Isolated Chronic Osteochondral Fracture of the Third Metatarsal Head Treated With Bioabsorbable Pins
Authors: Kurashige Toshinori , Suzuki Seiichi 
Published: February 2016

An osteochondral fracture of the metatarsal head is generally the result of direct trauma and is associated with additional proximal fractures of the medially adjacent metatarsals. An isolated osteochondral fracture of the metatarsal head is extremely rare, with only 10 published case reports. Open reduction and internal fixation was performed in 6 of 10 cases and in 2 of 4 chronic cases, each with different implants previously. The mechanism of injury was considered to be shear force in 5 of the reported cases. It is difficult to achieve and maintain reduction in these cases, and the best method for treatment of this type of fracture is unclear. We report a case of an isolated chronic osteochondral fracture of the third metatarsal head in a 14-year-old boy. The boy reported pain in his third metatarsophalangeal joint on dismounting from a bicycle 2 months prior to presentation. He could play soccer at first; however, the pain worsened after running long distances. Therefore, he was referred to our department. Magnetic resonance imaging revealed an osteochondral fracture of the metatarsal head without Freiberg’s disease. We achieved a good result 12 months postoperatively by using open reduction and internal fixation with 2 bioabsorbable thread pins. Levels of Evidence: Therapeutic, Level IV: Case study
Intentions to receive a potentially available Lyme disease vaccine in an urban sample
Authors: Fogel Joshua , Kusz Martin 
Published: February 2016

Objectives: The only human Lyme disease vaccine of LYMErix was voluntarily removed from the market in the United States in 2002 for a number of reasons. A new human Lyme disease vaccine is currently being developed. We would like any future approved human Lyme disease vaccine to be of interest and marketable to consumers. Methods: We surveyed 714 participants to determine variables associated with intentions to receive a Lyme disease vaccine. Predictor variables included demographics, protection motivational theory, Lyme disease knowledge, Lyme disease preventive behaviors, beliefs and perceived health. Results: We found in multivariate linear regression analyses that Asian/Asian American race/ethnicity ( p < 0.001), South Asian race/ethnicity ( p = 0.01) and coping appraisal variables of response efficacy ( p < 0.001) and self-efficacy ( p < 0.001) were each significantly associated with increased intentions. The belief that vaccines are typically not safe was significantly associated with decreased intentions ( p = 0.03). Conclusions: Asian/Asian American and South Asian race/ethnicities have a strong interest in receiving a Lyme disease vaccine. Although pharmaceutical companies may benefit by advertising a Lyme disease vaccine to Asian/Asian Americans and South Asians, marketers need to address and use approaches to interest those from other race/ethnicities. Also, marketers need to address the erroneous belief that vaccines are typically not safe in order to interest those with such beliefs to use a Lyme disease vaccine.
Personalized medicine in thrombosis: back to the future
Authors: Nagalla Srikanth , Bray Paul F. 
Published: February 2016

AbstractMost physicians believe they practiced personalized medicine prior to the genomics era that followed the sequencing of the human genome. The focus of personalized medicine has been primarily genomic medicine, wherein it is hoped that the nucleotide dissimilarities among different individuals would provide clinicians with more precise understanding of physiology, more refined diagnoses, better disease risk assessment, earlier detection and monitoring, and tailored treatments to the individual patient. However, to date, the “genomic bench” has not worked itself to the clinical thrombosis bedside. In fact, traditional plasma-based hemostasis-thrombosis laboratory testing, by assessing functional pathways of coagulation, may better help manage venous thrombotic disease than a single DNA variant with a small effect size. There are some new and exciting discoveries in the genetics of platelet reactivity pertaining to atherothrombotic disease. Despite a plethora of genetic/genomic data on platelet reactivity, there are relatively little actionable pharmacogenetic data with antiplatelet agents. Nevertheless, it is crucial for genome-wide DNA/RNA sequencing to continue in research settings for causal gene discovery, pharmacogenetic purposes, and gene-gene and gene-environment interactions. The potential of genomics to advance medicine will require integration of personal data that are obtained in the patient history: environmental exposures, diet, social data, etc. Furthermore, without the ritual of obtaining this information, we will have depersonalized medicine, which lacks the precision needed for the research required to eventually incorporate genomics into routine, optimal, and value-added clinical care.
Modafinil/armodafinil in obstructive sleep apnoea: a systematic review and meta-analysis
Authors: Chapman Julia L. , Vakulin Andrew , Hedner Jan , Yee Brendon J. , Marshall Nathaniel S. 
Published: February 2016

Modafinil is used internationally to treat residual sleepiness despite continuous positive airway pressure in obstructive sleep apnoea (res-OSA). In 2011, the European Medicines Agency removed the indication based on an unfavourable risk–benefit profile in two trials for efficacy and all accumulated safety data. We performed a meta-analysis of all randomised controlled trials of modafinil (or armodafinil) in res-OSA to quantify efficacy and safety.We systematically searched and assessed studies from major databases, conferences and trials registries to find randomised, placebo-controlled trials of modafinil/armodafinil for ≥2 weeks in adult res-OSA treating sleepiness.We analysed 10 of the 232 articles identified that met inclusion criteria (1466 patients). Modafinil/armodafinil improved the Epworth Sleepiness Scale score (2.2 points, 95% CI 1.5–2.9) and the Maintenance of Wakefulness Test over placebo (3 min, 95% CI 2.1–3.8 min). Modafinil/armodafinil tripled adverse events and doubled adverse events leading to withdrawal but did not increase serious adverse events (hospitalisations or death).Modafinil and armodafinil improve subjective and objective daytime sleepiness in res-OSA. We believe our analysis is a fairer analysis of the risk–benefit profile of this indication. Clinicians may want to use this data to balance the risks and benefits on a case-by-case basis with their patients.
Pulmonary artery size as a predictor of outcomes in idiopathic pulmonary fibrosis
Authors: Shin Stephanie , King Christopher S. , Puri Nitin , Shlobin Oksana A. , Brown A. Whitney , Ahmad Shahzad , Weir Nargues A. , Nathan Steven D. 
Published: February 2016

IPF patients have heightened propensity for pulmonary hypertension, which portends a worse outcome. Presence of pulmonary hypertension may be reflected in an enlarged pulmonary artery. We investigated pulmonary artery size measured on high-resolution computed tomography (HRCT) as an outcome predictor in IPF.We retrospectively reviewed all IPF patients evaluated at a tertiary-care centre between 2008 and 2013. Pulmonary artery and ascending aorta diameters were measured from chest HRCT with pulmonary artery:ascending aorta diameter (PA:A) ratio calculations. Outcome analysis defined by either death or lung transplant based on pulmonary artery size and PA:A ratio over 60 months was performed. Independent effects of different variables on overall outcomes were evaluated using the Cox proportional hazards model.98 IPF patients with available HRCT scans had a mean pulmonary artery diameter and PA:A ratio of 32.8 mm and 0.94, respectively. Patients with a PA:A ratio >1 had higher risk of death or transplant compared with a PA:A ratio ≤1 (p<0.001). A PA:A ratio >1 was also an independent predictor of outcomes in unadjusted and adjusted outcomes analyses (hazard ratio 3.99, p<0.001 and hazard ratio 3.35, p=0.002, respectively).A PA:A ratio >1 is associated with worse outcomes in patients with IPF. HRCT PA:A ratio measurement may assist in risk stratification and prognostication of IPF patients.
The lived experience with idiopathic pulmonary fibrosis: a qualitative study
Authors: Overgaard Dorthe , Kaldan Gudrun , Marsaa Kristoffer , Nielsen Thyge Lynghøj , Shaker Saher Burhan , Egerod Ingrid 
Published: February 2016

The disease course in idiopathic pulmonary fibrosis (IPF) is variable, but patients experience a progressive decline in lung function and increased symptom burden leading to death. Little is known about the patients' experience and their needs during the disease course or about the burden on family caregivers. Both patients and family caregivers face an altered life as the disease progresses. The aim of our study was to increase knowledge of life with IPF for patients and family caregivers.This study had a qualitative descriptive design using in-depth dyadic interviews with IPF patients (n=25) and family caregivers (n=24). We used the five-step analysis from the framework method and analysed the data on three levels: the patient, the family caregivers and couple level.The following six themes emerged as the main results: information and disclosure, reactional dyssynchrony, perpetual vigilance, emotional ambivalence, gradual and tacit role shift, and adapted coping strategies.Our findings suggest that IPF patients need information at the time of diagnosis, but some issues should be paced as the disease progresses. A palliation plan was demanded by patients and their caregivers. Further efforts are required to provide palliative care to IPF patients starting at the time of diagnosis.
Natural history of sleep disordered breathing in prepubertal children transitioning to adolescence
Authors: Bixler Edward O. , Fernandez-Mendoza Julio , Liao Duanping , Calhoun Susan , Rodriguez-Colon Sol M. , Gaines Jordan , He Fan , Vgontzas Alexandros N. 
Published: February 2016

Because there is a lack of agreed upon diagnostic criteria, it is critical to understand the natural history of obstructive sleep apnoea (OSA) in children in order to establish treatment strategies based on objective data.The Penn State Child Cohort is a representative, general-population sample of 700 elementary school children at baseline, of whom 421 were reassessed 8 years later, during adolescence.The remission of childhood apnoea–hypopnoea index (AHI) ≥2 events per h in adolescence was 52.9%. Using the higher threshold of AHI ≥5 events per h, remission was 100.0%, with 50.0% partially remitting to AHI 2– <5 events per h and the other half remitting to AHI <2 events per h. The incidence of adolescent AHI ≥2 events per h in those with childhood AHI <2 events per h was 36.5%, while the incidence of AHI ≥5 events per h in those with childhood AHI <5 events per h was 10.6%. This longitudinal study confirms that prepubertal OSA tends to resolve naturally during the transition to adolescence, and that primary snoring and mild sleep disordered breathing (SDB) do not appear to be strongly associated with progression to more severe SDB.The key risk factors for SDB in adolescence are similar to those found in middle-aged adults (i.e.male sex, older age and obesity). Moreover, consistent with recent studies in adults, this study includes the novel cross-sectional finding that visceral fat is associated with SDB as early as adolescence.
A tetraspanin regulates septate junction formation in Drosophila midgut
Authors: Izumi Yasushi , Motoishi Minako , Furuse Kyoko , Furuse Mikio 
Published: February 2016

ABSTRACT
Septate junctions (SJs) are membrane specializations that restrict the free diffusion of solutes through the paracellular pathway in invertebrate epithelia. In arthropods, two morphologically different types of septate junctions are observed; pleated (pSJs) and smooth (sSJs), which are present in ectodermally and endodermally derived epithelia, respectively. Recent identification of sSJ-specific proteins, Mesh and Ssk, in Drosophila indicates that the molecular compositions of sSJs and pSJs differ. A deficiency screen based on immunolocalization of Mesh identified a tetraspanin family protein, Tsp2A, as a newly discovered protein involved in sSJ formation in Drosophila. Tsp2A specifically localizes at sSJs in the midgut and Malpighian tubules. Compromised Tsp2A expression caused by RNAi or the CRISPR/Cas9 system was associated with defects in the ultrastructure of sSJs, changed localization of other sSJ proteins, and impaired barrier function of the midgut. In most Tsp2A mutant cells, Mesh failed to localize to sSJs and was distributed through the cytoplasm. Tsp2A forms a complex with Mesh and Ssk and these proteins are mutually interdependent for their localization. These observations suggest that Tsp2A cooperates with Mesh and Ssk to organize sSJs.
Problems of Definition and Use of Tolerance at Risk Management
Authors: Габриелов  , Gabrielov A. , Бархатов  , Barkhatov Vladimir , Удовин  , Udovin I. 
Published: February 2016

Risk tolerance is a widely used concept which, however, has no unambiguous
definition. In this paper are considered key distinctions in &#34;risk tolerance&#34;
term understanding in the context of a company’s risk management
system. The authors have allocated factors influencing tolerance level, and
have analyzed main approaches to this tolerance definition. A review of
actual practice for risk tolerance use in Russian and foreign companies is
presented in this paper. At conclusion the authors have defined problems
related to tolerance use in projects’ and organizations’ risk management
system, and also have formulated further research directions in this area.
Open reduction and internal fixation for the treatment of fractures of the lateral humeral condyle with an early delayed presentation in children
Authors: Liu T. J. , Wang E. B. , Dai Q. , Zhang L. J. , Li Q. W. , Zhao Q. 
Published: February 2016

Aims The treatment of late presenting fractures of the lateral humeral condyle in children remains controversial. Methods We report on the outcome for 16 children who presented with a fracture of the lateral humeral epicondyle at a mean of 7.4 weeks (3 to 15.6) after injury and were treated surgically. Results The mean follow-up was four years (1.1 to 8.9), at which time the mean age of the patients was 8.7 years (3.2 to 17.8). The mean Dhillon functional score improved from 3.3 to 5.6 and the mean overall scores improved from 5.6 to 8.5. A total of seven patients had a fishtail deformity and eight had partial lateral epiphyseal closure. None had avascular necrosis. MRI showed an abnormal cartilage signal, incongruence of the joint surface and partial premature closure of the lateral physis in four patients. Discussion Neither age at the time of injury, the time interval between injury and operation, nor the pre-operative function were correlated with the incidence of complications. These results support the use of internal fixation for children with a lateral humeral epicondylar fracture with a delayed presentation. Take home message: Open reduction and internal fixation yielded a satisfactory outcome within 16 weeks in children with a lateral humeral epicondylar fracture with a delayed presentation. Cite this article: Bone Joint J 2016;98-B:244–8.
Prediction of survival after surgery due to skeletal metastases in the extremities
Authors: Sørensen M. S. , Gerds T. A. , Hindsø K. , Petersen M. M. 
Published: February 2016

AimsThe purpose of this study was to develop a prognostic model for predicting survival of patients undergoing surgery owing to metastatic bone disease (MBD) in the appendicular skeleton.MethodsWe included a historical cohort of 130 consecutive patients (mean age 64 years, 30 to 85; 76 females/54 males) who underwent joint arthroplasty surgery (140 procedures) owing to MBD in the appendicular skeleton during the period between January 2003 and December 2008. Primary cancer, pre-operative haemoglobin, fracture versus impending fracture, Karnofsky score, visceral metastases, multiple bony metastases and American Society of Anaesthesiologist’s score were included into a series of logistic regression models. The outcome was the survival status at three, six and 12 months respectively. Results were internally validated based on 1000 cross-validations and reported as time-dependent area under the receiver-operating characteristic curves (AUC) for predictions of outcome.ResultsThe predictive scores obtained showed AUC values of 79.1% (95% confidence intervals (CI) 65.6 to 89.6), 80.9% (95% CI 70.3 to 90.84) and 85.1% (95% CI 73.5 to 93.9) at three, six and 12 months.DiscussionIn conclusion, we have presented and internally validated a model for predicting survival after surgery owing to MBD in the appendicular skeleton. The model is the first, to our knowledge, built solely on material from patients who only had surgery in the appendicular skeleton. Take home message: Applying this prognostic model will help determine whether the patients’ anticipated survival makes it reasonable to subject them to extensive reconstructive surgery for which there may be an extended period of rehabilitation. Cite this article: Bone Joint J 2016;98-B:271–7.
International metal-on-metal multidisciplinary teams
Authors: Berber R. , Skinner J. , Board T. , Kendoff D. , Eskelinen A. , Kwon Y-M. , Padgett D. E. , Hart A. 
Published: February 2016

Aims There are many guidelines that help direct the management of patients with metal-on-metal (MOM) hip arthroplasties. We have undertaken a study to compare the management of patients with MOM hip arthroplasties in different countries. Methods Six international tertiary referral orthopaedic centres were invited to participate by organising a multi-disciplinary team (MDT) meeting, consisting of two or more revision hip arthroplasty surgeons and a musculoskeletal radiologist. A full clinical dataset including history, blood tests and imaging for ten patients was sent to each unit, for discussion and treatment planning. Differences in the interpretation of findings, management decisions and rationale for decisions were compared using quantitative and qualitative methods. Results Overall agreement between the orthopaedic centres and the recommended treatment plans for the ten patients with MOM hip implants was moderate (kappa = 0.6). Full agreement was seen in a third of cases, however split decisions were also seen in a third of cases. Units differed in their interpretation of the significance of the investigation findings and put varying emphasis on serial changes, in the presence of symptoms. Discussion In conclusion, the management of raised or rising blood metal ions, cystic pseudotumours and peri-acetabular osteolysis led to inconsistency in the agreement between centres. Coordinated international guidance and MDT panel discussions are recommended to improve consensus in decision making. Take home message: A lack of evidence and the subsequent variation in regulator guidance leads to differences in opinions, the clinical impact of which can be reduced through a multi-disciplinary team approach to managing patients with MOM hip implants. Cite this article: Bone Joint J 2016;98-B:179–86.
Alice and Bix
Authors: Haim Albert , Barry Chris 
Published: February 2016

Just weeks before his death in the summer of 1931, Leon “Bix” Beiderbecke wrote to his parents that he was planning to marry a young lady named Alice O’Connell, mother’s maiden name Weiss. For years, aficionados and historians searched for her, hoping to learn more about Bix from one of the last people to know him. But they met with failure. Bix had the names of Alice’s father and mother reversed. We have identified the young woman as Alice Weiss, who, in 1931 was married to bassist Rex Gavitte and was listed in the 1930 U.S. Census as Alice Gavitte, head of the household, living in Astoria, Long Island, New York with her younger sister Veronica. With the help of members of the Weiss family and through research in public documents, we have been able to construct a fairly detailed biographical sketch for Alice. Alice kept Bix’s piano from the time he died in August 1931 until she died in 1982. We have traced Bix’s piano to its current owner and purchased it. It is currently on permanent loan to the Bix Beiderbecke Museum and Archives in Davenport, Iowa.
15. Comparison of the Effect of a Standard Inclusion Level of Inorganic Zinc to Organic Form at Lowered Level on Bone Development in Growing Male Ross Broiler Chickens
Authors: Tomaszewska Ewa , Dobrowolski Piotr , Kwiecień Małgorzata , Wawrzyniak Agata , Burmańczuk Natalia 
Published: February 2016

Abstract
The purpose of this study was to compare the effect of a standard inclusion level of inorganic zinc to organic form at lowered level on the bone development in growing male Ross 308 chickens, assessed on the basis of mechanical, geometric, and histomorphometric parameters of limb bone, and bone zinc content, as well as hormones of somatotropic axis. A total of 80 one-day-old male Ross broiler chickens were randomly allocated to 2 groups of 40 chickens each. The control group was fed with a corn-soybean meal basal diet providing the recommended zinc amount (100 mg×kg-1) from zinc oxide, and the experimental group was supplemented with glycinate chelate providing 25% of the total requirement of the microelement recommended for Ross 308 broiler chicks. The mechanical and histomorphometric parameters and geometry of tibia were determined as well as the serum concentration of growth hormone, IGF-1, osteocalcin and leptin. The serum concentration of Zn, Cu, Ca, Mg, Fe, P and zinc bone content were determined. The results showed that birds fed with the diet supplemented with organic zinc in the amount of 25% of the recommended amount did not exhibit weight and general growth disorders and had an unchanged concentration of growth hormone, leptin, and IGF-1. The serum concentration of Zn, Cu, Ca, Mg, Fe, P did not differ between groups. The contents of zinc detected in bones in the controls and the group supplemented with the organic source did not differ as well. Although tibial mechanics and geometry remained unchanged, histomorphometry revealed a disproportionately large osteoporotic bone. The changes in tibial trabecular bone as a result of the diet supplemented with glycinate chelate only in 25% of the total requirement of the microelement recommended for Ross 308 broiler chicks seems to be insufficient for tibia development.