bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of aqueous extract of Arctium lappa L. roots on serum lipid metabolism
Authors: Hou Bo , Wang Wencheng , Gao Hui , Cai Shanglang , Wang Chunbo 
Published: July 2017

Objective To identify potential genes that may be involved in lipid metabolism in rats after treatment with aqueous extract of Arctium lappa L (burdock). Methods Rats were randomly divided into six groups: (i) control (standard diet); (ii) model group (high-fat diet only); (iii) high-fat diet and low-dose aqueous burdock root extract (2 g/kg); (iv) high-fat diet and moderate-dose aqueous burdock root extract (4 g/kg); (v) high-fat diet and high-dose aqueous burdock root extract (8 g/kg); and (vi) a positive control group exposed to a high-fat diet and simvastatin (10 mg/kg). Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis was performed to find the potential candidate genes involved in the modulation of blood lipids by treatment with aqueous burdock root extract. Results Burdock root extract reduced body weight and cholesterol levels in rats. KEGG analysis revealed 113 genes that were involved in metabolic pathways. Of these, 27 potential genes associated with blood lipid metabolism were identified. Conclusions Aqueous extract of burdock root reduced body weight and cholesterol in rats, possibly by modulating the differential expression of genes.
One-year clinical outcomes of patients implanted with a Resolute Onyx™ zotarolimus-eluting stent
Authors: Tam Chor Cheung , Chan Kelvin , Lam Simon , Yung Arthur , Lam Yui Ming , Chan Carmen , Siu David , Tse Hung Fat 
Published: July 2017

Objective To evaluate the 1-year clinical outcomes of patients who received the Resolute Onyx™ stent. Methods This was a single-centre, retrospective registry analysis that reviewed the clinical data from all patients who were implanted with a Resolute Onyx™ stent between March 2015 and February 2016. Clinical follow-up was performed at 1 year post-implantation. Results A total of 252 patients received a Resolute Onyx™ stent and two patients were lost to follow-up. The mean age of the cohort was 66.9 years and 113 (45.2%) had diabetes mellitus. Thirty-eight patients (15.2%) had left main disease and 73 (29.2%) had three-vessel disease. A total of 175 patients (70.0%) had small vessel disease (<2.75 mm) and 210 (84.0%) had long lesions (>20 mm). The 1-year target lesion failure was 4.4% (11 of 250), cardiovascular death occurred in eight patients (3.2%), ischaemia-driven target lesion revascularization was undertaken in five patients (2.0%) and stent thrombosis occurred in one patient (0.4%). Conclusion The Resolute Onyx™ stent showed a favourable 1-year clinical performance in a real-world population.
Utilization and safety of onabotulinumtoxinA for the prophylactic treatment of chronic migraine from an observational study in Europe
Authors: Matharu Manjit , Pascual Julio , Nilsson Remahl Ingela , Straube Andreas , Lum Arlene , Davar Gudarz , Odom Dawn , Bennett Lee , Proctor Christina , Gutierrez Lia , Andrews Elizabeth , Johannes Catherine 
Published: July 2017

Objective To examine treatment utilization patterns and safety of onabotulinumtoxinA for the prophylactic treatment of chronic migraine in routine clinical practice. Background Clinical trials support onabotulinumtoxinA for the prophylaxis of headache in patients with chronic migraine, but real-world data are limited. Design/methods A prospective, observational, post-authorization study in adult patients with chronic migraine treated with onabotulinumtoxinA. Data were collected at the first study injection and approximately every three months for ≤52 weeks for utilization and ≤64 weeks for safety data, and summarized using descriptive statistics. Results Eighty-five physicians (81% neurologists) at 58 practices in the United Kingdom, Germany, Spain, and Sweden participated and recruited 1160 patients (84.2% female, median age 46.6 years). At baseline, 85.8% of patients had physician diagnoses of chronic migraine/transformed migraine and reported an average of 11.3 (SD = 6.9) severe headache days per 28 days; 50.6% had previously used onabotulinumtoxinA for chronic migraine. A total of 4017 study treatments were observed. The median number of injection sites (n = 31) and total dose (155 U) were consistent across all treatment sessions, with a median 13.7 weeks observed between sessions. At least one treatment-related adverse event was reported by 291 patients (25.1%); the most frequently reported treatment-related adverse event was neck pain (4.4%). Most patients (74.4%) were satisfied/extremely satisfied with onabotulinumtoxinA treatment. Conclusions Patient demographics/characteristics are consistent with published data on the chronic migraine population. Utilization of onabotulinumtoxinA treatment for chronic migraine appears to be consistent with the Summary of Product Characteristics and published PREEMPT injection paradigm. No new safety signals were identified.
Shrinking lung syndrome in systemic lupus erythematosus: a single-centre experience
Authors: Deeb M , Tselios K , Gladman DD , Su J , Urowitz MB 
Published: July 2017

Introduction Shrinking lung syndrome (SLS) is a rare manifestation of systemic lupus erythematosus (SLE), characterized by decreased lung volumes and extra-pulmonary restriction. The aim of this study was to describe the characteristics of SLS in our lupus cohort with emphasis on prevalence, presentation, treatment and outcomes. Patients and methods Patients attending the Toronto Lupus Clinic since 1980 ( n = 1439) and who had pulmonary function tests (PFTs) performed during follow-up were enrolled ( n = 278). PFT records were reviewed to characterize the pattern of pulmonary disease. SLS definition was based on a restrictive ventilatory defect with normal or slightly reduced corrected diffusing lung capacity for carbon monoxide (DLCO) in the presence of suggestive clinical (dyspnea, chest pain) and radiological (elevated diaphragm) manifestations. Data on clinical symptoms, functional abnormalities, imaging, treatment and outcomes were extracted in a dedicated data retrieval form. Results Twenty-two patients (20 females) were identified with SLS for a prevalence of 1.53%. Their mean age was 29.5 ± 13.3 years at SLE and 35.7 ± 14.6 years at SLS diagnosis. Main clinical manifestations included dyspnea (21/22, 95.5%) and pleuritic chest pain (20/22, 90.9%). PFTs were available in 20 patients; 16 (80%) had decreased maximal inspiratory (MIP) and/or expiratory pressure (MEP). Elevated hemidiaphragm was demonstrated in 12 patients (60%). Treatment with prednisone and/or immunosuppressives led to clinical improvement in 19/20 cases (95%), while spirometrical improvement was observed in 14/16 patients and was mostly partial. Conclusions SLS prevalence in SLE was 1.53%. Treatment with glucocorticosteroids and immunosuppressives was generally effective. However, a chronic restrictive ventilatory defect usually persisted.
Featured Article: Delivery of chemotherapeutic vcMMAE using tobacco mosaic virus nanoparticles
Authors: Kernan Daniel L , Wen Amy M , Pitek Andrzej S , Steinmetz Nicole F 
Published: July 2017

The first-line treatment for non-Hodgkin’s lymphoma is chemotherapy. While generally well tolerated, off-target effects and chemotherapy-associated complications are still of concern. To overcome the challenges associated with systemic chemotherapy, we developed a biology-inspired, nanoparticle drug delivery system (nanoDDS) making use of the nucleoprotein components of the tobacco mosaic virus (TMV). Virus-based nanoparticles, including the high-aspect ratio soft nanorods formed by TMV, are growing in popularity as nanoDDS due to their simple genetic and chemical engineerability, size and shape tunability, and biocompatibility. In this study, we used bioconjugation to modify TMV as a multivalent carrier for delivery of the antimitotic drug valine-citrulline monomethyl auristatin E (vcMMAE) targeting non-Hodgkin’s lymphoma. We demonstrate successful synthesis of the TMV-vcMMAE; data indicate that the TMV-vcMMAE particles remained structurally sound with all of the 2130 identical TMV coat proteins modified to carry the therapeutic payload vcMMAE. Cell uptake using Karpas 299 cells was confirmed with TMV particles trafficking to the endolysosomal compartment, likely allowing for protease-mediated cleavage of the valine-citrulline linker for the release of the active monomethyl auristatin E component. Indeed, effective cell killing of non-Hodgkin’s lymphoma in vitro was demonstrated; TMV-vcMMAE was shown to exhibit an IC50 of ∼250 nM. This study contributes to the development of viral nanoDDS. Impact statement Due to side effects associated with systemic chemotherapy, there is an urgent need for the development of novel drug delivery systems. We focus on the high-aspect ratio nanotubes formed by tobacco mosaic virus (TMV) to deliver antimitotic drugs targeted to non-Hodgkin’s lymphoma. Many synthetic and biologic nanocarriers are in the development pipeline; the majority of systems are spherical in shape. This may not be optimal, because high-aspect ratio filaments exhibit enhanced tumor homing, increased target cell interactions and decreased immune cell uptake, and therefore have favorable properties for drug delivery compared to their spherical counterparts. Nevertheless, the synthesis of high-aspect ratio materials at the nanoscale remains challenging; therefore, we turned toward the nucleoprotein components of TMV as a biologic nanodrug delivery system. This work presents groundwork for the development of plant virus-based vehicles for use in cancer treatment.
Differential characteristics, stroke recurrence, and predictors of covert atrial fibrillation of embolic strokes of undetermined source
Authors: Hawkes Maximiliano A , Farez Mauricio F , Pertierra Lucia , Gomez-Schneider Maia M , Pastor-Rueda José M , Ameriso Sebastián F 
Published: July 2017

Background and purpose Identifying embolic strokes of undetermined source (ESUS) patients likely to harbor atrial fibrillation may have diagnostic and therapeutic implications. Our aim was to examine differences between ESUS and cardioembolic strokes, to evaluate stroke recurrence rate among ESUS and to identify baseline characteristics of ESUS patients who were later diagnosed with atrial fibrillation. Materials and methods We assessed all ischemic stroke patients admitted between June 2012 and November 2013. ESUS were compared to cardioembolic strokes at discharge. After at least 12-month follow-up, ESUS patients diagnosed with atrial fibrillation were compared to those who remained as ESUS. Results There were 236 ischemic strokes, 32.6% were ESUS. Compared to cardioembolic strokes, ESUS were younger (p < 0.0001), had milder strokes (p < 0.05), less prevalence of hypertension (p < 0.05), peripheral vascular disease (p < 0.05), and previous ischemic stroke (p < 0.05). After follow-up, 15% of ESUS patients had stroke recurrences and 12% evidenced paroxysmal atrial fibrillation. ESUS patients diagnosed with atrial fibrillation in the follow-up were older (p < 0.0001), had higher erythrocyte sedimentation rate (p < 0.05), and were more likely to have ≥2 infarcts in the same arterial territory in the initial magnetic resonance imaging (p < 0.05). Conclusions Older age, small-scattered infarcts on initial magnetic resonance imaging and high erythrocyte sedimentation rate levels appear to identify ESUS patients more likely to be diagnosed of atrial fibrillation during follow-up.
Randomized Prospective Analysis of Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis: 1 Year Follow-up
Authors: Forsythe Brian , Zuke William , Go Beatrice , Yanke Adam Blair , Verma Nikhil N. , Romeo Anthony A. 
Published: July 2017

Objectives: Biceps pathology typically includes pain in the anterior shoulder that is reproduced with provocative maneuvers. However, optimal treatment of patient with this diagnosis is not clear and can include tenotomy or various forms of tenodesis. As tenotomy can lead to cosmetic deformity and anterior humeral discomfort from spasms, many surgeons perform tenodesis. Technique for tenodesis includes intra-articular soft tissue fixation or osseous fixation, suprapectoral osseous fixation, and subpectoral osseous fixation. Focusing on the later two, it is unclear if there is a clinical or surgical benefit of performing an open subpectoral biceps tenodesis (OBT) versus arthroscopic suprapectoral biceps tenodesis (ABT). We therefore designed this randomized clinical trial to assess these two techniques. Methods: Patients diagnosed with biceps tendinopathy meeting the inclusion and exclusion criteria were randomized into the arthroscopic and mini-open biceps tenodesis groups. Prior to surgery, patients were asked a series of questions regarding their anterior shoulder pain and underwent a subsequent shoulder exam. Follow-up was d at 3 months, 6 months, and 1 year time points, during which the shoulder exam and patient questionnaires were also d. Results: A total of 38 patients were enrolled with a mean age of 43.5 ± 10.5 years and a mean BMI of 28.3 ± 5.4. All patients had arthroscopic evidence of biceps pathology and underwent either an ABT (18) or an OBT (20). All patients underwent a concomitant arthroscopic subacromial decompression. The surgical time for the ABT group, 17.2 ± 3.7 minutes, was significantly greater than the OBT group, 11.7 ± 6.1 (p<0.01). One patient was converted from the ABT group to the OBT group due to sheering of a severely attenuated tendon preventing an ABT. One patient in the OBT group required a revision tenodesis. No significant difference (p > 0.05) was found in strength or anterior shoulder pain at 3 months, 6 months, and 1 year. Additionally, no significant difference (p > 0.05) was found in clinical outcome scores (ASES, Constant subjective, WORC, KJOC) between the two groups. Conclusion: This randomized clinical trial suggests there is no clinical difference between the two techniques. Additionally, while the arthroscopic procedure requires more surgical time, the revision rates are not different. Besides the cosmetic concern for an additional scar, we recommend decisions to be made based on surgeon preference and experience.
Effect of Patellar Tunnel Placement on Fracture Risk after MPFL Reconstruction- A Cadaveric Study
Authors: Lukosius Eric , Bonazza Nicholas , Lewis Greg , Roush Evan , Black Kevin P. , Dhawan Aman 
Published: July 2017

Objectives: Patella fracture is a rare complication after medial patellofemoral ligament (MPFL) reconstruction. Though many of the cases in the literature have been precipitated by trauma, the surgical factors that may lead to a higher risk of fracture are not well understood. The purpose of our study was to determine if transosseous tunnels that exit through the anterior cortex of the patella, and transverse bone tunnels have lower tensile load to failure as compared to control, and may predispose to post-operative patellar fracture. Methods: Fresh-frozen cadaveric human patellas were randomized to one of three groups: a control group with unmodified intact patellas, a group with two transverse tunnels (TT) drilled in the superior third of the patella that did not violate the anterior cortex, and a group with two transversetunnels that breach anterior cortex of the patella (PA). Patellas were connected to a freeze clamp mechanism via the remaining quadriceps and patellar tendons. A load cell was connected in series with the quadriceps clamp to measure maximum load to failure with a maximum load of 9000N. The angle of pull was fixed at 45 degrees, with the patella set in the trochlear groove of a composite synthetic femur. Patellas were cyclically loaded to 500 N for a total of 100 cycles. Specimens that did not fail during cyclic loading were then loaded to failure defined as fracture or tendon rupture. At failure, fluoroscopy was used to confirm a fracture if present and maximum load was recorded. The mean and standard deviation (STD) for each group were recorded. ANOVA and Student-T tests were used to identify significant differences between groups. Results: A total of 26 patellas were randomized and tested in this study. There were 12 male and 14 female patellas ranging in age from 37-95 years. There was no significant difference in the average age among the groups (Mean = 71.4 years, STD = 11.5 years, P =0.96). None of the patellas failed during cyclic loading alone. Control, TT and PA groups failed at 1915 N (STD= 508N), 1901 N (STD= 884N), and 1640 N (STD= 625N) respectively. This represents a 14% difference in means between Control and PA and Control and TT tunnels. There was no statistically significant difference between control and TT (p=.969), control and PA (p=.321), and TT and PA (p=.488). Subset analysis of fractures only through bone tunnels did not affect the significance. Conclusion: Our results show that breeching of the anterior cortex and transosseous tunnels that do not breach the anterior cortex during MPFL reconstruction do not significantly decrease the load to failure when compared to native patellas and, thus, may not pose an increased risk for patellar fracture. Further research is needed to analyze if other surgical factors may predispose to this complication.
Decreased Shoulder External Rotation and Flexion are Greater Predictors of Injury than Internal Rotation Deficits: Analysis of 132 Pitcher-Seasons in Professional Baseball
Authors: Camp Christopher L. , Sinatro Alec , Spiker Andrea , Werner Brian C. , Altchek David W. , Coleman Struan H. , Dines Joshua S. 
Published: July 2017

Objectives: There is a strong desire to identify modifiable risk factors for shoulder and elbow injuries in pitchers, that when corrected, have the potential to reduce injury burden. Although much attention has been paid to Glenohumeral Internal Rotation Deficits (GIRD), less is known about the value of other range of motion (ROM) deficits. Therefore, the purpose of this work was to determine the impact and predictive capacity of shoulder and elbow ROM on shoulder and elbow injuries in professional baseball pitchers. Methods: Over the course of 6 seasons (2010 to 2015), a comprehensive, preseason assessment of ROM was performed on all pitchers (n=132 pitcher-seasons) invited to Major League Baseball (MLB) Spring Training Camp for a single MLB organization. Total range of motion (TROM) and deficits were also calculated. All non-traumatic shoulder and elbow injuries that resulted in at least one day out of play were identified. Using multivariate binomial logistic regression analysis to control for age, height, weight, and all other ROM measures, the factors associated with an increased risk of subsequent shoulder or elbow injury were identified. Results: 53 shoulder (n=25) and elbow (n=28) injuries occurred during 132 pitcher-seasons. The most significant categorical risk factors associated with increased elbow injury rates included the presence of a shoulder ER deficit > 5° (OR 2.40; p=0.069) and shoulder flexion deficit > 5° (OR 2.83; p=0.042). For continuous variables, the most important factors included increasing shoulder ER deficit (OR 1.07, p=0.030), decreased shoulder flexion (OR 1.09, p=0.017), increased IR deficit (OR 1.04, p=0.068), weight (OR 1.10, p=0.012), and decreased shoulder ER (OR 1.06; p=0.076). Conclusion: A number of preseason ROM parameters are independent risk factors for the development of shoulder and elbow injuries during the upcoming season. This is particularly true for shoulder ER and flexion deficits. Although prior work has supported the importance of reducing GIRD in professional pitchers, this study demonstrates that deficits in shoulder ER and flexion are more significant predictors of subsequent injury.
Outcome for Arthroscopic Treatment of Anterior Inferior Iliac Spine/Subspine Related Hip Impingement
Authors: Nwachukwu Benedict Uchenna , Chang Brenda , Schairer William W. , Fields Kara G. , Nawabi Danyal H. , Kelly Bryan T. , Ranawat Anil S. 
Published: July 2017

Objectives: Extra-articular disorders of the hip are under-recognized and under-reported. Extra-articular forms of hip impingement can include anterior inferior iliac spine (AIIS) related subspine impingement. The purpose of this study was to investigate the outcome after arthroscopic treatment of anterior inferior iliac spine (AIIS)/Subspine related hip impingement. Methods: A prospective institutional hip preservation registry was reviewed to identify patients that underwent isolated arthroscopic AIIS decompression. Primary outcome tools captured in the registry included: the modified Harris Hip Score (mHHS), the Hip Outcome Score (HOS) and the international Hip Outcome Tool (iHOT-33). Patients with minimum one-year follow-up were included. Meaningful outcome improvement was determined based on minimal clinically important difference (MCID). Statistical analyses were primarily descriptive. Results: Thirty-three patients with mean follow-up 19.1 months (range: 12-44 months) were identified. All patients were female with a mean age of 26.1 (+ 10.3) years. All patients were found to have an associated labral tear and the mean acetabular version was increased at 2 and 3 o’clock (14.5 and 19.8 respectively). Mean pre-operative outcome scores on the mHHS, HOS activities of daily living (ADL), HOS Sport and iHOT-33 were 57.2 (SD+15.3), 66.9 (SD+18.8), 43.9 (SD+23.6) and 33.5 (SD+18.3) respectively. At final available follow-up, mean scores on these outcome measures were 79.5 (SD+19.0), 86.8 (SD+15.8), 70.4 (SD+32.8) and 65.0 (SD+31.0) respectively. By the one-year follow-up interval MCID had been achieved in the majority of patients across all four tools. Conclusion: There is a paucity of outcome evidence on AIIS/Subspine related hip impingement. This study demonstrates that isolated subspine impingement can be a cause of hip disability even in the absence of FAI. Patients with isolated subspine impingement are more likely to be women and they present with low patient reported outcome scores. Meaningful outcome improvement can be achieved however with arthroscopic AIIS decompression.