bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Biomechanical Study of Two Distinct Methods of Anterior Cruciate Ligament Rupture, and a Novel Surgical Reconstruction Technique, in a Small Animal Model of Posttraumatic Osteoarthritis
Authors: Ramme Austin , Lendhey Matin , Strauss Eric , Kennedy Oran 
Published: March 2017

AbstractSmall animal models are critical for studies of sports-related knee injury and disease such as posttraumatic osteoarthritis (PTOA) following anterior cruciate ligament (ACL) rupture. In such models, ACL damage can be achieved by surgical transection or, using a more recent innovation, by noninvasive biomechanical means. Whether these approaches differentially alter normal mechanics is unknown. Furthermore, while surgical reconstruction of ruptured ACL can greatly improve joint stability, its effect on PTOA development is also unclear. Our primary purpose was to characterize rodent knee joint mechanics in two models of ACL rupture using a novel quantitative laxity mechanical test. Our secondary aim was to characterize a new reconstruction technique using autograft tail tendon, and to assess its effect on joint mechanics. Our hypothesis was that surgical ACL transection would have a greater effect on joint mechanics. A total of 24 rat knee specimens underwent surgical or biomechanical ACL rupture and were stabilized using a new reconstruction technique using autograft tail tendon. Joint mechanics were assessed three times; preinjury, postinjury, and again after reconstruction, using quantitative joint laxity testing. Primary test readouts were maximum anteroposterior (AP) laxity, loading curve slope, and energy absorption. Student's t-tests were performed to identify intragroup differences. All surgical transections were completed successfully; maximum load in the biomechanical model was 67 ± 7.7 N, with a coefficient of variation of 11.43%. Surgical transection caused increased AP laxity, while biomechanical injury nonsignificantly increased this parameter. In both cases, these changes recovered to baseline by reconstruction. Loading curve slope was reduced in both models and was also returned to baseline by repair. Energy absorption followed the same pattern except it remained significantly different from baseline postreconstruction in the surgical group. This study supports our hypothesis knee joint mechanics is differentially affected by injury mechanism in a small animal model. We also report a novel reconstruction technique in this model, using autograft tail tendon.
Function of the Anterior Intermeniscal Ligament
Authors: Razu Swithin , Kuroki Keiichi , Cook James , Guess Trent 
Published: March 2017

AbstractThe function and importance of the anterior intermeniscal ligament (AIML) of the knee are not fully known. The purpose of this study was to evaluate the biomechanical and sensorimotor function of the AIML. Computational analysis was used to assess AIML and tibiomeniscofemoral biomechanics under combined translational and rotational loading applied during dynamic knee flexion–extension. Histologic and immunohistochemical examination was used to identify and characterize neural elements in the tissue. The computational models were created from anatomy and passive motion of two female subjects and histologic examinations were conducted on AIMLs retrieved from 10 fresh-frozen cadaveric knees. It was found that AIML strain increased with compressive knee loading and that external rotation of the tibia unloads the AIML, suppressing the relationship between AIML strain and compressive knee loads. Extensive neural elements were located throughout the AIML tissue and these elements were distributed across the three AIML anatomical types. The AIMLs have a beneficial influence on knee biomechanics with decreased meniscal load sharing with AIML loss. The AIML plays a significant biomechanical and neurologic role in the sensorimotor functions of the knee. The major role for the AIML may primarily involve its neurologic function.
Efficacy of Tranexamic Acid for Hemostasis in Patients Undergoing High Tibial Osteotomy
Authors: Suh Dong , Kyung Bong , Han Seung-Beom , Cheong Kuhoang , Lee Won 
Published: March 2017

AbstractExtensive bone bleeding and an uncomfortable hematoma can develop due to the opening gap and space during a medial open high tibial osteotomy (HTO). Tranexamic acid (TXA) has been used in various orthopaedic surgeries to reduce bleeding and wound complications. However, no study has investigated the effect of TXA during HTO. Therefore, the purpose of this study is to evaluate the efficacy of TXA in reducing postoperative blood loss in patients undergoing HTO. The hypothesis is that topical TXA administration will reduce postoperative bleeding in patients undergoing medial opening HTO. Topical TXA (2 g in 20 mL saline) was administered at the osteotomy site in patients (n = 15) who underwent medial open HTO from November 2015 to March 2016. Patients (n = 15) who underwent medial open wedge HTO by the same surgeon from October 2014 to October 2015 were enrolled as a control group for comparison. Drainage volumes on postoperative days (PODs) 1, 2, and 3 as well as hemoglobin (Hb) level on PODs 1, 6, and 13 were measured and compared. Mean total postoperative drainage volume was 246 mL in the TXA group and 377 mL in the control group. Mean drainage volume on POD 1 was 138 mL in the TXA group and 277 mL in the control group (p < 0.05). No differences in drainage volume were detected between the groups on POD 2 or 3. Preoperative Hb levels were 13.0 g/dL in the TXA group and 12.9 g/dL in the control group, which decreased to 11.9 g/dL in the TXA group and 11.2 g/dL in the control group on POD 1. These postoperative Hb differences were significant (p < 0.05). Also, Hb levels were 11.7 and 12.0 g/dL in the TXA group and 11.4 and 11.6 g/dL in the control group on PODs 6 and 13, respectively (p > 0.05). An extensive hematoma requiring additional surgery developed in one case in the control group. No wound complications were detected in the TXA group. Topical TXA was effective for reducing postoperative bleeding after medial open HTO. The level of evidence of the study is Level 3.
Adaptive Optiken – Möglichkeiten für die Diagnostik hereditärer Netzhauterkrankungen
Authors: Reiniger J. , Domdei N. , Pfau M. , Müller P. , Holz F. , Harmening W. 
Published: March 2017

ZusammenfassungAdaptive Optiken (AO) stellen eine technologische Schlüsselinnovation für die Bildgebung in der Ophthalmologie dar. Mit AO ausgestattete Ophthalmoskope erlauben es, die mikroskopische Netzhautstruktur nicht invasiv und auf zellulärer Ebene darzustellen. So kann die strukturelle Integrität der retinalen Nervenfaserschicht, des perifovealen Kapillarnetzwerks, einzelner Stäbchen- und Zapfenphotorezeptoren und des zellulären Mosaiks des retinalen Pigmentepithels in vivo beobachtet werden. Für die Beurteilung des Verlaufs von Netzhauterkrankungen, einer möglichen pharmakologischen Intervention und die Entschlüsselung der zugrunde liegenden physiologischen Mechanismen bedeutet dies eine völlig neue Untersuchungsebene. Insbesondere monogenetische Erkrankungen liegen im Fokus der aktuellen Forschung. Zum einen können Rückschlüsse auf einzelne Pathologien anderer multifaktorieller Netzhauterkrankungen gezogen und so die zugrundeliegenden physiologischen Mechanismen bzw. Verläufe genauer untersucht werden (Modellerkrankung). Zum anderen werden auch im Hinblick auf aktuelle und kommende Interventionen (u. a. Gentherapie) neuartige und zuverlässige Endpunkte zur Interpretation des Therapieerfolgs notwendig. Erste kommerzielle AO-Ophthalmoskope sind für den klinischen Einsatz erhältlich, und die Zahl mit AO untersuchter Netzhautpathologien wächst zunehmend. Für eine zellgenaue Struktur-Funktions-Korrelation kann jüngstens eine AO-basierte Mikrostimulationstechnologie eingesetzt werden.
Genersatztherapie bei hereditären Netzhauterkrankungen
Authors: Mühlfriedel R. , Sothilingam V. , Tanimoto N. , Seeliger M. 
Published: March 2017

ZusammenfassungCharakteristisch für erblich bedingte Netzhauterkrankungen sind Funktionsausfälle in der Reizaufnahme und Reizweiterleitung innerhalb der Netzhaut, die zur Reduktion des Sehvermögens bis zur Blindheit führen. Dabei verursachen genetisch bedingte Ausfälle photorezeptorspezifischer Gene eine große Zahl von klinisch und ursächlich abgrenzbaren Krankheitsbildern, wobei jedes für sich zu den seltenen Erkrankungen gehört. In ihrer Gesamtheit und mit einer Prävalenz von 1 : 2500 sind die erblichen Netzhauterkrankungen jedoch ein klinisch bedeutsamer Erkrankungstypus – insbesondere auch im Hinblick auf die damit einhergehenden Einschränkungen in der Erwerbsfähigkeit und dem Verlust an Lebensqualität für die Betroffenen. Bis heute konnten Mutationen in über 250 Genen identifiziert werden, die für die verschiedenen Formen erblicher Netzhautdystrophien verantwortlich sind (https://sph.uth.tmc.edu/Retnet). Die präklinische Forschung an geeigneten Tiermodellen hat in den letzten Jahren große Fortschritte im Verständnis der Mutation zugrunde liegender pathologischer und molekularbiologischer Vorgänge ermöglicht. Basierend auf diesen Erkenntnissen haben sich neue Perspektiven für die Entwicklung innovativer Therapiestrategien für erbliche Netzhauterkrankungen beim Menschen eröffnet, welche weltweit bislang noch nicht heilbar sind. Der Erfolg präklinischer Studien hat zum Beginn mehrerer humaner Translationen geführt. Die Ergebnislage der laufenden humanen Studien macht jedoch auch die Notwendigkeit sichtbar, Optimierungsstrategien des neuen therapeutischen Ansatzes zu entwickeln und zu prüfen.
Potenzial von fMRT für die Funktionsüberprüfung des pathologischen Sehsystems
Authors: Hoffmann M. , Thieme H. , Ahmadi K. 
Published: March 2017

ZusammenfassungAktuelle Entwicklungen zur funktionellen Magnetresonanztomografie (fMRT) des menschlichen visuellen Kortex haben eine Reihe von aussagekräftigen Ansätzen hervorgebracht, die vielversprechend für die moderne Ophthalmologie sind. Sie ermöglichen die objektive gesichtsfeldspezifische Überprüfung der Sehfunktion auch bei stark sehbehinderten Patienten und sogar die Untersuchung der funktionellen Organisation des visuellen Kortex von blinden Patienten. Damit eröffnen sie einerseits ein breites Anwendungsspektrum bei der ophthalmologischen Funktionsüberprüfung und andererseits grundlegende Einblicke in die Interaktion von Pathologie und Plastizität im menschlichen Sehsystem. Dies verdeutlichen aktuelle Studien an Patienten mit erworbenen und angeborenen Makuladefekten, Sehbahnabnormalitäten, flächigen Netzhautschäden und vollständiger Blindheit. Insbesondere zukünftige Therapieverfahren zur Restauration des visuellen Eingangs könnten hiervon wesentlich profitieren, sei es bei der Beurteilung der Erfolgschancen einer anstehenden retinalen Therapie oder als Biomarker für das objektive Auslesen des Therapieerfolgs.
On Classical Global Solutions of Nonlinear Wave Equations with Large Data
Authors: Miao Shuang , Pei Long , Yu Pin 
Published: March 2017

Abstract
This article studies the Cauchy problem for systems of semi-linear wave equations on $\mathbb{R}^{3+1}$ with nonlinear terms satisfying the null conditions. We construct future global-in-time classical solutions with arbitrarily large initial energy. The choice of the large Cauchy initial data is inspired by Christodoulou's characteristic initial data in his work [2] on formation of black holes. The main innovation of the current work is that we discovered a relaxed energy ansatz which allows us to prove decay-in-time-estimate. Therefore, the new estimates can also be applied in studying the Cauchy problem for Einstein equations.
UV surface habitability of the TRAPPIST-1 system
Authors: O’Malley-James Jack T. , Kaltenegger L. 
Published: March 2017

Abstract
With the discovery of rocky planets in the temperate habitable zone (HZ) of the close-by cool star TRAPPIST-1, the question of whether such planets could harbour life arises. Habitable planets around red dwarf stars can orbit in radiation environments that can be life-sterilizing. Ultraviolet (UV) flares from these stars are more frequent and intense than solar flares. Additionally, their temperate HZs are closer to the star. Here we present UV surface environment models for TRAPPIST-1’s HZ planets and explore the implications for life. TRAPPIST-1 has high X-ray/extreme-ultraviolet activity, placing planetary atmospheres at risk from erosion. If a dense Earth-like atmosphere with a protective ozone layer existed on planets in the HZ of TRAPPIST-1, UV surface environments would be similar to the present-day Earth. However, an eroded or an anoxic atmosphere would allow more UV to reach the surface, making surface environments hostile even to highly UV tolerant terrestrial extremophiles. If future observations detect ozone in the atmospheres of any of the planets in the HZ of TRAPPIST-1, these would be interesting targets for the search for surface life. We anticipate our assay to be a starting point for in-depth exploration of stellar and atmospheric observations of the TRAPPIST-1 planets to constrain their UV surface habitability.
Imaging Approaches to Stroke and Neurovascular Disease
Authors: Dehkharghani Seena , Andre Jalal 
Published: March 2017

Abstract
Imaging is paramount to the diagnosis and management of ischemic stroke, offering a battery of structural and functional probes of cerebrovascular physiology. The technical underpinnings of stroke imaging continue to evolve, bringing the neuroscience community increasingly closer to high-resolution, tissue-level biomarkers of brain perfusion, metabolism, and viability. The rapid expansion of neuroimaging in this domain has met with controversies, and in many respects, a lack of generalizable conclusions regarding optimized use in cerebrovascular disease. This review aims to provide the reader with the depth and scope of both established and emerging techniques, and an overview of prevailing viewpoints regarding neuroimaging in acute ischemic stroke.
Underestimated anuran radiations in the high Andes: five new species and a new genus of Holoadeninae, and their phylogenetic relationships (Anura: Craugastoridae)
Authors: De la Riva Ignacio , Chaparro Juan C , Castroviejo-Fisher Santiago , Padial José M 
Published: March 2017

AbstractDespite recent efforts to accelerate exploration and species description, the diversity of high Andean frogs remains highly underestimated. We report high levels of species diversity in direct-developing frogs or terraranas inhabiting the wet puna and adjacent cloud forests of the Amazonian versant of the Andes in Bolivia and Peru. Descriptive evidence of external morphology, distribution patterns and molecular phylogenetic analyses support the existence of nine unnamed species in two clades, which represents a 30% increase in species diversity for those clades. The relationships of these species and their relatives in Holoadeninae are tested using nuclear and mitochondrial genes for 159 terminals representing the 11 genera in this subfamily and 25 species of previously unknown relationships. Our results corroborate species monophyly in all but three cases and support the monophyly of all Holoadeninae genera, albeit the position of some differs between analyses. We propose a new genus (Microkayla gen. nov.) for the clade containing all Bolivian species formerly in Psychrophrynella plus five species from southern Peru. The new genus is monophyletic and supported by anatomical synapomorphies. Psychrophrynella is re-diagnosed and redefined to include three species from the Andes of southern Peru. We discuss the taxonomic instability associated with Noblella and Psychrophrynella due to the fact that the type species of both genera share a number of traits that support a close relationship. We also name and describe three new species of Bryophryne and two of Microkayla from Peru, provide baseline data for the future description of four Bolivian species of Microkayla, and describe the unknown mating calls of two species. Our results support that the grasslands of the Amazonian versant of the Andes harbour a large diversity of species with small altitudinal and horizontal distributions that replace each other along a latitudinal axis. These species belong to different lineages whose closest relatives are forest species, often from distant parts of the continent. These patterns suggest that high Andean environments were colonized several times independently by species with forest ancestors and which radiated into a multitude of species with remarkably similar ecomorphologies. The extent of these radiations remains obscured by a still rudimentary knowledge of species diversity due to insufficient fieldwork and taxonomic research.
Real-time ultrasound-guided thoracentesis
Authors: Krackov Rachel , Rizzolo Denise 
Published: March 2017

ABSTRACT
Clinicians commonly see patients with pleural effusions requiring thoracentesis. The latest evidence-based guidelines for thoracentesis recommend real-time ultrasound guidance for the safest outcomes from this procedure. This article reviews real-time ultrasound guidance for thoracentesis to help referring clinicians understand the technique and the guidelines for the performance of thoracentesis.
Using PAs in prehospital environments to reduce ED and EMS overuse
Authors: Thompson Katherine M. , Tozier William L. 
Published: March 2017

ABSTRACT
Emergency medical services (EMS) and EDs in large cities are burdened with a significant number of patients with chronic disease who have limited options for receiving proper care. Despite their relatively small numbers, these “superusers” can have a significant effect on EMS, particularly in large cities. Additionally, EDs are not designed to provide chronic and continuous healthcare. This article describes how several organizations use physician assistants to manage these patients.
PAs in orthopedics in the VHA's community-based outpatient clinics
Authors: Reed Daniel O. , Hooker Roderick S. 
Published: March 2017

ABSTRACT
In the Veterans Health Administration (VHA) system, most orthopedic care takes place in the VA medical centers (VAMCs). Because most patients receiving orthopedic care were referred by adult medicine providers, more widely deploying physician assistants (PAs) in orthopedic medicine might help offset this workload. An orthopedic medicine demonstration project recruited, trained, and positioned PAs in community-based outpatient clinics (CBOCs) to improve access to care. The project involved surgeons at the Houston VAMC instructing five newly employed PAs in a wide range of orthopedic evaluation and management strategies before their assignment to a CBOC. An administrative assessment compared encounter data pre- and postproject (2012 and 2014) to determine if this strategy modified orthopedic workload and improved patient access to care. By 2014, orthopedic patient visit volume had increased 31%—10% at the VAMC and 21% at the five CBOCs. Overall, the five deployed PAs managed 28% of all orthopedic encounters spread over 1 year and only 3.2% of visits required VAMC referral for further evaluation or treatment. During the project, the total volume of patient visits increased throughout the Houston VAMC region but access to care for this specialty service also increased, with more veteran musculoskeletal care being met at the five CBOCs, off-loading visit demand centrally. The adaptability and flexibility of new roles has been identified as one of the defining characteristics of PAs. That the VHA can take advantage of this role malleability suggests that employing PAs is useful in meeting medical service needs of veterans.
Development of the United Kingdom physician associate profession
Authors: Aiello Matthew , Roberts Karen A. 
Published: March 2017

ABSTRACT
The world of healthcare is changing, and patient needs are changing with it. Traditional doctor-driven models of workforce planning are no longer sustainable in the United Kingdom (UK) healthcare economy, and newer models are needed. In the multiprofessional, multiskilled clinical workforce of the future, the physician associate (PA) has a fundamental role to play as an integrated, frontline, generalist clinician. As of 2016, about 350 PAs were practicing in the UK, with 550 PAs in training and plans to expand rapidly. This report describes the development of the PA profession in the UK from 2002, with projections through 2020, and includes governance, training, and the path to regulation. With rising demands on the healthcare workforce, the PA profession is predicted to positively influence clinical workforce challenges across the UK healthcare economy.
Dose-Response Relationship Between Exercise Intensity, Mood States, and Quality of Life in Patients With Heart Failure
Authors: Evangelista Lorraine S. , Cacciata Marysol , Stromberg Anna , Dracup Kathleen 
Published: March 2017

Background:
We conducted a secondary analysis to (1) compare changes in mood disorders and quality of life (QOL) among 4 groups of patients with heart failure in a home-based exercise program who had varying degrees of change in their exercise capacity and (2) determine whether there was an association between exercise capacity, mood disorders, and QOL.

Methods:
Seventy-one patients were divided into 4 groups based on changes in exercise capacity from baseline to 6 months: group 1showed improvements of greater than 10% (n = 19), group 2 showed improvements of 10% or less (n = 16), group 3 showed reductions of 10% or less (n = 9), and group 4 showed reductions of greater than 10% (n = 27).

Results:
Over time, patients in all 4 groups demonstrated significantly lower levels of depression and hostility (P < .001) and higher levels of physical and overall quality of life (P = .046). Group differences over time were noted in anxiety (P = .009), depression (P = .015), physical quality of life (P < .001), and overall quality of life (P = .002). Greater improvement in exercise capacity was strongly associated with lower depression scores (r = −0.49, P = .01).

Conclusions:
An improvement in exercise capacity with exercise training was associated with a decrease in depression and anxiety and an increase in QOL in patients with heart failure.
Accuracy of Clinician Assessments of Medication Status in the Emergency Setting
Authors: Lopez Leonardo V. , Shaikh Atef , Merson Jonathan , Greenberg Jessica , Suckow Raymond F. , Kane John M. 
Published: March 2017

Abstract

Purpose
The present study aimed to assess the level of agreement between clinicians’ routine assessments of medication status and plasma levels of commonly prescribed antipsychotic medications in patients presenting to an emergency room with an exacerbation of psychosis.

Methods
We studied 105 patients presenting to an emergency room and admitted to an inpatient psychiatric unit with a diagnosis of schizophrenia, schizoaffective disorder, bipolar I disorder, or psychotic disorder not otherwise specified and a prior outpatient medication regimen including risperidone, olanzapine, quetiapine, aripiprazole, or paliperidone. Plasma levels of antipsychotics were drawn and sent to a specialty laboratory for testing.

Findings
Of the 97 patients with usable samples, 33 (34%) were found to have therapeutic antipsychotic levels. Of these, 22 were judged by emergency room staff to be taking their medications at the appropriately prescribed doses, whereas 11 were judged not to be taking medication at all. Sixty-four patients were found to have subtherapeutic antipsychotic levels, 31 of whom had been assessed to be taking medication as prescribed. Emergency assessment of medication status predicted therapeutic and nontherapeutic antipsychotic levels at rates of 41.5% and 75%, respectively. Emergency staff assessment was statistically independent from the likelihood of having a therapeutic antipsychotic level.

Implications
In patients presenting to emergency rooms with exacerbations of psychosis who are subsequently admitted to an inpatient facility, common assessments of medication status are frequently misleading. Readily available methods for rapidly measuring antipsychotic plasma levels in clinical settings are needed for clinicians to make reliable assessments.