bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy, Safety and Mucosal Healing of Methotrexate in a Large Longitudinal Cohort of Inflammatory Bowel Disease Patients
Authors: Rouiller-Braunschweig Carole , Fournier Nicolas , Pittet Valérie , Dudler Jean , Michetti Pierre 
Published: October 2017

<b><i>Background/Aims:</i></b> Evidence for the effectiveness of methotrexate (MTX) in treating inflammatory bowel disease (IBD) is still incomplete. This study assessed the effectiveness, safety and mucosal healing in IBD patients treated with MTX in the Swiss IBD Cohort. <b><i>Methods:</i></b> Efficacy was defined by physician assessment or by CD activity index &#x3c;150 points for Crohn’s disease (CD) or Modified Truelove and Witts activity index &#x3c;4 points for ulcerative colitis (UC), measured at least after 3 months of MTX therapy. Mucosal healing was evaluated after 3 months or more of therapy. <b><i>Results:</i></b> MTX was administered to 341 patients (262 CD; 79 UC) out of 2,660 patients. MTX effectiveness was 59.5% (128/215) in CD and 40.0% (24/60) in UC (chi<sup>2</sup> = 7.2409, <i>p</i> = 0.007). Among patients on MTX therapy at the time of analysis, remission was obtained in 87.4% (76/87) and 69.2% (9/13) for CD and UC patients respectively. The median duration of MTX therapy was 40 months for CD and 15 months for UC. Occurrence of adverse events was the first reason for treatment discontinuation (39.4% of all cases). The rate of mucosal healing with MTX was 9.5% for CD and 25% for UC patients respectively. <b><i>Conclusion:</i></b> MTX therapy was effective for the induction and maintenance therapy in IBD patients, with only a modest mucosal healing ability.
HERBARTIAN IDEAS IN EDUCATIONAL THEORY AND PRACTICE
Authors: Fedchyshyn N. O. , Klishch H. I. , Yelahina N. I. 
Published: October 2017

Мета статті – оцінити вплив гербартіанських ідей на освітню теорію і практику.Основна частина. У статті обґрунтовано новий підхід до розв’язання проблеми теорії і практики гербартіанської педагогіки в німецькомовних країнах другої половини ХІХ – ХХ ст. Проаналізовано передумови реформування системи освіти та розкрито оцінку діяльності гербартіанців в історії педагогіки. Виявлено відмінності між поглядами Й.-Ф. Гербарта і гербартіанцями. Установлено, що історія педагогічної думки країн Західної Європи представлена широким спектром різноманітних педагогічних течій та концепцій.Висновки. Зважаючи на особливості дефініцій морально-релігійні уявлення, педагогічний такт, культурно-історичні ступені навчання, встановлено, що гербартіанці акцентували увагу на розвитку дитини відповідно до психологічних законів й рекомендували підбір розумово-розвиваючого матеріалу, слідуючи ідеї про культурно-історичні ступені й на цій основі підготували та обґрунтували по-новому систему навчального плану, що певною мірою суперечило поглядам їх вчителя.
Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta‐analysis
Authors: Sukato Daniel C. , Abramowitz Jason M. , Boruk Marina , Goldstein Nira A. , Rosenfeld Richard M. 
Published: October 2017

ObjectiveUp to 75% of patients with chronic rhinosinusitis (CRS) suffer with poor sleep quality and reduced quality of life. Endoscopic sinus surgery has demonstrated encouraging results in improving sleep function. The aim of this systematic review is to assess the change in sleep quality after surgery for CRS.Data SourcesPubMed, Web of Science, EMBASE.Review MethodsAn electronic search was conducted with the keywords “sinusitis” or “rhinosinusitis” and “sleep.” Studies were included only when adults underwent endoscopic sinus surgery and were evaluated pre‐ and postoperatively by the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Apnea‐Hypopnea Index (AHI), the sleep domain of Sino‐Nasal Outcome Test–22, or the sleep domain of Rhinosinusitis Disability Index.ResultsThe database search yielded 1939 studies, of which 7 remained after dual‐investigator screening. The standardized mean differences (95% CI) for the ESS, PSQI, and AHI were −0.94 (−1.63 to −0.26), −0.80 (−1.46 to −0.14), and −0.20 (−0.32 to −0.07), indicating large, moderate to large, and small improvements, respectively. All analyses displayed high heterogeneity (I2 = 95%‐99%).ConclusionSleep quality, as measured by the ESS and PSQI surveys, shows substantial improvement after surgery for CRS, with smaller improvement seen for AHI. Generalizability of our results is limited by high heterogeneity among studies and by broad confidence intervals that cannot exclude small to trivial changes. The findings of this meta‐analysis provide insight into the effect of CRS‐related endoscopic sinus surgery on sleep quality, which should guide future research direction and counseling of patients in the clinical setting.
High‐Level Disinfection of Otorhinolaryngology Clinical Instruments: An Evaluation of the Efficacy and Cost‐effectiveness of Instrument Storage
Authors: Yalamanchi Pratyusha , Yu Jason , Chandler Laura , Mirza Natasha 
Published: October 2017

ObjectivesDespite increasing interest in individual instrument storage, risk of bacterial cross‐contamination of otorhinolaryngology clinic instruments has not been assessed. This study is the first to determine the clinical efficacy and cost‐effectiveness of standard high‐level disinfection and clinic instrument storage.MethodsTo assess for cross‐contamination, surveillance cultures of otorhinolaryngology clinic instruments subject to standard high‐level disinfection and storage were obtained at the start and end of the outpatient clinical workday. Rate of microorganism recovery was compared with cultures of instruments stored in individual peel packs and control cultures of contaminated instruments. Based on historical clinic data, the direct allocation method of cost accounting was used to determine aggregate raw material cost and additional labor hours required to process and restock peel‐packed instruments.ResultsAmong 150 cultures of standard high‐level disinfected and co‐located clinic instruments, 3 positive bacterial cultures occurred; 100% of control cultures were positive for bacterial species (P <. 001). There was no statistical difference between surveillance cultures obtained before and after the clinic day. While there was also no significant difference in rate of contamination between peel‐packed and co‐located instruments, peel packing all instruments requires 6250 additional labor hours, and conservative analyses place the cost of individual semicritical instrument storage at $97,852.50 per year.DiscussionWith in vitro inoculation of >200 otorhinolaryngology clinic instruments, this study demonstrates that standard high‐level disinfection and storage are equally efficacious to more time‐consuming and expensive individual instrument storage protocols, such as peel packing, with regard to bacterial contamination.Implications for PracticeStandard high‐level disinfection and storage are equally effective to labor‐intensive and costly individual instrument storage protocols.
Randomized controlled trial of chest tube removal aided by a party balloon
Authors: Thitivaraporn Puwadon , Narueponjirakul Natawat , Samorn Pasurachate , Prichayudh Supparerk , Sriussadaporn Sukanya , Pak-art Rattaplee , Sriussadaporn Suvit , Kritayakirana Kritaya 
Published: October 2017

Background Recurrent pneumothorax is one of the most common complications after thoracostomy tube removal. The purpose of this study was to assess the optimal method of thoracostomy tube removal by comparing party balloon-assisted Valsalva and classic Valsalva techniques. Methods Trauma patients with indications for tube thoracostomy from 2014 to 2015 were recruited. Exclusion criteria were age < 15- or > 64-years-old, history of chronic lung disease, Glasgow Coma Scale < 13, latex allergy, or tracheostomy. Participants were randomly allocated by randomized block design into 4 groups using different Valsalva maneuvers: group A: classic inspired, group B: classic expired, group C: balloon-inspired; and group D: balloon-expired. The primary and secondary outcomes were recurrent pneumothorax and respiratory complications. Results Forty-eight tube thoracostomies were randomized for analysis; 4 patients had bilateral tube thoracostomies. The mean patient age was 38.1 ± 19.9 years. The incidence of recurrent pneumothorax confirmed by chest radiography was 15.4% in group A, 16.8% in group B, and none in groups C and D ( p = 0.31). When group A combined with group B was compared with groups C and D, the incidence was 16% vs. 0%, respectively ( p = 0.11). The thoracostomy tube reinsertion rate in all 4 groups was 0%, 8.33%, 0%, and 0%, respectively, which was not significant ( p = 0.38). Conclusions Performing the Valsalva maneuver correctly during full inspiration may be the method of choice for removing thoracostomy tubes. Using a party balloon forces the patient perform the Valsalva maneuver adequately and is simpler to explain.
Multicenter Analysis of Midterm Clinical Outcomes of Arthroscopic Labral Repair in the Hip: Minimum 5-Year Follow-up
Authors: Hevesi Mario , Krych Aaron J. , Johnson Nick R. , Redmond John M. , Hartigan David E. , Levy Bruce A. , Domb Benjamin G. 
Published: October 2017

Background: The technique of hip arthroscopic surgery is advancing and becoming more commonly performed. However, most current reported results are limited to short-term follow-up, and therefore, the durability of the procedure is largely unknown. Purpose: To perform a multicenter analysis of mid-term clinical outcomes of arthroscopic hip labral repair and determine the risk factors for patient outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Prospectively collected data of primary hip arthroscopic labral repair performed at 4 high-volume centers between 2008 and 2011 were reviewed retrospectively. Patients were assessed preoperatively and postoperatively with the visual analog scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score–Sports-Specific Subscale (HOS-SSS) at a minimum of 5 years’ follow-up. Factors including age, body mass index (BMI), Tönnis grade, and cartilage grade were analyzed in relation to outcome scores, and revision rates were determined. Failure was defined as subsequent ipsilateral hip surgery, including revision arthroscopic surgery and open hip surgery. Results: A total of 303 patients (101 male, 202 female) with a mean age of 32.0 years (range, 10.7-58.9 years) were followed for a mean of 5.7 years (range, 5.0-7.9 years). Patients achieved mean improvements in VAS of 3.5 points, mHHS of 20.1 points, and HOS-SSS of 29.3 points. Thirty-seven patients (12.2%) underwent revision arthroscopic surgery, and 12 (4.0%) underwent periacetabular osteotomy, resurfacing, or total hip arthroplasty during the study period. Patients with a BMI >30 kg/m2 had a mean mHHS score 9.5 points lower and a mean HOS-SSS score 15.9 points lower than those with a BMI ≤30 kg/m2 ( P < .01). Patients aged >35 years at surgery had a mean mHHS score 4.5 points lower and a HOS-SSS score 6.7 points lower than those aged ≤35 years ( P = .03). Patients with Tönnis grade 2 radiographs demonstrated a 12.5-point worse mHHS score ( P = .02) and a 23.0-point worse HOS-SSS score ( P < .01) when compared with patients with Tönnis grade 0. Conclusion: Patients demonstrated significant improvements in VAS, mHHS, and HOS-SSS scores after arthroscopic labral repair. However, those with Tönnis grade 2 changes preoperatively, BMI >30 kg/m2, and age >35 years at the time of surgery demonstrated significantly decreased mHHS and HOS-SSS scores at final follow-up.
Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial
Authors: Chan Zoe Y.S. , Zhang Janet H. , Au Ivan P.H. , An Winko W. , Shum Gary L.K. , Ng Gabriel Y.F. , Cheung Roy T.H. 
Published: October 2017

Background: The increasing popularity of distance running has been accompanied by an increase in running-related injuries, such that up to 85% of novice runners incur an injury in a given year. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with many running ailments. However, softer footfalls may not necessarily prevent running injury. Purpose: To examine vertical loading rates before and after a gait retraining program and assess the effectiveness of the program in reducing the occurrence of running-related injury across a 12-month observation period. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 320 novice runners from the local running club completed this study. All the participants underwent a baseline running biomechanics evaluation on an instrumented treadmill with their usual running shoes at 8 and 12 km/h. Participants were then randomly assigned to either the gait retraining group or the control group. In the gait retraining group (n = 166), participants received 2 weeks of gait retraining with real-time visual feedback. In the control group (n = 154), participants received treadmill running exercise but without visual feedback on their performance. The training time was identical between the 2 groups. Participants’ running mechanics were reassessed after the training, and their 12-month posttraining injury profiles were tracked by use of an online surveillance platform. Results: A significant reduction was found in the vertical loading rates at both testing speeds in the gait retraining group ( P < .001, Cohen’s d > 0.99), whereas the loading rates were either similar or slightly increased in the control group after training ( P = .001 to 0.461, Cohen’s d = 0.03 to −0.14). At 12-month follow-up, the occurrence of running-related musculoskeletal injury was 16% and 38% in the gait retraining and control groups, respectively. The hazard ratio between gait retraining and control groups was 0.38 (95% CI, 0.25-0.59), indicating a 62% lower injury risk in gait-retrained runners compared with controls. Conclusion: A 2-week gait retraining program is effective in lowering impact loading in novice runners. More important, the occurrence of injury is 62% lower after 2 weeks of running gait modification. Registration: HKUCTR-1996 (University of Hong Kong Clinical Trials Registry).
Medial Meniscus Resection Increases and Medial Meniscus Repair Preserves Anterior Knee Laxity: A Cohort Study of 4497 Patients With Primary Anterior Cruciate Ligament Reconstruction
Authors: Cristiani Riccardo , Rönnblad Erik , Engström Björn , Forssblad Magnus , Stålman Anders 
Published: October 2017

Background: There are still controversies regarding the effects on knee laxity of additional meniscus resection or repair in the setting of anterior cruciate ligament reconstruction (ACLR). Hypothesis/Purpose: The purpose was to determine the effects on knee laxity of resection or repair of medial meniscus (MM) or lateral meniscus (LM) injuries in the ACLR knee. The hypothesis was that patients with an additional meniscus resection would have significantly increased postoperative knee laxity versus that of an isolated ACLR, whereas patients with meniscus repair would have laxity comparable to that of an isolated ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: The KT-1000 arthrometer, with an anterior tibial load of 134 N, was used to evaluate knee laxity preoperatively and at 6-month postoperative follow-up for a total of 4497 patients with primary hamstring tendon ACLR. Patients with isolated ACLR or ACLR with additional MM resection, MM repair, LM resection, LM repair, or MM plus LM resection were compared, with the isolated ACLR group as a control. Results: All patients showed a significant reduction of knee laxity preoperatively (3.6 ± 3.1 mm) to postoperatively (1.9 ± 2.2 mm) ( P < 0.0001). Patients who had an ACLR with either an MM resection (2.2 ± 2.55 mm) or MM + LM resection (2.35 ± 2.30 mm) showed significant increased postoperative knee laxity versus isolated ACLR (1.74 mm ± 2.11 mm) ( P < 0.05), whereas patients with MM repair (1.69 ± 2.37 mm) did not show significantly different knee laxity when compared with the control group ( P > 0.05). LM resection or repair did not significantly affect knee laxity. Significantly more surgical failures, defined as side-to-side difference >5 mm, were found in the ACLR + MM resection group and the ACLR + MM + LM resection group. Conclusion: In ACLR, additional MM resection increased whereas MM repair preserved knee laxity in comparison with the ACLR knee with intact menisci. Neither LM resection or LM repair showed a significant effect on knee laxity. Surgeons should make every effort to repair the meniscus whenever possible to avoid the residual postoperative laxity present in the meniscus-deficient knee.
The Structure of Psychopathology in Early Adolescence: Study of a Canadian Sample
Authors: Afzali Mohammad H. , Sunderland Matthew , Carragher Natacha , Conrod Patricia 
Published: October 2017

Objective: The current study investigates the correlational structure of psychopathology in a large sample of Canadian adolescents and highlights the association between the psychopathological dimensions and gender. Method: Data came from 3826 Canadian adolescents aged 12.8 ± 0.4 y. Five alternative dimensional models were tested using confirmatory factor analysis, and the association between gender, language, and the mean level of psychopathological dimensions was examined using a multiple-indicators multiple-causes model. Results: A bifactor model with 1 general psychopathology factor and 3 specific dimensions (internalizing, externalizing, thought disorder) provided the best fit to the data. Results indicated metric invariance of the bifactor structure with respect to language. Females reported higher mean levels of internalizing, and males reported higher mean levels of externalizing. No significant sex differences emerged in liability to thought disorder or general psychopathology. The presence of a general psychopathology factor increased the association between gender and specific dimensions. Conclusions: The current study is the first to highlight the bifactor structure including a specific thought disorder factor in a Canadian sample of adolescents. The findings further highlight the importance of transdiagnostic approaches to prevention and intervention among young adolescents.
Metabolic counterparts of sodium accumulation in multiple sclerosis: A whole brain 23Na-MRI and fast 1H-MRSI study
Authors: Donadieu Maxime , Le Fur Yann , Maarouf Adil , Gherib Soraya , Ridley Ben , Pini Lauriane , Rapacchi Stanislas , Confort-Gouny Sylviane , Guye Maxime , Schad Lothar R , Maudsley Andrew A , Pelletier Jean , Audoin Bertrand , Zaaraoui Wafaa , Ranjeva Jean-Philippe 
Published: October 2017

Background: Increase of brain total sodium concentrations (TSC) is present in multiple sclerosis (MS), but its pathological involvement has not been assessed yet. Objective: To determine in vivo the metabolic counterpart of brain sodium accumulation. Materials/methods: Whole brain 23Na-MR imaging and 3D-1H-EPSI data were collected in 21 relapsing-remitting multiple sclerosis (RRMS) patients and 20 volunteers. Metabolites and sodium levels were extracted from several regions of grey matter (GM), normal-appearing white matter (NAWM) and white matter (WM) T2 lesions. Metabolic and ionic levels expressed as Z-scores have been averaged over the different compartments and used to explain sodium accumulations through stepwise regression models. Results: MS patients showed significant 23Na accumulations with lower choline and glutamate–glutamine (Glx) levels in GM; 23Na accumulations with lower N-acetyl aspartate (NAA), Glx levels and higher Myo-Inositol (m-Ins) in NAWM; and higher 23Na, m-Ins levels with lower NAA in WM T2 lesions. Regression models showed associations of TSC increase with reduced NAA in GM, NAWM and T2 lesions, as well as higher total-creatine, and smaller decrease of m-Ins in T2 lesions. GM Glx levels were associated with clinical scores. Conclusion: Increase of TSC in RRMS is mainly related to neuronal mitochondrial dysfunction while dysfunction of neuro-glial interactions within GM is linked to clinical scores.
Safety and efficacy of helminth treatment in relapsing-remitting multiple sclerosis: Results of the HINT 2 clinical trial
Authors: Fleming John , Hernandez Gianna , Hartman Leslie , Maksimovic Jane , Nace Sara , Lawler Benjamin , Risa Todd , Cook Thomas , Agni Rashmi , Reichelderfer Mark , Luzzio Christopher , Rolak Loren , Field Aaron , Fabry Zsuzsanna 
Published: October 2017

Background: The hygiene hypothesis suggests that microbial replacement may be therapeutic in allergic and autoimmune diseases. Nevertheless, the results of helminth treatment, including in multiple sclerosis (MS), have been inconclusive. Objective: To assess safety and brain magnetic resonance imaging (MRI) activity in subjects with relapsing-remitting multiple sclerosis (RRMS) during oral administration of ova from the porcine whipworm, Trichuris suis (TSO). Methods: A total of 16 disease-modifying treatment (DMT) naive RRMS subjects were studied in a baseline versus treatment (BVT) controlled prospective study. MRI scans were performed during 5 months of screening-observation, 10 months of treatment, and 4 months of post-treatment surveillance. Results: No serious symptoms or adverse events occurred during treatment. For the cohort, there was a trend consistent with a 35% diminution in active lesions when observation MRIs were compared to treatment MRIs ( p = 0.08), and at the level of individuals, 12 of 16 subjects improved during TSO treatment. T regulatory lymphocytes were increased during TSO treatment. Conclusion: TSO is safe in RRMS subjects. Potentially favorable MRI outcomes and immunoregulatory changes were observed during TSO treatment; however, the magnitude of these effects was modest, and there was considerable variation among the responses of individual subjects.