bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenitally corrected transposition: complex anatomic repair or Fontan pathway?
Authors: Marathe Supreet P , Jones Matthew I , Ayer Julian , Sun Jessica , Orr Yishay , Verrall Charlotte , Nicholson Ian A , Chard Richard B , Sholler Gary F , Winlaw David S 
Published: June 2017

Background Successful anatomic repair of congenitally corrected transposition of the great arteries achieves excellent outcomes. Several centers report excellent long-term survival with the Fontan pathway as well. We have selectively applied both approaches depending on individual patient morphology, with anatomic repair preferred but utilizing the Fontan pathway when high technical complexity or operative risk is anticipated. Methods Hospital records over an 18-year period (1998–2016) were reviewed to identify patients with congenitally corrected transposition of the great arteries who underwent surgical management. Physiological repairs and hypoplastic ventricles were excluded. Patient- and procedure-related variables were reviewed. Results We identified 19 patients. Group 1 consisted of 12 anatomic repairs, of which 10 (83.3%) required prior interim staging procedures. Mean age at anatomic repair was 2.6 ± 1.3 years, mean follow-up was 8.7 ± 5.3 years. Nine (75%) patients experienced important complications and 4 (33.3%) required reintervention during follow-up. There were no deaths; one patient required heart transplantation. Group 2 (7 patients) underwent Fontan palliation. Mean age at Fontan completion was 7.2 ± 3.8 years, mean follow-up was 6.3 ± 4 years. There was no reintervention, death, or transplant. Conclusion Patients with congenitally corrected transposition of the great arteries and two adequate-sized ventricles do well with both anatomic repair and the Fontan pathway in the medium term. Excellent outcomes with reduced early complication and reintervention rates can be achieved for this cohort of patients when a strategy of avoiding complex anatomic repair in favor of the Fontan pathway is used.
Neuromuscular electrical stimulation for the prevention of venous thromboembolism
Authors: Ravikumar Raveena , Williams Katherine J , Babber Adarsh , Moore Hayley M , Lane Tristan RA , Shalhoub Joseph , Davies Alun H 
Published: June 2017

Objective Venous thromboembolism, encompassing deep vein thrombosis and pulmonary embolism, is a significant cause of morbidity and mortality, affecting one in 1000 adults per year. Neuromuscular electrical stimulation is the transcutaneous application of electrical impulses to elicit muscle contraction, preventing venous stasis. This review aims to investigate the evidence underlying the use of neuromuscular electrical stimulation in thromboprophylaxis. Methods The Medline and Embase databases were systematically searched, adhering to PRISMA guidelines, for articles relating to electrical stimulation and thromboprophylaxis. Articles were screened according to a priori inclusion and exclusion criteria. Results The search strategy identified 10 randomised controlled trials, which were used in three separate meta-analyses: five trials compared neuromuscular electrical stimulation to control, favouring neuromuscular electrical stimulation (odds ratio of deep vein thrombosis 0.29, 95% confidence interval 0.13–0.65; P = .003); three trials compared neuromuscular electrical stimulation to heparin, favouring heparin (odds ratio of deep vein thrombosis 2.00, 95% confidence interval 1.13–3.52; P = .02); three trials compared neuromuscular electrical stimulation as an adjunct to heparin versus heparin only, demonstrating no significant difference (odds ratio of deep vein thrombosis 0.33, 95% confidence interval 0.10–1.14; P = .08). Conclusion Neuromuscular electrical stimulation significantly reduces the risk of deep vein thrombosis compared to no prophylaxis. It is inferior to heparin in preventing deep vein thrombosis and there is no evidence for its use as an adjunct to heparin.
The effect of a corrective functional exercise program on postural thoracic kyphosis in teenagers: a randomized controlled trial
Authors: Feng Qiang , Wang Mei , Zhang Yanfeng , Zhou Yu 
Published: June 2017

Objective: To investigate the effects of a corrective functional exercise program on postural thoracic kyphosis in teenagers in China. Design: A single-blind randomized controlled trial including students with a thoracic kyphosis angle (TKA) >40° measured using the SpinalMouse. Setting: China Institute of Sport Science and three middle schools in Beijing, China. Subjects: A total of 181 subjects were included in this trial; of these, 164 subjects were included in the analyses (intervention group, n = 81; control group, n = 83). Intervention: The intervention group received a functional exercise program designed to correct postural thoracic kyphosis, and the control group received an exercise program designed in accordance with the state-regulated curriculum. Main measures: The primary outcome variable was TKA. Secondary outcome variables were lumbar lordosis angle (LLA), sacral angle (SA), and incline angle (INA) measured in the upright position; thoracic, lumbar, and sacral spine range of motion (ROM) and INA ROM (change in center of gravity) measured in the forward bending and extended positions; and changes in TKA, LLA, SA, and INA measured during the Matthiass test. Results: There were significant differences in pretest and posttest TKA in both groups (intervention group: pretest 47.09 ± 5.45, posttest 38.31 ± 9.18, P < 0.0001; control group: pretest 47.47 ± 6.06, posttest 43.59 ± 7.49, P < 0.0001). After adjustment for gender and pretest values, there were significant differences in posttest TKA, change in SA, and thoracic ROM in the intervention group compared to the control group ( P < 0.05). Conclusion: The corrective functional exercise program designed for this study improved exaggerated thoracic kyphosis in teenagers.
Isoflavones and gastrointestinal infection: Two potential triggers for reversible cerebral vasoconstriction syndrome
Authors: Machner Björn , Boppel Tobias , Münte Thomas 
Published: June 2017

Background Reversible cerebral vasoconstriction syndrome (RCVS) is an important differential diagnosis of singular or recurrent thunderclap headache. Prognosis is generally good, however complications of the transient segmental vasospasms of cerebral arteries such as stroke, subarachnoidal hemorrhage and brain edema may worsen the clinical outcome. Although the exact pathomechanism is still unclear, various vasoactive substances and conditions (e.g. post partum) have been identified as triggering RCVS. Cases We report on the clinical course and management of two cases of typical RCVS that were associated with two different precipitants previously not described: A gastrointestinal infection and isoflavones, which are phytoestrogens used for menopausal vasomotor symptoms. Discussion In the case of gastrointestinal infection, either systemic inflammatory processes might lead to disturbances of vascular tone, or the repetitive vomiting that resembles Valsalva manoeuvers known to trigger RCVS. In the case of isoflavone intake, it may be their estrogenic potential that induces dysregulation of cerebral arteries, a mechanism known from other states of hormonal change such as post-partum angiopathy. However, the association of both precipitating factors with RCVS in our two cases is not a proof for a causal relationship, and there may have been additional potential triggers for RCVS. Conclusion In patients with (gastrointestinal) infection and concomitant thunderclap headache, RCVS should be considered as an important differential diagnosis due to its major complications. Since RCVS may be triggered by various vasoactive substances, taking the medical history should always include over-the-counter drugs and dietary supplements (such as the isoflavones) beside the regular medication.
Composition and Variation of Macronutrients, Immune Proteins, and Human Milk Oligosaccharides in Human Milk From Nonprofit and Commercial Milk Banks
Authors: Meredith-Dennis Laura , Xu Gege , Goonatilleke Elisha , Lebrilla Carlito B. , Underwood Mark A. , Smilowitz Jennifer T. 
Published: June 2017

Background: When human milk is unavailable, banked milk is recommended for feeding premature infants. Milk banks use processes to eliminate pathogens; however, variability among methods exists. Research aim: The aim of this study was to compare the macronutrient (protein, carbohydrate, fat, energy), immune-protective protein, and human milk oligosaccharide (HMO) content of human milk from three independent milk banks that use pasteurization (Holder vs. vat techniques) or retort sterilization. Methods: Randomly acquired human milk samples from three different milk banks ( n = 3 from each bank) were analyzed for macronutrient concentrations using a Fourier transform mid-infrared spectroscopy human milk analyzer. The concentrations of IgA, IgM, IgG, lactoferrin, lysozyme, α-lactalbumin, α antitrypsin, casein, and HMO were analyzed by mass spectrometry. Results: The concentrations of protein and fat were significantly ( p < .05) less in the retort sterilized compared with the Holder and vat pasteurized samples, respectively. The concentrations of all immune-modulating proteins were significantly ( p < .05) less in the retort sterilized samples compared with vat and/or Holder pasteurized samples. The total HMO concentration and HMOs containing fucose, sialic acid, and nonfucosylated neutral sugars were significantly ( p < .05) less in retort sterilized compared with Holder pasteurized samples. Conclusion: Random milk samples that had undergone retort sterilization had significantly less immune-protective proteins and total and specific HMOs compared with samples that had undergone Holder and vat pasteurization. These data suggest that further analysis of the effect of retort sterilization on human milk components is needed prior to widespread adoption of this process.
Proposed Criteria for the Use of Low-Dose Vitamin K Supplementation in Patients Using Vitamin K Antagonists: A Literature Review of a Clinical Controversy
Authors: Evans Christy E. , Getchell Katerine E. , Ivy Delaney R. 
Published: June 2017

Background: Vitamin K antagonists (VKAs) have been used for decades to prevent thromboembolic events, but can be burdensome to patients based on numerous factors impacting anticoagulation control. Low-dose vitamin K supplementation has been theorized to improve anticoagulation control in patients on VKAs that may be vitamin K deficient. The objective of this literature review is to propose criteria for implementing low-dose vitamin K supplementation in patients on VKAs. Literature review: The CHEST 2012 antithrombotic guidelines recommended against routine use of vitamin K supplementation in patients on VKAs. An observational study and three randomized controlled trials pertaining to this recommendation were evaluated. A literature review was also performed on other studies looking at the impact of low-dose vitamin K supplementation on anticoagulation control through a search in PubMed and the Cochrane Database of Systematic Reviews. One retrospective and two prospective studies were reviewed. Six of the seven studies demonstrated a non-statistically significant trend in data supporting improvement in anticoagulation control with low-dose vitamin K supplementation. Conclusion: While many of the studies did not achieve significant results, the majority demonstrated a trend in support of the improvement of anticoagulation control with low-dose vitamin K supplementation in patients on VKAs.
Simulating actuator energy consumption for trajectory optimisation
Authors: Cooper Michael , Lawson Craig , Zare Shahneh Amir 
Published: June 2017

This work aims to construct a high-speed simulation tool which is used to quantify the dynamic actuator power consumption of an aircraft in flight, for use within trajectory optimisation packages. The purpose is to evaluate the energy penalties of the flight control actuation system as an aircraft manoeuvre along any arbitrary trajectory. The advantage is that the approximations include major transient properties which previous steady state techniques could not capture. The output can be used to provide feedback to a trajectory optimisation process to help it compute the aircraft level optimality of any given flight path. The tool features a six degree of freedom dynamic model of an aircraft which is combined with low frequency functional electro-mechanical actuator models in order to estimate the major transient power demands. The actuator models interact with the aircraft using an aerodynamic load estimator which generates load forces on the actuators that vary as a function of flight condition and control surface demands. A total energy control system is applied for longitudinal control and a total heading control system is implemented to manage the lateral motion. The outer loop is closed using a simple waypoint following guidance system with turn anticipation and variable turn radius control. To test the model, a simple trajectory analysis is undertaken which quantifies a heading change executed with four different turn rates. The tool shows that the actuation system requires 12.8 times more electrical energy when performing a 90° turn with a radius of 400 m compared to 1000 m. A second test is performed to verify the model’s ability to track a longer trajectory under windy conditions.
Using the CYRM-28 With South African Young People: A Factor Structure Analysis
Authors: van Rensburg Angelique C. , Theron Linda C. , Ungar Michael 
Published: June 2017

Purpose: The factor structure of the Child and Youth Resilience Measure (CYRM-28) was originally established using a Canadian sample. This factor structure was not confirmed in a study with New Zealand youth. Given such variability, the current study investigated the factor structure of the CYRM-28 in a sample of Sesotho-speaking South African youth who participated in Pathways to Resilience Study. Method: Using latent variable modeling, we tested six varied models in two randomly selected samples ( n1 = 559; n2 = 578). Results: Fit statistics indicated that a three-factor variation of the New Zealand model, namely, individual, family/relational, and composite context, fitted best. The contextual composite synthesizes the CYRM-28 clusters that measure social skills, educational, spiritual, community, and cultural resources. Conclusion: The contextual composite reflects traditional African ways of being. Accordingly, understanding the factor structure of the CYRM-28 precedes practitioner capacity to promote resilience in an evidence-informed way.
The role of arts activities in developing resilience and mental wellbeing in children and young people a rapid review of the literature
Authors: Zarobe Leyre , Bungay Hilary 
Published: June 2017

Aims: This rapid review explores the role of arts activities in promoting the mental wellbeing and resilience of children and young people aged between 11 and 18 years. Methods: A systematic search of the literature was undertaken across 18 databases; no date limit was set on publication. Search terms included a range of creative activities: music, dance, singing, drama and visual arts; these were combined with terms linked to aspects of mental health, emotional wellbeing and resilience. Only studies related to activities that took place within community settings and those related to extracurricular activities based within schools were included. Results: Following the application of inclusion and exclusion criteria, eight papers were included in the review. The interventions used in the studies were diverse and the research was heterogeneous; therefore, narrative synthesis of the results was conducted. The findings from the studies are considered in terms of the contribution the activities make to building resilience of children and young people. It was found that participating in arts activities can have a positive effect on self-confidence, self-esteem, relationship building and a sense of belonging, qualities which have been associated with resilience and mental wellbeing. Conclusions: Although the research evidence is limited, there is some support for providing structured group arts activities to help build resilience and contribute to positive mental wellbeing of children and young people.
Preclinical evaluation of NF-κB-triggered dendritic cells expressing the viral oncogenic driver of Merkel cell carcinoma for therapeutic vaccination
Authors: Gerer Kerstin F. , Erdmann Michael , Hadrup Sine R. , Lyngaa Rikke , Martin Lena-Marie , Voll Reinhard E. , Schuler-Thurner Beatrice , Schuler Gerold , Schaft Niels , Hoyer Stefanie , Dörrie Jan 
Published: June 2017

Background: Merkel cell carcinoma (MCC) is a rare but very aggressive skin tumor that develops after integration of a truncated form of the large T-antigen (truncLT) of the Merkel cell polyomavirus (MCV) into the host’s genome. Therapeutic vaccination with dendritic cells (DCs) loaded with tumor antigens is an active form of immunotherapy, which intends to direct the immune system towards tumors which express the respective vaccination antigens. Methods: Cytokine-matured monocyte-derived DCs of healthy donors and MCC patients were electroporated with mRNA encoding the truncLT. To permit major histocompatibility complex (MHC) class II next to class I presentation, we used an RNA construct in which the antigen was fused to a DCLamp sequence in addition to the unmodified antigen. To further improve their immunogenicity, the DCs were additionally activated by co-transfection with the constitutively active nuclear factor (NF)-κB activator caIKK. These DCs were used to stimulate autologous CD8+ T-cells or a mixture of CD4+ and CD8+ T-cells. Then the percentage of T-cells, specific for the truncLT, was quantified by interferon (IFN)γ ELISpot assays. Results: Both the truncLT and its DCLamp-fusion were detected within the DCs by flow cytometry, albeit the latter required blocking of the proteasome. The transfection with caIKK upregulated maturation markers and induced cytokine production. After 2–3 rounds of stimulation, the T-cells from 11 out of 13 healthy donors recognized the antigen. DCs without caIKK appeared in comparison less potent in inducing such responses. When using cells derived from MCC patients, we could induce responses for 3 out of 5 patients; however, here the caIKK-transfected DCs did not display their superiority. Conclusion: These results show that optimized DCs are able to induce MCV-antigen-specific T-cell responses. Therapeutic vaccination with such transfected DCs could direct the immune system against MCC.
Long-Term Outcomes in Anterior Cruciate Ligament Reconstruction: A Systematic Review of Patellar Tendon Versus Hamstring Autografts
Authors: Poehling-Monaghan Kirsten L. , Salem Hytham , Ross Kirsten E. , Secrist Eric , Ciccotti Michael C. , Tjoumakaris Fotios , Ciccotti Michael G. , Freedman Kevin B. 
Published: June 2017

Background: Much controversy still exists surrounding graft choice in anterior cruciate ligament (ACL) reconstruction. Over the past decade, an increase in comparative studies with longer follow-up has enhanced our understanding of current graft options and outcomes. Purpose: To describe the long-term comparative outcomes of ACL reconstruction with autograft bone–patellar tendon–bone (BPTB) versus autograft hamstring (HS) ACL reconstruction with regard to clinical and radiographic outcomes. Study Design: Systematic review; Level of evidence, 2. Methods: A search of the PubMed, MEDLINE, Cochrane, and Scopus databases was performed to identify studies in the English language with outcome data comparing ACL reconstruction utilizing autograft BPTB and autograft HS; only studies with a minimum 5-year follow-up were included. Outcome data included failure and complications, manual and instrumented laxity, patient-reported outcomes, and radiographic risk of osteoarthritis. Results: Twelve studies with a total of 953 patients met the inclusion criteria. Of these studies, 8 were level 1 evidence and 2 were level 2. Mean follow-up was 8.96 years (range, 5-15.3 years). No differences in graft failure or manual or instrumented laxity were seen in any studies. Lower clinical outcomes scores and greater motion loss were seen in BPTB patients in 1 and 2 studies, respectively. Two of 4 studies reporting on anterior knee pain, and 3 of 7 that recorded kneeling pain found it more frequently among BPTB patients. One study found significantly increased reoperation rates in HS patients, while another found a similar result in BPTB, and 1 study reported a significant increase in contralateral ACL tears in BPTB patients. Three of 5 studies reporting on radiographic evidence of osteoarthritis noted significantly increased rates in BPTB patients. Conclusion: This systematic review comparing long-term outcomes after ACL reconstruction with either autograft BPTB or autograft HS suggests no significant differences in manual/instrumented laxity and graft failures between graft types. An increase in long-term anterior knee pain, kneeling pain, and higher rates of osteoarthritis were noted with BPTB graft use.
Osteonecrosis in children and adolescents with acute lymphoblastic leukemia: a therapeutic challenge
Authors: Kuhlen Michaela , Kunstreich Marina , Krull Kathinka , Meisel Roland , Borkhardt Arndt 
Published: June 2017

AbstractOsteonecrosis (ON) represents one of the most common and debilitating sequelae of antileukemic treatment in children and adolescents with acute lymphoblastic leukemia (ALL). Systematic screening strategies can focus on early detection and intervention to prevent ON from progressing to stages associated with pain and functional impairment. These strategies hold promise for reducing ON-associated morbidity without the risk of impairing leukemia control. Herein, we critically reviewed clinical data on pharmacological, nonpharmacological/nonsurgical, and surgical (including cellular) treatment options for ON, which are covered in the literature and/or are conceivable based on the supposed underlying ON pathophysiology. Prevention of ON progression is of paramount importance, and attempts seem to be more effective in early (precollapse) disease status than in late-stage (collapse) ON. Based on the results of ongoing prospective magnetic resonance imaging screening studies, which will hopefully identify those patients with a high risk of ON progression and debilitating sequelae, prospective interventional studies are urgently needed. Although there is still a lack of high-quality studies, based on currently available data, core decompression surgery combined with cellular therapies (eg, employing mesenchymal stem cells) appears most promising for preventing joint infraction in children at high risk of developing late-stage ON.