bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute patellofemoral instability in children and adolescents
Authors: Antinolfi Pierluigi , Bartoli Matteo , Placella Giacomo , Speziali Andrea , Pace Valerio , Delcogliano Marco , Mazzola Claudio 
Published: June 2016

Patellofemoral problems are considered to be among the most frequent causes of knee pain in children and adolescents. Correcting bone abnormalities through specific and targeted interventions is mandatory in skeletally immature patients. Medial patellofemoral ligament (MPFL) reconstruction is the preferred procedure, but there are several important precautionary considerations that the surgeon must take into account. it must always be remembered that MPFL rupture is the result, not the cause, of an altered extensor mechanism; therefore, patellar stabilization with MPFL reconstruction is only the first step to be accomplished in the management of an MPFL rupture. If other anatomical alterations are encountered, alternative/additional surgical procedures should be considered. If MPFL rupture occurs without associated anatomical or functional knee alterations, an ap propriate rehabilitation program after MPFL reconstruction should be sufficient to achieve a good outcome.In conclusion, an acute patellar dislocation should be managed conservatively unless there is evidence of osteochondral damage or medial retinaculum lesions. Osseous procedures are contraindicated in children, while MPFL anatomical reconstruction with “physeal sparing” is the primary surgical option.
Effects of Decay Heat Distribution on Water Temperature in a Spent
Fuel Pit and Prediction Errors With a One-Region Model
Authors: Yanagi Chihiro , Murase Michio , Utanohara Yoichi 
Published: June 2016

Abstract
A prediction system with a one-region (1R) model was developed to predict water temperature in a spent fuel pit (SFP) after the shutdown of its cooling systems based on three-dimensional (3D) thermal-hydraulic behavior computed by using the computational fluid dynamics (CFD) software, FLUENT 6.3.26. The system was later extended to compute the water level in the SFP during the loss of all AC power supplies. This study aimed at confirming the applicability of the 1R model by the comparison of 3D computation results and 1R calculation results. Some of the effects that influence the SFP water temperature increase are decay heat and its distribution. Also, decay heat decreases with time, so for low decay heat, natural circulation force in the SFP becomes weak and the effect of heat loss to air for the water temperature increase will be relatively bigger than that for high decay heat. Therefore, in this study, the 3D computations with FLUENT 15.0 were done for four typical patterns of decay heat distribution and for three decay heat values (10, 5, and 1-MW). The computational results were compared to each other and evaluated. It was found that the effects of decay heat distribution were small on water temperature calculations, and the 1R model for SFP water was applicable to the prediction of SFP water temperature during the loss of all AC power supplies without consideration of the decay heat distribution.
Identification and Analysis of a Novel Group of Bacteriophages Infecting the Lactic Acid Bacterium Streptococcus thermophilus
Authors: McDonnell Brian , Mahony Jennifer , Neve Horst , Hanemaaijer Laurens , Noben Jean-Paul , Kouwen Thijs , van Sinderen Douwe 
Published: June 2016

ABSTRACT

We present the complete genome sequences of four members of a novel group of phages infecting
Streptococcus thermophilus
, designated here as the 987 group. Members of this phage group appear to have resulted from genetic exchange events, as evidenced by their “hybrid” genomic architecture, exhibiting DNA sequence relatedness to the morphogenesis modules of certain P335 group
Lactococcus lactis
phages and to the replication modules of
S. thermophilus
phages. All four identified members of the 987 phage group were shown to elicit adsorption affinity to both their cognate
S. thermophilus
hosts and a particular
L. lactis
starter strain. The receptor binding protein of one of these phages (as a representative of this novel group) was defined using an adsorption inhibition assay. The emergence of a novel phage group infecting
S. thermophilus
highlights the continuous need for phage monitoring and development of new phage control measures.

IMPORTANCE
Phage predation of
S. thermophilus
is an important issue for the dairy industry, where viral contamination can lead to fermentation inefficiency or complete fermentation failure. Genome information and phage-host interaction studies of
S. thermophilus
phages, particularly those emerging in the marketplace, are an important part of limiting the detrimental impact of these viruses in the dairy environment.
Differential Utilization of Basic Proline-Rich Glycoproteins during Growth of Oral Bacteria in Saliva
Authors: Zhou Yuan , Yang Jinghua , Zhang Luxia , Zhou Xuedong , Cisar John O. , Palmer Robert J. 
Published: June 2016

ABSTRACT

Although saliva is widely recognized as a primary source of carbon and nitrogen for growth of the dental plaque biofilm community, little is known about how different oral bacteria utilize specific salivary components. To address this question, 32 strains representing 16 genera commonly isolated from early plaque biofilms were compared for growth over two transfers in stimulated (by chewing Parafilm) whole saliva that was stabilized by heat treatment and dialysis. The cell densities, measured by quantitative PCR (qPCR), ranged from ∼1 × 10
6
to 1 × 10
7
/ml for strains of
Streptococcus gordonii
,
Streptococcus oralis
, and
Streptococcus mitis
and one strain of
Streptococcus sanguinis
. Strains of
Streptococcus mutans
,
Gemella haemolysans
, and
Granulicatella adiacens
reached ∼1 × 10
5
to 1 × 10
6
/ml. In contrast, little or no growth was noted for three other strains of
S. sanguinis
, as well as for strains of
Streptococcus parasanguinis
,
Streptococcus salivarius
,
Streptococcus vestibularis
,
Streptococcus sobrinus
,
Actinomyces
spp.,
Abiotrophia defectiva
, and
Rothia dentocariosa
. SDS-PAGE, lectin blotting, and two-dimensional gel electrophoresis of saliva from cultures of
S. gordonii
,
S. oralis
, and
S. mitis
revealed species-specific differences in the degradation of basic proline-rich glycoproteins (PRG). In contrast, saliva from cultures of other bacteria was indistinguishable from control saliva. Species-dependent differences in the utilization of individual host sugars were minor. Thus, differences in salivary glycan foraging between oral species may be important to cross-feeding and cooperation between organisms in dental plaque biofilm development.

IMPORTANCE
Bacteria in the mouth use saliva for nutrition. How each of the many types of bacteria uses saliva is not clear. We show that a major protein in saliva, called PRG, is an important nutrition source for certain bacteria but not for others. PRG has many sugar molecules linked in chains, but the sugar is not available for bacteria until the chains are degraded. The bacteria that can grow by digesting this protein break the sugar chains into parts which not only support their own growth but could also be available to support the growth of those bacteria that cannot use the intact protein.
Natural Competence of Xylella fastidiosa Occurs at a High Frequency Inside Microfluidic Chambers Mimicking the Bacterium's Natural Habitats
Authors: Kandel Prem P. , Lopez Samantha M. , Almeida Rodrigo P. P. , De La Fuente Leonardo 
Published: June 2016

ABSTRACT

Xylella fastidiosa
is a xylem-limited bacterium that is the causal agent of emerging diseases in a number of economically important crops. Genetic diversity studies have demonstrated homologous recombination occurring among
X. fastidiosa
strains, which has been proposed to contribute to host plant shifts. Moreover, experimental evidence confirmed that
X. fastidiosa
is naturally competent for recombination
in vitro
. Here, as an approximation of natural habitats (plant xylem vessels and insect mouthparts), recombination was studied in microfluidic chambers (MCs) filled with media amended with grapevine xylem sap. First, different media were screened for recombination in solid agar plates using a pair of
X. fastidiosa
strains that were previously reported to recombine in coculture. The highest frequency of recombination was obtained with PD3 medium, compared to those with the other two media (
X. fastidiosa
medium [XFM] and periwinkle wilt [PW] medium) used in previous studies. Dissection of the media components led to the identification of bovine serum albumin as an inhibitor of recombination that was correlated to its previously known effect on inhibition of twitching motility. When recombination was performed in liquid culture, the frequencies were significantly higher under flow conditions (MCs) than under batch conditions (test tubes). The recombination frequencies in MCs and agar plates were not significantly different from each other. Grapevine xylem sap from both susceptible and tolerant varieties allowed high recombination frequency in MCs when mixed with PD3. These results suggest that
X. fastidiosa
has the ability to be naturally competent in the natural growth environment of liquid flow, and this phenomenon could have implications in
X. fastidiosa
environmental adaptation.

IMPORTANCE
Xylella fastidiosa
is a plant pathogen that lives inside xylem vessels (where water and nutrients are transported inside the plant) and the mouthparts of insect vectors. This bacterium causes emerging diseases in various crops worldwide, including recent outbreaks in Europe. The mechanisms by which this bacterium adapts to new hosts is not understood, but it was previously shown that it is naturally competent, meaning that it can take up DNA from the environment and incorporate it into its genome (recombination). In this study, we show that the frequency of recombination is highest when the bacterium is grown under flow conditions in microfluidic chambers modeled after its natural habitats, and recombination was still high when the medium was amended with grapevine sap. Our results suggest that this bacterium is able to recombine when growing inside plants or insects, and this can be a mechanism of adaptation of this pathogen that causes incurable diseases.
Improving Interprofessional and Coproductive Outcomes of Care for Patients with Chronic Obstructive Pulmonary Disease
Authors: Moreo Kathleen , Greene Laurence , Sapir Tamar 
Published: June 2016

In the U.S., suboptimal care quality for patients with chronic obstructive pulmonary disease (COPD) is reflected by high rates of emergency department visits and hospital readmissions, as well as excessive costs. Moreover, a substantial proportion of COPD patients do not receive guideline-directed therapies. In quality improvement (QI) programs, these types of health care problems are commonly addressed through interventions that primarily or exclusively support physicians in aligning their practices with guidelines and clinical quality measures. However, the root causes of many deficits in health care quality are not necessarily “physician centric.” Instead, they often involve suboptimal collaboration among members of interprofessional health care teams and gaps in coproductive relationships among patients and providers.We conducted a QI project to identify interprofessional and coproductive correlates of COPD care quality in the context of a continuing education program designed to advance knowledge and skill among patients, providers, and the interprofessional COPD team regarding coproductive COPD care. Participants in the program included providers in 30 primary care practices across the U.S. who, along with their own COPD patients and a separate cohort of patients from COPD advocacy groups, completed a patient-provider survey study designed to identify alignments and mismatches in coproductive perceptions and behaviors, a private survey feedback session for each practice's team, and online/mobile educational activities on COPD. In addition, more than 1,000 additional providers and 200 patients participated in just the online/mobile education.From the patient perspective, baseline measures indicated a high rate of dissatisfaction with COPD treatment plans and suboptimal coproductive interaction with members of the interprofessional health care team. Across providers, there were gaps and variation in provision of patient education, attitudes and practices regarding shared decision-making, and care coordination with pulmonary specialists. In addition, relatively low proportions of providers reported high levels of skill in various coproductive processes.The project outcomes indicated mismatches between COPD patients and providers in perceived ability to recognize COPD exacerbations, shared treatment goals, barriers to medication adherence, perceived impact of COPD on quality of life, and other aspects of COPD care. Providers demonstrated improvements in knowledge and attitudes regarding coproductive and coordinated COPD care.
Statins and morbidity and mortality in COPD in the COMIC study: a prospective COPD cohort study
Authors: Citgez Emanuel , van der Palen Job , Koehorst-ter Huurne Kirsten , Movig Kris , van der Valk Paul , Brusse-Keizer Marjolein 
Published: June 2016

BackgroundBoth chronic inflammation and cardiovascular comorbidity play an important role in the morbidity and mortality of patients with chronic obstructive pulmonary disease (COPD). Statins could be a potential adjunct therapy. The additional effects of statins in COPD are, however, still under discussion. The aim of this study is to further investigate the association of statin use with clinical outcomes in a well-described COPD cohort.Methods795 patients of the Cohort of Mortality and Inflammation in COPD (COMIC) study were divided into statin users or not. Statin use was defined as having a statin for at least 90 consecutive days after inclusion. Outcome parameters were 3-year survival, based on all-cause mortality, time until first hospitalisation for an acute exacerbation of COPD (AECOPD) and time until first community-acquired pneumonia (CAP). A sensitivity analysis was performed without patients who started a statin 3 months or more after inclusion to exclude immortal time bias.ResultsStatin use resulted in a better overall survival (corrected HR 0.70 (95% CI 0.51 to 0.96) in multivariate analysis), but in the sensitivity analysis this association disappeared. Statin use was not associated with time until first hospitalisation for an AECOPD (cHR 0.95, 95% CI 0.74 to 1.22) or time until first CAP (cHR 1.1, 95% CI 0.83 to 1.47).ConclusionsIn the COMIC study, statin use is not associated with a reduced risk of all-cause mortality, time until first hospitalisation for an AECOPD or time until first CAP in patients with COPD.
Palliative care consultations in primary care: a cross-sectional survey among Dutch general practitioners
Authors: Hoek Patrick D , Schers Henk J , Hendriks Jan C M , Vissers Kris C P , Hasselaar Jeroen G J 
Published: June 2016

BackgroundExpert consultation supports general practitioners (GPs) in delivering adequate palliative homecare. Insight into consultation practices from a GP's perspective is needed in order to shape consultation services to their wishes and needs.AimTo explore palliative care consultation practices from a GP's perspective.Design and settingCross-sectional web-based survey among all GPs (n=235) in the region of Nijmegen, the Netherlands.MethodsOur questionnaire contained questions about the delivery of palliative care by GPs, their consultation practices and satisfaction with current services. Questions consisted mainly of 5-point Likert scales. We transformed these scales into numerical values to calculate mean scores. Linear mixed models for repeated measurements were used to study differences in scores.ResultsGPs most often consulted informal caregivers (mean score 3.6) or fellow GPs (mean score 3.3). Physical problems were discussed the most (mean score 3.5), while social and existential issues were discussed least (mean score 1.9 for both). In their choice of a particular consultation service, GPs considered the quality of the provided advice to be the most important factor. GPs were satisfied with current consultation services, with fellow GPs receiving the highest satisfaction scores (mean score 4.6). Finally, when recalling their last palliative patient, most GPs started requesting consultation during this patient's last month of life.ConclusionsNext to informal caregivers, GPs preferably seek advice from fellow GPs. Physical issues receive much attention during consultations; however, other vital aspects of palliative care seem to remain relatively neglected, such as social and existential issues and a proactive care approach.
Use of high-fidelity simulation to improve communication skills regarding death and dying: a qualitative study
Authors: Hawkins A , Tredgett K 
Published: June 2016

ObjectivesThe objectives of this study were to explore medical students' experiences of communicating with patients and their carers about death and dying, and to assess whether using high-fidelity simulation improved students' confidence in discussing cardiopulmonary resuscitation.MethodsThis qualitative study was carried out at a hospital in the south of England. Participants were 7 final-year medical students. Tutorials were developed using high-fidelity simulation to teach communication skills regarding discussion of cardiopulmonary resuscitation with patients and carers. Scenarios involved a simulated ward environment, a high-fidelity simulation mannequin and actor playing the role of a carer. Data were collected through joint interviews carried out by one researcher which were audio recorded and transcribed verbatim. The same researcher analysed the data using framework analysis.ResultsStudents reported a lack of experience observing conversations with patients and carers about death and dying. They also reported a lack of opportunities to interact with dying patients during their training. Barriers reported by students included healthcare professionals' and patients' attitudes. Students reported a lack of confidence and preparedness to have consultations with patients and carers about death, dying and cardiopulmonary resuscitation as junior doctors. They perceived role-play scenarios observed by their peers to be stressful, and this detracted from the learning experience. Students reported that the high-fidelity simulation scenarios were more realistic than low-fidelity (‘role-play’) scenarios. This improved the learning gained from the sessions and improved confidence among some students.ConclusionsThis study has suggested that high-fidelity simulation may be a useful adjunct for undergraduate communication skills training in palliative medicine. Further research is required to assess whether improvements in confidence described by students in this study translate to discernible improvements in competence, and whether using high-fidelity simulation in this setting is cost-effective.
Carotid artery stenting versus carotid endarterectomy
Authors: Nanna Michael G , Gomes Paulina , Njoh Roland F , Ward Charisse , Attaran Robert R , Mena Carlos 
Published: June 2016

AbstractStroke remains a significant contributor to morbidity and mortality in developed countries. Carotid artery stenosis is a major cause of stroke. Advances in medical therapy, surgical technique and endovascular maturation has resulted in options for the treatment of carotid stenosis. Here, we present a review of carotid artery stenting and carotid endarterectomy as it applies to trials comparing and contrasting the two treatment options. We also explore the intricacies surrounding reimbursement of these treatment strategies in the USA.
An update on cardiovascular effects of obstructive sleep apnoea syndrome
Authors: Uyar Meral , Davutoglu Vedat 
Published: June 2016

AbstractObstructive sleep apnoea syndrome is an important health problem which may cause or worsen systemic diseases. Chronic intermittent hypoxia during repetitive airflow cessations may cause endothelial dysfunction. Sleep apnoea is also shown to be associated with hypercoagulability which may be due to decreased nitric oxide levels and impaired vasodilatation. Endothelial dysfunction, increased systemic inflammation, sympathetic nervous system activation, increased oxidative stress and dysglycaemia may all contribute to cardiovascular processes such as hypertension, arrhythmia, stroke, heart failure and coronary artery disease in patients with obstructive sleep apnoea. Treatment approaches in patients with obstructive sleep apnoea mainly focus on maintaining upper airway patency either with positive airway pressure devices or upper airway appliances. Strategies involving positive airway pressure therapy are associated with decreased morbidity and mortality. Obstructive sleep apnoea should be suspected as an underlying mechanism in patients with cardiovascular disease and warrants appropriate treatment.
Which QT Correction Formulae to Use for QT Monitoring?
Authors: Vandenberk Bert , Vandael Eline , Robyns Tomas , Vandenberghe Joris , Garweg Christophe , Foulon Veerle , Ector Joris , Willems Rik 
Published: June 2016

Background

Drug safety precautions recommend monitoring of the corrected
QT
interval. To determine which
QT
correction formula to use in an automated
QT
‐monitoring algorithm in our electronic medical record, we studied rate correction performance of different
QT
correction formulae and their impact on risk assessment for mortality.

Methods and Results

All electrocardiograms (
ECG
s) in patients >18 years with sinus rhythm, normal
QRS
duration and rate <90 beats per minute (bpm) in the University Hospitals of Leuven (Leuven, Belgium) during a 2‐month period were included.
QT
correction was performed with Bazett, Fridericia, Framingham, Hodges, and Rautaharju formulae. In total, 6609 patients were included (age, 59.8±16.2 years; 53.6% male and heart rate 68.8±10.6 bpm). Optimal rate correction was observed using Fridericia and Framingham; Bazett performed worst. A healthy subset showed 99% upper limits of normal for Bazett above current clinical standards: men 472 ms (95%
CI
, 464–478 ms) and women 482 ms (95%
CI
474–490 ms). Multivariate Cox regression, including age, heart rate, and prolonged
QT
c, identified Framingham (hazard ratio [
HR
], 7.31; 95%
CI
, 4.10–13.05) and Fridericia (
HR
, 5.95; 95%
CI
, 3.34–10.60) as significantly better predictors of 30‐day all‐cause mortality than Bazett (
HR
, 4.49; 95%
CI
, 2.31–8.74). In a point‐prevalence study with haloperidol, the number of patients classified to be at risk for possibly harmful
QT
prolongation could be reduced by 50% using optimal
QT
rate correction.

Conclusions

Fridericia and Framingham correction formulae showed the best rate correction and significantly improved prediction of 30‐day and 1‐year mortality. With current clinical standards, Bazett overestimated the number of patients with potential dangerous
QT
c prolongation, which could lead to unnecessary safety measurements as withholding the patient of first‐choice medication.