bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Management of Coracoid Fracture Sustained During Sporting Activities and Time to Return to Sport: A Systematic Review
Authors: Knapik Derrick M. , Patel Sunny H. , Wetzel Robert J. , Voos James E. 
Published: August 2017

Background: Coracoid fractures sustained during sporting activities are rare. Previous reports are limited to individual case reports, small case series, and retrospective analyses. Purpose: To systematically review the literature and identify coracoid fractures sustained during sporting activities to determine fracture prevalence, sporting activities/mechanisms, management, and time to return to sport. Study Design: Systematic review. Methods: A systematic review was conducted investigating all studies in the literature published between January 1970 and April 2017 that reported on athletes sustaining coracoid fractures during sporting activity. The systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used PubMed, Biosis Previews, SPORTDiscus, PEDro, and EMBASE databases. Inclusion criteria were studies detailing (1) coracoid fractures with reported sporting activity causing injury, (2) fracture management (operative vs nonoperative), and (3) patient outcome. Exclusion criteria were (1) studies concerning fractures secondary to nonsporting activities (mechanical falls, motor vehicle accidents) and (2) studies not reporting fracture management or patient outcomes. Sporting activities, the presence or absence of associated acromioclavicular (AC) joint injury, fracture management, patient outcomes, and time to return to sport were analyzed. Results: A total of 21 cases of coracoid fractures sustained during sporting activity were identified; acute trauma was responsible for 71% (n = 15/21) of fractures, and the remaining injuries were secondary to fatigue fractures. Concurrent AC joint injury was present in 60% (n = 9/15) of athletes sustaining acute trauma and in no athlete with fatigue fractures. Fractures were treated conservatively in 76% (n = 16/21) of patients, with only 19% (n = 3/16) of athletes reporting complications. Mean overall time to return to sport was 2.8 ± 2.0 months; no significant differences in return to sport were noted in athletes with traumatic versus fatigue fractures or those with or without AC joint injury. Conclusion: Coracoid fractures secondary to sporting activities are rare, occurring primarily from direct trauma with associated AC joint injury, and are treated successfully with nonoperative management. No difference in return to sport was found regardless of fracture mechanism, treatment, or the presence of associated AC joint injury.
Dosimetry Verification of 125I Seeds Implantation With Three-Dimensional Printing Noncoplanar Templates and CT Guidance for Paravertebral/Retroperitoneal Malignant Tumors
Authors: Ji Zhe , Jiang Yuliang , Su Liang , Guo Fuxin , Peng Ran , Sun Haitao , Fan Jinghong , Wang Junjie 
Published: August 2017

Objective: To compare dose distributions of postoperative plans with preoperative plans for radioactive seed implantation of paravertebral/retroperitoneal tumors assisted by 3-dimensional printing noncoplanar templates and computed tomography. Methods: Sixteen patients with paravertebral/retroperitoneal tumors (21 lesions) underwent radioactive seed implantation with 3-dimensional printing noncoplanar templates. Prescribed dose was 110 to 160 Gy. We compared the dose distribution of the postoperative plan with the preoperative plan. Dose parameters were D90, minimum peripheral dose, V100, V150, conformal index and external index of the target volume, and the dose received by 2 cm3 of normal tissue of organs at risk (spinal cord, aorta, and kidney). Results: Sixteen 3-dimensional printing noncoplanar templates were produced for 21 treatment areas. Mean gross tumor volume (preoperative) of patients was 61.1 cm3, mean needle number was 17, mean number of implanted 125I seeds was 65, and mean D90 of postoperative target area (gross tumor volume) was 131.1 Gy. Actual number of seeds postbrachytherapy increased by 1 to 12 in 8 cases. For postoperative plans, the mean D90, minimum peripheral dose, V100, V150 was 131.1 Gy, 67.1 Gy, 90.2%, and 64.1%, respectively, and 135.0 Gy, 64.7 Gy, 90.9%, and 64.1%, respectively, in preoperative plans. Comparing with the preplanned cases, the dose of the target volume was slightly lower and the high-dose area of the target volume was larger in postoperative cases, but the difference was not statistically significant ( P > .05). Actual dose conformity of the target volume was lower than preplanned, and the difference was statistically significant ( P = .005). Conclusion: Three-dimensional printing noncoplanar templates can provide good accuracy for positioning and direction in radioactive seed implantation.
Activation and expression of μ-calpain in dorsal root contributes to RTX-induced mechanical allodynia
Authors: Yuan Xiao-Cui , Wu Cai-Hua , Gao Fang , Li Hong-Ping , Xiang Hong-Chun , Zhu He , Pan Xiao-Li , Lin Li-Xue , Liu Yan-Shen , Yu Wei , Tian Bo , Meng Xian-Fang , Li Man 
Published: August 2017

Background Calpain is a calcium-dependent cysteine protease, and inhibition of calpain by pre-treatment with MDL28170 attenuated the rat mechanical allodynia in a variety of pain models. Postherpetic neuralgia (Shingles) is a neuropathic pain conditioned with the presence of profound mechanical allodynia. Systemic injection of resiniferatoxin can reproduce the clinical symptoms of postherpetic neuralgia. In this study, we determined to study whether activation of calpain contributes to cleave the myelin basic protein of dorsal root and is involved in resiniferatoxin-induced mechanical allodynia of postherpetic neuralgia animal model. Results Resiniferatoxin up-regulated the expression and activation of µ-calpain in dorsal root. The expression of µ-calpain was located in Schwann cell of dorsal root, and resiniferatoxin increased the expression of µ-calpain in Schwann cell in L4–L6 dorsal root at six weeks after injection. Resiniferatoxin also induced myelin basic protein degradation in L4–L6 dorsal root at six weeks after injection. Moreover, intraperitoneal injection of calpain inhibitor MDL28170 prevented the degradation of myelin basic protein and then reduced the sprouting of myelinated afferent fibers into spinal lamina II, thus relieving resiniferatoxin-induced mechanical allodynia. Conclusions Up-regulation and activation of µ-calpain located in Schwann cell may be the mechanism underlying resiniferatoxin-mediated proteolysis of myelin basic protein in dorsal root. Calpain inhibitor MDL28170 prevents resiniferatoxin-induced sprouting of myelinated afferent fibers and mechanical allodynia through inhibition of degradation of the myelin basic protein in dorsal root. Our results indicate that inhibition of pathological µ-calpain activation may present an interesting novel drug target in the treatment of postherpetic neuralgia.
Insights on pulmonary tumor thrombotic microangiopathy: a seven‐patient case series
Authors: Godbole Rohit , Saggar Rajan , Zider Alexander , Betancourt Jamie , Wallace William D. , Suh Robert D. , Kamangar Nader 
Published: August 2017

Pulmonary tumor thrombotic microangiopathy (PTTM) is a disease process wherein tumor cells are thought to embolize to the pulmonary circulation causing pulmonary hypertension (PH) and death from right heart failure. Presented herein are clinical, laboratory, radiographic, and histologic features across seven cases of PTTM. Highlighted in this publication are also involvement of pulmonary venules and clinical features distinguishing PTTM from clinical mimics.We conducted a retrospective chart review of seven cases of PTTM from hospitals in the greater Los Angeles metropolitan area.Patients in this series exhibited: symptoms of cough and progressive dyspnea; PH and/or heart failure on physical exam; laboratory abnormalities of anemia, thrombocytopenia, elevated LDH, and elevated D‐dimer; chest computed tomography (CT) showing diffuse septal thickening, mediastinal and hilar lymphadenopathy and nodules; elevated pulmonary artery pressures on transthoracic echocardiogram and/or right heart catheterization; and presence of malignancy. Tumor emboli and fibrocellular intimal proliferation were seen in pulmonary arterioles, while two patients had pulmonary venopathy.PTTM is a devastating disease occurring in patients with metastatic carcinoma. An early diagnosis is challenging. Understanding the clinical presentation of PTTM and distinguishing PTTM from clinical mimics may help achieve an early diagnosis and allow time for initiation of treatment.
Interval training early after heart failure decompensation is safe and improves exercise tolerance and quality of life in selected patients
Authors: Doletsky Artem , Andreev Denis , Giverts Ilya , Svet Alexey , Brand Anna , Kuklina Maria , Sedov Vsevolod , Dikur Oxana , Syrkin Abram , Saner Hugo 
Published: August 2017

Aims To evaluate safety and efficacy of moderate intensity interval exercise training early after heart failure decompensation on exercise tolerance and health-related quality of life (HRQoL). Methods and results This is a prospective randomized controlled study. We screened 234 consecutive patients admitted with decompensated heart failure; 46 patients (42 men/4 women; 61 ± 12 years of age) were randomized to a moderate intensity aerobic interval training ( n = 24) or to a control group ( n = 22). Patients underwent cardiopulmonary exercise testing, echocardiography and Minnesota Living with Heart Failure questionnaire (MLHFQ) at baseline, after three weeks and after three months. After three weeks, peak-VO2 increased by 17% in the training group ( p = 0.003) with further increase by 10% after three months ( p < 0.001) but did not change significantly in controls. MLHFQ score improved after three weeks, with better results in the training group (from 64.6 ± 15.6 to 30.8 ± 12.9, p < 0.001). After three months, MLHFQ further improved in the exercise training group, but not in controls. Left ventricular ejection fraction was not significantly different between the two groups at baseline and after three months. No serious adverse events related to exercise testing or training were observed. Conclusions Interval exercise training early after an episode of heart failure decompensation is safe and effective in improving exercise tolerance and health-related quality of life in selected patients after achievement of clinical stability. Positive effects remained sustained after three months. Further studies are needed to define role and indications for interval exercise training early after heart failure decompensation.
Impact of organophosphate exposure on farmers’ health in Kulon Progo, Yogyakarta: Perspectives of physical, emotional and social health
Authors: Perwitasari Dyah Aryani , Prasasti Dian , Supadmi Woro , Jaikishin Sonia Amelia Dewi , Wiraagni Idha Arfianti 
Published: August 2017

Objective: The exposure of organophosphate could be caused by the absorption in some parts of the body like skin and breath. Toxicity may cause nausea, vomiting and dizziness which are not too specific related with the pesticide toxicity. The purpose of this study is to understand the association between organophosphate exposure and farmers’ health in Kulon Progo County from the perspectives of physical, emotional and social health. Methods: This study was conducted using descriptive observational design. The blood sample was collected during harvesting periods in 2016. The inclusion criterion of farmers was using organophosphate-contained pesticide during the planting period of red onion. The farmers who had renal disease, liver disease and cancer were excluded. The organophosphate exposure parameters were the duration and frequency of pesticide application, width of the area, serum cholinesterase activity and the completeness of personal protective equipment. Results: Among 84 farmers, most of them were male (85.7%), and the mean age was 49.1 (standard deviation: 12.5) years; 71.4% of the subjects experienced tremor, 17.86% experienced dizziness and 8.33% subjects experienced nausea–vomiting after pesticide application. According to the pesticide application, in average, subjects used pesticide 1.4 h/day with the area of 1.285 m2. The frequency of pesticide used is three times per week. Around 97.6% subjects used incomplete personal protective equipment. The average of serum cholinesterase activity in subjects with tremor is higher than subjects without tremor (p > 0.05). There is a significant association between serum cholinesterase activity and creatinine content (p < 0.05). The farmers’ quality-of-life domain scores are lower than the scores of the normal population in Yogyakarta. Conclusion: Organophosphate exposure may affect the farmers’ physical health and quality of life.
Burden of impaired sleep quality on work productivity in functional dyspepsia
Authors: Matsuzaki Juntaro , Suzuki Hidekazu , Togawa Koji , Yamane Tsuyoshi , Mori Hideki , Komori Takahiro , Masaoka Tatsuhiro , Kanai Takanori 
Published: August 2017

Background Impaired sleep quality is common, and can reduce work productivity in patients with functional dyspepsia (FD). Objective The objective of this article is to evaluate whether there is a direct association between the presence of FD and the severity of impaired sleep quality, and to calculate the economic loss due to the decreased work productivity associated with sleep quality. Methods In Study 1, using a web-based survey completed by workers with and without FD, we evaluated impaired sleep quality, work and daily productivity, and the severity of reflux and bowel symptoms. In Study 2, the association between the presence of FD and the severity of impaired sleep quality was validated in a hospital-based cohort. Results In both Study 1 and 2, although impaired sleep quality was more frequent in participants with FD than in those without FD, the independent association between the presence of FD and the severity of impaired sleep quality was not observed after adjustment for the severity of reflux and bowel symptoms. FD participants with impaired sleep quality reported additional economic loss of 53,500 Japanese yen/month. Conclusion Although the association between impaired sleep quality and FD was indirect, concomitant impaired sleep quality could worsen economic loss.
Choosing Wisely in Oncology: Are We Ready For Value-Based Care?
Authors: Rocque Gabrielle , Blayney Douglas W. , Jahanzeb Mohammad , Knape August , Markham Merry Jennifer , Pham Trang , Shelton Jeremy , Sudheendra Preeti , Evans Tracey 
Published: August 2017

Introduction: In 2012, ASCO created the Top Five Choosing Wisely (CW) list of low-value tests and procedures for which there is little evidence of benefit. ASCO’s Quality Oncology Practice Initiative, an oncologist-led practice-based quality assessment program, includes measures on the basis of these recommendations. Methods: CW test measures from spring and fall 2013, spring 2014, and spring 2015 were evaluated for concordance rates, change in the concordance over time, and variability by practice characteristics. Practice characteristics recorded included geographic location, academic affiliation, number of new cases, number of medical oncologists, and rounds of participation in Quality Oncology Practice Initiative. Medians, interquartile ranges, and percentages were calculated for concordance with recommendations and practice characteristics. Change in recommendation concordance over time was assessed using linear regression models. Results: From 2013 to 2015, 341 unique oncology practices abstracted the CW measures. Performance varied for specific recommendations. The median concordance was best for measure 1 (patients with low or undocumented performance status who received chemotherapy), where concordance ranged from 78.4% to 83.3%. The lowest concordance was for measure 3 (use of biomarkers or advanced imaging tests for surveillance in early breast cancer), where concordance ranged from 67.7% to 74.2%. Performance on CW measures varied markedly by individual practice. Variability over time and by practice characteristics was observed. Conclusion: Performance on ASCO’s CW demonstrates room for improvement. Concordance rates varied substantially by practice. Further education on CW measures is needed to improve patient care and enhance value.
Service evaluation of the implementation of a digitally-enabled care pathway for the recognition and management of acute kidney injury
Authors: Connell Alistair , Montgomery Hugh , Morris Stephen , Nightingale Claire , Stanley Sarah , Emerson Mary , Jones Gareth , Sadeghi-Alavijeh Omid , Merrick Charles , King Dominic , Karthikesalingam Alan , Hughes Cian , Ledsam Joseph , Back Trevor , Rees Geraint , Raine Rosalind , Laing Christopher 
Published: August 2017

Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians. It is uncertain, however, whether ‘alerting’ alone improves care quality. We have thus developed a digitally-enabled care pathway as a clinical service to inpatients in the Royal Free Hospital (RFH), a large London hospital. This pathway incorporates a mobile software application - the “Streams-AKI” app, developed by DeepMind Health - that applies the NHS AKI algorithm to routinely collected serum creatinine data in hospital inpatients. Streams-AKI alerts clinicians to potential AKI cases, furnishing them with a trend view of kidney function alongside other relevant data, in real-time, on a mobile device. A clinical response team comprising nephrologists and critical care nurses responds to these AKI alerts by reviewing individual patients and administering interventions according to existing clinical practice guidelines. We propose a mixed methods service evaluation of the implementation of this care pathway. This evaluation will assess how the care pathway meets the health and care needs of service users (RFH inpatients), in terms of clinical outcome, processes of care, and NHS costs. It will also seek to assess acceptance of the pathway by members of the response team and wider hospital community. All analyses will be undertaken by the service evaluation team from UCL (Department of Applied Health Research) and St George’s, University of London (Population Health Research Institute).
Communication between primary and secondary care
Authors: Pannell Laura MK , Tyrrell-Price Jonathan 
Published: August 2017

Background Up to date patient data is a cornerstone of optimal safety and care, so admission to hospital requires transfer of data held in the community to secondary care. Despite the advent of electronic medical record systems such as Connecting Care and EMIS, the telephone remains the mainstay of communication. Methods A prospective cross-sectional quality improvement project was conducted to assess the time taken in telephone communication between primary and secondary care doctors and determine if access to the electronic shared system, Connecting Care, would improve efficiency. As part of normal junior doctor activity, fifty GPs were contacted between September 2015 and February 2016 to obtain medical data on patients admitted to UH Bristol. Time taken to contact each GP and the duration of the conversation was recorded. One hundred patient records were accessed using Connecting Care between October 2015 and February 2016 and the length of time taken to access information documented. Results Out of 50 phone calls 27 resulted in direct transfer to a GP with time to transfer ranging from 12 seconds to 19 minutes 51 seconds (mean 8 minutes 10 seconds, median 7 minutes 16 seconds). A total of 28 messages were left with the receptionist with 16/28 phone calls being returned and time taken for the call to be returned ranged from 34 minutes to 21 hours 3 minutes (mean 5 hours 50 minutes 4 seconds, median 4 hours). Information was available for 88/100 patient records accessed using Connecting Care with a mean duration to access information required of 1 minute 47 seconds. This was significantly shorter than the mean duration of conversation with GPs (4 minutes 22 seconds), mean total duration of telephone call and mean total duration of time to achieve aim of call with GP practices of 13 minutes 18 seconds and 2 hours 14 minutes 11 seconds respectively. Conclusions This study identifies areas of potential improvement in current methods of communication between primary and secondary care. Direct telephone contact will always have an important role in sharing information. However, access for secondary care doctors to electronic patient records, with patient consent and consideration for confidentiality, would improve efficiency and alleviate time pressures on both busy primary and secondary care doctors. This would have a positive impact on patient care and safety.
La formación transdisciplinaria en el grado universitario: una experiencia de la asignatura de Análisis de la Sustentabilidad Ambiental de Proyectos
Authors: Mihura Enrique , Campanella Sandra Romina 
Published: August 2017

Frente a la crisis ambiental contemporánea es necesario contribuir a la construcción de una "Nueva Sociedad". Para que esto se logre, es necesario generar cambios en los patrones de comportamiento de los sujetos que diariamente conviven en ella. Frente a esta situación y como motores de producción de conocimiento, las universidades no pueden estar excluidas sino que, por el contrario, deben ser unpilar fundamental para lograrlo.Formar profesionales para un funcionamiento diferente de la sociedad es un gran desafío. Desde esta perspectiva, se trabaja desde la asignatura Análisis de la Sustentabilidad Ambiental de Proyectos de la carrera de Ingeniería Ambiental de la UNL en pos de generar nuevas herramientas para la sociedad actual. La asignatura está incluida como práctica de Extensión Experiencial de la UNL, y dentro de este marco se propone una metodología transdisciplinaria que pretende generar un acercamiento a las problemáticas actuales de la sociedad y buscar las vías y actores más acordes para resolverlas.
Sinergia entre extensión y docencia en la Facultad de Ciencias Agropecuarias de Universidad Nacional de Córdoba
Authors: Ferrer Guillermo , Barrientos Mario 
Published: August 2017

Este trabajo aborda una experiencia realizada por un grupo de universitarios que, en parte, comparten dos proyectos, uno docente vinculado a la constitución de un “área de consolidación” con la cual los estudiantes de agronomía finalizan sus estudios, y otro de extensión a partir de un proyecto de intervención que, desde una de sus líneas de trabajo, brinda apoyo a unidades de producción familiar entransición agroecológica, organizadas en ferias francas.Podemos concluir que se ha generado una importante sinergia entre el proyecto de extensión y el espacio curricular de la citada área de consolidación. Por el lado del proyecto de extensión, se ve fortalecido porque los productores reciben propuestas de posibles modificaciones tendientes a mejorar su emprendimiento y desde el aspecto pedagógico se cuenta con unidades de producción que posibilitan a los estudiantes la elaboración de una propuesta técnico–productiva que constituye una verdadera síntesis de carrera.