bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synthesis, characterization and biological evaluation of strontium/magnesium-co-substituted hydroxyapatite
Authors: Geng Zhen , Wang Renfeng , Li Zhaoyang , Cui Zhenduo , Zhu Shengli , Liang Yanqin , Liu Yunde , Huijing Bao , Li Xue , Huo Qianyu , Liu Zhili , Yang Xianjin 
Published: February 2016

The present study aims to investigate the contribution of two biologically important cations, Mg2+ and Sr2+, when co-substituted into the structure of hydroxyapatite (Ca10(PO4)6(OH)2, HA). The substituted samples were synthesized by a hydrothermal method that involved the addition of Mg2+ and Sr2+ containing precursors to partially replace Ca2+ in the apatite structure. Four co-substituted HA samples with different concentrations of Mg2+ and Sr2+ ((Mg + Sr)/(Mg + Sr + Ca) = 30%) were investigated, and they were compared with pure HA. Experimental results showed that only a limited amount of Mg (Mg/(Mg + Ca + Sr) < 14%) could successfully substitute for Ca in HA. In addition, Mg substitution resulted in reduced crystallinity, thermal stability and lattice parameters of HA. In contrast, Sr could fully substitute for Ca. Furthermore, the addition of Sr increased the lattice parameters of HA. Here, we obtained the cation leach liquor by immersing the prepared samples in a culture medium for cell experiments. The in vitro study showed that 10Mg20Sr promoted better MG63 cell attachment, proliferation and differentiation than HA. Thus, the presence of an appropriate proportion of Mg and Sr could play a significant role in the increased biocompatibility of HA.
Physician leadership development at Cleveland Clinic: a brief review
Authors: Christensen Terri , Stoller James K 
Published: February 2016

Objective: We aim to describe the rationale for and spectrum of leadership development programs, highlighting experience at a large healthcare institution (Cleveland Clinic, Cleveland, Ohio, USA). Conclusions: Developing leaders is a universal priority to sustain organizational success. In health care, significant challenges of ensuring quality and access and making care affordable are widely shared internationally and demand effective physician leadership. Yet, leadership competencies differ from clinical and scientific competencies and features of selecting and training physicians—who have been called “heroic lone healers” —often conspire against physicians being effective leaders or followers. Thus, developing leadership competencies in physicians is critical. Leadership development programs have been signature features of successful organizations and various Australian organizations offer such training (e.g. The Australian Leadership Foundation and the University of South Australia), but relatively few health care organizations have adopted the practice of offering such training, both in Australia and elsewhere. As a United States example of one such integrated program, the Cleveland Clinic, a large, closed-staff physician-led group practice in Cleveland, Ohio has offered physician leadership training for over 15 years. This paper describes the rationale, structure, and some of the observed impacts associated with this program.
Assessing functional exercise capacity using telehealth: Is it valid and reliable in patients with chronic heart failure?
Authors: Hwang Rita , Mandrusiak Allison , Morris Norman R , Peters Robyn , Korczyk Dariusz , Russell Trevor 
Published: February 2016

Introduction This study aimed to determine the validity and reliability of video-based telerehabilitation assessments in patients with heart failure. Methods Seventeen consecutive participants (mean age 69 years, SD 12 years and 88% males) undertook assessments of three functional tests via both telerehabilitation and face-to-face approaches, on the same day. The assessment order was randomised and conducted by independent assessors. Outcome measures included functional tests: timed up and go (time), six-minute walk (distance), grip strength (kilograms); system usability scale to rate participant experience with telerehabilitation assessment; and number of technical issues encountered. Validity and inter- and intra-rater reliability of telerehabilitation assessments were examined using limits of agreement, intra-class correlation coefficients (ICC), and paired t-tests. Results The limits of agreement for telerehabilitation assessments were within the clinically acceptable limits for timed up and go and grip strength. Telerehabilitation assessments for all functional tests were strongly associated with face-to-face assessments, with ICCs of between 0.85 and 0.96. Inter- and intra-rater reliability of telerehabilitation assessments for all functional tests were excellent (all ICC > 0.95). The mean (SD) system usability scale score was 85 (15)/100. Some incidences of Internet drop-outs, video freezing and auditory fading occurred. Discussion The use of telehealth for the assessment of functional exercise capacity appears to be valid and reliable in patients with heart failure.
Serum periostin in obstructive airways disease
Authors: Fingleton James , Braithwaite Irene , Travers Justin , Bowles Darren , Strik Rianne , Siebers Rob , Holweg Cecile , Matthews John , Weatherall Mark , Beasley Richard 
Published: February 2016

Serum periostin is a potential biomarker of response to therapies that target type 2 inflammation in asthma. The objectives of this study were to describe: 1) the distribution of serum periostin levels in adults with symptomatic airflow obstruction; 2) its relationship with other variables, including type 2 biomarkers; and 3) the effect of inhaled corticosteroids on periostin levels.Serum periostin levels were measured in a cross-sectional study exploring phenotypes and biomarkers in 386 patients aged 18–75 years who reported wheeze and breathlessness in the past 12 months. In 49 ICS-naïve patients, periostin levels were measured again after 12 weeks of budesonide (800 μg·day−1).The distribution of serum periostin levels was right skewed (mean±sd57.3±18.6 ng·mL−1, median (interquartile range) 54.0 (45.1–65.6) ng·mL−1, range 15.0–164.7 ng·mL−1). Periostin was positively associated with exhaled nitric oxide (Spearman's rho=0.22, p<0.001), blood eosinophil count (Spearman's rho=0.21, p<0.001), and total IgE (Spearman's rho=0.14, p=0.007). The Hodges–Lehmann estimator (95% CI) of change in periostin level after ICS therapy was −4.8 (−6.7– −3.2) ng·mL−1(p<0.001).These findings provide data on the distribution of serum periostin in adults with symptomatic airflow obstruction, the weak associations between periostin and other type 2 markers, and the reduction in periostin with inhaled corticosteroid therapy.
Decisional conflict in patients considering diagnostic thyroidectomy with indeterminate fine needle aspirate cytopathology
Authors: Taylor Benjamin A. , Hart Robert D. , Rigby Matthew H. , Trites Jonathan , Taylor S. Mark , Hong Paul 
Published: February 2016

Background Fine needle aspiration (FNA) cytopathology is the gold standard work-up for thyroid nodules. However, indeterminate lesions are encountered commonly and can lead to difficult treatment decisions. We sought to determine whether patients experienced decisional conflict surrounding management with diagnostic thyroidectomy in the setting of indeterminate FNA results. Methods Patients with indeterminate results of thyroid nodule FNA were prospectively enrolled. All consultations were carried out by three otolaryngologists in a consistent manner. After consultation, participants completed a demographics form and the Decisional Conflict Scale (DCS) questionnaire. Results Thirty-five patients (28 female) between the ages of 30 and 88 years (mean age 54.89) participated. The median total DCS score was 10.94 (interquartile range, 4.69–25.0). Twelve patients (34 %) scored at or above 25 on the DCS, indicating clinically significant level of decisional conflict. Patients reported feeling significantly more confident about their decision after the surgical consultation compared to before the consultation ( p = 0.00). The total DCS score was significantly negatively correlated with self-reported confidence after the consultation ( r = −0.421, p = 0.012). Conclusion Many patients experienced clinically significant decisional conflict when considering thyroidectomy for management of a thyroid nodule with indeterminate cytopathology. Future research should be directed at developing decision support tools for this patient group, and exploring the impact of decisional conflict on health outcomes.
Characterization of Ovarian Responses to Equine Chorionic Gonadotropin of Aromatase-Deficient Mice With or Without 17β-Estradiol Supplementation
Authors: Toda Katsumi , Hayashi Yoshihiro , Ono Masafumi , Saibara Toshiji 
Published: February 2016

Abstract
Aromatase is an enzyme catalyzing the final step of 17β-estradiol (E2) biosynthesis. Aromatase-deficient (ArKO) mice displayed vital roles of E2 at various tissue sites, including ovary. Here, we report attenuated responses of ArKO ovary to equine chorionic gonadotropin (eCG), an alternative to FSH. Ovarian contents of cAMP and anti-Müllerian hormone (AMH), putative factors reducing sensitivity to gonadotropins, were significantly elevated in ArKO mice compared with those in wild type (WT) mice in the basal state. Accordingly, eCG-induced ovarian alterations in cAMP contents, phosphorylation levels of signaling molecules, and mRNA expression of eCG-targeted genes were blunted in ArKO mice compared with those in WT mice. Treatment of ArKO mice with E2 decreased ovarian cAMP and AMH contents to the WT levels but did not restore the sensitivity. Microarray analysis coupled with quantitative RT-PCR analysis identified 7 genes of which the mRNA expression levels in ArKO ovaries were significantly different from those in the WT ovaries in the basal state and were not normalized by E2 supplementation, indicating possible involvement of these gene products in the determination of ovarian sensitivity to eCG. Thus, present analyses revealed that estrogen deficiency attenuates sensitivity of the ovary to gonadotropin, which might be associated with alterations in the ovarian contents of multiple molecules including cAMP and AMH. Given the importance of the ovarian responses to gonadotropins in reproductive function, detailed knowledge about the underlying mechanisms of abnormalities in the ArKO ovary might help to develop potential targets for infertility treatments.
Statin (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor)-based therapy for hepatitis C virus (HCV) infection-related diseases in the era of direct-acting antiviral agents
Authors: Kishta Sara Sobhy , El-Shenawy Reem , Kishta Sobhy Ahmed 
Published: February 2016

Recent improvements have been made in the treatment of hepatitis C virus (HCV) infection with the introduction of direct-acting antiviral agents (DAAs). However, despite successful viral clearance, many patients continue to have HCV-related disease progression. Therefore, new treatments must be developed to achieve viral clearance and prevent the risk of HCV-related diseases. In particular, the use of pitavastatin together with DAAs may improve the antiviral efficacy as well as decrease the progression of liver fibrosis and the incidence of HCV-related hepatocellular carcinoma. To investigate the management methods for HCV-related diseases using pitavastatin and DAAs, clinical trials should be undertaken. However, concerns have been raised about potential drug interactions between statins and DAAs. Therefore, pre-clinical trials using a replicon system and human hepatocyte-like cells from human-induced pluripotent stem cells should be conducted. Based on these pre-clinical trials, an optimal direct-acting antiviral agent could be selected for combination with pitavastatin and DAAs. Following the pre-clinical trial, the combination of pitavastatin and the optimal direct-acting antiviral agent should be compared to other combinations of DAAs (e.g., sofosbuvir and velpatasvir) according to the antiviral effect on HCV infection, HCV-related diseases and cost-effectiveness.
Progressive radiolucent lines following the implantation of the cemented Rimfit acetabular component in total hip arthroplasty using the rimcutter technique
Authors: Baker P. , Rankin K. , Naisby S. , Agni N. , Brewster N. , Holland J. 
Published: February 2016

AimsThe highly cross-linked polyethylene Exeter RimFit flanged cemented acetabular component was introduced in the United Kingdom in 2010. This study aimed to examine the rates of emergence of radiolucent lines observed when the Rimfit acetabular component was implanted at total hip arthroplasty (THA) using two different techniques: firstly, the ‘rimcutter’ technique in which the flange sits on a pre-prepared acetabular rim; and secondly, the ‘trimmed flange’ technique in which the flange is trimmed and the acetabular component is seated inside the rim of the acetabulum.Patients and MethodsThe radiographs of 150 THAs (75 ‘rimcutter’, 75 ‘trimmed flange’) involving this component were evaluated to assess for radiolucencies at the cement/bone interface by three observers.ResultsRimfit acetabular components implanted using the rimcutter technique had significantly higher rates of radiolucency than those introduced using the ‘trimmed flange’ technique one year post-operatively (one zone: 63/75 (84%) vs 17/75 (23%); two zones 42/75 (56%) vs 0/75 (0%); all three zones 17/75 (23%) vs 0/75 (0%):(all p < 0.001).ConclusionOn the basis of these findings, we have stopped using the ‘rimcutter’ technique when implanting the Rimfit acetabular component and have reverted to the ‘trimmed flange’ technique. Take home message: Surgeons should be vigilant of the performance of the Rimfit acetabular component when used alongside the rim cutter device due to an observed higher rate of progressive radiolucencies with this combination of component / technique. Cite this article: Bone Joint J 2016;98-B:313–19.
Short fusion strategy for thoracolumbar and lumbar adolescent idiopathic scoliosis using anterior dual-rod instrumentation.
Authors: Sudo H. , Kaneda K. , Shono Y. , Iwasaki N. 
Published: February 2016

Aims A total of 30 patients with thoracolumbar/lumbar adolescent idiopathic scoliosis (AIS) treated between 1989 and 2000 with anterior correction and fusion surgery using dual-rod instrumentation were reviewed. Patients and Methods Radiographic parameters and clinical outcomes were compared among patients with lowest instrumented vertebra (LIV) at the lower end vertebra (LEV; EV group) (n = 13) and those treated by short fusion (S group), with LIV one level proximal to EV (n = 17 patients). Results The allocation of the surgical technique was determined by the flexibility of the TL/L curves and/or neutral vertebrae located one level above LEV as determined on preoperative radiographs. If these requirements were met a short fusion was performed. The mean follow-up period was 21.4 years (16 to 27). The mean correction rate at final follow-up was significantly lower in the S group (74 sd 11%) than in the EV group (88 sd 13%) (p = 0.004).Coronal and sagittal balance, thoracic kyphosis, lumbar lordosis, and clinical outcomes evaluated by the Scoliosis Research Society-22 questionnaire scores were equivalent between the two groups. Conclusion Short fusion strategy, which uses LIV one level proximal to LEV can be considered as an alternative to the conventional strategy, which includes LEV in the fusion, when highly flexible TL/L curves are confirmed and/or neutral vertebrae are located one level above LEV in patients with thoracolumbar/lumbar AIS curves. Take home message: Short fusion strategy can be considered as an alternative to the conventional strategy in patients with thoracolumbar/lumbar AIS curves undergoing anterior spinal fusion with dual-rod instrumentation. Cite this article: Bone Joint J 2016;98-B:402–9.
The impact of patient and surgical factors on the rate of infection after primary total knee arthroplasty
Authors: Tayton E. R. , Frampton C. , Hooper G. J. , Young S. W. 
Published: February 2016

Aims The aim of this study was to identify risk factors for prosthetic joint infection (PJI) following total knee arthroplasty (TKA). Patients and Methods The New Zealand Joint Registry database was analysed, using revision surgery for PJI at six and 12 months after surgery as primary outcome measures. Statistical associations between revision for infection, with common and definable surgical and patient factors were tested. Results A total of 64 566 primary TKAs have been recorded on the registry between 1999 and 2012 with minimum follow-up of 12 months. Multivariate analysis showed statistically significant associations with revision for PJI between male gender (odds ratio (OR) 1.85, 95% confidence interval (CI) 1.24 to 2.74), previous surgery (osteotomy (OR 2.45 95% CI 1.2 to 5.03), ligament reconstruction (OR 1.85, 95% CI 0.68 to 5.00)), the use of laminar flow (OR 1.6, 95% CI 1.04 to 2.47) and the use of antibiotic-laden cement (OR 1.93, 95% CI 1.19 to 3.13). There was a trend towards significance (p = 0.052) with the use of surgical helmet systems at six months (OR 1.53, 95% CI 1.00 to 2.34). Conclusion These findings show that patient factors remain the most important in terms of predicting early PJI following TKA. Furthermore, we found no evidence that modern surgical helmet systems reduce the risk of PJI and laminar flow systems may actually increase risk in TKA. The use of this registry data assists the estimation of the risk of PJI for individual patients, which is important for both informed consent and the interpretation of infection rates at different institutions. Take home message: Infection rates in TKA are related to both individual patient and surgical factors, and some modern methods of reducing infection may actually increase infection risk. Cite this article: Bone Joint J 2016;98-B:334–40.
Mineralogical Evolution of Di- and Trioctahedral Smectites in Highly Alkaline Environments
Authors: Elert Kerstin , Pardo Eduardo Sebastián , Rodriguez-Navarro Carlos 
Published: February 2016

AbstractThe mineralogical evolution of di- and trioctahedral smectites (i.e. montmorillonite and saponite) exposed to high-pH environments has been studied to determine the influence of compositional differences on clay dissolution and the formation of new phases. The present study helps to gauge the effects of highly alkaline solutions on the swelling capacity of smectitic clays and experimental results are extrapolated to predict the behavior of smectite-rich soils in various technical applications such as nuclear-waste storage and architectural conservation. The present study revealed extensive dissolution of montmorillonite in 5 M NaOH or 5 M KOH solutions and the neoformation of various zeolites, thereby reducing the clay’s swelling capacity significantly. Saponite, in contrast, experienced less pronounced changes, including transformation into a randomly interstratified saponite-chlorite and a Si-rich amorphous phase. These changes only provoked a partial reduction in swelling capacity. The results imply that under repository conditions (e.g. alkaline environment caused by hyperalkaline fluids released during concrete leaching), the slow and limited transformation of saponite into corrensite-type minerals would be beneficial for preserving the clay’s swelling capacity and, therefore, its effectiveness as a sealing material. Conversely, the loss of swelling capacity as a result of zeolite formation in montmorillonite observed in the present experiments would limit the clay’s effectiveness as a sealing material in waste repositories. In the case of earthen architecture conservation, alkaline consolidation treatments aimed at reducing the soils’ swelling capacity and, thereby, improving water resistance, would only be effective for treating earthen structures made of soils rich in dioctahedral smectites. Soils containing trioctahedral smectites, in contrast, are not likely to improve their water resistance because the swelling capacity will only be partially reduced.
Formation and Restacking of Disordered Smectite Osmotic Hydrates
Authors: Gilbert Benjamin , Comolli Luis R. , Tinnacher Ruth M. , Kunz Martin , Banfield Jillian F. 
Published: February 2016

AbstractClay swelling, an important phenomenon in natural systems, can dramatically affect the properties of soils and sediments. Of particular interest in low-salinity, saturated systems are osmotic hydrates, forms of smectite in which the layer separation greatly exceeds the thickness of a single smectite layer due to the intercalation of water. In situ X-ray diffraction (XRD) studies have shown a strong link between ionic strength and average interlayer spacing in osmotic hydrates but also indicate the presence of structural disorder that has not been fully described. In the present study the structural state of expanded smectite in sodium chloride solutions was investigated by combining very low electron dose, high-resolution cryogenic-transmission electron microscopy observations with XRD experiments. Wyoming smectite (SWy-2) was embedded in vitreous ice to evaluate clay structure in aqua. Lattice-fringe images showed that smectite equilibrated in aqueous, low-ionic-strength solutions, exists as individual smectite layers, osmotic hydrates composed of parallel layers, as well as disordered layer conformations. No evidence was found here for edge-to-sheet attractions, but significant variability in interlayer spacing was observed. Whether this variation could be explained by a dependence of the magnitude of long-range cohesive (van der Waals) forces on the number of layers in a smectite particle was investigated here. Calculations of the Hamaker constant for layer-layer interactions showed that van der Waals forces may span at least five layers plus the intervening water and confirmed that forces vary with layer number. Drying of the disordered osmotic hydrates induced re-aggregation of the smectite to form particles that exhibited coherent scattering domains. Clay disaggregation and restacking may be considered as an example of oriented attachment, with the unusual distinction that it may be cycled repeatedly by changing solution conditions.
Techniques for a Wind Energy System Integration with an Islanded Microgrid
Authors: Goyal Megha , Fan Yuanyuan , Ghosh Arindam , Shahnia Farhad 
Published: February 2016

Abstract
This paper presents two different techniques of a wind energy conversion system (WECS) integration with an islanded microgrid (MG). The islanded microgrid operates in a frequency droop control where its frequency can vary around 50 Hz. The permanent magnet synchronous generator (PMSG) based variable speed WECS is considered, which converts wind energy to a low frequency ac power. Therefore it needs to be connected to the microgrid through a back to back (B2B) converter system. One way of interconnection is to synchronize the MG side converter with the MG bus at which it is connected. In this case, this converter runs at the MG frequency. The other approach is to bring back the MG frequency to 50 Hz using the isochronization concept. In this case, the MG side converter operates at 50 Hz. Both these techniques are developed in this paper. The proposed techniques are validated through extensive PSCAD/EMTDC simulation studies.