bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic Architecture of the Cardiovascular Risk Proteome
Authors: Benson Mark D. , Yang Qiong , Ngo Debby , Zhu Yineng , Shen Dongxiao , Farrell Laurie A. , Sinha Sumita , Keyes Michelle J. , Vasan Ramachandran S. , Larson Martin G. , Smith J. Gustav , Wang Thomas J. , Gerszten Robert E. 
Published: December 2017

Background:
We recently identified 156 proteins in human plasma that were each associated with the net Framingham Cardiovascular Disease Risk Score using an aptamer-based proteomic platform in Framingham Heart Study Offspring participants. Here we hypothesized that performing genome-wide association studies and exome array analyses on the levels of each of these 156 proteins might identify genetic determinants of risk-associated circulating factors and provide insights into early cardiovascular pathophysiology.

Methods:
We studied the association of genetic variants with the plasma levels of each of the 156 Framingham Cardiovascular Disease Risk Score–associated proteins using linear mixed-effects models in 2 population-based cohorts. We performed discovery analyses on plasma samples from 759 participants of the Framingham Heart Study Offspring cohort, an observational study of the offspring of the original Framingham Heart Study and their spouses, and validated these findings in plasma samples from 1421 participants of the MDCS (Malmö Diet and Cancer Study). To evaluate the utility of this strategy in identifying new biological pathways relevant to cardiovascular disease pathophysiology, we performed studies in a cell-model system to experimentally validate the functional significance of an especially novel genetic association with circulating apolipoprotein E levels.

Results:
We identified 120 locus-protein associations in genome-wide analyses and 41 associations in exome array analyses, the majority of which have not been described previously. These loci explained up to 66% of interindividual plasma protein-level variation and, on average, accounted for 3 times the amount of variation explained by common clinical factors, such as age, sex, and diabetes mellitus status. We described overlap among many of these loci and cardiovascular disease genetic risk variants. Finally, we experimentally validated a novel association between circulating apolipoprotein E levels and the transcription factor phosphatase 1G. Knockdown of phosphatase 1G in a human liver cell model resulted in decreased apolipoprotein E transcription and apolipoprotein E protein levels in cultured supernatants.

Conclusions:
We identified dozens of novel genetic determinants of proteins associated with the Framingham Cardiovascular Disease Risk Score and experimentally validated a new role for phosphatase 1G in lipoprotein biology. Further, genome-wide and exome array data for each protein have been made publicly available as a resource for cardiovascular disease research.
Cultura Obscura: Race, Power, and “Culture Talk” in the Health Sciences
Authors: Benjamin Ruha 
Published: December 2017

“The price of culture is a Lie.”This Article advances a critical race approach to the health sciences by examining “culture talk” as a discursive repertoire that attributes distinct beliefs, behaviors, and dispositions to ethno-racialized groups. Culture talk entails a twofold process of obfuscation – concealing the social reality of the people it describes and hiding the positionality of those who employ cultural generalizations. After tracing how culture talk circulates and reproduces racist narratives in and beyond the health sciences, I examine how cultural competency training in medical schools and diversity initiatives in stem cell research use the idiom of culture to manage and manufacture group differences. From culturing cells in the lab to enculturing people in the clinic, I apply the concept of coproduction to argue that culture talk is a precondition and product of scientific knowledge construction.
Utilization and Survival of Postoperative Radiation or Chemoradiation for pT1‐2N1M0 Head and Neck Cancer
Authors: Lee Anna , Givi Babak , Roden Dylan F. , Tam Moses M. , Wu S. Peter , Gerber Naamit K. , Hu Kenneth S. , Schreiber David 
Published: December 2017

ObjectiveTo analyze the patterns of care and survival for pT1‐2N1M0 head and neck cancer based on receipt of surgery alone, surgery + postoperative radiotherapy (S + RT), or surgery + postoperative chemoradiotherapy (S + CRT).Study DesignRetrospective analysis.SettingNational Cancer Database.Subjects and MethodsWe queried the database for patients with stage pT1‐2N1M0 squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx between 2004 and 2012 who were treated with surgery with negative margins and no extracapsular extension. Logistic regression was used to assess predictors of receipt of postoperative treatment. Overall survival was assessed by the Kaplan‐Meier method, and Cox regression analysis identified covariates that affected it.ResultsThere were 1598 patients included in this study: 566 (35.4%) received surgery alone; 726 (45.4%), S + RT; and 306 (19.1%), S + CRT. The 5‐year overall survival was 68.8%, 74.0%, and 87.8%, respectively (P =. 009 comparing S + RT and surgery alone, P <. 001 for all other comparisons). On multivariable logistic regression, academic centers were associated with a decreased likelihood of S + RT (odds ratio = 0.71) and S + CRT (odds ratio = 0.66). Multivariable Cox regression demonstrated no difference in survival for S + RT over surgery alone (hazard ratio = 0.88, 95% CI = 0.70‐1.09, P =. 24); however, there was a survival benefit associated with S + CRT (hazard ratio = 0.57, 95% CI = 0.39‐0.81, P =. 002).ConclusionNearly 65% of patients with pT1‐2N1 head and neck cancer with negative margins and no extracapsular extension received S + RT or S + CRT. Improvement in survival was noted only for patients who received S + CRT.
Do Selective COX-2 Inhibitors Affect Pain Control and Healing After Arthroscopic Rotator Cuff Repair? A Preliminary Study
Authors: Oh Joo Han , Seo Hyuk Jun , Lee Ye-Hyun , Choi Hye-Yeon , Joung Ho Yun , Kim Sae Hoon 
Published: December 2017

Background: Selective cyclooxygenase (COX)–2 inhibitors are commonly used analgesics that provide similar analgesia as that of other analgesics but with fewer adverse effects. However, few prospective studies have performed comparative analyses in this regard. Purpose: To evaluate the efficacy of a selective COX-2 inhibitor in early postoperative pain control, satisfaction with pain management, and incidence of systemic adverse effects in patients undergoing arthroscopic rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: This study included 180 patients who underwent arthroscopic rotator cuff repair between September 2011 and August 2012. The patients were randomly assigned to receive celecoxib, ibuprofen, or tramadol (n = 60 each). Visual analog scale (VAS) scores for pain intensity and satisfaction with medication, incidence of adverse effects, and use of rescue medication were recorded and compared between the 3 groups at 3 days and 2 weeks after surgery. Magnetic resonance and ultrasonography images of 82 patients were retrospectively reviewed at least 24 months after surgery, along with the range of motion and pain VAS and functional scores. Results: There were no significant differences among the 3 groups in terms of pain intensity, incidence of adverse effects, or dosage of rescue medication at 3 days or 2 weeks after surgery. Pain VAS and functional scores at the final follow-up were also comparable among the 3 groups. However, the retear rate in the celecoxib group (11/30 [37%]) was significantly higher than those in the ibuprofen (2/27 [7%]) and tramadol (1/25 [4%]) groups ( P = .009). Conclusion: Despite having similar postoperative analgesic effects as other nonsteroidal anti-inflammatory drugs and opioids, selective COX-2 inhibitors should not be used for postoperative analgesia because they might negatively affect tendon-to-bone healing after surgical repair. Registration: NCT02850211 ( ClinicalTrials.gov identifier)
Randomized Study of Long-term (15-17 Years) Outcome After Microfracture Versus Mosaicplasty in Knee Articular Cartilage Defects
Authors: Solheim Eirik , Hegna Janne , Strand Torbjørn , Harlem Thomas , Inderhaug Eivind 
Published: December 2017

Background: Few comparative randomized long-term studies on microfracture versus mosaicplasty have been published, and only 2 studies reported a follow-up of 10 years. Hypothesis/Purpose: The purpose was to compare the clinical outcome of microfracture versus mosaicplasty/osteochondral autograft transfer in symptomatic cartilage lesions. The null hypothesis was that the outcome was not statistically different at any point of time. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Forty patients with articular cartilage defects were randomized to undergo cartilage repair by either microfracture (n = 20) or mosaicplasty (n = 20). Inclusion criteria were as follows: age 18 to 50 years at the time of surgery, 1 or 2 symptomatic focal full-thickness articular chondral defects on the femoral condyles or trochlea, and size 2 to 6 cm2. The main outcome variable was the Lysholm knee score recorded before the surgery and at 12 months, median 5 years, median 10 years, and minimum 15 years after the surgery. Results: Forty patients were included in the study (28 men, 12 women; median age, 32 years; range, 18-48 years). Defects with a median size of 3.5 cm2 (range, 2-5 cm2) were treated. A significant increase in the Lysholm score was seen for all subjects— from a mean 53 (SD, 16) at baseline to 69 (SD, 21) at the minimum 15-year follow-up ( P = .001). The mean Lysholm score was significantly higher in the mosaicplasty group than the microfracture group at 12 months, median 5 years, median 10 years, and minimum 15 years: 77 (SD, 17) versus 61 (SD, 22), respectively ( P = .01), at the last follow-up. At all follow-up time points, the difference in mean Lysholm score was clinically significant (>10 points). Conclusion: At short, medium, and long term (minimum 15 years), mosaicplasty results in a better, clinically relevant outcome than microfracture in articular cartilage defects (2-5 cm2) of the distal femur of the knee in patients aged 18 to 50 years.
Predictors of Medication Nonadherence From Outpatient Pharmacy Data Within a Large, Academic Health System
Authors: Davidson Erica , Lam Simon , Sokn Erick 
Published: December 2017

Background: Medication nonadherence is a worldwide issue that can lead to poor clinical outcomes and increased health-care costs. Objective: To determine the predictors of medication nonadherence. Methods: A retrospective chart review was conducted for patients who received prescription medications from Cleveland Clinic outpatient pharmacies. Prediction variables consisted of demographics, socioeconomic status, number of medications, and number of daily administrations. These variables were analyzed using a logistic regression to determine independent predictors of medication adherence. Results: Between January and September 2015, over 300 000 eligible prescriptions were filled, corresponding with over 70 000 unique patients. Of these, 29 134 patients were included. After multivariable regression, increasing age (odds ratio [OR]: 1.01), household income (OR: 1.03), and medication count (OR: 1.05) were found to be associated with adherence. Male gender (OR: 0.88), African American (OR: 0.45), Hispanic (OR: 0.62), or other race (OR: 0.87), being single (OR: 0.92), and increasing frequency of administrations per day (OR: 0.76) were associated with nonadherence. Conclusion: Medication nonadherence was associated with nonwhite race, single status, male gender, low socioeconomic status, and increasing frequency of medication administration. Based on these results, a risk prediction tool could be created to determine which patients are at the highest risk of medication nonadherence.
Anatomic Evaluation of Percutaneous Achilles Tendon Lengthening
Authors: Phillips Sierra , Shah Ashish , Staggers Jackson Rucker , Pinto Martim , Godoy-Santos Alexandre Leme , Naranje Sameer , de Cesar Netto Cesar 
Published: December 2017

Background: The objective of the study was to evaluate the accuracy of percutaneous Achilles tendon lengthening (TAL) using a triple hemisection technique and the improvement in ankle dorsiflexion. Methods: Ten fresh-frozen above-knee cadaveric specimens were used. A percutaneous triple hemisection of the Achilles tendon (proximal, intermediate, and distal) was performed. Maximum ankle dorsiflexion was evaluated pre- and postprocedure with a digital goniometer. After proper dissection, the relative width of the cuts was noted. Following forced ankle dorsiflexion, displacement in the tensile gaps was measured in all 3 cuts with a precision digital caliper. Results: The overall relative width of the percutaneous cut was 51.3% ± 16.3% of the Achilles tendon diameter, 44.3% ± 13.6% for the proximal cut, 50.3% ± 15.6% for the intermediate cut, and 59.3% ± 18.4% for the distal cut. Tendon excursion averaged 13.0 ± 3.8 mm for the proximal cuts, 12.5 ± 4.7 mm for the intermediate cuts, and 8.2 ± 3.7 mm for the distal cuts. One cadaver had a complete rupture of the Achilles tendon and was excluded from the excursion data analysis. The mean range of motion for ankle dorsiflexion was 8.1 ± 3.9 degrees preprocedure and 27.6 ± 5.3 degrees postprocedure. The dorsiflexion angle significantly increased ( P < .0001) at an average of 19.5 ± 5.0 degrees following TAL. Conclusion: Our cadaveric study demonstrated that the percutaneous triple hemisection of the Achilles was an accurate technique that provided successful lengthening of the tendon and increased ankle dorsiflexion. Complete ruptures are possible complications. Clinical Relevance: Our cadaveric study showed that in a clinical situation, triple hemisections of the Achilles tendon can be performed reliably, with significant improvement of the ankle dorsiflexion, mainly through increased tendon excursion at the proximal and intermediate cuts, and with low risk of complete ruptures.
Fatigue Bending Strength of Jones Fracture Specific Screw Fixation
Authors: Jastifer James , McCullough Kirk A. 
Published: December 2017

Background: Intramedullary screw fixation is a common method of treating proximal metadiaphyseal fifth metatarsal (ie, Jones) fractures. Fatigue failure is a complication of this fixation. There are many screw designs available, including Jones fracture specific fixation, but the optimal choice of screw design is unknown. The purpose of this study was to compare the fatigue strength of Jones fracture specific screw designs as well as other commonly used screw designs. Our hypothesis was that there would be no difference in fatigue strength for Jones fracture specific screw designs at similar screw diameters. Methods: A study was performed to determine the fatigue bending strength of 5 different screw designs including Jones fracture specific screw designs at 3 different screw diameters. Six screws of each size and design underwent cyclic fatigue testing, and a median fatigue limit (MFL) was determined for each screw design and size. Results: The Stryker Asnis JFX solid 4.0-mm, 5.0-mm, and 6.0-mm screws had a higher MFL than all other screws with similar diameter tested (all P < .0001). Both Jones fracture specific screw designs (Stryker Asnis JFX solid screws and Charlotte Carolina Jones screws) had higher MFLs than the other screw designs tested. Conclusion: This study provides comparative fatigue strength data on larger screw diameters, which have not been previously reported. There was a statistically significant difference in screw fatigue properties at the screw diameters tested. Clinical Relevance: The clinical significance of this study is that it provides surgeons with fatigue strength data to aid in screw selection for Jones fracture fixation.
Exploring the knowledge and attitude of medical and pharmacy students about generic medicine in Lahore, Pakistan
Authors: Asif Usama , Saleem Zikria , Yousaf Mahrukh , Saeed Hamid , Hashmi Furqan Khurshid , Hassali Mohamed Azmi 
Published: December 2017

Background The age of out-of-pocket health-care expenditures demands the practice of generic medicine. Our objective was to evaluate the knowledge and attitude about generic medicine among medical and pharmacy students of Lahore, Pakistan. Methods A cross-sectional study was performed among calculated sample size (via online Raosoft calculator) of 295 students including 185 pharmacy and 110 medical students from third, fourth, and final year of studies using convenient sampling approach. A pre-validated questionnaire was used to assess the knowledge of students regarding generic medicine. Data were analyzed using SPSS version 20. Results We found that a majority of both pharmacy and medical students were aware of the meaning of brand and generic medicine where 86 (29.7%) students believed that generic medicine is bioequivalent to brand name product and 108 (36.5%) students agreed that cost burden will be reduced with the use of generics. There were concerns about quality (P ≤ 0.05) and side effects (P ≤ 0.005) of generic medicine as compared to brands. Significant associations were found between the knowledge of medical and pharmacy students (P ≤ 0.005). Conclusion Educational interventions and policies regarding generic medicine practices are strongly needed to overcome the knowledge deficits among pharmacy and medical students.
Environmental Press, Aging in Place, and Residential Satisfaction of Urban Older Adults
Authors: Byrnes Mary , Lichtenberg Peter A. , Lysack Cathy 
Published: December 2017

Sociologists who study and work with older adults often use the term “aging in place” when discussing older adults' residential environments. Aging in place suggests that what is best for older people (and society at large) is to remain in the residential environment (e.g. home and neighborhood) in which they have lived most of their lives. The goal of this study was to utilize the theory of environmental press in a sample of older adults living in the central city of Detroit to begin to understand their levels of satisfaction with their residential environment, and to examine potential limitations in the theory of aging in place. A random telephone survey was used in a sample of older adults (n = 604) living in the central city of Detroit, Michigan. Hierarchical logistic regression was used to test residential satisfaction using demographics, home hazards, neighborhood hazards, personal competencies, geographic location, and interaction variables. Home hazards, neighborhood hazards, geographic location, and interaction press measures predicted housing satisfaction (Nagelkerke R2=40.2 percent) and neighborhood satisfaction (Nagelkerke R2=50.5 percent). The environmental press and residential satisfaction of the highest and lowest mentally and physically functioning older adults were also investigated. Respondents who reported the lowest levels of mental and physical functioning also reported the lowest levels of residential satisfaction and faced the greatest environmental challenges. The results suggest that older adults occupying disadvantaged social locations may be overlooked in current practice definitions of aging in place.
Clinico-Radiographic Discordance: An Evidence-Based Commentary on the Management of Degenerative Cervical Spinal Cord Compression in the Absence of Symptoms or With Only Mild Symptoms of Myelopathy
Authors: Witiw Christopher D. , Mathieu Francois , Nouri Aria , Fehlings Michael G. 
Published: December 2017

Study Design: Narrative review with commentary. Objectives: The growing use of magnetic resonance imaging (MRI) often leaves clinicians faced with scenarios where imaging findings are inconsistent with the clinical picture. This is particularly relevant for degenerative cervical spinal cord compression (CSCC). In this article, we provide a focused narrative literature review to address whether (1) surgery should be offered to asymptomatic patients with CSCC and (2) should MRI spinal cord signal changes influence clinical decisions for a patient with mild myelopathy from CSCC? Methods: Illustrative cases are presented with expert commentary which is supplemented by a focused literature review. Results: The literature suggests that CSCC from degenerative pathology is a common incidental radiographic finding. For those without symptoms of myelopathy, the short-term risk of progression is low. There is a lack of evidence to support surgery for asymptomatic individuals with CSCC who have no risk factors for progression. For these patients, the authors suggest non-operative management that includes education on the symptoms of myelopathy, clinical follow-up within 6 to 12 months, and avoidance of high-risk activities. Conversely, symptomatic patients have a notable risk of progression. Surgical intervention improves neurological function and quality of life regardless of severity. The authors support surgery as an option for all patients with mild myelopathy who are appropriate operative candidates. Intramedullary signal change on MRI has not been shown to reliably predict progression. Conclusions: While MRI technologies are under evolution, we advise that surgical decisions for patients with CSCC should rely on clinical assessment and not imaging findings.
A simple algorithm for the identification of clinical COPD phenotypes
Authors: Burgel Pierre-Régis , Paillasseur Jean-Louis , Janssens Wim , Piquet Jacques , ter Riet Gerben , Garcia-Aymerich Judith , Cosio Borja , Bakke Per , Puhan Milo A. , Langhammer Arnulf , Alfageme Inmaculada , Almagro Pere , Ancochea Julio , Celli Bartolome R. , Casanova Ciro , de-Torres Juan P. , Decramer Marc , Echazarreta Andrés , Esteban Cristobal , Gomez Punter Rosa Mar , Han MeiLan K. , Johannessen Ane , Kaiser Bernhard , Lamprecht Bernd , Lange Peter , Leivseth Linda , Marin Jose M. , Martin Francis , Martinez-Camblor Pablo , Miravitlles Marc , Oga Toru , Sofia Ramírez Ana , Sin Don D. , Sobradillo Patricia , Soler-Cataluña Juan J. , Turner Alice M. , Verdu Rivera Francisco Javier , Soriano Joan B. , Roche Nicolas 
Published: December 2017

This study aimed to identify simple rules for allocating chronic obstructive pulmonary disease (COPD) patients to clinical phenotypes identified by cluster analyses.Data from 2409 COPD patients of French/Belgian COPD cohorts were analysed using cluster analysis resulting in the identification of subgroups, for which clinical relevance was determined by comparing 3-year all-cause mortality. Classification and regression trees (CARTs) were used to develop an algorithm for allocating patients to these subgroups. This algorithm was tested in 3651 patients from the COPD Cohorts Collaborative International Assessment (3CIA) initiative.Cluster analysis identified five subgroups of COPD patients with different clinical characteristics (especially regarding severity of respiratory disease and the presence of cardiovascular comorbidities and diabetes). The CART-based algorithm indicated that the variables relevant for patient grouping differed markedly between patients with isolated respiratory disease (FEV1, dyspnoea grade) and those with multi-morbidity (dyspnoea grade, age, FEV1and body mass index). Application of this algorithm to the 3CIA cohorts confirmed that it identified subgroups of patients with different clinical characteristics, mortality rates (median, from 4% to 27%) and age at death (median, from 68 to 76 years).A simple algorithm, integrating respiratory characteristics and comorbidities, allowed the identification of clinically relevant COPD phenotypes.