bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between self-care and comprehensive understanding of heart failure and its signs and symptoms
Authors: Lee Kyoung Suk , Moser Debra K , Dracup Kathleen 
Published: December 2017

Background: Although incomplete understanding of heart failure and its signs and symptoms appears to be a barrier to successful self-care, there are few studies examining the relationship between self-care and levels of comprehensive understanding of heart failure and its signs and symptoms. Aim: To determine whether incomplete understanding of heart failure and its signs and symptoms is associated with self-care in heart failure patients who were recently discharged from the hospital due to heart failure exacerbation. Methods: Patients completed the nine-item European Heart Failure Self-care Behavior scale and questionnaire to assess knowledge of heart failure and its signs and symptoms. Three groups were formed by their different levels of understanding of heart failure and its signs and symptoms. Multivariable linear regression was used to determine whether these three levels of understanding groups predicted self-care after controlling for demographic and clinical variables. Results: Of 571 patients 22.1%, 40.1% and 37.8% had poor, moderate, and complete understanding, respectively. Compared with patients in the poor understanding group, patients in complete and moderate understanding groups were more likely to have better adherence to self-care activities (standardized β = −0.14, 95% confidence interval −3.41, −0.47; standardized β = −0.19, 95% confidence interval −4.26, −1.23, respectively). Conclusions: Fewer than half of the patients had a comprehensive understanding of heart failure and its signs and symptoms, which was associated with poor self-care. Our study suggests that patient education should include contents to promote comprehensive understanding of heart failure and its symptoms, as well as the importance of self-care behaviors.
Intermedin attenuates high-glucose exacerbated simulated hypoxia/reoxygenation injury in H9c2 cardiomyocytes via ERK1/2 signaling
Authors: Li Hong , Xiao Chuan-Shi , Bian Yun-Fei , Bai Rui , Gao Fen 
Published: November 2017

Objective: This study investigated whether and how intermedin (IMD) exerted a protective effect against simulated hypoxia/reoxygenation (H/R) injury in high-glucose-treated H9c2 cells. Methods: Cellular viability was assessed via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Oxidative stress was determined by malondialdehyde and superoxide dismutase content in the culture medium supernatant. Flow cytometry with Annexin V/propidium iodide staining was used to detect the cardiomyocyte apoptosis rate. The protein expression of Bax, Bcl-2, caspase-3, and ERK1/2 was determined by western blot. Results: IMD administration to H9c2 cells during H/R injury decreased oxidative stress product generation and inhibited apoptosis ( P < 0.05 or P < 0.01) while these effects were blocked by the ERK1/2 inhibitor ( P < 0.05 or P < 0.01). Through the application of a specific ERK1/2 inhibitor, it was demonstrated that IMD mitigates high-glucose-induced oxidative stress and apoptosis via ERK1/2 signaling. Conclusion: Intermedin may be a novel therapeutic agent for mitigating diabetic cardiovascular injury in the clinical setting.
Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study
Authors: Okano Ichiro , Sawada Takatoshi , Kushima Nobumasa , Tachibana Tetsuya , Inagaki Katsunori 
Published: November 2017

Background: Basicervical proximal femoral fracture is a known subtype of extracapsular fracture and is mechanically unstable, especially for the rotational direction, which may lead to implant failure. A cephalomedullary nail (CMN) is widely used for the fixation of unstable extracapsular fracture; however, its application for basicervical fracture remains controversial. Helical blade CMN is proven to have more rotational stability than traditional lag screw implants and potentially advantageous in the treatment of basicervical fracture. The aim of this study is to assess the effectiveness of helical blade CMN for basicervical fracture in elderly patients. Methods: We conducted a retrospective review of 500 consecutive extracapsular fracture patients treated surgically between January 2005 and February 2015. Patients who had trochanteric extension or multifragment fracture were excluded. Sixteen cases of 2-part basicervical proximal femoral fracture were identified. All patients were treated with the same single helical blade CMN system (DePuy Synthes PFNA-II). Implant-related complications were recorded. Results: Two patients dropped out during follow-up and 14 patients were included in the analysis. The average follow-up period was 21.9 months. No major complication was observed. The patients were subcategorized into 2 groups: nondisplaced (displacement <2 mm at any point of the fracture line) or displaced. Excessive telescoping was observed in 2 patients, both of whom were in the displaced fracture group. The overall implant-related complication rate was 14.2% (2/16). Conclusion: Internal fixation with the helical blade CMN system can be considered as a treatment option for 2-part basicervical proximal femoral fracture in elderly patients.
Game Schedules and Rate of Concussions in the National Football League
Authors: Teramoto Masaru , Cushman Daniel M. , Cross Chad L. , Curtiss Heather M. , Willick Stuart E. 
Published: November 2017

Background: Concussion prevention in the National Football League (NFL) is an important priority for player safety. The NFL now has modified game schedules, and one concern is that unconventional game schedules, such as a shortened rest period due to playing on a Thursday rather than during the weekend, may lead to an increased risk of injuries. Hypothesis: Unconventional game schedules in the NFL are associated with an increased rate of concussion. Study Design: Descriptive epidemiological study. Methods: This study analyzed concussions and game schedules over the NFL regular seasons from 2012 to 2015 (4 years). Documented numbers of concussions, identified by use of the online database PBS Frontline Concussion Watch, were summarized by regular-season weeks. Association of days of rest and game location (home, away, or overseas) with the rate of concussion was examined by use of the χ2 test. Logistic regression analysis was performed to examine the relationships of days of rest and home/away games to the risk of repeated concussions, with adjustment for player position. Results: A total of 582 concussions were analyzed in this study. A significantly greater number of concussions occurred in the second half of the season ( P < .01). No significant association was found between the rate of concussion and the days of rest, game location, or timing of the bye week by the team or the opponent ( P > .05). Game schedules were not significantly associated with the occurrence of repeat concussions ( P > .05). Conclusion: Unconventional game schedules in the NFL, including playing on Thursday and playing overseas, do not seem to put players at increased risk of concussions.
Do athletes alter their running mechanics after an Achilles tendon rupture?
Authors: Jandacka Daniel , Silvernail Julia Freedman , Uchytil Jaroslav , Zahradnik David , Farana Roman , Hamill Joseph 
Published: November 2017

AbstractBackgroundOver the past thirty years, there has been dramatic increase in incidence of Achilles tendon rupture in the athletic population. The purpose of this study was to compare the lower extremity mechanics of Achilles tendon ruptured runners with healthy controls.MethodsThe participants with a past history of an Achilles tendon repair (n = 11) and healthy control (n = 11) subgroups were matched on sex, age, type of regular physical activity, mass, height, footfall pattern and lateral dominancy. Running kinetics and kinematics of the ankle, knee and hip were recorded using a high‐speed motion capture system interfaced with a force platform. Achilles tendon length was measured using ultrasonography. Main outcome measures were lower extremity joint angles and moments during stance phase of running and Achilles tendon lengths.ResultsAthletes from Achilles tendon group had an affected gastro‐soleus complex. Athletes with history of Achilles tendon rupture had reduced ankle range of motion during second half of the stance phase of running (Δ7.6°), an overextended knee during initial contact (Δ5.2°) and increased affected knee range of motion (Δ4.4°) during the first half of stance phase on their affected limb compared to the healthy control group. There was a 22% increase in the maximal hip joint moment on contralateral side of the Achilles tendon group compared to the healthy controls.ConclusionThese results suggest a compensation mechanism, relatively extended knee at initial ground contact against the deficit in the muscle‐tendon complex of the triceps surae. Overextension during sporting activities may place the knee at risk for further injury. Avoidance of AT lengthening and plantarflexion strength deficit after surgery and during rehabilitation might help to manage AT rupture since these factors may be responsible for altered running kinematics.
Evidence Basis for Regional Anesthesia in Ambulatory Anterior Cruciate Ligament Reconstruction: Part III: Local Instillation Analgesia—A Systematic Review and Meta-analysis
Authors: Yung Eric M. , Brull Richard , Albrecht Eric , Joshi Girish P. , Abdallah Faraj W. 
Published: December 2017

BACKGROUND:
Local infiltration analgesia offers effective postoperative analgesia after knee arthroplasty, but the role of its counterpart, local instillation analgesia (LIA), in anterior cruciate ligament reconstruction (ACLR) is unclear. This systematic review and meta-analysis evaluates the analgesic benefits of LIA for outpatient ACLR.

METHODS:
We sought randomized controlled trials investigating the analgesic effects of LIA versus control in adults having outpatient ACLR and receiving multimodal analgesia (excluding nerve blocks, which are examined in parts I and II of this project). Cumulative postoperative analgesic consumption at 24 hours was designated as a primary outcome. Analgesic consumption during postanesthesia care unit stay, proportion of patients requiring analgesic supplementation, time-to-first analgesic request, rest pain scores during the first 48 hours, hospital length of stay, and incidence of opioid-related side effects were analyzed as secondary outcomes and pooled using random effects modeling.

RESULTS:
Eleven randomized controlled trials (515 patients) were included. Analgesic consumption was selected as the primary outcome in 4 trials (36%). Compared to control, LIA reduced the 24-hour morphine consumption by a weighted mean difference (95% confidence interval) of −18.0 mg (−33.4 to −2.6) (P = .02). LIA reduced postanesthesia care unit morphine consumption by −55.9 mg (−88.4 to −23.4) (P < .05) and decreased the odds (odds ratio [95% confidence interval]) of analgesic supplementation during the first 24 hours by 0.4 (0.2–0.8) (P = .004). LIA also improved pain scores during the 0–24-hour interval, most notably at 4 hours (−1.6 [−2.2 to −1.0) (P < .00001).

CONCLUSIONS:
Administering LIA for outpatient ACLR improves postoperative analgesia by decreasing opioid consumption and improving pain control up to 24 hours, with minimal complications. These findings encourage integrating LIA into the care standard for ACLR. Questions regarding the ideal LIA components, location, and role in the setting of hamstring grafts require further research.
Large Variability in the Diversity of Physiologically Complex Surgical Procedures Exists Nationwide Among All Hospitals Including Among Large Teaching Hospitals
Authors: Dexter Franklin , Epstein Richard H. , Thenuwara Kokila , Lubarsky David A. 
Published: November 2017

BACKGROUND:
Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province).

METHODS:
The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl).

RESULTS:
A total of 53.9% of all hospitals commonly performed <10 physiologically complex procedures (lower 99% confidence limit [CL], 51.3%). A total of 14.2% (lower 99% CL, 12.4%) of hospitals had >3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P < .0001). Teaching hospitals had greater diversity than did the rural and urban nonteaching hospitals (P < .0001). A total of 80.0% of the 170 large teaching hospitals commonly performed >30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures).

CONCLUSIONS:
The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that “large teaching hospital” alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the operational and financial consequences of performing a wide diversity of surgical procedures. Future research can evaluate the extent to which hospitals with very large diversity are indispensable in their catchment area.
Design and Evaluation of a Closed-Loop Anesthesia System With Robust Control and Safety System
Authors: West Nicholas , van Heusden Klaske , Görges Matthias , Brodie Sonia , Rollinson Aryannah , Petersen Christian L. , Dumont Guy A. , Ansermino J. Mark , Merchant Richard N. 
Published: November 2017

BACKGROUND:Closed-loop control of anesthesia involves continual adjustment of drug infusion rates according to measured clinical effect. The NeuroSENSE monitor provides an electroencephalographic measure of depth of hypnosis (wavelet-based anesthetic value for central nervous system monitoring [WAVCNS]). It has previously been used as feedback for closed-loop control of propofol, in a system designed using robust control engineering principles, which implements features specifically designed to ensure patient safety. Closed-loop control of a second drug, remifentanil, may be added to improve WAVCNSstability in the presence of variable surgical stimulation. The objective of this study was to design and evaluate the feasibility of a closed-loop system for robust control of propofol and remifentanil infusions using WAVCNSfeedback, with an infusion safety system based on the known pharmacological characteristics of these 2 drugs.METHODS:With Health Canada authorization, research ethics board approval, and informed consent, American Society of Anesthesiologists I–III adults, requiring general anesthesia for elective surgery, were enrolled in a 2-phase study. In both phases, infusion of propofol was controlled in closed loop during induction and maintenance of anesthesia, using WAVCNSfeedback, but bounded by upper- and lower-estimated effect-site concentration limits. In phase I, remifentanil was administered using an adjustable target-controlled infusion and a controller was designed based on the collected data. In phase II, remifentanil was automatically titrated to counteract rapid increases in WAVCNS.RESULTS:Data were analyzed for 127 patients, of median (range) age 64 (22–86) years, undergoing surgical procedures lasting 105 (9–348) minutes, with 52 participating in phase I and 75 in phase II. The overall control performance indicator, global score, was a median (interquartile range) 18.3 (14.2–27.7) in phase I and 14.6 (11.6–20.7) in phase II (median difference, −3.25; 95% confidence interval, −6.35 to −0.52). The WAVCNSwas within ±10 of the setpoint for 84.3% (76.6–90.6) of the maintenance of anesthesia in phase I and 88.2% (83.1–93.4) in phase II (median difference, 3.7; 95% confidence interval, 0.1–6.9). The lower propofol safety bound was activated during 30 of 52 (58%) cases in phase I and 51 of 75 (68%) cases in phase II.CONCLUSIONS:Adding closed-loop control of remifentanil improved overall controller performance. This controller design offers a robust method to optimize the control of 2 drugs using a single sensor. The infusion safety system is an important component of a robust automated anesthesia system, but further research is required to determine the optimal constraints for these safe conditions.
The primary role of zebrafish nanog is in extra-embryonic tissue
Authors: Gagnon James A. , Obbad Kamal , Schier Alexander F. 
Published: November 2017

ABSTRACT
The role of the zebrafish transcription factor Nanog has been controversial. It has been suggested that Nanog is primarily required for the proper formation of the extra-embryonic yolk syncytial layer (YSL) and only indirectly regulates gene expression in embryonic cells. In an alternative scenario, Nanog has been proposed to directly regulate transcription in embryonic cells during zygotic genome activation. To clarify the roles of Nanog, we performed a detailed analysis of zebrafish nanog mutants. Whereas zygotic nanog mutants survive to adulthood, maternal-zygotic (MZnanog) and maternal mutants exhibit developmental arrest at the blastula stage. In the absence of Nanog, YSL formation and epiboly are abnormal, embryonic tissue detaches from the yolk, and the expression of dozens of YSL and embryonic genes is reduced. Epiboly defects can be rescued by generating chimeric embryos of MZnanog embryonic tissue with wild-type vegetal tissue that includes the YSL and yolk cell. Notably, cells lacking Nanog readily respond to Nodal signals and when transplanted into wild-type hosts proliferate and contribute to embryonic tissues and adult organs from all germ layers. These results indicate that zebrafish Nanog is necessary for proper YSL development but is not directly required for embryonic cell differentiation.
The skeletal phenotype of achondrogenesis type 1A is caused exclusively by cartilage defects
Authors: Bird Ian M. , Kim Susie H. , Schweppe Devin K. , Caetano-Lopes Joana , Robling Alexander G. , Charles Julia F. , Gygi Steven P. , Warman Matthew L. , Smits Patrick J. 
Published: November 2017

ABSTRACT
Inactivating mutations in the ubiquitously expressed membrane trafficking component GMAP-210 (encoded by Trip11) cause achondrogenesis type 1A (ACG1A). ACG1A is surprisingly tissue specific, mainly affecting cartilage development. Bone development is also abnormal, but as chondrogenesis and osteogenesis are closely coupled, this could be a secondary consequence of the cartilage defect. A possible explanation for the tissue specificity of ACG1A is that cartilage and bone are highly secretory tissues with a high use of the membrane trafficking machinery. The perinatal lethality of ACG1A prevents investigating this hypothesis. We therefore generated mice with conditional Trip11 knockout alleles and inactivated Trip11 in chondrocytes, osteoblasts, osteoclasts and pancreas acinar cells, all highly secretory cell types. We discovered that the ACG1A skeletal phenotype is solely due to absence of GMAP-210 in chondrocytes. Mice lacking GMAP-210 in osteoblasts, osteoclasts and acinar cells were normal. When we inactivated Trip11 in primary chondrocyte cultures, GMAP-210 deficiency affected trafficking of a subset of chondrocyte-expressed proteins rather than globally impairing membrane trafficking. Thus, GMAP-210 is essential for trafficking specific cargoes in chondrocytes but is dispensable in other highly secretory cells.
FYCO1 regulates accumulation of post-mitotic midbodies by mediating LC3-dependent midbody degradation
Authors: Dionne Lai Kuan , Peterman Eric , Schiel John , Gibieža Paulius , Skeberdis Vytenis Arvydas , Jimeno Antonio , Wang Xiao-Jing , Prekeris Rytis 
Published: December 2017

ABSTRACT
The post-mitotic midbody (MB) is a remnant of cytokinesis that can be asymmetrically inherited by one of the daughter cells following cytokinesis. Until recently, the MB was thought to be degraded immediately following cytokinesis. However, recent evidence suggests that the MB is a protein-rich organelle that accumulates in stem cell and cancer cell populations, indicating that it may have post-mitotic functions. Here, we investigate the role of FYCO1, an LC3-binding protein (herein, LC3 refers to MAP1LC3B), and its function in regulating the degradation of post-mitotic MBs. We show that FYCO1 is responsible for formation of LC3-containing membrane around the post-mitotic MB and that FYCO1 knockdown increases MB accumulation. Although MBs accumulate in the stem-cell-like population of squamous cell carcinomas, FYCO1 depletion does not affect the clonogenicity of these cells. Instead, MB accumulation leads to an increase in anchorage-independent growth and invadopodia formation in HeLa cells and squamous carcinoma cells. Collectively, our data suggest that FYCO1 regulates MB degradation, and we present the first evidence that cancer invasiveness is a feature that can be modulated by the accumulation of MBs in cancer stem cells.
This article has an associated First Person interview with the first author of the paper.