bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Geometry and Depth of Resections on Bone Support for Total Ankle Replacement
Authors: Bischoff Jeffrey E. , Schon Lew , Saltzman Charles 
Published: July 2017

Background: Aseptic component loosening is a leading cause of revision for total ankle replacement. Different operative approaches for resecting the tibia and talus impact the bony support for the prostheses due to variations in both bone density and resection area, and may therefore impact loosening performance. Methods: Computed tomography data from 116 subjects were obtained, and solid models of the talus and tibia were generated. Bone density, resection area, and bony support were measured on a series of flat resections for each subject, at multiple resection depths. Similar measurements were performed using a series of subject-specific, anatomic radius–based resections (“round resections”) at multiple depths. Results were compared to assess the impact of both resection type (flat vs round) and resection depth (6-16 mm for the tibia, 2-6 mm for the talus) on bony support. Results: Statistically significant decreases in bony support for both the talus and the tibia were obtained for flat resections as compared to round resections. A decrease of 8% to 19% for the tibia was seen for all resection depths; a decrease of 8% to 46% for the talus was seen, with greater decreases seen for shallower flat-cut resections. Conclusion: Bony support in total ankle arthroplasty may be decreased using flat resections compared to round resections at comparable resection depths. Estimated differences are resection-level dependent and different for the distal tibia vs the proximal talus. Clinical Relevance: Biomechanical characteristics of total ankle replacement impacted by bony support of the prostheses, including implant stability and resistance to subsidence, may be improved with round resections as compared to flat-cut resections.
A systematic review of short versus long intramedullary fixation in the management of pertrochanteric fractures
Authors: Sohatee MA , Bennet J 
Published: July 2017

Introduction The aim was to determine whether there is a significant difference in clinical outcomes when using short vs. long nails for pertrochanteric femur fractures. Methods A systematic literature search was undertaken of Pubmed and Embase in April 2016. All papers published in English reporting studies comparing long vs. short nails for pertrochanteric femur fractures were studied. Data were pooled for blood loss and transfusion requirement, operative time, length of stay, incidence of delayed or non-union, incidence of avascular necrosis or infection, fracture or metalware failure and was analysed to examine the differences between long and short nails. Results From 90 potential studies, nine were considered to be eligible for inclusion. The short nail resulted in a statistically significant benefit when looking at transfusion requirement (p = 0.02); however, blood loss was not statistically different (p = 0.33) Operative time was also quicker with the short nail (p = 0.004), but the length of stay was no different (p = 0.41). When examining complications and fixation outcomes, there was no difference in delayed union rates (p = 0.29) and non-union rates (p = 0.19) nor when looking at metalware failure (p = 0.41) and fracture (p = 0.14). Discussion The use of short intramedullary nails for pertrochanteric femur fractures appeared to be beneficial when looking at transfusion requirements and operative time. When looking at complications such as fracture and metalware failure, despite there being a slightly higher incidence of these in the short nail group, it is not statistically significant. This study advocates that both devices are safe to use, however, the short nail may have some perceived benefits in reducing transfusion requirements and have cost benefits with a shorter operative time.
Aetiological factors contributing to road traffic accidents in Riyadh City, Saudi Arabia
Authors: Nofal Fatin H. , Saeed Abdalla A. W. , Anokute Charles C. 
Published: July 2017

The study analysed 13,390 police records of road traffic accidents (RTAs) covering a three and a half year period according to different suspected aetiological factors. The majority of the accidents were recorded for vehicles in good condition on well-paved straight roads with well-operating traffic light systems. Adverse weather conditions such as precipitation, fog and dust were of minimal importance, with most of the accidents being reported during sunny days during the rush period of 12 noon to 3 pm. Driver's error was identified as the main contributing factor in about two thirds of all RTAs mainly as reckless driving and excess speeding. About 27% of the drivers were professional drivers and 41% were in the age group 25-35 years in good health with no alcohol or drug intake. Hence, human errors may be attributed to carelessness, experience, lack of knowledge or attention, over-exhaustion or fatigue. The effects of physical stressors on performance of drivers need to be further explored and clarified but this need not under estimate the importance of vehicle and environment since most accidents are multifactoral and a slight change in them may effectively enhance perception and minimise personal error. Recommendations for remedial measures adopting an interdisciplinary approach are presented.
Pyridoxine Deficiency After Solid Organ Transplant
Authors: Van Arsdale Summer , Yost Sarah E. , Hsu Chiu-Hsieh , Meer Mary , Schoentag Shari , Habib Shahid 
Published: July 2017

Objective: Pyridoxine is 1 of 8 B vitamins that assist in a variety of essential functions including immune functions. The purpose of this study was to assess the risk factors associated with low pyridoxine levels in solid organ transplantation recipients. Design: The study cohort was divided into 2 groups: (a) patients with normal pyridoxine levels or (b) patients with low pyridoxine levels. Dietary evaluation and clinical characteristics of all patients, rejection episodes, and immunosuppression were collected. Simple descriptive statistics were used to analyze the overall cohort. Results: Of the 48 patients, 29 (60%) in the study cohort were identified to have low pyridoxine levels. The mean interval between transplantation and pyridoxine level check was 910 days (standard deviation [SD] 456). The mean weight at the time of dietary consultation was 80 kg (SD 20.7). More patients in the deficient group received thymoglobulin for rejection treatment (56% vs 0%; P = .01) and were thymoglobulin recipients (78% vs 10%; odds ratio [OR] = 31.5; 95% confidence interval [CI], 2.35-422.30; P < .01). A strong correlation was identified between thymoglobulin treatment for induction and a low level of pyridoxine (correlation coefficient R = 0.6, P = .004) and between thymoglobulin treatment for rejection and a low pyridoxine level (correlation coefficient R = 0.5, P = .05). Based on multivariate logistic regression analysis, only thymoglobulin treatment (induction or rejection treatment) was significantly associated with low pyridoxine levels (OR = 19.5, 95% CI, 1.01-375.24; P < .05). Conclusions: Low levels of pyridoxine appear to be relatively common, and thymoglobulin treatments are associated with low pyridoxine levels. Prospective studies are needed to confirm and valuate the significance of these findings.
Percutaneous laser disc decompression versus microdiscectomy for sciatica: Cost utility analysis alongside a randomized controlled trial
Authors: van den Akker-van Marle M Elske , Brouwer Patrick A , Brand Ronald , Koes Bart , van den Hout Wilbert B , van Buchem Mark A , Peul Wilco C 
Published: July 2017

Background Percutaneous laser disc decompression (PLDD) for patients with lumbar disc herniation is believed to be cheaper than surgery. However, cost-effectiveness has never been studied. Materials and Methods A cost utility analysis was performed alongside a randomized controlled trial comparing PLDD and conventional surgery. Patients reported their quality of life using the EuroQol five dimensions questionnaire (EQ-5D), 36-item short form health survey (SF-36 and derived SF-6D) and a visual analogue scale (VAS). Using cost diaries patients reported health care use, non-health care use and hours of absenteeism from work. The 1-year societal costs were compared with 1-year quality adjusted life years (QALYs) based on the United States (US) EQ-5D. Sensitivity analyses were carried out on the use of different utility measures (Netherland (NL) EQ-5D, SF-6D, or VAS) and on the perspective (societal or healthcare). Results On the US EQ-5D, conventional surgery provided a non-significant gain in QALYs of 0.033 (95% confidence interval (CI) −0.026 to 0.093) in the first year. PLDD resulted in significantly lower healthcare costs (difference €1771, 95% CI €303 to €3238) and non-significantly lower societal costs (difference €2379, 95% CI −€2860 to €7618). For low values of the willingness to pay for a QALY, the probability of being cost-effective is in favor of PLDD. For higher values of the willingness to pay, between €30,000 and €70,000, conventional microdiscectomy becomes favorable. Conclusions From a healthcare perspective PLDD, followed by surgery when needed, results in significantly lower 1-year costs than conventional surgery. From a societal perspective PLDD appears to be an economically neutral innovation.
Factors associated with success in the oral part of the European Diploma in Intensive Care
Authors: Waldauf Petr , Rubulotta Francesca , Sitzwohl Christian , Elbers Paul , Girbes Armand , Saha Rajnish , Marsh Brian , Kumar Ravindra , Maggiorini Marco , Duška František 
Published: July 2017

Introduction The oral part of European Diploma in Intensive Care diploma examinations changed in 2013 into an objective structured clinical examination-type exam. This step was undertaken to provide a fair and reproducible clinical exam. All candidates face identical questions with predefined correct answers simultaneously in seven high throughput exam centres on the same day. We describe the factors that are associated with success in part 2 European Diploma in Intensive Care exam. Methods We prospectively collected self-reported data from all candidates sitting European Diploma in Intensive Care part 2 in 2015, namely demographics, professional background and attendance to a European Diploma in Intensive Care part 2 or generic objective structured clinical examination preparatory courses. After testing association with success (with cutoff at p < 0.10) and co-linearity of these factors as independent variables, we performed a multivariate logistical analysis, with binary exam outcome (pass/fail) as the dependent variable. Structural equation modelling was used to gain further insight into relations among determinants of success in the oral part of the European Diploma in Intensive Care. Results Out of 427 candidates sitting the exam, completed data from 341 (80%) were available for analysis. The following candidates' factors were associated with increased chance of success: English as native language (odds ratio 4.3 (95% CI 1.7–10.7)), use of Patient-centred Acute Care Training e-learning programme module (odds ratios 2.0 (1.2–3.3)), working in an EU country (odds ratios 2.5 (1.5–4.3)), and better results in the written part of the European Diploma in Intensive Care (for each additional SD of 6.1 points odds ratios 1.9 (1.4–2.4)). Chance of success in the European Diploma in Intensive Care 2 decreased with increased candidates ‘age (for each additional SD of 5.5 years odds ratios 0.67 (0.51–0.87)). Exam centres (7 in total) could be clustered into 3 groups with similar success rates. There were significant differences in exam outcomes among these 3 groups of exam centres even after adjustment to known candidates' factors (G1 vs G2 odds ratios 2.4 (1.4–4.1); G1 vs G3 odds ratios 9.7 (4.0–23.1) and G2 vs G3 odds ratios 3.9 (1.7–9.2)). A short data collection period (only one year) and 20% of missing candidates' data are the main limitations of this study. Conclusions Younger age, English as native language, better results in written part of the exam, working at a European country and the use of PACT for preparation, were factors associated with success in the oral part of the European Diploma in Intensive Care exam. Despite the limitations of this study, the differences in outcome among the exam centres will need further investigation.
Antimicrobial effects of lysophosphatidylcholine on methicillin-resistant Staphylococcus aureus
Authors: Miyazaki Haruko , Midorikawa Naoko , Fujimoto Saki , Miyoshi Natsumi , Yoshida Hideto , Matsumoto Tetsuya 
Published: July 2017

Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is an important health care-associated and community-associated pathogen and causes a large number of infections worldwide. For the purpose of application to topical treatment of MRSA infection, we examined the antimicrobial effects of lysophosphatidylcholine (LPC) on MRSA strains. We also investigated the combination effect of LPC and gentamicin on MRSA growth. Methods: The LPC minimum inhibitory concentrations (MIC) for Gram-positive ( S. aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae) and Gram-negative ( Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, and Pseudomonas aeruginosa) bacteria were measured by the broth microdilution method. The mechanism of LPC-mediated MRSA killing was investigated by membrane permeability analysis with DiSC3(5) fluorescence and growth curve analysis. Lastly, the effects of LPC on gentamicin-induced bactericidal activity were determined in combination treatment studies with 15 gentamicin-resistant MRSA isolates from the skin, nose, or ears. Results: The LPC MIC for Gram-positive bacteria varied between 32 µg/ml and >2048 µg/ml, whereas that for all Gram-negative bacteria was >2048 µg/ml. Consistently, membrane permeability analysis showed that LPC was substantially more effective in inducing membrane permeability in Gram-positive bacteria than in Gram-negative counterparts. Growth curve analysis in cotreatment studies demonstrated that LPC has intrinsic bactericidal effects and can also potentiate gentamicin sensitivity in resistant MRSA strains. Conclusions: Our study demonstrates that LPC exhibits intrinsic antimicrobial effects and can enhance the antimicrobial effects of gentamicin for resistant MRSA strains, suggesting that LPC may be a beneficial additive in topical antibiotics for superficial skin infections.
Modeling risk for developing drug resistant bacterial infections in an MDR-naive critically ill population
Authors: Sonti Rajiv , Conroy Megan E. , Welt Elena M. , Hu Yi , Luta George , Jamieson Daniel B. 
Published: July 2017

Purpose: To create a model predictive of an individual’s risk of developing a de novo multidrug-resistant (MDR) infection while in the intensive care unit (ICU). Methods: This is a case-control study in which 189 ICU patients diagnosed with their first infection with an MDR organism were compared on the basis of demographic, past medical and clinical variables to randomly selected ICU patients without such an infection, era-matched in a 2:1 ratio. A prediction tool was derived using multivariate logistic regression. Results: Five features remained predictive of developing an infection with a drug-resistant pathogen: hospitalization within a year [adjusted odds ratio (OR) 2.14], chronic hemodialysis (3.86), underlying oxygen-dependent pulmonary disease (1.86), endotracheal intubation within 24 h (2.46) and reason for ICU admission (respiratory failure 2.89, non-respiratory failure, non-shock presentation 1.85). Using a scoring system (0–7 points) based on the adjusted OR, risk categories were derived (low: 0–2 points, intermediate: 3–4 points and high risk: 5–7 points). The negative predictive value at a score cutoff of 2 is excellent (88.9%). Conclusions: A clinical prediction rule comprised of five easily measured ICU variables reasonably discriminates between patients who will develop their first MDR infection versus those who will not.
Sequentially annealed highly cross-linked polyethylene reduced in vivo wear particle generation in total knee arthroplasty
Authors: Minoda Yukihide , Hata Kanako , Goto Katsuko , Itohara Tomonobu , Nakamura Hiroaki 
Published: July 2017

Introduction: Sequentially annealed highly cross-linked polyethylene (HXLPE) was recently introduced to reduce the wear in total knee arthroplasty (TKA). However, an in vivo advantage of sequentially annealed HXLPE on wear particle generation is still controversial. The purpose of this study is to compare the characteristics of in vivo wear particles between sequentially annealed HXLPE and conventional polyethylene after TKA. Materials and Methods: Synovial fluid was obtained from the eight knees with sequentially annealed HXLPE and from eight knees with conventional polyethylene 12 months after the operation. Polyethylene particles were isolated and examined using a scanning electron microscope and image analyzer. Results: Total number of wear particles in each knee was 2.1 ± 1.0 × 107 with sequentially annealed HXLPE (mean ± standard deviation) and 4.9 ± 3.6 × 107 with conventional polyethylene ( p = 0.036). Particle size (equivalent circle diameter) was 1.01 ± 0.26 μm with sequentially annealed HXLPE and 1.02 ± 0.20 μm with conventional polyethylene ( p = 0.674). Aspect ratio was 1.33 ± 0.04 with sequentially annealed HXLPE and 1.39 ± 0.10 with conventional polyethylene ( p = 0.462). Conclusions: The sequentially annealed HXLPE reduced the in vivo polyethylene wear particles by 58% compared with conventional polyethylene without the significant change of particle size and shape.
Computer Simulation of Film Blowing
Authors: Sidiropoulos V. , Tian J. J. , Vlachopoulos J. 
Published: July 2017

The present work is concerned with the numerical simulation of the blown film process and its comparison to experimental data. The bubble formation and the biaxial stretching of the film were studied using a non-isothermal, purely viscous, temperature dependent model. The model is incorporated into a software package called B-FILMCAD. Special attention has been given to the importance of the temperature in the modeling of the blown film process. It was found that temperature is by far the most important modeling parameter. The results show that the majority of the process parameters can be successfully predicted by the employed model, showing a good agreement between experimental data from various investigators and numerical predictions. This was valid for most of the studied cases despite the diversity of the experimental data. With the use of the present model many useful conclusions can be drawn about blown film production lines.
Patient-reported outcomes in hematology: is it time to focus more on them in clinical trials and hematology practice?
Authors: Efficace Fabio , Gaidano Gianluca , Lo-Coco Francesco 
Published: July 2017

Abstract
In less than 2 decades, major clinical advances have been made in various areas of hematologic malignancies. Clinicians and patients now frequently face challenging choices regarding various treatments that are often similar in regard to safety or clinical effectiveness; hence, medical decision making has grown in complexity. For example, several novel drugs have been developed as oral agents, introducing an additional challenge in patient management, such as ensuring an optimal adherence to therapy in order to maximize drug effectiveness. This rapidly changing scenario provides a rationale for a more systematic collection of patient-reported outcomes (PRO) in clinical research and routine care. In the former case, PRO may help to better understand overall treatment effectiveness of a new drug being tested. In the latter case, it may aid in making more informed, individualized treatment decisions in daily practice by obtaining more accurate information on the actual symptom burden experienced by the patient. In any case, evaluating PRO requires making several, and often challenging, decisions depending, for example, on the population being studied and the specific setting. Therefore, if PROs are to fulfill their potential of generating clinically meaningful data that robustly inform patient care, special attention should be given to methodological rigor. We outline the value of a more systematic and rigorous implementation of PRO assessment in the current hematology arena, by providing some real world examples of how PRO data have contributed in better understanding the value of new therapies. We also discuss practical considerations in PRO assessment in clinical research.
PLCζ is the physiological trigger of the Ca2+ oscillations that induce embryogenesis in mammals but conception can occur in its absence
Authors: Hachem Alaa , Godwin Jonathan , Ruas Margarida , Lee Hoi Chang , Ferrer Buitrago Minerva , Ardestani Goli , Bassett Andrew , Fox Sebastian , Navarrete Felipe , de Sutter Petra , Heindryckx Björn , Fissore Rafael , Parrington John 
Published: July 2017

ABSTRACT
Activation of the egg by the sperm is the first, vital stage of embryogenesis. The sperm protein PLCζ has been proposed as the physiological agent that triggers the Ca2+ oscillations that normally initiate embryogenesis. Consistent with this, recombinant PLCζ induces Ca2+ oscillations in eggs and debilitating mutations in the PLCZ1 gene are associated with infertility in men. However, there has been no evidence that knockout of the gene encoding PLCζ abolishes the ability of sperm to induce Ca2+ oscillations in eggs. Here, we show that sperm derived from Plcz1–/– male mice fail to trigger Ca2+ oscillations in eggs, cause polyspermy and thus demonstrate that PLCζ is the physiological trigger of these Ca2+ oscillations. Remarkably, some eggs fertilized by PLCζ-null sperm can develop, albeit at greatly reduced efficiency, and after a significant time-delay. In addition, Plcz1–/– males are subfertile but not sterile, suggesting that in the absence of PLCζ, spontaneous egg activation can eventually occur via an alternative route. This is the first demonstration that in vivo fertilization without the normal physiological trigger of egg activation can result in offspring. PLCζ-null sperm now make it possible to resolve long-standing questions in fertilization biology, and to test the efficacy and safety of procedures used to treat human infertility.