bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two-Year Outcomes of a Randomized Trial Investigating a 6-Week Return to Full Weightbearing After Matrix-Induced Autologous Chondrocyte Implantation
Authors: Ebert Jay R. , Edwards Peter K. , Fallon Michael , Ackland Timothy R. , Janes Gregory C. , Wood David J. 
Published: November 2016

Background: Matrix-induced autologous chondrocyte implantation (MACI) has demonstrated encouraging outcomes in treating patients with knee cartilage defects. Postoperatively, the time required to attain full weightbearing (WB) remains conservative. Hypothesis: We hypothesized that patients would have no significant clinical or radiological differences or graft complications after an 8-week or 6-week return to full WB after MACI. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 37 knees (n = 35 patients) were randomly allocated to either an 8-week return to full WB that we considered current best practice based on the existing literature (CR group; n = 19 knees) or an accelerated 6-week WB approach (AR group; n = 18 knees). Patients were evaluated preoperatively and at 1, 2, 3, 6, 12, and 24 months after surgery, using the Knee Injury and Osteoarthritis Outcome Score, 36-Item Short Form Health Survey, visual analog pain scale, 6-minute walk test, and active knee range of motion. Isokinetic dynamometry was used to assess peak knee extension and flexion strength and limb symmetry indices (LSIs) between the operated and nonoperated limbs. Magnetic resonance imaging (MRI) was undertaken to evaluate the quality and quantity of repair tissue as well as to calculate an MRI composite score. Results: Significant improvements ( P < .05) were observed in all subjective scores, active knee flexion and extension, 6-minute capacity, peak knee extensor torque in the operated limb, and knee extensor LSI, although no group differences existed. Although knee flexor LSIs were above 100% for both groups at 12 and 24 months after surgery, LSIs for knee extensor torque at 24 months were 93.7% and 87.5% for the AR and CR groups, respectively. The MRI composite score and pertinent graft parameters significantly improved over time ( P < .05), with some superior in the AR group at 24 months. All patients in the AR group (100%) demonstrated good to excellent infill at 24 months, compared with 83% of patients in the CR group. Two cases of graft failure were observed, both in the CR group. At 24 months, 83% of patients in the CR group and 88% in the AR group were satisfied with the results of their MACI surgery. Conclusion: Patients in the AR group who reduced the length of time spent ambulating on crutches produced comparable outcomes up to 24 months, without compromising graft integrity.
Effects of Electrolyte Replacement Protocol Implementation in a Medical Intensive Care Unit
Authors: Pearson Daniel J. , Sharma Anit , Lospinoso Joshua A. , Morris Michael J. , McCann Edward T. 
Published: November 2016

Purpose: To evaluate the effects of electrolyte replacement protocol (ERP) implementation in the medical intensive care unit (MICU) setting. We hypothesized that a protocol would reduce the time of replacement dose administration and increase provider satisfaction with the process of electrolyte replacement. Methods: This was a retrospective review of electronic medical record data before and after implementation of a standardized ERP in an 18-bed military tertiary care MICU. Results: Median time from abnormal laboratory result to time of documented dose administration for potassium decreased from 180 to 98 minutes ( P < .01), phosphorus decreased from 190 to 135 minutes ( P < .01), calcium decreased from 95 to 61 minutes ( P < .01), and magnesium decreased from 155 to 149 minutes ( P < .01). Overall, there was a significant reduction in time to electrolyte repletion from 146 to 98 minutes ( P < .01) for all electrolytes. Nursing satisfaction for autonomy, timeliness, effectiveness, and the need to seek orders was all improved ( P < .01), and physicians saved 4.4 minutes/patient/day ( P = .04). Conclusions: Electrolyte replacement protocols can be safely implemented in the MICU and reduce the time from abnormal laboratory result to electrolyte replacement dose administration. They can improve provider satisfaction and reduce physician time with the process of electrolyte replacement.
Enhancement of osseointegration by direct coating of rhBMP-2 on target-ion induced plasma sputtering treated SLA surface for dental application
Authors: Kim Sungwon , Park Cheonil , Moon Byeong-Seok , Kim Hyoun-Ee , Jang Tae-Sik 
Published: November 2016

Owing to the excellent bioactive properties of recombinant human bone morphogenetic proteins (rhBMPs), dentistry considers them as a fascinating adjuvant alternative for enhancing bone regeneration and bone-to-implant junction in the early implantation stages. However, stable loading and delivery efficiency of rhBMPs on the implant surfaces involve major concerns because of the harsh wearing condition under load during implantation. In this study, to achieve successful rhBMP-2 delivery, a nanoporous surface structure is introduced on the sandblasting with large grit and acid-etching (SLA)-treated titanium (Ti) surface via the tantalum (Ta) target-ion induced plasma sputtering (TIPS) technique. Unlike oxidation-induced surface nanoporous fabrications on a Ti surface, TIPS-treated surfaces provide excellent structural unity of the nanoporous structure with the substrate due to their etching-based fabrication mechanism. SLA/TIPS-treated Ti exhibits distinct nanoporous structures on the microscale surface geometry and better hydrophilicity compared with SLA-treated Ti. A sufficiently empty nanoporous surface structure combined with the hydrophilic property of SLA/TIPS-treated Ti facilitates the formation of a thick and uniform coating layer of rhBMP-2 on the surface without any macro- and microcoagulation. Compared with the SLA-treated Ti surface, the amount of coated rhBMP-2 increases up to 63% on the SLA/TIPS-treated Ti surface. As a result, the in vitro pre-osteoblast cell response of the SLA/TIPS-treated Ti surface, especially cell adhesion and differentiation behaviors, improves remarkably. A bone-regenerating direct comparison between the rhBMP-2-coated SLA-treated and SLA/TIPS-treated Ti is conducted on a defective dog mandible model. After 8 weeks of implantation surgery, SLA/TIPS-treated Ti with rhBMP-2 exhibits a better degree of contact area for the implanted bone, which mineralizes new bones around the implant. Quantitative results of bone-in-contact ratio and new bone volume also show significantly higher values for the SLA/TIPS-treated Ti with the rhBMP-2 specimen. These results confirm that an SLA/TIPS-treated surface is a suitable rhBMP-2 carrier for a dental implant to achieve early and strong osseointegration of Ti dental implants.
Factors Distinguishing Positive Deviance Among Low-Income African American Women: A Qualitative Study on Infant Feeding
Authors: Barbosa Cecilia E. , Masho Saba W. , Carlyle Kellie E. , Mosavel Maghboeba 
Published: November 2016

Background: Positive deviant individuals practice beneficial behaviors in spite of having qualities characterizing them as high risk for unhealthy behaviors. Objective: This study aimed to identify and understand factors distinguishing low-income African American women who breastfeed the longest (positive deviants) from those who breastfeed for a shorter duration or do not breastfeed. Methods: Seven mini-focus groups on infant-feeding attitudes and experiences were conducted with 25 low-income African American women, grouped by infant-feeding practice. Positive deviants, who had breastfed for 4 months or more, were compared with formula-feeding participants who had only formula fed their babies and short-term breastfeeding participants who had breastfed for 3 months or less. Results: Positive deviant women had more schooling, higher income, breastfeeding intention, positive breastfeeding and unfavorable formula-feeding attitudes, higher self-efficacy, positive hospital and Special Supplemental Nutrition Program for Women, Infants, and Children experiences, more exclusive breastfeeding, and greater comfort breastfeeding in public. Short-term breastfeeding women varied in breastfeeding intention and self-efficacy, seemed to receive insufficient professional breastfeeding support, and supplemented breastfeeding with formula. Some showed ambivalence, concern with unhealthy behaviors, and discomfort with breastfeeding in public. Formula-feeding women intended to formula feed, feared breastfeeding, thought their behaviors were incompatible with breastfeeding, were comfortable with and found formula convenient, and received strong support to formula feed. Conclusion: Tapping into the strengths of positive deviants; tailoring interventions to levels of general and breastfeeding self-efficacy; increasing social, institutional, and community supports; and removing inappropriate formula promotion may offer promising strategies to increase breastfeeding among low-income African American women.
Perspectives of US and Australian Hand Therapists About Pediatric Hand Transplantation
Authors: Mukesh Nitin , Bramstedt Katrina A. 
Published: November 2016

Introduction: Pediatric hand transplantation (PHT), an investigational therapy, was recently performed in the United States. Research Questions: Perspectives of hand therapists about PHT patient selection (inclusion and exclusion criteria), team configuration, patient assent, and patient compliance were explored. Design: Quantitative survey. We used a research ethics committee–approved 18-question e-link anonymous questionnaire to survey members of the American Society of Hand Therapists and the Australian (AU) Hand Therapy Association for their perspectives on PHT. Results: All surveyed hand therapists work with children (n = 18 Australia [AU], n = 85 United States) and some had been involved in adult hand transplant rehabilitation (28% AU, 21% United States; P = .543, not significant (NS)). The US and AU therapists differ regarding their opinions on multidisciplinary team membership, smoking as an exclusion criterion, and risk of posttransplant rehabilitation noncompliance. Discussion: This research opens a dialogue on the clinical and ethical complexity of PHT, including team configuration, inclusion/exclusion criteria, the assent process, and rehabilitation access/compliance. Furthermore, international perspectives are informative as they highlight funding and access issues and can potentially guide global professional society policy.
Multicenter Experience of Surgical Explantation of Carotid Stents for Recurrent Stenosis
Authors: Columbo Jesse A. , McCallum John C. , Goodney Philip P. , Bower Thomas C. , Schermerhorn Marc L. , Powell Richard J. , DeMartino Randall R. 
Published: November 2016

Objective: A significant cohort of patients who have undergone carotid artery stenting (CAS) will have in-stent restenosis (ISR). The optimal management of symptomatic or severe ISR remains poorly defined. The purpose of this study was to describe the indications, treatment, and mid- to long-term outcomes of patients undergoing CAS explantation for ISR. Methods: All patients undergoing internal carotid artery stent explantation with carotid artery reconstruction at Mayo Clinic Rochester, Dartmouth-Hitchcock Medical Center, and Beth-Israel Deaconess Medical Center from 2003 to 2013 were retrospectively reviewed. Isolated common carotid artery stents were excluded. Demographics, comorbidities, indications for explantation, operative details, and perioperative and postoperative outcomes were reviewed. Results: Over the study interval, a total of 971 patients underwent carotid stenting across the 3 centers. Of these, 8 patients ultimately underwent CAS explantation with carotid artery reconstruction. Mean age was 69 years and 5 patients were male. Index stent placement was for symptomatic stenosis in 4 patients, asymptomatic restenosis after endarterectomy in 2 patients, asymptomatic high lesion in 1 patient, and asymptomatic critical stenosis in 1 patient. Indications for explantation were symptomatic ISR in 4 patients and asymptomatic severe ISR in 4 patients. Method of repair was stent explantation and patch angioplasty in 5 and en bloc carotid resection with bypass in 3 patients. There were no perioperative neurologic events or cranial nerve injuries. At a mean follow-up of 38.7 months, there were 2 late disabling ipsilateral strokes (14.4 months and 19.1 months). Conclusion: A significant cohort of patients who have undergone CAS will have ISR. Although excellent perioperative results after surgical explantation can be obtained, this patient subgroup remains at risk for late neurologic events. Appropriate patient selection and diligent long-term follow-up are mandated to obtain optimal outcomes.
Neuropathic pain may be common in chronic lower limb tendinopathy: a prospective cohort study
Authors: Wheeler Patrick C 
Published: November 2016

Background: To identify the prevalence of neuropathic pain, through the use of the painDETECT questionnaire, in a cohort of patients with chronic lower limb tendinopathy conditions. Methods: Patients with chronic lower limb tendinopathy conditions treated within a Sport and Exercise Medicine hospital clinic were identified from clinical records. At the time of the clinical consultation, pain and painDETECT scores were recorded. Results: In total, 282 suitable patients with chronic lower limb tendinopathy conditions were identified who had completed a painDETECT questionnaire. There was a median age of 51.9 years, 35% of patients were male and a median duration of symptoms of 24.0 months. There was a median score of 7.0/10 for self-reported ‘average’ pain and 8.0/10 for self-reported ‘worst’ pain. There was a median painDETECT score of 14.0, 28% of respondents scored 19 or higher with painDETECT (neuropathic component to pain may be likely), 29% scored 13–18 (equivocal result) and 43% of respondents scored 12 or less (neuropathic pain component was unlikely). Conclusions: This study suggests that neuropathic pain as identified by the painDETECT questionnaire may be common in patients with chronic lower limb tendinopathy conditions. It is unclear if patients with tendinopathy who have neuropathic pain may have poorer outcomes from initial treatments, contributing to the high proportion seen in secondary care. These are results from a single hospital clinic, and comparison with a control group is currently lacking. However, on the results to date, neuropathic pain should be considered in management strategies in patients with chronic tendinopathy.
Weekly versus every-three-weeks platinum-based chemoradiation regimens for head and neck cancer
Authors: Melotek James M. , Cooper Benjamin T. , Koshy Matthew , Silverman Joshua S. , Spiotto Michael T. 
Published: November 2016

Background The majority of chemoradiation (CRT) trials for locally advanced head and neck squamous cell carcinoma (HNSCC) have relied on platinum-based chemotherapy regimens administered every-3-weeks. However, given the increased utilization of weekly platinum regimens, it remains unclear how different chemotherapy schedules compare regarding efficacy and toxicity. Methods We retrospectively identified 212 patients with HNSCC who were treated at a single academic medical center with concurrent platinum-based CRT given weekly ( N = 68) or every-three-weeks ( N = 144). JMP version 10 (SAS Institute) was used for statistical analysis. Discrete variables were compared with the chi-square test and differences in the medians were assessed using the Wilcoxon test. Survival curves were constructed using the Kaplan-Meier method and significance was assessed using the log rank test. For univariate analysis and multivariate analysis, we used Cox proportional hazard or logistic regression models to compare differences in survival or differences in categorical variables, respectively. Results Patients receiving weekly platinum regimens were more likely to be older (median age 61.4 vs. 55.5 y; P < .001), have high or very high Charlson comorbidity index (45.6% vs. 27.8%; P = .01), and receive carboplatin-based chemotherapy (6.3% vs. 76.5%; P < .001). Weekly and every-3-week platinum regimens had similar locoregional control (HR 1.10; 95% CI 0.63–1.88; P = .72), progression-free survival (HR 1.13; 95% CI 0.75–1.69; P = .55), and overall survival (HR 1.11; 95% CI 0.64–1.86; P = .71). Every-3-weeks platinum regimens were associated with increased days of hospitalization (median: 3 days vs. 0 days; P = .03) and acute kidney injury (AKI) during radiotherapy (50.0% vs. 22.1%; P < .001). On multivariate analysis, AKI was significantly associated with every-3-weeks regimens (OR: 24.38; 95% CI 3.00–198.03; P = .003) and high comorbidity scores (OR: 2.74; 95% CI 2.15–5.99; P = .01). Conclusions Our results suggest that every-3-weeks and weekly platinum-containing CRT regimens have similar disease control but weekly platinum regimens are associated with less acute toxicity.
Molecular Structure of Poly(vinyl alcohol)-Derived Carbon-Centered Radicals Studied by Rapid-Flow and Spin-Trapping ESR Measurements: A Short-Lived Intermediate Radical in the Initial Stage of the Graft Polymerization Reaction
Authors: Nishihara Yuko , Matsui Kazuma , Kuwabara Keiko , Murata Naoya , Yamaguchi Tomoko , Miyake Yusuke , Ikegami Tohru , Kanaori Kenji , Tajima Kunihiko 
Published: November 2016

Abstract
Continuous rapid-flow electron spin resonance (ESR) was used to detect poly(vinyl alcohol) (PVA)-derived carbon-centered radicals, in order to characterize the short-lived intermediate radicals in the initial stage of the graft polymerization of PVA. ESR spectra were recorded by mixing PVA, hydrogen peroxide, and Ti2(SO4)3 at pH 2.0. The observed spectrum indicated three paramagnetic species: a minor species A, and two major species B1, and B2. Based on the observed proton hyperfine coupling constant (hfcc) values, species A was assigned to the carbon-centered radical of PVA produced by hydrogen atom abstraction from the methine carbon bearing a hydroxyl group. Species B1 and B2 were ascribed to two structural isomers of the PVA-derived, carbonyl-conjugated radical produced by acid-catalyzed radical reaction at the vicinal diol moiety (i.e., head-to-head structure) of PVA. Spin-trapping ESR measurements were performed at 80 °C using a water-soluble spin-trapping reagent 3,5-dibromo-4-nitroso-benzenesulfonate sodium salt (DBNBS). Based on the hfcc values observed for the spin-adducts, species B1 and B2 were confirmed to be the major PVA main-chain-derived radicals produced under the graft reaction conditions. These findings demonstrated that the PVA-derived, carbonyl-conjugated radicals are one of the intermediate radicals in the initial stage of the graft polymerization reaction under acidic conditions.
Η Περιβαλλοντική Εκπαίδευση και η μέθοδος project ως Πλαίσιο Εφαρμογής Μετασχηματιστικής Μάθησης: Εμπειρίες από το χώρο της Επιμόρφωσης των Εκπαιδευτικών
Authors: Μαναβή Χαρίκλεια 
Published: November 2016

<p><strong>ΠΕΡΙΛΗΨΗ</strong></p><p>Το άρθρο αυτό αποτελείται από δύο μέρη. Αρχικά, περιγράφει ένα πρόγραμμα τρίμηνης ενδοσχολικής επιμόρφωσης, όπως εφαρμόστηκε στην πράξη το 2000, με θέμα «Επιμόρφωση Εκπαιδευτικών στην Ανάπτυξη project Περιβαλλοντικής Εκπαίδευσης για την Αξιοποίηση της Πολιτισμικής Κληρονομιάς: Οι Βυζαντινοί Νερόμυλοι του Δήμου Πολίχνης». Παρουσιάζονται οι στόχοι, η μεθοδολογία και η υλοποίηση του προγράμματος με έμφαση στις παραμέτρους που καθιστούν την περιβαλλοντική εκπαίδευση και τη μέθοδο project κατάλληλο πλαίσιο ανάπτυξης μετασχηματιστικής μάθησης. Το δεύτερο μέρος του άρθρου επικαιροποιεί και συμπληρώνει το αρχικό πρόγραμμα, παρουσιάζοντας αναλυτικά ένα εργαστήριο τρίωρης επιμόρφωσης εκπαιδευτικών πάνω στο ίδιο θέμα όπου εφαρμόζεται η μεταγενέστερη προσέγγιση του Α. Κόκκου «Μετασχηματίζουσα Μάθηση μέσω Αισθητικών Εμπειριών». Στο τέλος συζητούνται διαπιστώσεις σε σχέση με τις εν λόγω εφαρμογές.</p><p> </p><p> </p>
Παιδαγωγικές πρακτικές και μεθοδολογικές προτάσεις για την ενίσχυση της κοινωνικότητας των παιδιών προσχολικής ηλικίας. Εφαρμογή του προγράμματος “play with me”
Authors: Μπεαζίδου Ελευθερία , Μπότσογλου Καφένια 
Published: November 2016

<p>Τα προβλήματα συμπεριφοράς που εκδηλώνουν τα παιδιά από την προσχολική ηλικία αποτελούν στη σημερινή εποχή ένα ανησυχητικό φαινόμενο με έντονες κοινωνικές προεκτάσεις. Η εκπαιδευτική κοινότητα καλείται να διαχειριστεί αυτά τα προβλήματα αποδοτικά και αποτελεσματικά. Σε αυτή την κατεύθυνση, πολλοί επιστήμονες ασχολήθηκαν με μεθόδους και πρακτικές τόσο για την πρόληψη όσο και την αντιμετώπιση αυτών των φαινομένων (ενδοσχολική βία, αποκλεισμός κ.α) στη σχολική πραγματικότητα. Ωστόσο, οι καινοτόμες παιδαγωγικές πρακτικές που στηρίζονται σε μεθοδολογικές προτάσεις (μοντέλα) και προωθούν νέες αντιλήψεις στην εκπαίδευση αυτών των παιδιών στην προσχολική ηλικία είναι ελάχιστες. Στο παρόν άρθρο παρουσιάζεται πρόγραμμα πρόληψης το οποίο δίνει τη δυνατότητα στους μαθητές να αναπτύσσονται γνωστικά, ψυχοσυναισθηματικά και κοινωνικά διαμέσου της συνεργασίας, της αλληλεπίδρασης και της σχέσης με τους συμμαθητές τους. Αποσκοπεί στην προαγωγή της κοινωνικής ικανότητας των μαθητών και στην εξάλειψη του κοινωνικού αποκλεισμού και των εκδηλώσεων βίας στο σχολικό περιβάλλον. Το παρόν πρόγραμμα στηρίζεται στα αποτελέσματα έρευνας μοντέλου πρόβλεψης της κοινωνικότητας των παιδιών στο νηπιαγωγείο. Η εφαρμογή του ολοκληρώνεται σε τρεις φάσεις με δραστηριότητες που είναι συνυφασμένες με το αναλυτικό πρόγραμμα σπουδών. </p>
Culturing bone marrow cells with dexamethasone and ascorbic acid improves osteogenic cell sheet structure
Authors: Akahane M. , Shimizu T. , Kira T. , Onishi T. , Uchihara Y. , Imamura T. , Tanaka Y. 
Published: November 2016

ObjectivesTo assess the structure and extracellular matrix molecule expression of osteogenic cell sheets created via culture in medium with both dexamethasone (Dex) and ascorbic acid phosphate (AscP) compared either Dex or AscP alone.MethodsOsteogenic cell sheets were prepared by culturing rat bone marrow stromal cells in a minimal essential medium (MEM), MEM with AscP, MEM with Dex, and MEM with Dex and AscP (Dex/AscP). The cell number and messenger (m)RNA expression were assessed in vitro, and the appearance of the cell sheets was observed after mechanical retrieval using a scraper. β-tricalcium phosphate (β-TCP) was then wrapped with the cell sheets from the four different groups and subcutaneously implanted into rats.ResultsAfter mechanical retrieval, the osteogenic cell sheets from the MEM, MEM with AscP, and MEM with Dex groups appeared to be fragmented or incomplete structures. The cell sheets cultured with Dex/AscP remained intact after mechanical retrieval, without any identifiable tears. Culture with Dex/AscP increased the mRNA and protein expression of extracellular matrix proteins and cell number compared with those of the other three groups. More bridging bone formation was observed after transplantation of the β-TCP scaffold wrapped with cell sheets cultured with Dex/AscP, than in the other groups.ConclusionsThese results suggest that culture with Dex/AscP improves the mechanical integrity of the osteogenic cell sheets, allowing retrieval of the confluent cells in a single cell sheet structure. This method may be beneficial when applied in cases of difficult tissue reconstruction, such as nonunion, bone defects, and osteonecrosis. Cite this article: M. Akahane, T. Shimizu, T. Kira, T. Onishi, Y. Uchihara, T. Imamura, Y. Tanaka. Culturing bone marrow cells with dexamethasone and ascorbic acid improves osteogenic cell sheet structure. Bone Joint Res 2016;5:569–576. DOI: 10.1302/2046-3758.511.BJR-2016-0013.R1.