bluuebunny/crossref_metadata_2025_split huggingface dataset:
PepsinA as a Marker of Laryngopharyngeal Reflux Detected in Chronic Rhinosinusitis Patients
Authors: Ren Jian‐jun , Zhao Yu , Wang Jing , Ren Xue , Xu Yang , Tang Wenlong , He Zhaoping 
Published: May 2017

ObjectivesWe aimed to confirm the presence of pepsinA in the nasal secretions and tissues of chronic rhinosinusitis (CRS) patients and reveal the relationship between CRS and laryngopharyngeal reflux (LPR).Study DesignCross‐sectional study.SettingThe study was conducted at the Department of Oto‐Rhino‐Laryngology, West China Hospital, Sichuan University.Subjects and MethodsA total of 32 CRS patients with or without nasal polyps (CRSwNP and CRSsNP, respectively) and 10 normal controls were enrolled in our study. We investigated the expression of pepsinA in the nasal tissues, secretions, and blood plasma from the subjects by immunohistochemical staining, Western blot, or ELISA. Additionally, the expressions of MUC4, MUC5AC, MUC5B, MUC8, and pepsinogenA in nasal tissue were evaluated by quantitative real‐time polymerase chain reaction.ResultsImmunohistochemistry and Western blot revealed that the pepsinA expression levels in the turbinate mucosa in CRSwNP/CRSsNP patients, which were largely restricted to the epithelial layer or glandular mucous cells in nasal tissues, were significantly higher than those in controls and in the polyp tissues of CRSwNP patients (P <. 05). In addition, the concentration of pepsinA in nasal secretions was significantly increased in the CRSwNP (147.85 ± 53.69 ng/mL, P <. 001) and CRSsNP (134.12 ± 36.23 ng/mL, P <. 001) groups as compared with the controls (68.69 ± 19.28 ng/mL). Although MUC5AC, MUC5B, and MUC8 expression differed among the groups, no correlation between pepsinA and mucin genes was found.ConclusionThe results of this study provided evidence of an association between LPR and CRS, although no correlation was found to exist between LPR and mucin genes in CRS patients.
Toward a bioethical framework for antibiotic use, antimicrobial resistance and for empirically designing ethically robust strategies to protect human health: a research protocol
Authors: Hernández-Marrero Pablo , Martins Pereira Sandra , de Sá Brandão Patrícia Joana , Araújo Joana , Carvalho Ana Sofia 
Published: May 2017

Introduction Antimicrobial resistance (AMR) is a challenging global and public health issue, raising bioethical challenges, considerations and strategies. Objectives This research protocol presents a conceptual model leading to formulating an empirically based bioethics framework for antibiotic use, AMR and designing ethically robust strategies to protect human health. Methods Mixed methods research will be used and operationalized into five substudies. The bioethical framework will encompass and integrate two theoretical models: global bioethics and ethical decision-making. Results Being a study protocol, this article reports on planned and ongoing research. Conclusions Based on data collection, future findings and using a comprehensive, integrative, evidence-based approach, a step-by-step bioethical framework will be developed for (i) responsible use of antibiotics in healthcare and (ii) design of strategies to decrease AMR. This will entail the analysis and interpretation of approaches from several bioethical theories, including deontological and consequentialist approaches, and the implications of uncertainty to these approaches.
Short-term application of dexamethasone on stem cells derived from human gingiva reduces the expression of RUNX2 and β-catenin
Authors: Kim Bo-Bae , Kim Minji , Park Yun-Hee , Ko Youngkyung , Park Jun-Beom 
Published: May 2017

Objective Next-generation sequencing was performed to evaluate the effects of short-term application of dexamethasone on human gingiva-derived mesenchymal stem cells. Methods Human gingiva-derived stem cells were treated with a final concentration of 10−7 M dexamethasone and the same concentration of vehicle control. This was followed by mRNA sequencing and data analysis, gene ontology and pathway analysis, quantitative real-time polymerase chain reaction of mRNA, and western blot analysis of RUNX2 and β-catenin. Results In total, 26,364 mRNAs were differentially expressed. Comparison of the results of dexamethasone versus control at 2 hours revealed that 7 mRNAs were upregulated and 25 mRNAs were downregulated. The application of dexamethasone reduced the expression of RUNX2 and β-catenin in human gingiva-derived mesenchymal stem cells. Conclusion The effects of dexamethasone on stem cells were evaluated with mRNA sequencing, and validation of the expression was performed with qualitative real-time polymerase chain reaction and western blot analysis. The results of this study can provide new insights into the role of mRNA sequencing in maxillofacial areas.
Proton Density Fat-Fraction of Rotator Cuff Muscles Is Associated With Isometric Strength 10 Years After Rotator Cuff Repair: A Quantitative Magnetic Resonance Imaging Study of the Shoulder
Authors: Karampinos Dimitrios C. , Holwein Christian , Buchmann Stefan , Baum Thomas , Ruschke Stefan , Gersing Alexandra S. , Sutter Reto , Imhoff Andreas B. , Rummeny Ernst J. , Jungmann Pia M. 
Published: May 2017

Background:Quantitative muscle fat-fraction magnetic resonance (MR) imaging techniques correlate with semiquantitative Goutallier scores with failure after rotator cuff (RC) repair.Purpose:To investigate the relationship of proton density fat fraction (PDFF) of the RC muscles with semiquantitative MR scores, cartilage T2 relaxation times, and clinical isometric strength measurements in patients 10 years after unilateral RC repair.Study Design:Cross-sectional study; Level of evidence, 3.Methods:Bilateral shoulder MR imaging was performed in 13 patients (11 male, 2 female; age, 72 ± 8 years) 10.9 ± 0.4 years after unilateral autologous periosteal flap augmented RC repair (total shoulders assessed, N = 26). Goutallier classification, muscle atrophy, RC tendon integrity, and cartilage defects were determined based on morphological MR sequences. A paracoronal 2D multi-slice multi-echo sequence was used for quantitative cartilage T2 mapping. A chemical shift-encoding-based water-fat separation technique (based on a 6-echo 3D spoiled gradient echo sequence) was used for quantification of the PDFF of RC muscles. Isometric shoulder abduction strength was measured clinically. Mean and SD, Pearson correlation, and partial Spearman correlation were calculated.Results:There were 6 RC full-thickness retears in ipsilateral shoulders and 6 RC full-thickness tears in contralateral shoulders. Isometric shoulder abduction strength was not significantly different between ipsilateral and contralateral shoulders (50 ± 24 N vs 54 ± 24 N; P = .159). The mean PDFF of RC muscles was 11.7% ± 10.4% (ipsilateral, 14.2% ± 8.5%; contralateral, 9.2% ± 7.8%; P = .002). High supraspinatus PDFF correlated significantly with higher Goutallier scores ( R = 0.75, P < .001) and with lower isometric muscle strength ( R = −0.49, P = .011). This correlation remained significant after adjustment for muscle area measurements and tendon rupture ( R = −0.41, P = .048). More severe cartilage defects at the humerus were significantly associated with higher supraspinatus PDFF ( R = 0.44; P = .023). Cartilage T2 values did not correlate with muscle PDFF ( P > .05).Conclusion:MR imaging–derived RC muscle PDFF is associated with isometric strength independent of muscle atrophy and tendon rupture in shoulders with early and advanced degenerative changes. It therefore provides complementary, clinically relevant information in tracking RC muscle composition on a quantitative level.
Leading education beyond what works
Authors: Møller Jorunn 
Published: May 2017

Currently, the issue of inequality is one of the most pressing concerns in education and educational research. Factors such as increased socio-economic inequality, movement of people across national boundaries and refugees create major challenges for local communities and schools. Therefore, it is crucial to ensure that teaching and leadership are informed by the best available knowledge to meet these challenges. This article, which is based on research on successful school leadership and school reforms, aims to explore what type of knowledge is used and, given priority, when politicians and administrators make decisions about improving education. The article also discusses what we need to know to address equity-relevant progress and improvement.In the analysis, the role the OECD has in setting the agenda in educational research is problematized and methodological shortcomings within research traditions focusing on successful school leadership are discussed. A main argument is that our thinking about educational leadership must be complemented and informed by research which focuses on recent changes in the political economy that have challenged public education severely. To lead education beyond the agenda of what works, we need different approaches to research, including critical studies addressing the power structures.
Free-Riders or Competitive Races? Strategic Interaction across the American States on Tobacco Policy Making
Authors: Pacheco Julianna 
Published: May 2017

AbstractThis article contributes to our understanding of policy diffusion in two ways. First, by explicitly focusing on the competition mechanism of diffusion, I consider how policy externalities contribute to free-rider dynamics or competitive races across the American states. The second contribution is the focus on the interdependence of the early stages of agenda setting as well as policy enactments. Using a unique dataset on four different types of tobacco policies that are introduced and eventually enacted in the states from 1990 to 2010, I find evidence that states engage in free-riding dynamics and that strategic interaction exists in the early stages of agenda setting. There is also evidence that states respond to legitimate policy threats in neighboring states. Overall, the results stress the importance of scholars to explore the conditional nature of policy diffusion dynamics by focusing on variations in policy content and stages of the policymaking process other than policy enactment.
Can we use the ipsilateral Hamstrings for ACL Reconstruction in case of medial collateral ligament insufficiency?
Authors: Domnick Christoph , Herbort Mirco , Zoll Alexander 
Published: May 2017

Aims and Objectives: Semitendinosus and gracilis muscles (hamstring muscles) are frequently harvested autologous tendon grafts of the knee e.g. for cruciate ligament reconstruction. This study investigated the joint-stabilizing effects of these muscles in case of insufficiency of the medial collateral ligament (MCL). Hypotheses: First, both the semitendinosus and the gracilis muscles can actively stabilize the joint against valgus stress in the medial collateral unstable knee. Second, this stabilizing influence of these muscles decreases with increasing flexion angle Meterials and Methods: Kinematics were examined in ten fresh-frozen human cadaveric knees using a robotic/UFS testing system and an optical tracking system. The knee kinematics under 5 Nm and 10 Nm valgus stress were determined in the a) MCL intact and b) MCL deficient knee in different flexion angles, respectively using the following simulated muscle loads: 1) 0 N (Idle), 2) 200 N semitendinosus load (ST) and 3) 280 N combined semitendinosus and gracilis load (STGT). Results: Cutting the MCL increased valgus angle under all tested conditions and angles in contrast to the MCL intact knee by 4.3-8.1 degrees for 5 Nm, 6.5-11.9 degrees for 10 Nm valgus torque; P<.01; RM-ANOVA). Applied 200 N simulated ST load reduced the valgus angle significantly in 0°, 10°, 20° and 30° of flexion under 5 Nm and 10 Nm (P< .05) valgus stress. In 0°, 10° and 20° these values were close to the MCL intact joint under the respective torque (both P >.05). The combined 280 N simulated STGT load reduced significantly valgus angle in 0°, 10° and 20° of flexion under 5 Nm and 10 Nm of valgus stress (P< .05) to values near the intact joint (5 Nm: 0°, 10°; 10 Nm: 0°, 10°, 20° - P >.05). In 60° and 90° of flexion ST and STGT loads could not decrease resulting valgus angle of the MCL deficient knee (without hamstring load; P>.05 or valgus increase P<.05). Conclusion: In this human cadaveric study semitendinosus and gracilis muscles can successfully stabilize against valgus stress in the MCL insufficient knee in near-to-extension flexion angles. In the valgus-unstable knee, hamstring muscles should be preserved in (multi-) ligament surgery, but also in joint arthroplasty and osteosynthesis if possible.
Kinematics of the posterolateral corner of the knee: A human cadaveric cutting study.
Authors: Drenck Tobias , Domnick Christoph , Herbort Mirco , Raschke Michael , Frosch Karl-Heinz 
Published: May 2017

Aims and Objectives: The posterolateral corner of the knee consists of different structures, which contribute to instability when damaged after injury or within surgery. Knowing the kinematic influences may help to improve clinical diagnostics and surgical techniques. The purpose was to determine static stabilizing effects of the posterolateral corner by dissecting stepwise all fibers and ligaments (the arcuat complex, AC) connected with the popliteus tendon (PLT) and the influence on lateral stability in the lateral collateral ligament (LCL) intact-state. Materials ans Methods: Kinematics were examined in 13 fresh-frozen human cadaveric knees using a robotic/UFS testing system with an optical tracking system. The knee kinematics were determined for 134 N anterior/posterior loads, 10 Nm valgus/varus loads and 5 Nm internal/external rotational loads in 0°, 20°, 30°, 60° and 90° of knee flexion. The posterolateral corner structures were consecutively dissected: The I.) intact knee joint, II.) with dissected posterior cruciate ligament, III.) meniscofibular/-tibial fibers, IV.) popliteofibular ligament, V.) popliteotibial fascicle (last structure of static AC), VI.) PLT and VII.) LCL. Results: The external rotation angle increased significantly by 2.6° to 7.9° (P<.05) in 0° to 90° of knee flexion and posterior tibial translation increased by 2.9 mm to 5.9 mm in 20° to 90° of knee flexion (P<.05) after cutting the AC/PLT structures (with intact LCL) in contrast to the PCL deficient knee. Differences between dissected static AC and dissected PLT were only found in 60° and 90° external rotation tests (by 2.1° and 3.1°; P<.05). In the other 28 kinematic tests, no significant differences between PLT and AC were found. Cutting the AC/PLT complex did not further decrease varus, valgus or anterior tibial stability in any flexion angle in comparison to the PCL dissected state. Conclusion: The arcuat complex is an important static stabilizer for external rotatory and posterior tibial loads of the knee, even in the lateral collateral ligament intact-state. After dissecting the major parts of the arcuat complex, the static stabilizing function of the popliteus tendon is lost. The arcuat complex has no varus-stabilizing function in the LCL-intact knee. The anatomy and function of these structures for external-rotational and posterior-translational stabilization should be considered for clinical diagnostics and when performing surgery in the posterolateral corner.
Trends and incidence of cartilage, ligament- and arthroscopic surgery: Analysis of German in-patient records 2005-2013
Authors: Lodde Georg , Domnick Christoph , Herbort Mirco , Garcia Patric , Raschke Michael 
Published: May 2017

Aims and Objectives: Apart from some international cruciate ligament and arthroplasty register data, little epidemiological baseline facts are known about many joint surgical procedures. The German Federal Statistical Office collects the encoded population-based data of all medical in-patient procedures performed in Germany. The purpose of this study was to analyze these data to assess epidemiological trends and incidences in joint surgery. Materials and Methods: The comprehensive database of medical procedures of the German DRG system between 2005 and 2013, including 154 million anonymized in-patient records, were screened and analyzed for joint surgical procedures. Results: Trends of incidence rates of many joint surgical procedures have been detected. There was an increasing incidence of arthroscopic procedures in relation to the open procedures. Anterior cruciate ligament reconstruction or repair has a high incidence of 46 per 100,000 person-years, most popular grafts were hamstring tendon (90%) and patellar tendon (6.3%) autografts (2013). Conclusion: This is the first baseline epidemiological data out of 154 million in-patient records in Germany including joint and ligament surgical procedures with a focus on knee and shoulder surgery. The knowledge of the trends and incidences of these procedures help to validate and discuss the results of clinical studies and registers.
Plate osteosynthesis after patellar fracture: 1-year results of a prospective study
Authors: Ellwein Alexander , Katthagen Jan , Jensen Gunnar , Lill Helmut , Raschke Michael 
Published: May 2017

Aims and Objectives: Tension band wiring after patellar fractures is associated to a high number of implant related complications (22-53%). Revision surgery is necessary in 10-55% of the patients with mostly unsatisfactory results. The patella plate is an alternative treatment with the advantages of a locked plating implant. Biomechanical studies have shown a significant higher stability compared to tension band wiring. Therefore an immediate full weight bearing after surgery is allowed with the prophylaxis of knee-stiffness. The purpose of this study was to evaluate the first time clinical prospective results and complications of this new implant. Materials and Methods: Between April 2013 and May 2015 all patients that were treated with locked plating for patella fractures were included in this prospective study. Patients were examined after 6 weeks, 6 and 12 months. Information about patient satisfaction, pain situation and the functional result were collected. Additionally subjective scores (Tegner activity score, Lysholm-score, Kujala-score) were determined and compared to their value before trauma. Complications and revision surgeries were recorded and analysed. Results: 17 patients, 6 women and 11 men, with a mean age of 58 (19-87) years were included in this study. The range of motion of the injured knee was 120° after 6 weeks and improved to 138° after 6 months, corresponding to 84% and 97% of the range of motion of the healthy opposite knee. The Tegner activity scale increased from 2,5 to 3,5 (initial value: 4), the Lysholm score from 78 to 92 points (initial value: 97) and the Kujala score from 72 to 88 points (initial value: 96). Two complications occurred: one patient had a reactive bursitis praepatellaris and one patient sustained a loss of reduction. Another two patients had their implants removed. Patient satisfaction reached 94% after one year. Conclusion: Locked plating of patella fractures is a reliable alternative treatment with good functional outcomes, low complication rates and high patient satisfaction. Already 6 months after surgery the functional results and subjective scores reached results as before trauma. Furthermore the aftercare with immediate full-weight bearing and motion exercise improves quality of life through an early return to daily life.
Radiographic analysis of Re-Ruptures of reconstructed ACLs - Evaluation of tunnel position as a possible cause of Failure
Authors: Sobau Christian , Zimmerer Alexander , Fallscheer Max , Ellermann Andree 
Published: May 2017

Objectives: Previous studies detected femoral and / or tibial tunnel malpositioning as possible causes for the failure of an anterior cruciate ligament reconstruction. We investigated various radiological angles and criterias for ACL revision surgery to find possible causes for the failure of the primary reconstructed ACLs based on digital X-ray images. Materials and Methods: 529 ACL revisions after previous reconstruction were carried out between 1993 and 2013, of which we were able to include 100 patients with digital radiographs in our study. We investigated the angles of the femoral and tibial tunnel position in the coronal and sagittal plane. Furthermore we analyzed the entry point on the femur in accordance with the quadrant method described by Bernard and Hertel. We divided into: A) adequate trauma (n = 87) and non-trauma group (n = 13); B) Hamstring (n = 76) and Patella-BTB group (n = 24); C) transtibial (n = 83) and anteromedial group (n = 17). In addition we built subgroups B1/C1 adequate re-trauma or B2/C2 no adequate trauma to analyze whether there were differences in these groups. Results: The trauma group differed significantly from the non-trauma group in the measured angle of the tibial tunnel in the ap radiograph (trauma group 28.4°, non-trauma group 22.67°; p = 0.013). The Hamstring group differed significantly from the BTB group in the measured inclination angle of the femoral tunnel in the ap radiograph (HS group 54.86°, BTB group 62.78°; p = 0.015). There was also a significant difference concerning the tibial tunnel in the ap radiograph (HS group 29.56°, BTB group 21.63°; p = 0.0001). Comparing the two groups for the femoral tunnel placement-techniques we could find significant differences in the femoral ap-radiographs (inclination angle: TT = 59.04°, AM = 45.64°; p = 0.0001). The analysis of the 4 subgroups revealed differences in the tibial ap images: The BTB trauma group had an average of 23.56° relative to the BTB non-trauma group of 16.91° (p=0.013). The HS groups among themselves did not differ significantly, but the HS non-trauma group had a significantly higher angle with 29.38° to 16.91° in the BTB non-trauma group (p = 0.0003). In addition there was a significant difference when comparing the transtibial trauma group with the transtibial non trauma group (TT trauma = 27.66°, TT non trauma = 21.15°; p = 0.017) Conclusion: Overall we could only find a few significant differences in the measured angles and only a few deviations from the values described within the literature. Therefore a real trauma was necessary to rupture the reconstructed ACL in 87%. In 13% we could find a possible cause within the tibial tunnel: the steeper the tibial tunnel was, less trauma was necessary for failure, especially when using the transtibial drilling method or Patella-BTB grafts. However the small sample size limits the results therefore further studies are necessary.