bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glenoid Bone Loss in Posterior Shoulder Instability: Prevalence and Outcomes in Arthroscopic Treatment
Authors: Hines Adam , Cook Jay B. , Shaha James S. , Krul Kevin , Shaha Steve H. , Johnson John , Bottoni Craig R. , Rowles Douglas J. , Tokish John M. 
Published: January 2018

Background: Glenoid bone loss is a well-accepted risk factor for failure after arthroscopic stabilization of anterior glenohumeral instability. Glenoid bone loss in posterior instability has been noted relative to its existence in posterior instability surgery. Its effect on outcomes after arthroscopic stabilization has not been specifically evaluated and reported. Purpose: The purpose was to evaluate the presence of posterior glenoid bone loss in a series of patients who had undergone arthroscopic isolated stabilization of the posterior labrum. Bone loss was then correlated to return-to-duty rates, complications, and validated patient-reported outcomes. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective review was conducted at a single military treatment facility over a 4-year period (2010-2013). Patients with primary posterior instability who underwent arthroscopic isolated posterior labral repair were included. Preoperative magnetic resonance imaging was used to calculate posterior glenoid bone loss using a standardized “perfect circle” technique. Demographics, return to duty, complications, and reoperations, as well as outcomes scores including the Single Assessment Numeric Evaluation and the Western Ontario Shoulder Instability Index (WOSI) scores, were obtained. Outcomes were analyzed across all patients based on percentage of posterior glenoid bone loss. Bone loss was then categorized as below or above the subcritical threshold of 13.5% to determine if bone loss effected outcomes similar to what has been shown in anterior instability. Results: There were 43 consecutive patients with primary, isolated posterior instability, and 32 (74.4%) completed WOSI scoring. Mean follow-up was 53.7 months (range, 25-82 months) The mean posterior glenoid bone loss was 7.3% (0%-21.5%). Ten of 32 patients (31%) had no appreciable bone loss. Bone loss exceeded 13.5% in 7 of 32 patients (22%), and 2 patients (6%) exceeded 20% bone loss. Return to full duty or activity was nearly 90% overall. However, those with >13.5%, subcritical glenoid bone loss, were statistically less likely to return to full duty (relative risk = 1.8), but outcomes scores, complications, and revision rates were otherwise not different in those with no or minimal bone loss versus those with more significant amounts. Conclusion: Posterior glenoid bone loss has not previously been evaluated independently relative to patients with shoulder instability repairs. Sixty-nine percent of our patients had measurable bone loss, and 22% had greater than 13.5%, or above subcritical bone loss. While these patients were statistically less likely to return to full duty, the reoperation rate, complications, and patient-reported outcomes between groups were not different.
Patient empowerment: Its implementation and systems within hospitals in England and Greece
Authors: Boudioni Markella , McLaren Susan , Lister Graham 
Published: January 2018

Introduction International health policies recognise patient empowerment, resulting in diverse empowerment models and systems. Research on organisational systems for implementing patient empowerment between countries or from organisational stakeholders’ perspective, however, is limited. Aims and methodology: This paper explores and compares organisational systems and structures for patient empowerment implementation in six acute public hospitals in England and Greece (three in each country), their cross-case and cross-national similarities and differences. It uses a comparative, qualitative, explanatory embedded case study design. Semi-structured interviews with a representative sample of stakeholders (n = 33) and documentary sources (n = 79) were analysed with framework. Results Two main patient empowerment themes were identified: (1) organisational leadership, systems, structures; (2) operational structures, services, mechanisms and activities. Generic organisational systems and structures for patient empowerment varied across-cases, but with common organisation of empowerment roles in England and common leadership in Greece. Operational structures, services and mechanisms supporting empowerment varied across-cases and cross-nationally, but with similarities in the main services. Conclusion Implementation of patient empowerment was weaker in Greece than in England, attributable to differing approaches to strategic and operational leadership, limited development of strategies and influential organisational structures. Overall, patient empowerment is well-embedded in organisations with a highly visible patient empowerment profile; commitment to policies and strategy implementation at different levels; strategic and operational leadership investing in dedicated roles with clear authority for patient empowerment, influential empowerment structures and mechanisms.
Cardiovascular diseases in patients receiving small molecules with anti-vascular endothelial growth factor activity: A meta-analysis of approximately 29,000 cancer patients
Authors: Totzeck Matthias , Mincu Raluca-Ileana , Mrotzek Simone , Schadendorf Dirk , Rassaf Tienush 
Published: January 2018

Background Targeted therapy with tyrosine kinase inhibitors with anti-vascular endothelial growth factor activity improves survival of cancer patients. Cardiovascular complications are critical and it is unknown whether these require specific treatment strategies. We aimed to clarify the associated risk of cardiovascular adverse events in patients treated with tyrosine kinase inhibitors. Design The design of this study was a meta-analysis of randomised controlled trials. Methods We searched PubMed, Cochrane, EMBASE and Web of Science databases for randomised controlled trials published until January 2017 that assessed patients with different types of cancer treated with or without tyrosine kinase inhibitors in addition to standard chemotherapy. Results A total of 29,252 patients from 71 randomised controlled trials were included. Tyrosine kinase inhibitor treatment was associated with a higher cardiac ischaemia relative risk (relative risk = 1.69; 95% confidence interval: 1.12–2.57; p = 0.01), with the highest risks observed for sorafenib and patients with renal cancer. Risk of thrombocytopaenia (relative risk = 2.2; 95% confidence interval: 1.73–2.79; p < 0.001) was highest for regorafenib and patients with breast cancer. Left ventricular systolic dysfunction was increased after tyrosine kinase inhibitor therapy (relative risk = 2.53; 95% confidence interval:1.79 – 3.57; p < 0.001), with the highest risks reported for sunitinib and hepatocellular cancer. QT corrected interval prolongation (relative risk = 6.25; 95% confidence interval: 3.44–11.38; p < 0.001) and arterial hypertension (relative risk = 3.78; 95% confidence interval: 3.15-4.54; p < 0.001) were reported. The relative risks of arterial adverse events, cerebral ischaemia, venous adverse events and pulmonary embolism were similar across groups. Conclusion Tyrosine kinase inhibitors increase the risk of severe cardiovascular and particularly thrombotic adverse events. Specific treatment regimens when prescribing tyrosine kinase inhibitor therapies appear desirable.
Factors associated with health-related quality of life in stable ambulatory congestive heart failure patients: Systematic review
Authors: Baert Anneleen , De Smedt Delphine , De Sutter Johan , De Bacquer Dirk , Puddu Paolo Emilio , Clays Els , Pardaens Sofie 
Published: January 2018

Background Since improved treatment of congestive heart failure has resulted in decreased mortality and hospitalisation rates, increasing self-perceived health-related quality of life (HRQoL) has become a major goal of congestive heart failure treatment. However, an overview on predictieve factors of HRQoL is currently lacking in literature. Purpose The aim of this study was to identify key factors associated with HRQoL in stable ambulatory patients with congestive heart failure. Methods A systematic review was performed. MEDLINE, Web of Science and Embase were searched for the following combination of terms: heart failure, quality of life, health perception or functional status between the period 2000 and February 2017. Literature screening was done by two independent reviewers. Results Thirty-five studies out of 8374 titles were included for quality appraisal, of which 29 were selected for further data extraction. Four distinct categories grouping different types of variables were identified: socio-demographic characteristics, clinical characteristics, health and health behaviour, and care provider characteristics. Within the above-mentioned categories the presence of depressive symptoms was most consistently related to a worse HRQoL, followed by a higher New York Heart Association functional class, younger age and female gender. Conclusion Through a systematic literature search, factors associated with HRQoL among congestive heart failure patients were investigated. Age, gender, New York Heart Association functional class and depressive symptoms are the most consistent variables explaining the variance in HRQoL in patients with congestive heart failure. These findings are partly in line with previous research on predictors for hard endpoints in patients with congestive heart failure.
Prevalence of oral human papillomavirus (HPV) in the adult population of Córdoba, Argentina
Authors: Criscuolo MI , Belardinelli PA , Morelatto RA , Mosmann J , Venezuela RF , Kiguen AX , Cuffini C , Lopez de Blanc S 
Published: January 2018

Objective: To determine the prevalence of oral human papillomavirus (HPV) in the population of Córdoba, Argentina and its association with other risk factors. Methods: A sample of 401 volunteers over 18 years, representative of Cordoba city population, was selected. Using a questionnaire, we collected sociodemographic data including the use of tobacco, alcohol, and mate consumption. Two biological samples were taken from each individual, whole mouth saliva and a scraping of the posterior border of the tongue. HPV was determined by polymerase chain reaction using MY09/11 primers. Statistical associations were analyzed using χ2 test. Results: Prevalence of HPV in the population was of 3% (13/401). The mean age of HPV-positive cases was 42 years with a range of 20–85; 54% were females. Among the 13 cases whose saliva was positive for HPV, only 7 (54%) had HPV-DNA in the tongue scraping. All identified genotypes were of low risk and HPV11 was the most frequent type in 62% of positive cases. None of the positive subjects exhibited oral lesions compatible with HPV infection. Ten (77%) of the HPV-positive subjects exhibited lesions in the oral mucosa, mostly related to chronic mechanical irritation (CMI) (odds ratio 3, 95% confidence interval: 1.01–8.97, p < 0.05). Fifty-four percent of HPV-positive individuals were light smokers and consumed alcohol moderately. The combination of both habits was observed in 31%. Sixty-two percent drank mate at high water temperatures. No differences were detected in the sexual behavior or in the reported number of sexual partners between HPV-positive and -negative subjects. Conclusion: The overall prevalence of oral HPV in adults was 3%; only the low-risk genotypes were detected and no association with other risk factors for oral cancer was found. However, an association with CMI of the oral mucosa was noted. The saliva sample proved to be a simple, efficient, and well-tolerated method suitable for screening for HPV, and more cases were detected in saliva compared with tissue scrapings.
Do Elevated Inflammatory Markers Associate With Infection in Revision Shoulder Arthroplasty?
Authors: Chalmers Peter N , Sumner Shelby , Romeo Anthony A , Tashjian Robert Z 
Published: January 2018

Background Serologic erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) measurements, which have been successfully utilized in the lower extremity, are thought to lack adequate sensitivity in the diagnosis of infection after shoulder arthroplasty. The purpose of this study is to determine the diagnostic performance of preoperative white blood cell (WBC) count, ESR, and CRP in the diagnosis of infection in the setting of revision shoulder arthroplasty with the gold standard of infection being defined as a later diagnosis of infection. Patients and methods A national insurance database between the years of 2007 and 2015 (PearlDiver, Warsaw, IN) was queried for those patients who underwent revision shoulder arthroplasty using a combination of procedural (common procedural terminology codes 23472 and 23474) and diagnostic codes (International Classification of Diseases [ICD]-9 code 81.97 and equivalent ICD-10 codes). This database contains demographics, laboratory data, and complication data to allow identification of patients with an infection within 1 year postoperatively. Results The database contained 1392 patients who met criteria. Among these, the best diagnostic performance was with a combined test which was positive if CRP, ESR, or WBC was positive with a sensitivity of 7% to 42%, a specificity of 92%, a positive predictive value of 8% to 45%, a negative predictive value of 91%, and an accuracy of 84% to 85%. On multivariate analyses, predictors included an abnormal ESR (odds ratio 2.4, P = .05) and male gender (3.8, <.001). Conclusions Those patients with an abnormal preoperative ESR have significantly increased odds of a subsequent infection following revision shoulder arthroplasty. ESR, CRP, and WBC in combination are specific but insensitive. Level of Evidence: Diagnostic, Level III
A phase 1 study of ibrutinib in combination with R-ICE in patients with relapsed or primary refractory DLBCL
Authors: Sauter Craig S. , Matasar Matthew J. , Schoder Heiko , Devlin Sean M. , Drullinsky Pamela , Gerecitano John , Kumar Anita , Noy Ariela , Palomba Maria L. , Portlock Carol S. , Straus David J. , Zelenetz Andrew D. , McCall Susan J. , Miller Shoshana T. , Courtien Amanda I. , Younes Anas , Moskowitz Craig H. 
Published: January 2018

Key Points
Ibrutinib plus R-ICE was safe, tolerable, and was not prohibitive to mobilizing hematopoietic stem cells for autologous transplantation. A favorable early signal in all evaluable rel/ref non-GC DLBCL achieving a complete metabolic remission was observed.
Routine versus on demand removal of the syndesmotic screw; a protocol for an international randomised controlled trial (RODEO-trial)
Authors: Dingemans S. A. , Birnie M. F. N. , Sanders F. R. K. , van den Bekerom M. P. J. , Backes M. , van Beeck E. , Bloemers F. W. , van Dijkman B. , Flikweert E. , Haverkamp D. , Holtslag H. R. , Hoogendoorn J. M. , Joosse P. , Parkkinen M. , Roukema G. , Sosef N. , Twigt B. A. , van Veen R. N. , van der Veen A. H. , Vermeulen J. , Winkelhagen J. , van der Zwaard B. C. , van Dieren S. , Goslings J. C. , Schepers T. 
Published: January 2018

Abstract
Background
Syndesmotic injuries are common and their incidence is rising. In case of surgical fixation of the syndesmosis a metal syndesmotic screw is used most often. It is however unclear whether this screw needs to be removed routinely after the syndesmosis has healed. Traditionally the screw is removed after six to 12 weeks as it is thought to hamper ankle functional and to be a source of pain. Some studies however suggest this is only the case in a minority of patients. We therefore aim to investigate the effect of retaining the syndesmotic screw on functional outcome.

Design
This is a pragmatic international multicentre randomised controlled trial in patients with an acute syndesmotic injury for which a metallic syndesmotic screw was placed. Patients will be randomised to either routine removal of the syndesmotic screw or removal on demand. Primary outcome is functional recovery at 12 months measured with the Olerud-Molander Score. Secondary outcomes are quality of life, pain and costs. In total 194 patients will be needed to demonstrate non-inferiority between the two interventions at 80% power and a significance level of 0.025 including 15% loss to follow-up.

Discussion
If removal on demand of the syndesmotic screw is non-inferior to routine removal in terms of functional outcome, this will offer a strong argument to adopt this as standard practice of care. This means that patients will not have to undergo a secondary procedure, leading to less complications and subsequent lower costs.

Trial registration
This study was registered at the Netherlands Trial Register (NTR5965), Clinicaltrials.gov (NCT02896998) on July 15th 2016.
Factors associated with timing of umbilical cord clamping in tertiary hospital of Nepal
Authors: Nelin Viktoria , KC Ashish , Andersson Ola , Rana Nisha , Målqvist Mats 
Published: January 2018

Abstract
Objective
Delayed umbilical cord clamping (DCC) (≥ 60 s) is recognized to improve iron status and neurodevelopment compared to early umbilical cord clamping. The aim of this study is to identify current umbilical cord clamping practice and factors determining the timing of clamping in a low-resource setting where prevalence of anemia in infants is high.

Results
A cross-sectional study design including 128 observations of clinical practice in a tertiary-level maternity hospital in Kathmandu, Nepal. Overall 48% of infants received DCC. The mean and median cord clamping times were 61 ± 33 and 57 (38–79) s, respectively. Univariate analysis showed that infants born during the night shift were five times more likely to receive DCC (OR 5.6, 95% CI 1.4–38.0). Additionally, infants born after an obstetric complication were 2.5 times more likely to receive DCC (OR 2.5, 95% CI 1.2–5.3), and babies requiring ventilation had a 65% lower likelihood of receiving DCC (OR 0.35, 95% CI 0.13–0.88). Despite the existence of standard protocols for cord clamping and its proven benefit, the lack of uniformity in the timing of cord clamping reveals poor translation of clinical guidelines into clinical practice.
Clinical trial registration ISRCTN97846009
The Sox2 promoter-driven CD63-GFP transgenic rat model allows tracking of neural stem cell-derived extracellular vesicles
Authors: Yoshimura Aya , Adachi Naoki , Matsuno Hitomi , Kawamata Masaki , Yoshioka Yusuke , Kikuchi Hisae , Odaka Haruki , Numakawa Tadahiro , Kunugi Hiroshi , Ochiya Takahiro , Tamai Yoshitaka 
Published: January 2018

ABSTRACT
Extracellular vesicles (EVs) can modulate microenvironments by transferring biomolecules, including RNAs and proteins derived from releasing cells, to target cells. To understand the molecular mechanisms maintaining the neural stem cell (NSC) niche through EVs, a new transgenic (Tg) rat strain that can release human CD63-GFP-expressing EVs from the NSCs was established. Human CD63-GFP expression was controlled under the rat Sox2 promoter (Sox2/human CD63-GFP), and it was expressed in undifferentiated fetal brains. GFP signals were specifically observed in in vitro cultured NSCs obtained from embryonic brains of the Tg rats. We also demonstrated that embryonic NSC (eNSC)-derived EVs were labelled by human CD63-GFP. Furthermore, when we examined the transfer of EVs, eNSC-derived EVs were found to be incorporated into astrocytes and eNSCs, thus implying an EV-mediated communication between different cell types around NSCs. This new Sox2/human CD63-GFP Tg rat strain should provide resources to analyse the cell-to-cell communication via EVs in NSC microenvironments.
Strength Training Effects on Muscular Regeneration after ACL Reconstruction
Authors: FRIEDMANN-BETTE BIRGIT , PROFIT FRANCESCA , GWECHENBERGER THOMAS , WEIBERG NADINE , PARSTORFER MARIO , WEBER MARC-ANDRÉ , STREICH NIKOLAUS , BARIÉ ALEXANDER 
Published: January 2018

ABSTRACT

Purpose
Protracted quadriceps muscle atrophy is observed after anterior cruciate ligament reconstruction (ACL-R). The aim of this study was to assess if quadriceps strength training with eccentric overload (CON/ECC+) is more efficient to induce muscle regeneration after ACL-R than conventional concentric/eccentric (CON/ECC) strength training.

Methods
Biopsies from the vastus lateralis muscle were obtained from 37 recreational athletes after 12 wk of regular rehabilitation after ACL-R and again after 12 wk with twice a week of either conventional CON/ECC (n = 16) or CON/ECC+ (n = 21) one-legged supervised leg-press training. Immunohistochemical analyses were used to determine satellite cell (SC) number (Pax7+); activated SC number (Pax7+/MyoD+); fibers expressing myosin heavy-chain (MHC) I and II, MHC neonatal, and fiber cross-sectional area. Magnetic resonance imaging was performed to measure quadriceps cross-sectional area and isokinetic testing for the measurement of quadriceps strength.

Results
CON/ECC+ induced a significantly (P = 0.002) greater increase in quadriceps cross-sectional area than did CON/ECC. There also was a significant increase in the fiber cross-sectional areas of all fiber types and in quadriceps strength, but without significant difference between training groups. Only CON/ECC+ training led to a significant (P < 0.05) increase in percent type I fibers. After training, the number of MHC I+/MHCneo+ fibers was significantly (P < 0.05) greater in the CON/ECC+ than after in the CON/ECC group. The proportion of hybrid fibers tended to decrease in both groups; percent type II fibers, SC number, and activated SC number remained unchanged.

Conclusions
CON/ECC+ leads to significantly greater muscle hypertrophy compared with CON/ECC, but without the hypothesized enhancing effect on SC activation. At the same time, CON/ECC+ induces a less favorable slower muscle phenotype for strong and fast movements.
The diagnostic accuracy of cross-sectional imaging for detecting acute scaphoid fractures in children: a systematic review
Authors: Offiah Amaka C , Burke Derek 
Published: January 2018

Objective:
To determine the diagnostic accuracy of cross-sectional imaging for the diagnosis of acute scaphoid fractures in children.

Methods:
A systematic review of Medline, Embase and Cochrane databases between 1980 and July 2017 was independently performed by two observers. Criteria for study inclusion in a meta-analysis and assessment of the quality of such studies using the QADAS tool, were predetermined.

Results:
No studies were eligible for inclusion in a meta-analysis. Three studies (of low quality when assessed against the STARD guidelines for reporting of studies of diagnostic accuracy) assessed MRI (performed between Days 2 and 10 after acute injury) for the diagnosis of scaphoid fractures in a total of 119 children (age range 6 to 16 years). Study 1 (45 children) reported inter-observer reliability of radiographs and MRI of 0.53 and 0.95 respectively. Study 3 (18 children) reported a negative predictive value of MRI (even as early as Day 2), of 100%. No measure of diagnostic accuracy or observer reliability was reported in Study 2 (56 children). In all 3 studies, MRI identified more scaphoid fractures (and other carpal injuries) than radiographs. Study 3 showed that follow-up MRI between Days 38 and 45 added no new information compared to initial MRI.

Conclusion:
Based on a systematic review of the literature, there is currently no evidence on which to suggest an imaging protocol for suspected scaphoid fracture in children. Until such evidence is available, existing guidelines (which are based on findings from adult studies) should be followed.

Advances in knowledge:
(1) There is low quality evidence regarding the diagnostic accuracy of cross-sectional imaging for suspected scaphoid fractures in children and no evidence on which to propose an optimal imaging strategy. (2) Until such evidence is available, current guidelines (based predominantly on findings in adults and expert opinion) should be followed.