bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salvage of the PWI/DWI Mismatch up to 48 h from Stroke Onset Leads to Favorable Clinical Outcome
Authors: Ma H. , Wright P. , Allport L. , Phan T. G. , Churilov L. , Ly J. , Zavala J. A. , Arakawa S. , Campbell B. , Davis S. M. , Donnan G. A. 
Published: March 2014

Background and Purpose In acute ischemic stroke perfusion/diffusion-weighted image, mismatch using magnetic resonance imaging approximates the ischemic penumbra. For early time windows, mismatch salvage improves clinical outcomes, but uncertainty exists at later time epochs. We hypothesized that (a) mismatch may exist up to 48 h; (b) the proportion of mismatch salvage is time independent; and (c) when salvaged, it improves clinical outcomes. Methods Magnetic resonance imaging was performed within 48 h of ischemic stroke. Perfusion-weighted image was defined by relative Tmax two-second delay. Perfusion/diffusion-weighted image mismatch was the perfusion-weighted image not overlapped by the diffusion-weighted image when coregistered. Infarct volume and disability (modified Rankin Score) were assessed at three-months. Mismatch salvage was the region not overlapped by final infarction. Favorable outcome was defined as modified Rankin Score 0–1. Results Sixty-six patients were studied [mean age 69·9 years (standard deviation 13·1), initial median National Institute of Health Stroke Scale 9·0 (interquartile range 6·0, 18·3)]. There was no relationship between time of stroke onset and the proportion of mismatch salvaged ( P = 0·73). Age (adjusted odds ratio = 0·92, 95% confidence interval 0·86–0·98, P = 0·01), initial National Institute of Health Stroke Scale (adjusted odds ratio = 0·80, 95% confidence interval 0·70–0·92, P < 0·01), mismatch volume (adjusted odds ratio = 0·98, 95% confidence interval 0·968–0·1, P = 0·05), and percentage of mismatch salvage (adjusted odds ratio = 1·04, 95% confidence interval 0·99–1·07, P = 0·05) were independently associated with favorable outcome. Conclusion Using coregistered perfusion/diffusion-weighted image criteria, mismatch persists up to 48 h post stroke. For the whole group, the proportion of mismatch salvage remains independent of time and, although the effect is small, its salvage is independently associated with improved clinical outcomes at three-months. Larger sample sizes are needed to determine the time limit for mismatch salvage.
The HIV‐1 gp41 ectodomain is cleaved by matriptase to produce a chemotactic peptide that acts through FPR2
Authors: Wood Matthew P. , Cole Amy L. , Eade Colleen R. , Chen Li‐Mei , Chai Karl X. , Cole Alexander M. 
Published: March 2014

SummarySeveral aspects of HIV‐1 virulence and pathogenesis are mediated by the envelope protein gp41. Additionally, peptides derived from the gp41 ectodomain have been shown to induce chemotaxis in monocytes and neutrophils. Whereas this chemotactic activity has been reported, it is not known how these peptides could be produced under biological conditions. The heptad repeat 1 (HR1) region of gp41 is exposed to the extracellular environment and could therefore be susceptible to proteolytic processing into smaller peptides. Matriptase is a serine protease expressed at the surface of most epithelia, including the prostate and mucosal surfaces. Here, we present evidence that matriptase efficiently cleaves the HR1 portion of gp41 into a 22‐residue chemotactic peptide MAT‐1, the sequence of which is highly conserved across HIV‐1 clades. We found that MAT‐1 induced migration of primary neutrophils and monocytes, the latter of which act as a cellular reservoir of HIV during early stage infection. We then used formyl peptide receptor 1 (FPR1) and FPR2 inhibitors, along with HEK 293 cells, to demonstrate that MAT‐1 can induce chemotaxis specifically using FPR2, a receptor found on the surface of monocytes, macrophages and neutrophils. These findings are the first to identify a proteolytic cleavage product of gp41 with chemotactic activity and highlight a potential role for matriptase in HIV‐1 transmission and infection at epithelial surfaces and within tissue reservoirs of HIV‐1.
Transarticular Fixation With Cortical Screws Combined With Dorsal Laminectomy and Partial Discectomy as Surgical Treatment of Degenerative Lumbosacral Stenosis in 17 Dogs: Clinical and Computed Tomography Follow‐Up
Authors: Golini Lorenzo , Kircher Patrick R. , Lewis Fraser I. , Steffen Frank 
Published: March 2014

ObjectiveTo describe clinical outcome and technical outcome assessed using computed tomography (CT) in dogs with degenerative lumbosacral stenosis (DLSS) treated by dorsal laminectomy, partial discectomy, and transarticular screw fixation.Study DesignRetrospective observational case series.AnimalsDogs with DLSS (n = 17).MethodsDogs with neurologic and magnetic resonance imaging (MRI) findings compatible with DLSS treated by dorsal laminectomy, partial discectomy and transarticular screw fixation were enrolled. Pre‐ and postoperative neurologic status was compared. Lumbosacral (LS) angle in extension and misalignment in preoperative MRI were compared with the postoperative CT. Residual mobility of the LS joint after fixation was also evaluated. Status of screws, presence of new bone formation over screw heads/articular facets and presence of adjacent segment disease (ASD) were assessed.ResultsMedian CT follow‐up was 12 months. Clinical improvement was seen in 13 dogs, 2 dogs had intermittent LS pain, and 2 dogs needed revision surgery. In 5 dogs, screws were either pulled out or broken. Reduction of LS angle in extension and misalignment was achieved. Residual mobility of the LS segment was present and ASD was not recognized.ConclusionsTransarticular screw fixation in dogs with DLSS is associated with a considerable number of technical failures and does not result in rigid stabilization; however, this did not significantly adversely influence clinical outcome.
Arthroscopic Biceps Ulnar Release Procedure (BURP): Technique Description and In Vitro Assessment of the Association of Visual Control and Surgeon Experience to Regional Damage and Tenotomy Completeness
Authors: Wilson David M. , Goh Clara S.S. , Palmer Ross H. 
Published: March 2014

Objectives(1) Describe arthroscopic BURP surgical technique, (2) assess association of visual control and surgeon experience to tenotomy completeness and regional iatrogenic tissue damage.Study DesignCadaveric study.Sample PopulationCanine cadavers weighing >20 kg (n = 16; 32 elbows).MethodsPhase 1 = dissection/anatomic description/procedural refinement (n = 6). Phase 2 = technique description (n = 6). Phase 3 = association of surgeon experience and procedural visual control to tenotomy completion and regional iatrogenic damage (n = 20). Elbows were randomly assigned via coin toss to an experienced‐ or inexperienced‐arthroscopist. Using conventional medial portals, surgeons sought to identify the medial collateral ligament (MCL) and ulnar insertion of the biceps tendon (uBT) before attempting complete tenotomy. Upon procedural completion, surgeons assigned a standardized “visual control score” (VCS) describing viewing that governed procedure and predicted % uBT release, MCL, and median nerve damage. Post‐procedural dissection determined actual tenotomy completion and iatrogenic tissue damage.ResultsComplete BURP was achieved in 16 of 19 elbows. VCS was associated with tenotomy completeness (P < .01). “Blind” BURP was incomplete in both elbows in which it was attempted. Perception of complete BURP was associated with complete release (P < .01). MCL damage occurred in 10% of elbows. Surgeon experience did not influence VCS, regional damage, or BURP completeness.ConclusionIn canine cadavers, arthroscopic BURP can be consistently performed using conventional arthroscopic instruments and portals by both experienced and inexperienced arthroscopists when visual control guides the tenotomy into the distal aspect of the tendon.
In VitroIncidence of Fibular Penetration With and Without the Use of a Jig During Tibial Plateau Leveling Osteotomy
Authors: Flynn Patrick , Duncan Colleen G. , Palmer Ross H. , Duerr Felix M. 
Published: March 2014

ObjectiveTo determine the incidence of fibular penetration during placement of the Synthes® locking TPLO plate with and without the use of a jig.Study DesignCadaveric, experimental study.Sample PopulationCadaveric paired pelvic limbs (n = 8) from skeletally mature dogs.MethodsLimbs were assigned to 1 of 2 groups (jig‐less‐TPLO = no jig used; jig‐TPLO = jig used). Synthes® locking TPLO plates were applied using proximal screws of excessive length to facilitate identification of fibular penetration. Screw tip locations were identified by dissection and frequency of fibular penetration was compared between groups.ResultsNone of the jig‐TPLO limbs and 6 (75%) of jig‐less‐TPLO limbs had fibular penetration, a difference that was statistically significant. Fibular penetration was most frequently associated with the most proximal screw.ConclusionsA significantly higher incidence of fibular penetration occurs when Synthes® locking TPLO is performed without use of a jig.
Laparoscopic Vasectomy in African Elephants (Loxodonta africana)
Authors: Rubio‐Martínez Luis M. , Hendrickson Dean A. , Stetter Mark , Zuba Jeffery R. , Marais Hendrik J. 
Published: March 2014

ObjectiveTo describe a surgical technique for, and outcome after, laparoscopic vasectomy of free‐ranging elephants.Study DesignCase series.AnimalsAfrican elephants (Loxodonta africana; n = 14).MethodsMale elephants (12–35 years old) were anesthetized with etorphine and supported in a sling in a modified standing position, and positive pressure ventilated with oxygen. Anesthesia was maintained with IV etorphine. Vasectomy was performed under field conditions by bilateral, open‐approach, flank laparoscopy with the abdomen insufflated with filtered ambient air. A 4‐cm segment of each ductus deferens was excised. Behavior and incision healing were recorded for 8 months postoperatively.ResultsSuccessful bilateral vasectomy (surgical time, 57–125 minutes) was confirmed by histologic examination of excised tissue. Recovery was uneventful without signs of abnormal behavior. Large intestine lacerations (3 elephants; 1 full and 2 partial thickness) were sutured extracorporeally. One elephant found dead at 6 weeks, had no prior abnormal signs. Skin incisions healed without complication.ConclusionsLaparoscopic vasectomy can be performed in African elephants in their natural environment.
Complications Associated With Perineal Urethrotomy in 27 Equids
Authors: Kilcoyne Isabelle , Dechant Julie E. 
Published: March 2014

ObjectiveTo report the clinical findings, incidence of complications, and outcome associated with perineal urethrotomy in equids.Study DesignRetrospective case series.AnimalsEquids (n = 27).MethodsMedical records (January 2000 to December 2010) of equids that had a perineal urethrotomy were reviewed. Data retrieved and evaluated were breed, age, surgical technique, use of general anesthesia, complications, time from surgery to development of complications and their management, and outcome.ResultsPerineal urethrotomy was performed for urolithiasis (n = 22), for treatment of urethral rents (3), severe balanoposthitis (1), and bladder atony caused by equine protozoal myeloencephalitis (1). The incidence of complications was 52%, including recurrence of urolithiasis in 5 (23%) equids. Horses that had postoperative cystoscopy and bladder lavage were significantly less like likely to have recurrence of urolithiasis (P = .039). Of equids that had postoperative indwelling urinary catheters, 75% developed complications.ConclusionsPerineal urethrotomy can be an effective for treatment of urolithiasis, hematuria, and urethral trauma. Postoperative cystoscopy and bladder lavage significantly reduced the incidence of postoperative recurrence of urolithiasis.
Comparison of Growth Factor Treatments on the Fibrochondrogenic Potential of Canine Fibroblast‐Like Synoviocytes for Meniscal Tissue Engineering
Authors: Spina Jason , Warnock Jennifer , Duesterdieck‐Zellmer Katja , Baltzer Wendy , Ott Jesse , Bay Brian 
Published: March 2014

ObjectiveTo determine thein vitroeffects of differing growth factor treatments on the fibrochondrogenic potential of fibroblast‐like synoviocytes from cruciate ligament deficient femorotibial joints of dogs.Study DesignIn vitrostudy.Sample PopulationSynoviocytes from dogs (n = 8) with naturally occurring cruciate ligament insufficiency.MethodsSynoviocytes were cultured in monolayer and synthesized into tensioned synoviocyte bioscaffolds (TSB) suspended in media containing TGF‐β3, or FGF‐2, TGF‐β1, and IGF‐I. The 1,9‐dimethylmethylene blue (DMMB) assay and toluidine blue stain assessed glycosaminoglycan content; hydroxyproline assay, and collagen I and II immunohistochemistry assessed collagen content. Biomechanical properties were determined by materials testing/force–deformation curves.ResultsAll tissue cultures formed tensioned fibrous tissue‐like constructs. Mean tissue cellularity and cellular viability was significantly greater in the triple growth factor‐treated TSB by 0.09% and 44%, respectively. Percentage collagen content, and relative gene expression for collagen I, II, and aggrecan was not significantly different between groups. Median percentage of GAG content was significantly greater in triple growth factor‐treated TSB by 1.6%. Biomechanical properties were not different in compression. Triple growth factor‐treated TSB were significantly stronger in toughness, peak load to failure, and stiffness in tension.ConclusionsTGF‐β3 cultured bioscaffolds failed to outperform triple growth factor‐treated TSB. Architectural extracellular matrix (ECM) organization and cellularity likely explained the differences between groups. TGF‐β3 alone cannot be recommended at this time forin vitroformation of autologous fibrocartilage bioscaffolds for meniscal deficiency.
Biomechanical Analysis of Laparoscopic Incisional Gastropexy With Intracorporeal Suturing Using Knotless Polyglyconate
Authors: Imhoff Darren J. , Cohen Andrea , Monnet Eric 
Published: March 2014

ObjectiveTo evaluate load to failure of laparoscopic incisional gastropexy performed with intracorporeal suturing using knotless polyglyconate (KP).Study DesignCadaveric study.AnimalsCanine cadavers (n = 12).MethodsLaparoscopic incisional gastropexy using 2 strands of KP was performed in 6 canine cadavers and by an open approach in 6 cadavers. Length of the gastropexy, number of suture bites on each side of the gastropexy, and number of inadvertent full thickness gastric suture bites were recorded. Load to failure was measured.ResultsThere was no significant difference in mean (±SD) gastropexy load to failure for the open (46.3 ± 19.6 N) and laparoscopic (69.0 ± 26.0 N) approaches (P = .123). No significant differences between laparoscopic and open approaches were detected for mean stomach (3.1 ± 0.1 cm; 3.0 ± 0.2 cm; P = .353) or abdominal wall (3.1 ± 0.2 cm; 3.0 ± 0.2 cm; P = .553) incision lengths. There was no significant difference between groups for number of suture bites medially (P = .448) or laterally (P = .363). There were 3 instances of a single gastric intraluminal suture for the laparoscopic group and none for the open approach (P = .023).ConclusionIncisional gastropexy performed with laparoscopic intracorporeal suturing and KP has a load to failure that is comparable with an open method. Load to failure was similar to reported values for open incisional gastropexy with knotless glycomer 631.
Early identification of ineffective cooperative learning teams
Authors: Hsiung C.M. , Luo L.F. , Chung H.C. 
Published: March 2014

AbstractCooperative learning has many pedagogical benefits. However, if the cooperative learning teams become ineffective, these benefits are lost. Accordingly, this study developed a computer‐aided assessment method for identifying ineffective teams at their early stage of dysfunction by using the Mahalanobis distance metric to examine the difference between the sequential test scores of the unknown team and the test scores of a reference group of functioning teams. The effectiveness of the proposed method was verified by conducting field experiments over an 18‐week engineering course in Taiwan. Forty‐eight students were randomly assigned to cooperative learning teams. The students' learning performance was evaluated by means of unit tests and homework tests. The functioning of the cooperative teams was examined at seven different points during the course of the study. The ineffective teams were identified with quantified type I errors. It was found that some teams failed persistently. Such teams require some form of external intervention to remedy the group dynamics. The results also showed that teams can become ineffective at any stage of the cooperative learning process. Thus, continuous monitoring is required to ensure that appropriate remedial actions are taken in a timely manner.
A Collaborative National Model to Assess Competencies for Medical Students, Residents, and Other Healthcare Practitioners in Gait and Falls Risk Evaluation
Authors: Atkinson Hal H. , Tan Zaldy S. , Brennan Maura , Granville Lisa 
Published: March 2014

To ensure that the healthcare workforce is adequately prepared to care for the growing population of older adults, minimum competencies in geriatrics have been published for medical students and primary care residents. Approaches to teaching and assessing these competencies are needed to guide medical schools, residencies, and continuing medical education programs. With sponsorship by the Education Committee and Teachers Section of the American Geriatrics Society (AGS), geriatrics educators from multiple institutions collaborated to develop a model to teach and assess a major domain of student and resident competency: Gait and Falls Risk Evaluation. The model was introduced as a workshop at annual meetings of the AGS and the American College of Physicians in 2011 and 2012. Participants included medical students, residents, geriatrics fellows, practicing physicians, and midlevel practitioners. At both national meetings, participants rated the experience highly and reported statistically significant gains in overall competence in gait and falls risk evaluation. The largest gains were observed for medical students, residents, and practicing physicians (P < .001 for all); geriatrics fellows reported a higher level of baseline competence and therefore had a lower magnitude of improvement, albeit still significant (P = .02). Finally, the majority of participants reported intent to disseminate the model in their institutions. This article describes the design, implementation, and evaluation of this collaborative national model. A number of institutions have used the model, and the goal of this article is to aid in further dissemination of this successful approach to teaching and assessing geriatrics competencies.
An Educational Intervention to Improve Internal Medicine Interns' Awareness of Hazards of Hospitalization in Acutely Ill Older Adults
Authors: Wilkerson Loren M. , Iwata Isao , Wilkerson Matthew D. , Heflin Mitchell T. 
Published: March 2014

Hospitalized older adults are susceptible to complications termed “hazards of hospitalization” (HOH), which collectively result in poor patient outcomes. Previous research has shown that residents are not aware of their patients' risk factors for HOH. This study investigated the effect of an educational intervention to increase internal medicine interns' knowledge and self‐efficacy of HOH and to improve their care of hospitalized older adults as measured by their documentation of HOH. Targeted learners were internal medicine interns on their geriatrics rotation at a large academic hospital in 2011 to 2012. The intervention covered 10 specific HOH: delirium, pressure ulcers, urinary incontinence and retention, functional decline, falls, suboptimal prescribing, dehydration and malnutrition, infection, depression, and inappropriate interventions. Knowledge and self‐efficacy were measured before and after training. HOH documentation rates of interns who did and did not complete the training were compared over a preset 8‐week period. Forty‐two of 43 eligible interns completed the curriculum. After training, knowledge was significantly greater (approximately 1 more correct question out of 3, P < .001). Self‐reported confidence in managing each hazard also significantly increased (13 questions on two 5‐point Likert scales, P < .001). Trained interns had significantly more‐frequent documentation of patients' activities of daily living, gait, and plan for functional decline prevention than interns who were not trained (P < .05). Conversely, documentation of instrumental activities of daily living was more frequent among interns who were not trained (P < .01). Implementation of an educational intervention was successful in improving educational and behavior change outcomes regarding HOH.
The relationship between living arrangement and adherence to antiepileptic medications among individuals with developmental disabilities
Authors: Hom C. L. , Touchette P. , Nguyen V. , Fernandez G. , Tournay A. , Plon L. , Himber P. , Lott I. T. 
Published: March 2014

AbstractBackgroundNon‐adherence to antiepileptic drugs (AEDs) is associated with considerable morbidity and mortality in the general population but little is known about adherence in individuals with intellectual disability (ID).MethodUsing the records of a closed pharmacy billing system over a 30 month period, we examined the medication non‐adherence rates for AEDs among 793 individuals with ID. We calculated the medication possession ratio (number of days each participant was in possession of an AED), and defined non‐adherence as 25% or more of the exposure days without the possession of an AED. All participants studied had filled prescriptions for AEDs spanning at least 6 months.ResultsControlling for age and gender, we found non‐adherence rates varied by living arrangement. Compared with those living in group homes, individuals with ID living in family homes or in semi‐independent settings were significantly less adherent to AEDs (P < 0.0003).ConclusionNon‐adherence to AEDs is a potential medical risk for individuals with ID that is significantly impacted by the type of community living arrangement.
Three‐dimensional optical transfer functions in the aberration‐corrected scanning transmission electron microscope
Authors: JONES L. , NELLIST P.D. 
Published: March 2014

SummaryIn the scanning transmission electron microscope, hardware aberration correctors can now correct for the positive spherical aberration of round electron lenses. These correctors make use of nonround optics such as hexapoles or octupoles, leading to the limiting aberrations often being of a nonround type. Here we explore the effect of a number of potential limiting aberrations on the imaging performance of the scanning transmission electron microscope through their resulting optical transfer functions. In particular, the response of the optical transfer function to changes in defocus are examined, given that this is the final aberration to be tuned just before image acquisition. The resulting three‐dimensional optical transfer functions also allow an assessment of the performance of a system for focal‐series experiments or optical sectioning applications.