bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost Benefit Analysis of Sports Medicine Team Coverage
Authors: Tjoumakaris Fotios P. , Eck Brandon , Freedman Kevin B. , Pepe Matthew D. , Austin Luke , Tucker Bradford S. 
Published: September 2013

Objectives: Coverage of high school athletic football by orthopaedic sports medicine specialists is considered standard of care in many localities. Taking time away from an orthopaedic practice to provide on field athletic care has potential advantages and disadvantages. Determining the economic viability of this endeavor has never been investigated. The purpose of the present investigation was to perform a cost/benefit risk analysis of local high school sports coverage by an orthopaedic sports medicine practice. Methods: From January 2010 to June 2012, a prospective injury report database was used to collect sports injuries from five high school athletic programs covered by a single orthopaedic sports medicine practice. Patients referred for orthopaedic care were then tracked to determine ultimate cost of care (potential revenue). Evaluation and management codes and current procedure terminology codes were obtained to determine the value of physician visits and surgical care rendered using standardized Medicare reimbursement rates. Total values were also analyzed in respect to visits and surgical treatments for the covering practice during this time period. Direct costs were estimated based on physician time required for team coverage and hourly reimbursement rates for orthopaedic surgeons, based on previously reported hourly reimbursement rates. Results: 19,165 athletic trainer evaluations resulted in 473 (2.5%) physician referrals. 185 (39%) of these referrals were to an orthopaedic surgeon. Of the physician referrals, 26 (5.4%) required orthopaedic surgical treatment. The covering team practice handled 89/185 (48%) of the orthopaedic referrals, and handled 17/26 (65%) of the patients that required surgical treatment. The total cost of orthopaedic care for the athletes requiring treatment was $44,239.94 (total potential revenue). The total revenue collected by the covering team practice was $26,226.14 (actual revenue). The cost of a covering team physician for the required hours of coverage was $12,627.81 (overhead). Overall profit of orthopaedic visits and treatment during this period for the covering practice was $13,598.33 (actual revenue - overhead). Total possible profit during the treatment period was $31,612.13 (total potential revenue - overhead). Based on actual revenue collections, the hourly wage of the sports medicine surgeon was calculated to be $116.24. Conclusion: A potentially profitable and personally beneficial engagement with local athletes can lead to a symbiotic relationship between physicians and their local communities. The covering team practice handled 48% of the orthopaedic referrals, 65% of the surgical cases, and captured 43% of the potential profit. The hourly rate of reimbursement calculated based on this revenue for the covering team physician is only slightly higher to that found in a prior study.
Donor-derived CD19-targeted T cells cause regression of malignancy persisting after allogeneic hematopoietic stem cell transplantation
Authors: Kochenderfer James N. , Dudley Mark E. , Carpenter Robert O. , Kassim Sadik H. , Rose Jeremy J. , Telford William G. , Hakim Frances T. , Halverson David C. , Fowler Daniel H. , Hardy Nancy M. , Mato Anthony R. , Hickstein Dennis D. , Gea-Banacloche Juan C. , Pavletic Steven Z. , Sportes Claude , Maric Irina , Feldman Steven A. , Hansen Brenna G. , Wilder Jennifer S. , Blacklock-Schuver Bazetta , Jena Bipulendu , Bishop Michael R. , Gress Ronald E. , Rosenberg Steven A. 
Published: September 2013

Key Points
Donor-derived anti-CD19-CAR T cells cause regressions of refractory malignancies after allogeneic transplantation.
Glomerular C1q deposition and serum anti-C1q antibodies in anti-glomerular basement membrane disease
Authors: Hu Shui-yi , Jia Xiao-yu , Yang Xiao-wei , Yu Feng , Cui Zhao , Zhao Ming-hui 
Published: September 2013

Abstract

Background
Anti-glomerular basement membrane (GBM) disease is a well-known antibody-induced autoimmune disease. A few patients have glomerular C1q deposition, but it is usually absent on renal histopathology. The role of C1q deposition in kidney injury is unclear. Recently, anti-C1q antibodies are demonstrated to be pathogenic in the target organ damage of many autoimmune diseases, by facilitating C1q deposition and enhancing complement activation via classical pathway. In the current study, we investigated the associations between anti-C1q antibodies in sera and C1q deposition in kidney of patients with anti-GBM disease.

Results
It was shown that the severity of kidney injury was comparable between patients with and without C1q deposition, including the prevalence of oliguria/auria, the median percentage of crescents in glomeruli and the mean concentration of serum creatinine. Serum anti-C1q antibodies were detected in 15/25 (60%) patients with a low titer. The prevalence of C1q deposition in kidney was comparable between patients with and without serum anti-C1q antibodies (26.7% vs. 30.0%, p > 0.05). No association was found between anti-C1q antibodies and the severity of kidney injury.

Conclusions
The classical pathway of complement may not play a pathogenic role in the kidney injury of human anti-GBM disease. Anti-C1q antibodies could be detected in more than half of patients, which need further investigations.
Novel aspects of glutamine synthetase (GS) regulation revealed by a detailed expression analysis of the entire GS gene family of Medicago truncatulaunder different physiological conditions
Authors: Seabra Ana R , Silva Liliana S , Carvalho Helena G 
Published: September 2013

Abstract

Background
Glutamine Synthetase (GS, EC 6.3.1.2) is a central enzyme in nitrogen metabolism, and a key component of nitrogen use efficiency (NUE) and plant yield and thus it is extremely important to understand how it is regulated in plants. Medicago truncatula provides an excellent model system to study GS, as it contain a very simple GS gene family comprising only four expressed genes, MtGS1a and MtGS1b encoding cytosolic polypeptides, and MtGS2a and MtGS2b encoding plastid-located enzymes. To identify new regulatory mechanisms controlling GS activity, we performed a detailed expression analysis of the entire GS gene family of M. truncatula in the major organs of the plant, over a time course of nodule or seed development and during a diurnal cycle.

Results
Individual GS transcripts were quantified by qRT-PCR, and GS polypeptides and holoenzymes were evaluated by western blot and in-gel activity under native electrophoresis. These studies revealed that all four GS genes are differentially regulated in each organ of the plant, in a developmental manner, and identified new regulatory controls, which appear to be specific to certain metabolic contexts. Studies of the protein profiles showed that the GS polypeptides assemble into organ-specific protein complexes and suffer organ-specific post-translational modifications under defined physiological conditions. Our studies also reveal that GS expression and activity are modulated during a diurnal cycle. The biochemical properties of the four isoenzymes were determined and are discussed in relation to their function in the plant.

Conclusions
This work provides a comprehensive overview of GS expression and regulation in the model legume M. truncatula, contributing to a better understanding of the specific function of individual isoenzymes and to the identification of novel organ-specific post-translational mechanisms of GS regulation. We demonstrate that the GS proteins are modified and/or integrated into protein-complexes that assemble into a specific composition in particular organs of the plant. Taken together, the results presented here open new avenues to explore the regulatory mechanisms controlling GS activity in plants, a subject of major importance due to the crucial importance of the enzyme for plant growth and productivity.
Older adults with acquired brain injury: a population based study
Authors: Chan Vincy , Zagorski Brandon , Parsons Daria , Colantonio Angela 
Published: September 2013

Abstract

Background
Acquired brain injury (ABI), which includes traumatic (TBI) and non-traumatic brain injury (nTBI), is a leading cause of death and disability worldwide. The objective of this study was to examine the trends, characteristics, cause of brain injury, and discharge destination of hospitalized older adults aged 65 years and older with an ABI diagnosis in a population with universal access to hospital care. The profile of characteristics of patients with TBI and nTBI causes of injury was also compared.

Methods
A population based retrospective cohort study design with healthcare administrative databases was used. Data on acute care admissions were obtained from the Discharge Abstract Database and patients were identified using the International Classification of Diseases – Version 10 codes for Ontario, Canada from April 1, 2003 to March 31, 2010. Older adults were examined in three age groups – 65 to 74, 75 to 84, and 85+ years.

Results
From 2003/04 to 2009/10, there were 14,518 episodes of acute care associated with a TBI code and 51, 233 episodes with a nTBI code. Overall, the rate of hospitalized TBI and nTBI episodes increased with older age groups. From 2007/08 to 2009/10, the percentage of patients that stayed in acute care for 12 days or more and the percentage of patients with delayed discharge from acute care increased with age. The most common cause of TBI was falls while the most common type of nTBI was brain tumours. The percentage of patients discharged to long term care and complex continuing care increased with age and the percentage discharged home decreased with age. In-hospital mortality also increased with age. Older adults with TBI and nTBI differed significantly in demographic and clinical characteristics and discharge destination from acute care.

Conclusions
This study showed an increased rate of acute care admissions for both TBI and nTBI with age. It also provided additional support for falls prevention strategies to prevent injury leading to cognitive disability with costly human and economic consequences. Implications for increased numbers of people with ABI are discussed.
Bodyweight loss in predicting neonatal hyperbilirubinemia 72 hours after birth in term newborn infants
Authors: Yang Wen-Chieh , Zhao Lu-Lu , Li Yu-Cheng , Chen Chi-Hua , Chang Yu-Jun , Fu Yun-Ching , Wu Han-Ping 
Published: September 2013

AbstractBackgroundSevere dehydration is generally believed to be a cause of significant hyperbilirubinemia in newborn babies. This study aimed to analyze the weight loss of healthy term newborn infants at 24, 48 and 72 hours after birth to predict significant hyperbilirubinemia at 72 hours.MethodsFrom January 2007 to December 2008, we conducted this retrospective chart review by measuring total bilirubin (transcutaneous and serum) in 343 healthy, term newborns with a birth body weight of more than 2500 g. We then analyzed the association between body weight loss (BWL) and significant hyperbilirubinemia (total bilirubin more than 15 mg/dL) 72 hours after birth. Receiver operating characteristic curves were used to evaluate the appropriate cutoff BWL percentages on the first three days after birth for the prediction of neonatal hyperbilirubinemia 72 hours after birth.ResultsA total of 115 (33.5%) neonates presented with significant hyperbilirubinemia 72 hours after birth, and the percentages of BWL on the first three days were all higher than those in the non-significant hyperbilirubinemia group (allp < 0.05). Breastfeeding was not statistically correlated with significant hyperbilirubinemia (p=0.86). To predict significant hyperbilirubinemia 72 hours after birth, receiver operating characteristic curve analysis showed that the optimum cutoff BWL percentages were 4.48% on the first day of life (sensitivity: 43%, specificity: 70%, positive likelihood ratio [LR+]: 1.43, and negative likelihood ratio [LR-]: 0.82), 7.60% on day 2 (sensitivity: 47%, specificity: 74%, LR+: 1.81, LR-: 0.72), and 8.15% on day 3 (sensitivity: 57%, specificity: 70%, LR+: 1.92, LR-: 0.61) (allp < 0.05).ConclusionsBWL on the first three days after birth may be a predisposing factor for neonatal hyperbilirubinemia, and may also serve as a helpful clinical factor to prevent significant hyperbilirubinemia 72 hours after birth. The optimal BWL cutoff percentages on the first three days after birth presented in this study may predict hyperbilirubinemia and indicate the need for supplementary feeding.
Self-perceived sleepiness in emergency training physicians: prevalence and relationship with quality of life
Authors: Belayachi Jihane , Benjelloun Oumama , Madani Naoufel , Abidi Khalid , Dendane Tarek , Zeggwagh Amine Ali , Abouqal Redouane 
Published: September 2013

Abstract

Introduction
Sleep deprivation among training physicians is of growing concern; training physicians are susceptible due to their prolonged work hours and rotating work schedules. The aim of this study was to determine the prevalence of self-perceived sleepiness in emergency training physicians, and to establish a relationship between self-perceived sleepiness, and quality of life.

Methods
Prospective survey in Ibn Sina University hospital Center in Morocco from January to April 2011 was conducted. Questionnaires pertaining to socio-demographic, general, and sleep characteristics were completed by training physician who ensured emergency service during the month preceding the survey. They completed the Epworth sleepiness scale (ESS) which assessed the self-perceived sleepiness, and the EuroQol-5 dimensions (EQ-5D) scale which assessed the general quality of life.

Results
Total 81 subjects (49 men and 32 women) were enrolled with mean age of 26.1 ± 3.4 years. No sleepiness was found in 24.7% (n = 20), excessive sleepiness 39.5% (n = 32), and severe sleepiness in 35.8% (n = 29) of training physicians. After adjusting for multiple confounding variables, four independent variables were associated with poorer quality of life index in training physician; unmarried (ß −0.2, 95% CI −0.36 to −0.02; P = 0.02), no physic exercise (ß −0.2, 95% CI −0.39 to 0.006; P = 0.04), shift-off sleep hour less than 6 hours (ß −0.13, 95% CI −0.24 to −0.02; P = 0.01), and severe sleep deprivation(ß −0.2, 95% CI −0.38 to −0.2; P = 0.02).

Conclusion
Nearly two third of training physicians had suffered from sleepiness. There is an association between poor quality of life and severe sleepiness in unmarried physicians, sleeping less than 6 hours in shift-off day, and doing no physical activity.
Toxoplasma gondii prevalence in food animals and rodents in different regions of China: isolation, genotyping and mouse pathogenicity
Authors: Wang Lin , Cheng Hua-Wei , Huang Kai-Quan , Xu Yuan-Hong , Li Yong-Nian , Du Jian , Yu Li , Luo Qing-Li , Wei Wei , Jiang Ling , Shen Ji-Long 
Published: September 2013

Abstract

Background
Recent studies of Toxoplasma gondii isolates from animals in different regions of China have shown a limited genetic diversity and type China 1 was the dominant genotype of T. gondii prevalent in Chinese animals. However, little has been known concerning the isolation and genotyping of T. gondii circulating in chickens, pigs and rodents in China. The aim of the study was to characterize samples of T. gondii isolates obtained from naturally infected cats, pigs and free-range chickens slaughtered for human consumption in China.

Methods
In the present study, brain tissues of 77 animals collected from different areas of China, including 24 free-range chickens (Gallus domesticus) , 13 voles (Rattus flavipectus), 23 pigs and 17 cats, were bioassayed in mice and viable T. gondii were isolated from the brains of eleven. These eleven T. gondii isolates were maintained in Kunming (KM) outbred mice and DNA isolated from tissues of infected mice was characterized using 11 PCR-restriction fragment length polymorphism (PCR-RFLP) markers: SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, Apico, and CS3. Moreover, to determine mouse virulence of China 1 lineage of parasites, a TgCtgy5 genotype isolate was selected randomly and assessed in KM mice with different inoculation doses.

Results
Results of genotyping revealed that ten isolates were type China 1 (ToxoDB PCR-RFLP genotype #9), and TgCksz1 was a new genotype that was reported for the first time designated here as ToxoDB PCR-RFLP #225. No clonal types I, II and III lineages were found. DNA sequencing of four introns (EF1, HP2, UPRT1 and UPRT7) and two genes (GRA6 and GRA7) from representative isolates confirmed the results of PCR-RFLP genotyping. The TgCtgy5 isolate was highly virulent in KM mice; all infected mice died of acute toxoplasmosis, irrespective of the inoculation dose. The results indicate that mouse virulent isolates of T. gondii are predominantly circulating in cats in China.

Conclusions

T. gondii isolated from chickens, pigs, cats and rodents in different locations in China were genotyped and the results reconfirmed the limited diversity of T. gondii in China and showed that type China 1 lineage was dominant in this country.
Muscle free amino acid profiles are related to differences in skeletal muscle growth between single and twin ovine fetuses near term
Authors: Sales Francisco , Pacheco David , Blair Hugh , Kenyon Paul , McCoard Sue 
Published: September 2013

Abstract
Twin sheep fetuses have reduced skeletal muscle weight near birth relative to singles as a result of restricted muscle hypertrophy. Intracellular free amino acids (FAA) are reported to regulate metabolic pathways which control muscle protein accretion, whereby reduced intracellular content of specific FAA may reduce their activation and therefore, muscle hypertrophy. The aim of this study was to determine whether differences in muscle weight between singleton and twin fetuses, under different maternal conditions is associated with reduced concentration of specific FAA. The FAA content in the semitendinosus muscle (ST) in singleton and twin fetuses (rank) at 140 days of gestation from heavy (H) or light (L) ewes fed ad libitum (A) or maintenance (M) level of nutrition was measured. Muscle weight was reduced in twin fetuses compared to singletons in all groups. Reduced concentrations of leucine, threonine and valine, but higher concentrations of methionine, ornithine, lysine and serine were found in twin fetuses compared to singletons. Maternal size and nutrition interaction with rank resulted in reduced glutamine in twins from HM-ewes (H-ewes under M nutrition) compared to their singleton counterparts. Maternal weight interaction with pregnancy rank reduced the concentration of arginine in twins, with a larger effect on H-ewes compared with L-ewes. Maternal size interaction with pregnancy rank resulted in twins from M-ewes to have lower alanine, while twins from A-ewes had lower aspartic acid concentration compared to singletons. The ST muscle weight was positively correlated only with arginine concentration after taking into account rank, size and nutrition. The present results indicate that reduced concentrations of specific intracellular FAA, such as arginine, leucine, valine, glutamine, which are known to play a role in muscle growth, could be acting as limiting factors for muscle hypertrophy in twin fetuses during late gestation. Ewe size and nutrition can influence the concentration of specific FAA in muscle and should be considered in any intervention plan to improve twin fetal muscle growth.
Circulating Irisin in Relation to Insulin Resistance and the Metabolic Syndrome
Authors: Hee Park Kyung , Zaichenko Lesya , Brinkoetter Mary , Thakkar Bindiya , Sahin-Efe Ayse , Joung Kyoung Eun , Tsoukas Michael A. , Geladari Eleni V. , Huh Joo Young , Dincer Fadime , Davis Cynthia R. , Crowell Judith A. , Mantzoros Christos S. 
Published: September 2013

Context:
Irisin, a recently identified hormone, has been proposed to regulate energy homeostasis and obesity in mice. Whether irisin levels are associated with risk of the metabolic syndrome (MetS), cardiometabolic variables, and cardiovascular disease (CVD) risk in humans remains unknown.

Objective:
Our objective was to assess the associations between baseline serum irisin levels and MetS, cardiometabolic variables, and CVD risk.

Design, Setting, and Subjects:
We conducted a comparative cross-sectional evaluation of baseline circulating levels of the novel hormone irisin and the established adipokine adiponectin with MetS, cardiometabolic variables, and CVD risk in a sample of 151 subjects.

Results:
Baseline irisin levels were significantly higher in subjects with MetS than in subjects without MetS. Irisin was associated negatively with adiponectin (r = −0.4, P &lt; .001) and positively with body mass index (r = 0.22, P = .008), systolic (r = 0.17, P = .04) and diastolic (r = 0.27, P = .001) blood pressure, fasting glucose (r = 0.25, P = .002), triglycerides (r = 0.25, P = .003), and homeostasis model assessment for insulin resistance (r = 0.33, P &lt; .001). After adjustment for potential confounders, including body mass index, subjects in the highest tertile of irisin levels were more likely to have MetS (odds ratio [OR] = 9.44, 95% confidence interval [CI] = 2.66–33.44), elevated fasting blood glucose (OR = 5.80, 95% CI = 1.72–19.60), high triglycerides (OR = 3.89, 95% CI = 1.16–13.03), and low high-density lipoprotein cholesterol (OR = 3.30, 95% CI = 1.18–9.20). Irisin was independently associated with homeostasis model assessment for insulin resistance and general Framingham risk profile in multiple linear regression analyses after adjustment for confounders. Adiponectin demonstrated the expected associations with outcomes.

Conclusions:
Irisin is associated with increased risk of MetS, cardiometabolic variables, and CVD in humans, indicating either increased secretion by adipose/muscle tissue and/or a compensatory increase of irisin to overcome an underlying irisin resistance in these subjects.
A medial approach for open redo groin surgery for varicose vein recurrence
Authors: Nelzén O. 
Published: September 2013

SummaryAims: To describe the technique of a medial approach for redo groin surgery for varicose vein recurrence and to report the one year prospective results for this procedure.Method: The standardised technique employed is described. Prospective one year data regarding the effectiveness of this procedure was taken from a one year audit performed 2009–2010 at Skaraborg Hospital. Details regarding this patient cohort and the surgery performed were registered. The outcome was measured by using venous clinical severity score (VCSS) and the disease specific quality of life was measured with the Aberdeen varicose vein questionnaire (AVVQ). Venous duplex ultrasound scanning (DUS) was performed preoperatively, after 4–6 weeks and after one year.Results: Out of 255 venous operations 34 regarded redo groin surgery and these were assessed. Females dominated 25/34 and the median age was 55 years (range 26–80). All patients had a probable stump according to DUS. CEAP C3-C4 dominated 28 patients/ legs and C5-C6 in 4 legs. The median operating time was 69 minutes (range 35–120) and the operating time was significantly correlated to the number of incisions (p<0.001). The complication rate was 15 %, including 2 wound infections but no DVT or lymph leakage. Both the VCSS and the AVVQ scores were significantly improved after one year (p<0.001). After one year DUS detected recurrence in the groin was observed in 19 %, mostly neovascularisation.Conclusion: Redo groin surgery by a standardised medial approach is a safe and not an especially technically demanding technique that can be performed reasonably rapidly. The one year results are promising and the early DUS recurrence rate seems low.