bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation Between Scapular Dyskinesis Test and Lateral Scapular Slide Test in Scapular Assessment
Authors: Yüksel Ertuğrul , Yeşilyaprak Sevgi Sevi 
Published: December 2014

Objectives: Alterations of the normal position or any abnormal motion of the scapula during active motions of shoulder is termed Scapular Dyskinesis (SD). SD is quite common in overhead athletes with or without shoulder pain. In addition to overhead athletes, SD has also been identified in healthy, asymptomatic individuals. Although there are several proposed methods to identify SD, there are two common methods used in clinical practice; as Lateral Scapular Slide Test (LSST) and Scapular Dyskinesis Test (SDT). SDT was developed as a dynamic functional test after the development of LSST which is a static measurement. SDT has also relatively higher reliability than LSST. In the 2013 consensus statement from ‘scapular summit’, SDT was recommended as a simple and reliable method for scapular assessment because of being a dynamic functional assessment method. The purpose of this study was to investigate the correlation of these two observational tests in asymptomatic population Methods: Eighty-three healthy participants (mean age 21.74±2.3 years, 166 arms, 32 Female-51 Male) were recruited. Participants were eligible if they were ≥18 years of age, having active full shoulder motion, and who have no health problem to hinder them from participate. Individuals with symptoms produced by cervical spine motion, impingement syndrome, frozen shoulder, shoulder instability and a history of shoulder fracture/surgery were excluded. All participants performed SDT and LSST in a random order. Pearson's chi-squared test was used for statistical analysis. Results: SDT detected SD in 44 participants (53%), LSST detected SD in 30 participants (36%). 20 participants (24%) determined as having SD in both tests. There was a moderate significant correlation between SDT and LSST (p=0.000, Pearson Chi-Square value=32.856, Phi=0.445). Conclusion: SDT and LSST have moderate correlation in identifying SD. In recent years, it is suggested that scapula shouldn’t be assessed in static positions/postures. Although both SDT and LSST show the presence of SD, they don’t evaluate SD in the same way because of the fact that LSST is a static assessment method whereas SDT is a dynamic method. Furthermore, SDT has higher reliability rather than other static assessment methods. Moderate correlation between these two tests may not always provide compatible outcome. For these reasons, we don’t recommend the use of LSST solely or instead of SDT in examination of SD. LSST’s complementary role in determination of SD with other assessment methods is arguable due to reliability issues. Optimal observational assessment algorithm in determination of SD should be investigated in future studies.
Functional Strength Ratio in Athletes with and Without Glenohumeral Internal Rotation Deficit (GIRD)
Authors: Güney Hande , Harput Gülcan , Çolakoğlu Filiz , Baltacı Gül 
Published: December 2014

Objectives: Eccentric external rotator (ER) and concentric internal rotator (IR) strength is expressed as a functional strength ratio (ER:IR) for shoulder. The difference in functional strength ratio has been well documented in athletes, but no one compared the functional ratio in athletes with glenohumeral internal rotation deficit (GIRD). The aim of this study was to investigate the effects of GIRD on functional ER:IR strength ratio of the adolescent athletes. Methods: Fifty-three adolescent athletes (12-18 years) from basketball and volleyball teams participated in the study. All the athletes were filled a questionnaire to obtain demographic information and information about their sporting activity. To determine the GIRD, the range of glenohumeral internal rotation motion was measured with the use of a digital inclinometer. An isokinetic dynamometer was used for the assessment of eccentric and concentric muscle strength of the dominant and non-dominant shoulders. Student-t test was used to assess the difference on ER:IR strength ratio between groups. Results: After the clinical examination of all shoulders the athletes were divided into 2 different groups, which were shoulders with glenohumeral internal rotation deficit (Group 1, n=34) and shoulders without GIRD (Group 2, n=22). There was a significant difference among groups on functional ER: IR strength ratio (t=-2.172, p=0.034). The ratio was lower in shoulders with GIRD. Conclusion: GIRD has an adverse effect on functional shoulder ratio, which is one of the causes of shoulder injuries in adolescent athletes. Therefore, GIRD should be treated to prevent future injuries.
Retrospective Evaluation of the Results of Arthroscopy Assisted Reduction and Osteosynthesis of Tibial Plateau Fractures and the Role of the Arthroscopy at Tibial Plateau Fractures
Authors: Ozturk Hasan , Tuzlu Mahmut , Savran Ahmet , Kose Bayram 
Published: December 2014

Objectives: Aim of this study is to compare the medium and long term functional and radiological results of 31 patients with tibial plateau fractures, treated by same surgeon with arthroscopy assisted reduction and osteosynthesis between 2006 and 2013. Methods: This study is designed as evaluation of retrospective case series. 52 patients who has administered Tepecik Education and Research Hospital or Private Izmir Hospital between 2006 and 2013 with tibial plateau fracture and treated by same surgeon with arthroscopic assisted reduction and osteosynthesis is evaluated. Patients with insufficient data and cannot continue follow-up are excluded. 31 patient is included to study meeting our criteria. Injury mechanism, physical examination findings, operation records, concomitant intra articular pathologies, need for allograft or autograft and radiological investigations are retrospectively obtained from hospital medical record system. Preoperative evaluation depends on Schatzker Classification. Patients with floating knee, ipsilateral tibia diaphysis fracture, distal femoral intraarticular fracture, compartment syndrome or neurovascular injury is excluded from study. We didn’t take Schatzker Class is not an exclusion criteria. Results are investigated with Rasmussen radiological and clinical scores statistically. Results: 31 patients (23 male, 7 female) with mean age of 46,3 (min. 18- max. 67) is included our study with the mean follow-up of 45 months. Simultaneous meniscus lesion is detected in 15 patients and repair or partial meniscectomy is performed depending on the lesion. 10 patients need for allograft or autografting for joint surface restoration. Medial and/or lateral plate osteosynthesis is performed depending on fracture configuration. Final average Rasmussen functional score is calculated 25,7 and final average Rasmussen radiological score as 16,5. Secondary arthroscopic debridement is needed in 3 patients with arthrofibrosis. Conclusion: First arthroscopy assisted intra-articular fracture treatment is done in 1993 at knee joint and technique is improved with years. With the published satisfactory results of arthroscopy assisted series, current treatment of choice in tibial plateau fractures became arthroscopy assisted osteosynthesis, same as our routine application in our clinics. Advantages of arthroscopy is opportunity of treatment of concomitant intra articular pathologies, differentiation of these lesions as acute or degenerative and chronic more objective than any other imaging modality, detection of chondral injury more accurate and control of anatomical reduction of fracture lines. Downside of our study is lack of control group. Our conclusion is arthroscopy assistance in tibial plateau fractures improves results without increase in compartment syndrome or other complication rate when compared to literature.
Design of a Single Mechanical Joint for Multitype Angular Position Sensors Used in Gait Analysis
Authors: Irmak Rafet , Bicer Gökan , Irmak Ahsen 
Published: December 2014

Objectives: Gait and motion analysis are important tools in assessment of athletic performance and clinical evaluation. Wearable sensor based solutions have advantages over video based systems by their prices and ease. Resistive, magnetic or optic Encoders, flexible resistors and accelerometers are common sensor types unsed in gait analysis systems used in rehabilitation. All these sensors have similar mounting and electronic instrumentation approach but all have separate mechanical joint design. The purpose of this study is to develop a single mechanical joint for multitype angular position sensors used in gait analysis. Methods: Single turn analog encoder, flexible resistor and 3 axis accelerometer was used as angular position sensor. Constant voltage source (7805) was used for instrumentation of analog encoder and 3 axis accelerometer driver circuit. A voltage divider was used for flexible resistor driver circuit. Mechanical design was made to obtain small and light mechanical joint where all sensors can be mounted. Results: Flexible sensor and encoder was mounded on the center of mechanical joint. Encoder is mounted outside and flexible sensor was mounted in side of the mechanical joint center. Accelerometer was mounted on lower (movable) arm of mechanical joint. Encoder has direct connection with upper and lower arms of mechanical joint. Root of flexible sensor is mounted on one side o the mechanical joint and driven by a mechanical dial on the other arm. Range of motion for analog encoder is 0-360 degree in a single plane, flexible is 0-180 degree for single plane and accelerometer is 0-360 degree for tree planes. Conclusion: Most difficult part of the design was to obtain highest range for flexible resistor. This sensor have 3 inclenght and changes its restinte related to its bending angle. It’s possible to obtain measurement by directly paste it on skin and it’s also easy to have measurement on mechanical joints in narrow angles. For a conventional mechanical joint the range can not be lower then 180 degrees. The length of resistor limits the range. This design problem was solved by adding a secondary mechanical shaft to joint center, winding the sensor over it a mechanical dial. This design can be used in training and research purpose where double check is needed. Future studies may focus on adding contless sensors and integrated circuit type angular sensors to mechanical joint.
How I treat incidental pulmonary embolism
Authors: O’Connell Casey 
Published: December 2014

Abstract
The identification of pulmonary embolism (PE) on computed tomography scans performed for indications other than identification of thromboembolism is a growing clinical problem that has not been adequately addressed by prospective treatment trials. The prevalence of incidentally detected PE ranges from 1% to 4% in unselected populations, with higher rates among hospital inpatients and patients with cancer. Current guidelines recommend using the same approach to type and duration of anticoagulation as is used for patients with suspected PE. Available data regarding the significance of symptomatic subsegmental PE (SSPE) are conflicting, making it difficult to draw conclusions about the appropriate treatment of incidentally detected SSPE, for which the data are sparse. Among cancer patients, the bulk of available data suggest that incidental SSPE is associated with recurrent venous thromboembolism and, when symptomatic, may adversely impact survival. Here, the topic is reviewed utilizing 3 clinical cases, each of which is followed by a discussion of salient features and then by treatment recommendations.
Design, synthesis, docking study and cytotoxic activity evaluation of some novel letrozole analogs
Authors: Vosooghi Mohsen , Firoozpour Loghman , Rodaki Abolfazl , Pordeli Mahboobeh , Safavi Maliheh , Ardestani Sussan K , Dadgar Armin , Asadipour Ali , Moshafi Mohammad Hassan , Foroumadi Alireza 
Published: December 2014

BackgroundBreast cancer is the most common type of female cancer. One class of hormonal therapy for breast cancer drugs -non steroidal aromatase inhibitors- are triazole analogues. In this work, some derivatives of these drugs was designed and synthesized. All synthesized compounds were evaluated for their cytotoxic activities on breast cancer cell lines (MDA-MB-231, T47D and MCF-7).MethodsOur synthetic route for designed compounds started from 4-bromotolunitrile which was reacted with 1H-1,2,4-triazole to afford 4-(4-cyanobenzyl)-1,2,4-triazole. The reaction of later compound with aromatic aldehydes led to formation of the designed compounds. Eleven novel derivatives 1a-k were tested for their cytotoxic activities on three human breast cancer cell lines.ResultsAmong the synthesized compound, 4-[2-(3-chlorophenyl)-1-(1H-1,2,4-triazol-1-yl)ethenyl]benzonitrile (1c) showed the highest activity against MCF-7 and MDA-MB-231 cell lines and 4-[2-(4-methoxyphenyl)-1-(1H-1,2,4-triazol-1-yl)ethenyl]benzonitrile (1 h) exhibited highest activity against T47D cell line. According to cytotoxic activities results, compound 4-[2-(4-dimethylamino)-1-(1H-1,2,4-triazol-1-yl)ethenyl]benzonitrile (1 k) showed comparative activity against T47D and MDA-MB-231 cell lines with compound (1 h) and our reference drug Etoposide.ConclusionIn the process of anti-cancer drug discovery, to find new potential anti-breast cancer agents, we designed and synthesized a novel series of letrozole analogs. Cytotoxicity evaluation revealed that compounds (1c) and (1 k) were the most potent compounds with comparative activity with Etoposide. The results revealed that π-π interactions are responsible for the enzyme inhibitions of compounds (1 c) and (1 k).
Effectiveness of biostimulation through nutrient content on the bioremediation of phenanthrene contaminated soil
Authors: Kalantary Roshanak Rezaei , Mohseni-Bandpi Anoushiravan , Esrafili Ali , Nasseri Simin , Ashmagh Fatemeh Rashid , Jorfi Sahand , Ja’fari Mahsa 
Published: December 2014

Abstract
Bioremediation has shown its applicability for removal of polycyclic aromatic hydrocarbons (PAHs) from soil and sediments. In the present study, the effect of biostimulation on phenanthrene removal from contaminated soil via adding macro and/or micronutrients and trace elements was investigated. For these purposes three macro nutrients (as N, P and K), eight micronutrients (as Mg, S, Fe, Cl, Zn, Mn, Cu and Na) and four trace elements (as B, Mo, Co and Ni) in 11 mineral salts (MS) as variables were used. Placket-Burman statistical design was used to evaluate significance of variables (MS) in two levels of high and low. A consortium of adapted microorganisms with PAHs was used for inoculation to the soil slurry which was spiked with phenanthrene in concentration of 500 mg/kg soil. The optimal reduction resulted when a high level of macro nutrient in the range of 67-87% and low level of micro nutrient in the range of 12-32% were used with the nitrogen as the dominant macronutrient. The Pareto chart showed that NH4NO3 was the most effective variable in this experiment. The effect of elements on phenanthrene biodegradation showed following sequence as N > K > P > Cl > Na > Mg. Effectiveness of the other elements in all runs was less than 1%. The type and concentration of nutrient can play an important role in biodegradation of phenanthrene. Biostimulation with suitable combination of nutrient can enhance bioremediation of PAHs contaminated soils.
Receipt of Chemotherapy Among Medicare Patients With Cancer by Type of Supplemental Insurance
Authors: Warren Joan L. , Butler Eboneé N. , Stevens Jennifer , Lathan Christopher S. , Noone Anne-Michelle , Ward Kevin C. , Harlan Linda C. 
Published: December 2014

Purpose Medicare beneficiaries with cancer bear a greater portion of their health care costs, because cancer treatment costs have increased. Beneficiaries have supplemental insurance to reduce out-of-pocket costs; those without supplemental insurance may face barriers to care. This study examines the association between type of supplemental insurance coverage and receipt of chemotherapy among Medicare patients with cancer who, per National Comprehensive Cancer Network treatment guidelines, should generally receive chemotherapy. Patients and Methods This retrospective, observational study included 1,200 Medicare patients diagnosed with incident cancer of the breast (stage IIB to III), colon (stage III), rectum (stage II to III), lung (stage II to IV), or ovary (stage II to IV) from 2000 to 2005. Using the National Cancer Institute Patterns of Care Studies and linked SEER-Medicare data, we determined each Medicare patient's supplemental insurance status (private insurance, dual eligible [ie, Medicare with Medicaid], or no supplemental insurance), consultation with an oncologist, and receipt of chemotherapy. Using adjusted logistic regression, we evaluated the association of type of supplemental insurance with oncologist consultation and receipt of chemotherapy. Results Dual-eligible patients were significantly less likely to receive chemotherapy than were Medicare patients with private insurance. Patients with Medicare only who saw an oncologist had comparable rates of chemotherapy compared with Medicare patients with private insurance. Conclusion Dual-eligible Medicare beneficiaries received recommended cancer chemotherapy less frequently than other Medicare beneficiaries. With the increasing number of Medicaid patients under the Affordable Care Act, there will be a need for patient navigators and sufficient physician reimbursement so that low-income patients with cancer will have access to oncologists and needed treatment.
Bone Marrow or Peripheral Blood for Reduced-Intensity Conditioning Unrelated Donor Transplantation
Authors: Eapen Mary , Logan Brent R. , Horowitz Mary M. , Zhong Xiaobo , Perales Miguel-Angel , Lee Stephanie J. , Rocha Vanderson , Soiffer Robert J. , Champlin Richard E. 
Published: December 2014

PurposeThere have been no randomized trials that have compared peripheral blood (PB) with bone marrow (BM) grafts in the setting of reduced-intensity conditioning (RIC) transplantations for hematologic malignancy. Because immune modulation plays a significant role in sustaining clinical remission after RIC, we hypothesize that higher graft-versus-host disease (GVHD) associated with PB transplantation may offer a survival advantage.Patients and MethodsThe primary outcome evaluated was overall survival. Cox regression models were built to study outcomes after transplantation of PB (n = 887) relative to BM (n = 219) for patients with acute myeloid leukemia, myelodysplastic syndrome, or non-Hodgkin lymphoma, the three most common indications for unrelated RIC transplantation. Transplantations were performed in the United States between 2000 and 2008. Conditioning regimens consisted of an alkylating agent and fludarabine, and GVHD prophylaxis involved a calcineurin inhibitor (CNI) with either methotrexate (MTX) or mycophenolate mofetil (MMF).ResultsAfter adjusting for age, performance score, donor-recipient HLA-match, disease, and disease status at transplantation (factors associated with overall survival), there were no significant differences in 5-year rates of survival after transplantation of PB compared with BM: 34% versus 38% with CNI-MTX and 27% versus 20% with CNI-MMF GVHD prophylaxis.ConclusionSurvival after transplantation of PB and BM are comparable in the setting of nonirradiation RIC regimens for hematologic malignancy. The effect of GVHD prophylaxis on survival merits further evaluation.
Emergency Department Attendance by Patients With Cancer in Their Last Month of Life: A Systematic Review and Meta-Analysis
Authors: Henson Lesley A. , Gao Wei , Higginson Irene J. , Smith Melinda , Davies Joanna M. , Ellis-Smith Clare , Daveson Barbara A. 
Published: December 2014

Purpose To explore factors associated with emergency department (ED) attendance by patients with cancer in their last month of life. Methods Five electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Library) were searched through February 2014 for studies investigating ED attendance toward the end of life by adult patients (age 18 years or older) with cancer. No time or language limitations were applied. We performed meta-analysis of factors using a random-effects model, with results expressed as odds ratios (OR) for ED attendance. Sensitivity analyses explored heterogeneity. Results Thirty studies were identified, reporting three demographic, five clinical, and 13 environmental factors, combining data from five countries and 1,181,842 patients. An increased likelihood of ED attendance was found for men (OR, 1.24; 95% CI, 1.19 to 1.29; I2, 58.2%), black race (OR, 1.45; 95% CI, 1.40 to 1.50; I2, 0.0%; reference, white race), patients with lung cancer (OR, 1.17; 95% CI, 1.10 to 1.23; I2, 59.5%; reference, other cancers), and those patients of the lowest socioeconomic status (SES; OR, 1.15; 95% CI, 1.10 to 1.19; I2, 0.0%; reference, highest SES). Patients receiving palliative care were less likely to attend the ED in their last month of life (OR, 0.43; 95% CI, 0.36 to 0.51; I2, 59.4%). Conclusion We identified demographic (men; black race), clinical (lung cancer), and environmental (low SES; no palliative care) factors associated with an increased risk of ED attendance by patients with cancer in their last month of life. Our findings may be used to develop screening interventions and assist policy-makers to direct resources. Future studies should also investigate previously neglected areas of research, including psychosocial factors, and patients' and caregivers' emergency care preferences.
Tumor-Infiltrating Lymphocytes and Response to Neoadjuvant Chemotherapy With or Without Carboplatin in Human Epidermal Growth Factor Receptor 2–Positive and Triple-Negative Primary Breast Cancers
Authors: Denkert Carsten , von Minckwitz Gunter , Brase Jan C. , Sinn Bruno V. , Gade Stephan , Kronenwett Ralf , Pfitzner Berit M. , Salat Christoph , Loi Sherene , Schmitt Wolfgang D. , Schem Christian , Fisch Karin , Darb-Esfahani Silvia , Mehta Keyur , Sotiriou Christos , Wienert Stephan , Klare Peter , André Fabrice , Klauschen Frederick , Blohmer Jens-Uwe , Krappmann Kristin , Schmidt Marcus , Tesch Hans , Kümmel Sherko , Sinn Peter , Jackisch Christian , Dietel Manfred , Reimer Toralf , Untch Michael , Loibl Sibylle 
Published: December 2014

Purpose Modulation of immunologic interactions in cancer tissue is a promising therapeutic strategy. To investigate the immunogenicity of human epidermal growth factor receptor 2 (HER2) –positive and triple-negative (TN) breast cancers (BCs), we evaluated tumor-infiltrating lymphocytes (TILs) and immunologically relevant genes in the neoadjuvant GeparSixto trial. Patients and Methods GeparSixto investigated the effect of adding carboplatin (Cb) to an anthracycline-plus-taxane combination (PM) on pathologic complete response (pCR). A total of 580 tumors were evaluated before random assignment for stromal TILs and lymphocyte-predominant BC (LPBC). mRNA expression of immune-activating (CXCL9, CCL5, CD8A, CD80, CXCL13, IGKC, CD21) as well as immunosuppressive factors (IDO1, PD-1, PD-L1, CTLA4, FOXP3) was measured in 481 tumors. Results Increased levels of stromal TILs predicted pCR in univariable (P < .001) and multivariable analyses (P < .001). pCR rate was 59.9% in LPBC and 33.8% for non-LPBC (P < .001). pCR rates ≥ 75% were observed in patients with LPBC tumors treated with PMCb, with a significant test for interaction with therapy in the complete (P = .002) and HER2-positive (P = .006), but not the TNBC, cohorts. Hierarchic clustering of mRNA markers revealed three immune subtypes with different pCR rates (P < .001). All 12 immune mRNA markers were predictive for increased pCR. The highest odds ratios (ORs) were observed for PD-L1 (OR, 1.57; 95% CI, 1.34 to 1.86; P < .001) and CCL5 (OR, 1.41; 95% CI, 1.23 to 1.62; P < .001). Conclusion Immunologic factors were highly significant predictors of therapy response in the GeparSixto trial, particularly in patients treated with Cb. After further standardization, they could be included in histopathologic assessment of BC.