bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior Facet Cartilage Injury in Operatively Treated Intra-articular Calcaneus Fractures
Authors: Rothberg David L. , Yoo Brad J. 
Published: June 2014

Background: Direct visualization of the posterior facet in displaced intra-articular calcaneus fractures (DIACF) frequently shows partial or full thickness cartilage delamination. This is felt to be secondary to the depression of an osteoarticular segment of the posterior facet within the calcaneal body and the subsequent contact with fracture edges as it impacts caudally. The purpose of this study was to determine the frequency of cartilage injury and if it correlates with fracture classification. Methods: A single surgeon prospective, observational series of 28 patients with 28 DIACFs was reviewed for patient demographic and injury data, radiographic fracture characterization, and intraoperative observation of articular injury size, depth, and location over the time period of February 2010 to December 2012. Observations were correlated with the OTA and Sanders classification systems. Results: Age, sex, mechanism of injury, and depth and location of cartilage injury were not significantly different between the 13 OTA/Sanders type 2 and 15 type 3 DIACFs evaluated in this study. Posterior facet articular cartilage delamination was found in 77% of type 2 and 100% of type 3 fractures ( P = .09). Location of cartilage injury was common (56%) along the distal, lateral aspect of the posterior facet ( P < .05). The percentage area of cartilage injury was significantly larger in type 3 fractures (3.1%) then type 2 (1.3%) ( P < .02). Conclusions: DIACFs had a consistent location of posterior facet articular cartilage delamination along the distal lateral aspect of the osteoarticular fragment. This lesion was larger in OTA/Sanders classification type 3 fractures compared to type 2 fractures. Level of Evidence: Level IV, prospective, observational series.
Accessory Talar Facet Impingement in Pathologic Conditions of the Peritalar Region in Adults
Authors: Niki Hisateru , Hirano Takaaki , Akiyama Yui , Beppu Moroe 
Published: June 2014

Introduction: Associations between accessory anterolateral talar facet (AALTF) and sinus tarsi pain in adults have not been reported. This study aimed to investigate the clinical and imaging characteristics of pathologic conditions of the peritalar region in adults with painful accessory talar facet impingement (ATFI). Methods: We included 31 patients (aged 19-75 years) with persistent sinus tarsi pain who underwent surgery and had pathologic conditions of the peritalar region, including adult acquired flatfoot deformity (AAFD; 18 patients), ankle osteoarthritis (8 patients), and ankle instability (5 patients). Continuity between the articular surface of the posterior facet of the talus and AALTF was identified on preoperative computed tomography and magnetic resonance imaging (MRI) of the cartilage. In addition, focal abutting bone marrow edema (FABME) of the talus and calcaneal neck around the AALTF on short TI inversion recovery sequence MRI was confirmed. Subtalar arthroscopy was used to evaluate the AALTF surface characteristics. Pre- and postoperative objective scores were compared. Eight pre- and postoperative radiographic parameters were compared to confirm the effect of foot alignment changes after reconstructions on sinus tarsi pain with ATFI. Pre- and postoperative changes in FABME were compared with 17.1 (7-60) months of follow-up. Results: Subjects underwent accessory facet resection with balancing reconstruction. Arthroscopically, 66% of patients showed a focal defect on the AALTF cartilage surface, and 83% showed attenuation of the posterior capsular ligament. All x-ray parameters in AAFD patients showed significant improvement postoperatively ( P < .001). Mean objective scores improved from 54.0 preoperatively to 91.0 postoperatively ( P < .001). Sinus tarsi pain and FABME were absent in all cases at the final follow-up. Conclusion: AALTF represents a new etiology of subsequent painful intra-articular talocalcaneal impingement. When addressing sinus tarsi pain, it is important to detect the signs of AALTF on MRI of the cartilage and accompanying FABME. Level of Evidence: Level IV, retrospective case series.
Inflammatory joint disease in cats
Authors: Lemetayer Julie , Taylor Susan 
Published: June 2014

Practical relevance: Osteoarthritis, a degenerative non-inflammatory joint disease, is common in cats, usually causing gradual changes in behavior and lifestyle rather than severe lameness. Inflammatory arthritis occurs much less frequently and is nearly always associated with debilitating lameness. It may have an infectious or immune-mediated cause – but, unlike the canine disease, is much more likely to be infectious in origin. Clinical challenges: Cats with inflammatory joint disease are presented for evaluation of lethargy, anorexia, reluctance to walk or fever. Synovial fluid collection and analysis is required to confirm joint inflammation, but this is a procedure many veterinarians are not comfortable performing in cats. Once inflammatory arthritis is confirmed, extensive testing is required to diagnose infectious causes and determine appropriate treatment. Immune-mediated polyarthritis can be treated with immunosuppressive drugs only after all infectious possibilities are eliminated. Radiographs are used to characterize the arthritis as erosive or nonerosive, but radiographic changes in cats are often subtle compared with those described in canine rheumatoid-like arthritis. Audience: This review, aimed at all veterinarians who treat cats, describes the general clinical approach to feline joint disease, the collection and analysis of synovial fluid, and the diagnosis and management of inflammatory joint diseases affecting cats. The diagnostic approach to an unusual case of erosive polyarthritis is discussed in the Case Notes. Evidence base: To date, the veterinary literature on inflammatory joint disease in cats has been limited to older reviews of immune-mediated disorders and multiple single case reports or small case series describing infectious disorders. This article offers a current comprehensive review of these disorders.
Feline respiratory disease
Authors: Lee-Fowler Tekla 
Published: June 2014

Practical relevance: Non-hemotropic Mycoplasma species are frequently implicated in cases of respiratory disease, and also conjunctivitis, in cats. Clinical challenges: Mycoplasma species are considered commensal bacteria of the conjunctiva and the upper respiratory tract of cats, and hence their role as a primary pathogen is difficult to determine. These organisms certainly appear to play a significant role as a secondary pathogen in the upper airways, and there is increasing evidence that in some animals they may represent a primary infection. However, mycoplasmas have not been found in the lower airways of clinically healthy cats – suggesting that, when present, they likely represent a pathologic process. Diagnostic challenges exist as well; Mycoplasma species are not typically identified via cytology due to their small size, and culture of these organisms requires special media and handling. Although PCR has improved identification and allowed for speciation, conflicting culture and PCR results can create a dilemma regarding the clinical relevance of infection. Evidence base: This article draws on original research and case reports to provide information about the role of Mycoplasma species in thefeline upper and lower respiratory tract, diagnostic methods and associated challenges, and treatment options. Audience: The goal is to provide small animal practitioners with a current and organized review of the often-conflicting literature regarding the role of Mycoplasma species in feline respiratory infections.
Nuclear expression of renin-angiotensin system components in NRK-52E renal epithelial cells
Authors: Alzayadneh Ebaa M , Chappell Mark C 
Published: June 2014

Introduction: Isolated nuclei of sheep proximal tubules express angiotensin (Ang) receptors as well as angiotensinogen (AGT) and renin. The present study characterized the NRK-52E tubular epithelial cell line for the intracellular expression of renin-angiotensin system (RAS) components. Methods: RAS components were visualized by immunofluorescent staining in intact cells and protein expression in isolated nuclei. Results: An antibody to the angiotensin I (Ang I) sequence of AGT (AI-AGT) revealed only cytosolic staining, while an antibody to an internal sequence of AGT (Int-AGT) revealed primarily nuclear staining. Immunoblots of nuclear and cytosolic fractions confirmed the differential cell staining of AGT. Immunostaining for renin was present on nuclei of intact cells. Nuclear renin activity averaged 0.77±0.05 nmol/mg protein/h that was reduced by aliskiren (0.13±0.01 nmol/mg/h, n=3, p<0.01); trypsin activation increased activity three-fold. Peptide staining localized angiotensin II (Ang II) and Ang-(1-7) to the nucleus and peptide content averaged 59±2 and 57±22 fmol/mg ( n=4), respectively. Peptide metabolism in isolated nuclei revealed the processing of Ang I to Ang-(1-7) by thimet oligopeptidase. Conclusion: We conclude that the NRK-52E cells express an intracellular RAS localized to the nucleus and may be an appropriate cell model to elucidate the functional relevance of this system.
Design of Polycaprolactone Vascular Grafts
Authors: Yalcin I , Horakova J , Mikes P , Sadikoglu T Gok , Domin R , Lukas D 
Published: June 2014

A large number of patients suffer from vascular diseases, resulting in the need for bypass surgery. Since there are still limitations in the replacement of small diameter vascular grafts, the need and demand for developing more desirable grafts is increasing day by day. In this study, polycaprolactone small-diameter (6 mm) vascular grafts were produced successfully using custom-designed electrospinning apparatus. Radial fiber orientation was achieved by increasing the rotational speed of the collector. The morphological, structural, mechanical, and biological properties were examined. The results show that oriented scaffolds with 2 µm average fiber diameter provide 1 MPa ultimate tensile strength in the radial direction. The pore size area was found to be adequate in the oriented samples required for cell proliferation and diffusion through the tunica media. In vitro biocompatibility of the grafts was proven with 3T3 mouse fibroblasts. After cell seeding, the oriented fibers serve as a cue for radial cell alignment. An understanding of electrospun material parameters together with knowledge of native blood vessel structures and properties is a considerable part in designing small-diameter vascular grafts.
Computer-Based Cognitive Training for Individuals With Intellectual and Developmental Disabilities
Authors: Siberski James , Shatil Evelyn , Siberski Carol , Eckroth-Bucher Margie , French Aubrey , Horton Sara , Loefflad Rachel F. , Rouse Phillip 
Published: June 2014

Background: There is a growing focus in the United States on preserving cognitive functioning. However, individuals with intellectual and developmental disabilities (ID/DD) are not provided with opportunities to prevent cognitive decline. To investigate whether participants with ID/DD would improve in cognitive function after cognitive training, a cognitive training group (N = 11) was compared to 2 control groups, a computer games group (N = 11) and a waitlist group (N = 10) on performance on 15 cognitive functions. Findings: (1) Very high adherence rates (94%) of the sample and 100% of the cognitive training group indicate that when given adequate individual support, adults with ID/DD can successfully use a cognitive stimulation program. (2) No significant between- or within-group effects were observed for cognitive training when a stringent α, corrected for multiple comparisons, was used. (3) Trends of improvement in cognitive function were observed for the cognitive training group.
Total wrist arthroplasty: a systematic review of the evidence from the last 5 years
Authors: Yeoh D. , Tourret L. 
Published: June 2014

We reviewed evidence on total wrist replacement from the last 5 years. Eight articles met a minimum set standard. The results of 405 prostheses were available, including seven different manufacturers. The mean follow up was 2.3–7.3 years with an average age of 52–63. Rheumatoid arthritis was the indication in 42% of patients. Motec demonstrated the best post-operative DASH scores. Only Maestro achieved a defined functional range of motion post-operatively. Universal 2 displayed the highest survival rates (100% at 3–5 years), while Elos had the lowest (57% at 5 years). Biaxial had the highest complication rates (68.7%), while Remotion had the lowest (11%). Wrist arthroplasty preserves some range of motion. Functional scores improved and were maintained over the mid- to long-term. Complication rates were higher than wrist fusion, with reports of radiological loosening and osteolysis. The evidence does not support the widespread use of arthroplasty over arthrodesis, and careful patient selection is essential. Level of Evidence: III
Extended interval dosing of natalizumab: a two-center, 7-year experience
Authors: Bomprezzi Roberto , Pawate Siddharama 
Published: June 2014

Background: The enthusiasm for natalizumab, a highly efficacious agent in the treatment of multiple sclerosis (MS), has been tempered by the risks of progressive multifocal leukoencephalopathy associated with its use, and strategies to minimize those risks are of great interest. Extended interval dosing (EID) has been proposed as a way to maintain the efficacy of natalizumab while reducing exposure to it. We reviewed a cohort of patients who received natalizumab at 6–8-week intervals instead of the typical infusions every 4 weeks with the goal to assess if patients on EID had an increase in clinical relapses. Methods: This is a retrospective review of all patients with MS treated with natalizumab at two MS centers where patients were offered the opportunity to switch to an EID every 6 or 8 weeks. Results: A total of 361 patients received natalizumab for 22 ± 13 months (minimum duration 6 months). Of these, 96 patients received EID natalizumab at some point for 20 ± 11 months (minimum duration 6 months). Over the study period, there was no significant difference between the relapse rate in the monthly dosing (13%) and the EID (13%) groups of patients. Conclusion: Natalizumab is effective in controlling MS as very few clinical relapses were observed in our dataset. We found that EID did not compromise the treatment effect as measured by relapse rate and no significant breakthrough disease activity was observed. EID is an optional regimen for maintenance natalizumab therapy, but prospective studies are warranted to determine its efficacy.
To what extent can evaluation frameworks help NGOs to address health inequalities caused by social exclusion?
Authors: Kara Helen , Arvidson Malin 
Published: June 2014

Aim: Tackling health inequalities is a top priority for public health services in England. Third sector organisations, or non-governmental organisations (NGOs), are seen as having a key role in providing these services, particularly to the socially excluded, often dubbed ‘hard to reach’, for whom services must be provided if health inequalities are to be reduced. The plethora of evaluation frameworks available to NGOs have a variety of value bases, ranging from those which unambiguously support commissioners and providers to address health inequalities and work with the ‘hard to reach’, through to those which could offer such support if suitably adapted, to those that would struggle to address these issues in practice. In this context, the aim of this article is to answer the question, ‘to what extent can evaluation frameworks help NGOs to address health inequalities caused by social exclusion?’ Method: The literature on health inequalities, evaluation frameworks, and the policy context within which NGOs deliver public health services, is briefly reviewed. We then draw on the concepts of ‘comparative advantage’ and the ‘space of access’ to explore the extent to which evaluation frameworks can help NGOs to address health inequalities caused by social exclusion. Results: We identify contradictions between recent government policies around public service delivery in England which can make it difficult for service providers and commissioners to know which value(s) to focus on. This confusion is likely to at least perpetuate, perhaps even exacerbate, the marginalisation of socially excluded people, particularly in the current climate of austerity. The evaluation frameworks NGOs choose to use, and how they decide to use them, can have a real impact on health inequalities. We argue that, wherever possible, NGOs should place social value at the centre of the evaluation process, or at least make sure they capture as much as they can of the social value they create, in line with their own value base. Conclusion: Commissioners and providers do not always have a free choice about which evaluation framework to use, for example, due to resource constraints. Nevertheless, commissioners or providers can still influence evaluators to address health inequalities and involve the ‘hard to reach’.
Lateral Ankle Sprain and Chronic Ankle Instability
Authors: Kobayashi Takumi , Gamada Kazuyoshi 
Published: June 2014

Many studies investigated the contributing factors of chronic ankle instability, but a consensus has not yet been obtained. The objective of this critical review is to provide recent scientific evidence on chronic ankle instability, including the epidemiology and pathology of lateral ankle sprain as well as the causative factors of chronic ankle instability. We searched MEDLINE from 1964 to December 2013 using the terms ankle, sprain, ligament, injury, chronic, functional, mechanical, and instability. Lateral ankle sprain shows a very high recurrence rate and causes considerable economic loss due to medical care, prevention, and secondary disability. During the acute phase, patients with ankle sprain demonstrate symptoms such as pain, range of motion deficit, postural control deficit, and muscle weakness, and these symptoms may persist, leading to chronic ankle instability. Although some agreement regarding the effects of chronic ankle instability with deficits in postural control and/or concentric eversion strength exists, the cause of chronic ankle instability remains controversial. Levels of Evidence: Therapeutic Level IV: Review of Level IV studies
A phase 2 single-center study of carfilzomib 56 mg/m2 with or without low-dose dexamethasone in relapsed multiple myeloma
Authors: Lendvai Nikoletta , Hilden Patrick , Devlin Sean , Landau Heather , Hassoun Hani , Lesokhin Alexander M. , Tsakos Ioanna , Redling Kaitlyn , Koehne Guenther , Chung David J. , Schaffer Wendy L. , Giralt Sergio A. 
Published: June 2014

Key Points
Carfilzomib 56 mg/m2 provided a high overall response rate with a remarkable duration of response in patients with R/RMM. Nonhematologic grade 3/4 AEs likely related to carfilzomib treatment included hypertension and heart failure.
Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials
Authors: van Es Nick , Coppens Michiel , Schulman Sam , Middeldorp Saskia , Büller Harry R. 
Published: June 2014

Key Points
DOACs have similar efficacy as VKAs in the treatment of acute symptomatic VTE, but significantly reduce the risk of major bleeding. The efficacy and safety of DOACs in the treatment of acute VTE are consistent in clinically important subgroups.
A case study of outsourced primary healthcare services in Sindh, Pakistan: is this a real reform?
Authors: Tanzil Sana , Zahidie Aysha , Ahsan Adeel , Kazi Ambreen , Shaikh Babar Tasneem 
Published: June 2014

AbstractBackgroundSince a decade, low and middle income countries have a rising trend of contracting their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services to a semi-autonomous government entity i.e. Peoples’ Primary Healthcare Initiative (PPHI). This small scale study has assessed the quality of healthcare services at the contracted Basic Health Units (BHUs) with the PPHI and compared it with those managed by the local district government in the province of Sindh.MethodsA cross-sectional mix methods survey was conducted in November 2011. Two BHUs of each type were selected from the districts Karachi and Thatta in Sindh province. BHUs were selected randomly and a purposive sampling technique was used to recruit the study participants at the two study sites. Focus group discussions were conducted with patients visiting the facility while in-depth interviews were conducted with service providers. An observation based resource availability checklist was also administered.ResultsThere was a significant difference between the PPHI and the district government administered BHUs with regard to infrastructure, availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. These BHUs were found to have sufficient number of trained clinical staff and no punctuality and retention issues whatsoever. The district government administered BHUs presented a dismal picture in all the aspects.ConclusionOut-sourcing of primary healthcare facilities has resulted in significantly improved certain aspects quality and responsiveness of primary healthcare services. This strategy is likely to achieve an efficient and perhaps an equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services.
PLGA/nHA hybrid nanofiber scaffold as a nanocargo carrier of insulin for accelerating bone tissue regeneration
Authors: Haider Adnan , Gupta Kailash Chandra , Kang Inn-Kyu 
Published: June 2014

AbstractThe development of tissue engineering in the field of orthopedic surgery is booming. Two fields of research in particular have emerged: approaches for tailoring the surface properties of implantable materials with osteoinductive factors as well as evaluation of the response of osteogenic cells to these fabricated implanted materials (hybrid material). In the present study, we chemically grafted insulin onto the surface of hydroxyapatite nanorods (nHA). The insulin-grafted nHAs (nHA-I) were dispersed into poly(lactide-co-glycolide) (PLGA) polymer solution, which was electrospun to prepare PLGA/nHA-I composite nanofiber scaffolds. The morphology of the electrospun nanofiber scaffolds was assessed by field emission scanning electron microscopy (FESEM). After extensive characterization of the PLGA/nHA-I and PLGA/nHA composite nanofiber scaffolds by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction spectroscopy (XRD), X-ray photoelectron spectroscopy (XPS), energy-dispersive X-ray spectrometry (EDS), and transmission electron microscopy (TEM), the PLGA/nHA-I and PLGA/nHA (used as control) composite nanofiber scaffolds were subjected to cell studies. The results obtained from cell adhesion, alizarin red staining, and Von Kossa assay suggested that the PLGA/nHA-I composite nanofiber scaffold has enhanced osteoblastic cell growth, as more cells were proliferated and differentiated. The fact that insulin enhanced osteoblastic cell proliferation will open new possibilities for the development of artificial scaffolds for bone tissue regeneration.