bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive Risk of Ulnar Collateral Ligament Injury Based on Ligament Morphology and Dynamic Abnormalities in Professional Baseball Pitchers Using Stress Ultrasonography
Authors: Mayer Braden K. , Shanley Ellen , Bailey Lane Brooks , Thigpen Charles A. , Wyland Douglas J. , Hawkins Richard J. , Kissenberth Michael J. , Noonan Thomas J. 
Published: August 2015

Objectives: Ulnar collateral ligament (UCL) injury of the elbow is a common and debilitating problem seen frequently in elite baseball pitchers. Ultrasound has been shown to be a useful diagnostic tool in evaluating UCL injuries. We hypothesized that the evaluation using stress ultrasound (US) of the elbow to measure both the morphology of the UCL and the ulnohumeral joint space gapping as a surrogate for UCL incompetence will be helpful to predict UCL injury in professional baseball pitchers. Methods: Ultrasound imaging was used to assess the medial joint laxity of both arms of 70 asymptomatic professional baseball pitchers during spring training. Medial joint laxity and UCL morphology was assessed using OsiriX Imaging Software under 2 conditions: (1) gravity valgus load and (2) 10 lbs of valgus load using a handheld dynamometer with the shoulder in the maximal cocking position and the elbow in 90° of flexion. Two trials of resting position, elbow gapping, and UCL thickness were collected, measured and averaged for data analysis. Intra and inter rater reliability was established and maintained with ICC's in the acceptable range for all measures (.84-.99). One-way ANOVA (α=0.05) was used to compare pitchers’ dominant variables between those with a prospective UCL injury to those who never had a UCL injury. Receiver Operating Curve (ROC) was used to identify pitchers who, based on elbow gapping measures (by cut score), were at high-risk versus those at low risk for UCL injury. (AUC > .70; α=0.05). Results: Players with a prospective UCL injury (n=7) presented with a trend toward wider (mm) D arm resting joint opening (4.9± 1.2 vs. 4.0±1.1; p=0.07), significantly wider gapped opening (6.5± 1.2 vs. 5.3 ± 1.2; p=0.01) and greater peak stiffness (nm) (.17±.09 vs. 10 ±.07; p=0.03) when compared to pitchers without UCL injury history (n=63). Figure 1 displays larger values of dynamic elbow gapping differentiated between UCL injured (>5.5 mm) and uninjured pitchers (AUC=0.77; p=0.02). Conclusion: Our data suggests that changes present in the UCL and detectable on ultrasound may help distinguish elbows at risk for later clinical UCL insufficiency. Screening using ultrasound of UCL thickness, loaded joint gapping, and stiffness may help predict the likelihood of elbow injury in professional baseball pitchers.
Patient Activity Levels After Reverse Total Shoulder Arthroplasty
Authors: Garcia Grant , Taylor Samuel A. , Mahony Gregory Thomas , Grawe Brian , Dines Joshua S. , Warren Russell F. , Craig Edward V. , Gulotta Lawrence Vincent 
Published: August 2015

Objectives: Indications for reverse total shoulder arthroplasty (RTSA) are expanding, resulting in younger patients who wish to remain active following the procedure. Little information, however, is available to help manage expectations of both physicians and patients for return to sporting activities. The purpose of this study was to determine the rate of return of sports activities, assess average time to return to sports for patients having undergone RTSA. Methods: A prospectively collected registry was queried for consecutive patients who underwent RTSA at our institution between 2007 and 2013. Patients with a minimum of 1-year follow-up were included. Patients without preoperative sporting activity were excluded. All patients were asked to complete a questionnaire regarding their physical fitness, sporting activities. The questionnaire was designed in accordance with previously published activity assessments for total joint arthroplasty. Each patient also completed an ASES and VAS assessment. Results: 76 patients played a sport preoperatively and met inclusion/exclusion criteria. The average follow-up was 31.6 months (12-65 mons) and average age was 74.84 years (49.9 - 92.6 yrs). Preoperative diagnoses were cuff tear arthropathy (55.2%), osteoarthritis (30.9%), proximal humerus fracture (17.1%), and rheumatoid arthritis (5.2%). 73% of the cohort had undergone prior ipsilateral shoulder surgery. Average VAS pain scores improved from 6.57 to 0.63 (p<0.001). Average ASES scores improved from 34.30 to 81.45 (p<0.001). 85.5% of patients who participated in sports preoperatively returned to at least one sport following RTSA. Average time to full return to sport was 5.3 months. Walking had the highest direct rate of return (85.7%), followed by fitness sports (81.5%), swimming (66.7%), running (57.1%), cycling (50.0%) and golf (50%). Age less than 70 years had significant improvement in rate of return to sports (p<0.002). 41.1% reported improved physical fitness following RTSA. 88.2% felt their sports outcome was good to excellent and 93.4% felt their surgical outcome was good to excellent. The two most commonly reported reasons for not returning to a sport were pain (13.1%) and lack of interest (9.2%). For all types of sports and rates of return see fig 1. Conclusion: Patients undergoing RTSA had an 85% rate of return to one or more sporting activities at an average of 5.3 months following surgery. Non-contact high demand activities (swimming, skiing, golf, and tennis) had lower return rates than lower demand activities. Age greater than 70 years old was a significant predictor of decreased return to activities. This is the only study to document both preoperative and postoperative sports and activities of daily living following RTSA. The present study offers valuable information to help manage patient and surgeon expectations.
Does Prior Shoulder Surgery Negatively Impact Shoulder Arthroplasty Outcomes?
Authors: Frank Rachel M. , Aiyash Sal , Kupfer Noam , Tilton Annemarie K. , Cole Brian J. , Verma Nikhil N. , Nicholson Gregory P. , Romeo Anthony A. 
Published: August 2015

Objectives: Several studies have shown a negative correlation between prior knee arthroscopy and ultimate knee arthroplasty outcomes compared to patients without prior arthroscopy. The purpose of this study was to determine the effects of prior shoulder surgery on patients undergoing total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) compared to patients without prior shoulder surgery. Methods: A retrospective review of prospectively collected data was performed on 107 patients undergoing TSA or rTSA. All medical records were analyzed for demographic variables, type of prior shoulder surgery, and type of arthroplasty. All patients underwent a clinical follow-up evaluation, and were evaluated with the American Shoulder and Elbow Society (ASES), Simple Shoulder Test (SST), and Visual Analog Scale (VAS) outcomes scores. Complications, failures, and reoperations were also recorded an analyzed. Results: A total of 107 patients (47 males, 60 females) were included with an average follow-up of 24 months (minimum 12 months). Seventy-one patients (underwent arthroplasty without prior surgery (30 rTSA, 41 TSA) while 50 patients underwent arthroplasty with a history of at least one prior shoulder surgery (27 rTSA, 9 TSA). Prior surgeries included a mix of both open and arthroscopic procedures, including open and arthroscopic rotator cuff repair, open and arthroscopic stabilization (with and without bone augmentation), arthroscopic capsular release, and arthroscopic debridement. Following arthroplasty, both groups experienced significant improvements in ASES, SST, and VAS scores compared to preoperative scores (P<0.05 for all). There was a statistically significant difference in postoperative ASES scores in the no-surgery group compared to the prior-surgery group (84.49 versus 71.67, P=0.0003) as well as in the SST scores (8.97 versus 5.47, P<0.0001); there were no differences in the VAS score (0.83 vs 1.40, P=0.104). Conclusion: Shoulder arthroplasty after undergoing prior shoulder surgery results in overall clinically improved outcomes, however these results are inferior compared to patients without a history of prior shoulder surgery. Further research examining this correlation is needed.
Association Between Remoteness to a Health Care Facility and Incidence of Ambulance Calls in Rural Areas of Japan
Authors: Kashima Saori , Inoue Kazuo , Matsumoto Masatoshi , Eboshida Akira , Takeuchi Keisuke 
Published: August 2015

Objectives: Whether traffic remoteness from health care service in rural areas influences usage of ambulance service has not been well investigated. This study aimed to evaluate the relation between remoteness to health care facilities and incidence of ambulance calls in rural areas of Japan. Methods: We analyzed 155 rural communities of Hiroshima. Data were obtained on all ambulance dispatches from 2010 to 2012. Driving time was calculated from each community to the closest primary/secondary and tertiary health care facility (equivalent to tertiary emergency care centers). We estimated the incidence rate and the incidence rate ratio (IRR) of ambulance calls for each 10-minute increase in the driving time, using generalized log-linear regression models, and evaluated the effect among each specific subgroup of emergency level and season. Results: During the study period, the median incidence rate was 436 per 10 000 people in targeted communities. When driving time to the closest primary/secondary facility increased by an increment of 10 minutes, there was a significant increase in the IRR of ambulance calls, especially during colder seasons (IRR: 1.29 [95% confidence interval: 1.11-1.49]), and this relation was also obtained for most emergency levels. In comparison, there was no such increase in IRRs observed for driving time to a tertiary facility. Conclusion: This study indicated a positive association between remoteness to primary/secondary medical facilities and the frequency of ambulance calls. The remoteness to a primary/secondary health care may induce an increase in ambulance calls, particularly during cold seasons.
Activity of ibrutinib in mantle cell lymphoma patients with central nervous system relapse
Authors: Bernard Sophie , Goldwirt Lauriane , Amorim Sandy , Brice Pauline , Brière Josette , de Kerviler Eric , Mourah Samia , Sauvageon Hélène , Thieblemont Catherine 
Published: August 2015

Key Points
Ibrutinib induces a rapid, dramatic, and sustained response in MCL patient with symptomatic CNS relapse. Ibrutinib penetration through the blood-brain barrier was confirmed using plasma and cerebrospinal fluid pharmacokinetic analyses.
Theoretical analysis of headache recurrence in patients administered triptans for migraine based on receptor occupancy
Authors: Tokuoka Kentaro , Takayanagi Risa , Toyabe Mioko , Watanabe Masayuki , Kitagawa Yasuhisa , Yamada Yasuhiko 
Published: August 2015

Abstract

Background
In this study, we retrospectively analyzed the relationship between headache recurrence and serotonin 5-HT1B/1D receptor occupancy (Φ1B and Φ1D). Triptans marketed in Japan (sumatriptan, zolmitriptan, eletriptan, rizatriptan, naratriptan) were investigated.

Methods
Receptor occupancies were calculated from both the pharmacokinetic and pharmacodynamic data of triptans. We examined the relationships between recurrence rate and elimination half-lives, and Ф1B and Ф1D, as calculated from the time-course of plasma drug concentration obtained from other studies. The time until Ф1B and Ф1D became 50 % or less, 40 % or less, and 30 % or less was calculated as duration time to examine the relationship with recurrence rate.

Results
For Ф1B, eletriptan remained at a low level. For Ф1D, it was indicated that all triptans obtained an occupancy of 80 % or higher at maximum. For all items, though recurrence tended to be lower along with longer half-life, no significant statistical correlation was found. For both Ф1B and Ф1D, the recurrence rate tended to be lower as the duration became longer. In addition, a significant correlation was observed for Ф1D (p < 0.05). For clarifying the Ф value and time period most closely correlated with recurrence rate, recurrence and Ф1B and Ф1D at 6, 12, and 18 h after administration were calculated. The most significant correlation was observed between recurrence rate and Ф1D at 12 h after administration (p < 0.01).

Conclusions
As an index for evaluating headache recurrence following triptan administration, recurrence rate and Ф1D value at 12 h after administration were found to be most closely correlated and useful for analysis. Our results indicate that headache recurrence inhibition can be evaluated using these values.
Machine learning as a tool for classifying electron tomographic reconstructions
Authors: Staniewicz Lech , Midgley Paul A. 
Published: August 2015

AbstractElectron tomographic reconstructions often contain artefacts from sources such as noise in the projections and a “missing wedge” of projection angles which can hamper quantitative analysis. We present a machine-learning approach using freely available software for analysing imperfect reconstructions to be used in place of the more traditional thresholding based on grey-level technique and show that a properly trained image classifier can achieve manual levels of accuracy even on heavily artefacted data, though if multiple reconstructions are being processed, a separate classifier will need to be trained on each reconstruction for maximum accuracy.
Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group
Authors: Palumbo Antonio , Avet-Loiseau Hervé , Oliva Stefania , Lokhorst Henk M. , Goldschmidt Hartmut , Rosinol Laura , Richardson Paul , Caltagirone Simona , Lahuerta Juan José , Facon Thierry , Bringhen Sara , Gay Francesca , Attal Michel , Passera Roberto , Spencer Andrew , Offidani Massimo , Kumar Shaji , Musto Pellegrino , Lonial Sagar , Petrucci Maria T. , Orlowski Robert Z. , Zamagni Elena , Morgan Gareth , Dimopoulos Meletios A. , Durie Brian G.M. , Anderson Kenneth C. , Sonneveld Pieter , San Miguel Jésus , Cavo Michele , Rajkumar S. Vincent , Moreau Philippe 
Published: August 2015

PurposeThe clinical outcome of multiple myeloma (MM) is heterogeneous. A simple and reliable tool is needed to stratify patients with MM. We combined the International Staging System (ISS) with chromosomal abnormalities (CA) detected by interphase fluorescent in situ hybridization after CD138 plasma cell purification and serum lactate dehydrogenase (LDH) to evaluate their prognostic value in newly diagnosed MM (NDMM).Patients and MethodsClinical and laboratory data from 4,445 patients with NDMM enrolled onto 11 international trials were pooled together. The K-adaptive partitioning algorithm was used to define the most appropriate subgroups with homogeneous survival.ResultsISS, CA, and LDH data were simultaneously available in 3,060 of 4,445 patients. We defined the following three groups: revised ISS (R-ISS) I (n = 871), including ISS stage I (serum β2-microglobulin level < 3.5 mg/L and serum albumin level ≥ 3.5 g/dL), no high-risk CA [del(17p) and/or t(4;14) and/or t(14;16)], and normal LDH level (less than the upper limit of normal range); R-ISS III (n = 295), including ISS stage III (serum β2-microglobulin level > 5.5 mg/L) and high-risk CA or high LDH level; and R-ISS II (n = 1,894), including all the other possible combinations. At a median follow-up of 46 months, the 5-year OS rate was 82% in the R-ISS I, 62% in the R-ISS II, and 40% in the R-ISS III groups; the 5-year PFS rates were 55%, 36%, and 24%, respectively.ConclusionThe R-ISS is a simple and powerful prognostic staging system, and we recommend its use in future clinical studies to stratify patients with NDMM effectively with respect to the relative risk to their survival.
Life-Long Implications of Developmental Exposure to Environmental Stressors: New Perspectives
Authors: Grandjean Philippe , Barouki Robert , Bellinger David C. , Casteleyn Ludwine , Chadwick Lisa H. , Cordier Sylvaine , Etzel Ruth A. , Gray Kimberly A. , Ha Eun-Hee , Junien Claudine , Karagas Margaret , Kawamoto Toshihiro , Lawrence B. Paige , Perera Frederica P. , Prins Gail S. , Puga Alvaro , Rosenfeld Cheryl S. , Sherr David H. , Sly Peter D. , Suk William , Sun Qi , Toppari Jorma , van den Hazel Peter , Walker Cheryl L. , Heindel Jerrold J. 
Published: August 2015

AbstractThe Developmental Origins of Health and Disease (DOHaD) paradigm is one of the most rapidly expanding areas of biomedical research. Environmental stressors that can impact on DOHaD encompass a variety of environmental and occupational hazards as well as deficiency and oversupply of nutrients and energy. They can disrupt early developmental processes and lead to increased susceptibility to disease/dysfunctions later in life. Presentations at the fourth Conference on Prenatal Programming and Toxicity in Boston, in October 2014, provided important insights and led to new recommendations for research and public health action. The conference highlighted vulnerable exposure windows that can occur as early as the preconception period and epigenetics as a major mechanism than can lead to disadvantageous “reprogramming” of the genome, thereby potentially resulting in transgenerational effects. Stem cells can also be targets of environmental stressors, thus paving another way for effects that may last a lifetime. Current testing paradigms do not allow proper characterization of risk factors and their interactions. Thus, relevant exposure levels and combinations for testing must be identified from human exposure situations and outcome assessments. Testing of potential underpinning mechanisms and biomarker development require laboratory animal models and in vitro approaches. Only few large-scale birth cohorts exist, and collaboration between birth cohorts on a global scale should be facilitated. DOHaD-based research has a crucial role in establishing factors leading to detrimental outcomes and developing early preventative/remediation strategies to combat these risks. (Endocrinology 156: 3408-3415, 2015)
Developmental Origins of Health and Disease: Integrating Environmental Influences
Authors: Heindel Jerrold J. , Balbus John , Birnbaum Linda , Brune-Drisse Marie Noel , Grandjean Philippe , Gray Kimberly , Landrigan Philip J. , Sly Peter D. , Suk William , Slechta Deborah Cory , Thompson Claudia , Hanson Mark 
Published: August 2015

AbstractThere are now robust data supporting the Developmental Origins of Health and Disease (DOHaD) paradigm. This includes human and animal data focusing on nutrition or environmental chemicals during development. However, the term DOHaD has not been generally accepted as the official term to be used when one is concerned with understanding the pathophysiological basis for how environmental influences acting during early development influence the risk of later noncommunicable diseases. Similarly, there is no global research or public health program built around the DOHaD paradigm that encompasses all aspects of environment. To better inform the global health efforts aimed at addressing the growing epidemic of chronic noncommunicable diseases of environmental origin, we propose a two-pronged approach: first, to make it clear that the current concept of DOHaD comprehensively includes a range of environmental factors and their relevance to disease occurrence not just throughout the life span but potentially across several generations; and second, to initiate the discussion of how adoption of DOHaD can promote a more realistic, accurate, and integrative approach to understanding environmental disruption of developmental programming and better inform clinical and policy interventions. (Endocrinology 156: 3416–3421, 2015)
Case Report: Pheochromocytoma-related catecholamine cardiomyopathy with successful outcomes after orthotopic heart transplantation
Authors: Ullal Jagdeesh , Old Wayne , Silverberg Marc L. , Nguyen-Buckley Christine , Miller Rebecca E. , Richardson Donald 
Published: August 2015

Pheochromocytomas (rare catecholamine-producing neuroendocrine tumors) have many different manifestations, and complications can occasionally include myocardial infarction and cardiomyopathy. In a majority of cases, cardiomyopathy reverses following medical or surgical treatment of the pheochromocytoma. We report a case of a 28-year-old male patient with preoperative diagnosis of pheochromocytoma and for whom a successful adrenalectomy revealed a benign pheochromocytoma. The patient had decompensation of heart failure and subsequent needed heart transplantation for irreversible cardiomyopathy; this gave a good outcome three years post-transplant. The heavy burden of atherosclerosis and fibrosis in a young patient with few cardiac risk factors and the irreversible cardiac damage are unique features of this case. This is also the first report (to our knowledge) of a patient with a pheochromocytoma that was surgically resected but who subsequently needed cardiac transplantation. We conclude that catecholamine-induced cardiomyopathy may be irreversible if there is structural damage to myocytes despite adequate medical and surgical treatment of a pheochromocytoma.
Case Report: A case report highlighting bilateral EDB wasting as a clinical marker for lumbar canal stenosis
Authors: Kumar Bijoy Mohan , Munakomi Sunil 
Published: August 2015

Herein we discuss a case of a 55 year old male presenting with history suggestive of sciatica on the left leg. Straight leg raising (SLR) test was positive at 45 degrees on the left side. His ankle reflex was absent and the power of extensor hallusus longus (EHL) was 4/5 on the same side. MRI lumbosacral spine revealed left paramedian disc prolapsed on L4/L5 level with spinal canal diameter of 9mm.However since his bilateral extensor digitorm brevis (EDB) were wasted, we suspected associated lumbar canal stenosis and thereby opted for laminectomy and discectomy in this case. Intraoperatively dural wasting, hypertrophied facets and narrow canal were confirmed. Laminectomy, medial facectectomy and discectomy were carried out. The patient recovered uneventfully with resolution of his sciatica-like pain. Bilateral EDB wasting thereby provides a clinical clue to the underlying lumbar canal stenosis and can help in making correct therapeutic decisions.
The involvement of older people in their rehabilitation: Generating a substantive grounded theory
Authors: Rickard Norman AS , Clarke Charlotte L 
Published: August 2015

Aims: To identify the process of involvement in rehabilitation and produce a substantive theory of involvement based on data from a grounded theory study. Methods: Qualitative data were collected longitudinally from 4 older people and 15 health care staff during the older people's stay in a rehabilitation unit in the UK and after discharge. Data were collected as recorded interviews with the older person in rehabilitation, interviews with their practitioners and routine conversations between the participants and staff. Results: This study describes the components of involvement and how they interact within therapeutic relationships. The results suggest that involvement in rehabilitation operates through a set of involvement attributes, which are either psychologically based or action-based. The involvement attributes are: vision and incentive with goal planning, setting and achievement; a disposition towards rehabilitation; personal learning; and risk taking, all of which operate within therapeutic relationships. To be maximally involved, the involvement attributes have to be strong and balanced, with alignment between the psychologically based and action-based attributes. Conclusions: The findings of this research and substantive grounded theory suggest that the process of involvement is managed through a set of involvement attributes within therapeutic relationships. This substantive theory of involvement is associated with earlier research and provides a fuller understanding of the process of involvement of older people in rehabilitation. Further research is now needed to demonstrate the transferability of this substantive theory in other settings and with other client groups.