bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rabbit model of antegrade selective cerebral perfusion with cardioplegic arrest
Authors: Zou L , Liu J , Zhang H , Wu S , Long C , Ji B , Yu Z , Tang Y , Meng L , Wu A 
Published: August 2015

Objective: Due to the weak ascending aorta, it is extremely challenging to establish an anterograde selective cerebral perfusion (ASCP) model in rabbits, especially when cardioplegic arrest is required. Herein, the aim of this study was to establish a rabbit ASCP model with cardiac arrest being easily performed and being similar to the clinical scenario. Materials and methods: Twenty-two adult New Zealand white rabbits were selected for ASCP model establishment and another 22 rabbits were utilized for blood donation. The cardiopulmonary bypass (CPB) circuit consisted of a roller pump, a membrane oxygenator, a heat-cooler system and a blood reservoir, which were connected by silicone tubing. The total priming volume of the circuit was 70 ml. Cannulations on the right and left subclavian arteries were used for arterial inflow and cardioplegia perfusion, respectively. Venous drainage was conducted through the right atrial appendage. ASCP was initiated by clamping the innominate artery; the flow rate was maintained 10 ml/kg/minute and sustained for 60 minutes. After 120 minutes of reperfusion, the rabbits were sacrificed. The mean arterial pressure, heart rate, electrocardiogram and urine output were monitored. Arterial blood samples were analyzed at the following time points: after anesthesia, immediately after CPB, after aorta cross-clamping and cardioplegia perfusion, 5 min after the re-opening of the aorta and at CPB termination. Results: ASCP modeling was performed successfully on 18 rabbits and 4 rabbits unsuccessfully. Vital signs and blood gas indictors changed in an acceptable range throughout the experiments. One rabbit had ventricular fibrillation after re-opening of the ascending aorta. Obvious hemodilution occurred after the perfusion of cardioplegia, but the hematocrit improved after CPB termination. Conclusion: By using cannulation of the subclavian artery rather than the aorta and with a low priming volume, we established a modified rabbit model of ASCP with cardioplegic arrest. The model has excellent repeatability and operability, which is similar to the clinic process and is suitable for the study of cerebral, cardiac and renal protection.
Five-Year Changes in Gait Biomechanics After Concomitant High Tibial Osteotomy and ACL Reconstruction in Patients With Medial Knee Osteoarthritis
Authors: Marriott Kendal , Birmingham Trevor B. , Kean Crystal O. , Hui Catherine , Jenkyn Thomas R. , Giffin J. Robert 
Published: August 2015

Background: Concomitant high tibial osteotomy (HTO) and anterior cruciate ligament (ACL) reconstruction is a combined surgical procedure intended to improve kinematics and kinetics in the unstable ACL-deficient knee with varus malalignment and medial compartment knee osteoarthritis (OA). Purpose: To investigate 5-year changes in gait biomechanics as well as radiographic and patient-reported outcomes bilaterally after unilateral, concomitant medial opening wedge HTO and ACL reconstruction. Study Design: Controlled laboratory study. Methods: A total of 33 patients (mean ± SD age, 40 ± 9 years) with varus malalignment (mean mechanical axis angle, −5.9° ± 2.9°), medial compartment knee OA, and ACL deficiency completed 3-dimensional gait analysis preoperatively and 2 and 5 years postoperatively. Primary outcomes were the peak external knee adduction (first peak) and flexion moments. Secondary outcomes were the peak external knee extension and transverse plane moments, peak knee angles in all 3 planes, radiographic static knee alignment measures (mechanical axis angle and posterior tibial slope), and the Knee injury and Osteoarthritis Outcome Score (KOOS). Results: There was a substantial decrease in the knee adduction moment in the surgical limb (%BW × H, −1.49; 95% CI, −1.75 to −1.22) and a slight increase in the nonsurgical limb (%BW × H, 0.16; 95% CI, 0.03 to 0.30) from preoperatively to 5 years postoperatively. There was also a decrease in the knee flexion moment for both the surgical (%BW × H, −0.67; 95% CI, −1.19 to −0.15) and nonsurgical limbs (%BW × H, –1.06; 95% CI, –1.49 to −0.64). Secondary outcomes suggested that substantial improvements were maintained at 5 years, although smaller declines were observed in several measures and in both limbs from 2 to 5 years. Conclusion: Changes in the peak external moments about the knee in all 3 planes during walking were observed 5 years after concomitant medial opening wedge HTO and ACL reconstruction. These findings are consistent with an intended, sustained shift in the mediolateral distribution of knee loads. Clinical Relevance: These findings suggest that concomitant HTO and ACL reconstruction results in substantial changes in gait biomechanics. Future clinical research comparing treatment strategies is both warranted and required for this relatively uncommon but seemingly biomechanically efficacious procedure.
Exertional Heat Illnesses and Environmental Conditions During High School Football Practices
Authors: Tripp Brady L. , Eberman Lindsey E. , Smith Michael Seth 
Published: August 2015

Background: Guidelines for preventing exertional heat illnesses (EHIs) during extreme heat stress should be specific to regional environments, age, and sport and should be based on evidence of reducing the risk. Each year in the United States, over 1 million high school football players practice in the August heat; however, no published data describe the incidence of EHIs in these athletes. Purpose: To describe the environmental conditions and incidence of EHIs during high school football practices over a 3-month period. Study Design: Descriptive epidemiology study. Methods: For a 3-month period (August-October), athletic trainers at 12 high schools in North Central Florida recorded the practice time and length, environmental conditions (wet-bulb globe temperature), and incidences of EHIs in varsity football athletes. Results: Athletes suffered 57 total EHIs during 29,759 athlete-exposures (AEs) for the 3-month data collection period (rate = 1.92/1000 AEs). August accounted for the majority of all EHIs, with 82.5% (47/57) and the highest rate (4.35/1000 AEs). Of total heat illnesses, heat cramps accounted for 70.2% (40/57), heat exhaustion 22.8% (13/57), and heat syncope 7.0% (4/57). The odds ratio indicated that athletes in August practices that lasted longer than the recommended 3 hours were 9.84 times more likely to suffer a heat illness than those in practices lasting ≤3 hours. Conclusion: The highest rate of EHIs was during August. Practices in August that exceeded the recommended 3 hours were associated with a greater risk of heat illnesses. The overall rate of EHIs was lower for the high school football athletes observed in the study compared with that reported for collegiate football athletes in the region. The low rates of EHIs recorded suggest that the prevention guidelines employed by sports medicine teams are appropriate for the region and population. Clinical Relevance: Team physicians and athletic trainers should employ evidence-based, region- and population-specific EHI prevention guidelines. Sports medicine teams, coaches, and athletes should be aware of the increased risk of EHIs during August practices and the risk of prolonged practices during August.
The Interrater and Intrarater Agreement of a Modified Neer Classification System and Associated Treatment Choice for Lateral Clavicle Fractures
Authors: Cho Chul-Hyun , Oh Joo Han , Jung Gu-Hee , Moon Gi-Hyuk , Rhyou In Hyeok , Yoon Jong Pil , Lee Ho Min 
Published: August 2015

Background: As there is substantial variation in the classification and diagnosis of lateral clavicle fractures, proper management can be challenging. Although the Neer classification system modified by Craig has been widely used, no study has assessed its validity through inter- and intrarater agreement. Purpose: To determine the inter- and intrarater agreement of the modified Neer classification system and associated treatment choice for lateral clavicle fractures and to assess whether 3-dimensional computed tomography (3D CT) improves the level of agreement. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Nine experienced shoulder specialists and 9 orthopaedic fellows evaluated 52 patients with lateral clavicle fractures, completing fracture typing according to the modified Neer classification system and selecting a treatment choice for each case. Web-based assessment was performed using plain radiographs only, followed by the addition of 3D CT images 2 weeks later. This procedure was repeated 4 weeks later. Fleiss κ values were calculated to estimate the inter- and intrarater agreement. Results: Based on plain radiographs only, the inter- and intrarater agreement of the modified Neer classification system was regarded as fair (κ = 0.344) and moderate (κ = 0.496), respectively; the inter- and intrarater agreement of treatment choice was both regarded as moderate (κ = 0.465 and 0.555, respectively). Based on the plain radiographs and 3D CT images, the inter- and intrarater agreement of the classification system was regarded as fair (κ = 0.317) and moderate (κ = 0.508), respectively; the inter- and intrarater agreement of treatment choice was regarded as moderate (κ = 0.463) and substantial (κ = 0.623), respectively. There were no significant differences in the level of agreement between the plain radiographs only and plain radiographs plus 3D CT images for any κ values (all P > .05). Conclusion: The level of interrater agreement of the modified Neer classification system for lateral clavicle fractures was fair. Additional 3D CT did not improve the overall level of interrater or intrarater agreement of the modified Neer classification system or associated treatment choice. To eliminate a common source of disagreement among surgeons, a new classification system to focus on unclassifiable fracture types is needed.
Length Changes of the Anterolateral Ligament During Passive Knee Motion
Authors: Zens Martin , Niemeyer Philipp , Ruhhammer Johannes , Bernstein Anke , Woias Peter , Mayr Herrmann O. , Südkamp Norbert P. , Feucht Matthias J. 
Published: August 2015

Background: Persistent rotatory instability after anterior cruciate ligament (ACL) reconstruction may be a result of unaddressed insufficiency of the anterolateral structures. Recent publications about the anatomy of the anterolateral ligament (ALL) have led to a renewed interest in lateral extra-articular procedures, and several authors have proposed ALL reconstruction to supplement intra-articular ACL reconstruction. However, only limited knowledge about the biomechanical characteristics of the ALL exists. Purpose/Hypothesis: The purpose of this study was to analyze length changes of the ALL during passive knee motion. The study hypothesis was that the ALL lengthens with knee flexion and internal tibial rotation. Study Design: Controlled laboratory study. Methods: The ALL of 6 cadaveric knees was dissected. Specimens were mounted in a specifically designed test rig that allowed unconstrained passive flexion/extension movement between 0° and 90° as well as external/internal tibial rotation of 25° at various flexion angles. Highly elastic, capacitive polydimethylsiloxane strain gauges were attached to the insertion sites of the ALL. Length changes were recorded continuously at flexion angles between 0° and 90° and during internal/external tibial rotation at 0°, 15°, 30°, 45°, 60°, 75°, and 90°. All measurements were calculated as the relative length change (%) of the ALL compared with 0° of flexion and neutral rotation. Results: The mean relative length of the ALL significantly increased with increasing knee flexion ( P < .001), with an estimated mean length change of +0.15% per degree. Both internal and external tibial rotation were independent determinants for length change; internal rotation significantly increased the length of the ALL ( P < .001), whereas external rotation significantly decreased its length ( P < .001). The mean length change with internal rotation increased with knee flexion, with a significantly greater length change at 90° compared with 0° ( P = .048), 15° ( P = .033), and 30° ( P = .015). The maximum mean length change was +33.77% ± 9.62%, which was observed at 25° of internal rotation and 90° of flexion. Conclusion: The ALL is a nonisometric structure that tensions with knee flexion and internal tibial rotation. Length changes with internal rotation were greater at higher flexion angles, with the greatest length change of the ALL observed at 90° of flexion. Clinical Relevance: The ALL can be considered a stabilizer against internal tibial rotation, especially at deep flexion angles. With regard to ALL reconstruction procedures, tensioning and fixation of the graft should be performed near 90° of flexion because graft tensioning near extension may cause excessive ligament strain with increasing knee flexion.
Mobilizing Community Resources to Enhance Postdischarge Support for Breastfeeding in Massachusetts (USA)
Authors: Colchamiro Rachel , Edwards Roger A. , Nordstrom Christina , Eshelman Jill , Ghiringhelli Kara , Forgit Julie , Tolan Ellen , Mainello Kristen , Foley Judi 
Published: August 2015

Background: The Massachusetts Department of Public Health’s (MDPH) Mass in Motion Program (MiM) facilitates the adoption of community-level strategies that promote healthy weight in 52 municipalities. MiM provided the platform for enhancing postdischarge continuity of care for breastfeeding. Objective: This study aimed to improve the continuity of breastfeeding care and support for mothers by enhancing postdischarge care infrastructure and supportive contacts for women and families. Methods: The MDPH awarded catalyst grants to community-based organizations (CBOs) that facilitated the formation of teams for improving breastfeeding support. The effort focused on populations that often experience disparities in breastfeeding outcomes such as minority women and women receiving Medicaid. The Added Value Model of Community Coalitions was used to qualitatively assess effect across multiple levels of the socioecological model of influence. Results: Six communities were awarded grants to enhance or convene Breastfeeding Continuity-of-Care Teams consisting of at least 3 CBOs, including 1 maternity hospital, the local Special Supplemental Nutrition Program for Women, Infants, and Children, and the local MiM representative. Teams implemented customized plans with performance indicators to create and strengthen infrastructure for supportive contacts with breastfeeding mothers. The project included Baby Café pilots in 3 additional MiM communities. Across all grantee communities, there was an average total increase of 491 contacts with mothers per month, an improvement of 8.5% over baseline. The project created 153 added value outcomes of community collaboration at 5 levels in the socioecological framework. Conclusion: The project demonstrated how cross-sector, coordinated efforts focused on vulnerable populations can leverage local strengths to establish/enhance breastfeeding support services customized to local needs.
Breastfeeding Resources in Maternity Hospitals and Birth Centers in the Commonwealth of Massachusetts (USA)
Authors: Eshelman Jill , Edwards Roger A. , Ghiringhelli Kara , Mainello Kristen , Colchamiro Rachel , Forgit Julie , Tolan Ellen , Nordstrom Christina 
Published: August 2015

Background: Few studies have analyzed patient education materials provided at discharge. To the best of our knowledge, there are no comprehensive studies analyzing and reporting the content of breastfeeding discharge packets within the United States. Objective: This study analyzed the extent to which patient education materials provided at discharge from maternity facilities in Massachusetts cover topics that support successful breastfeeding. Methods: We collected discharge packets from all 48 maternity hospitals/birth centers. Topics for analysis were based on recommendations associated with the Baby-Friendly Hospital Initiative and content identified for discharge packets generally. Materials were reviewed independently and scored according to 39 criteria that we assembled from various sources for optimal breastfeeding information at discharge. Bivariate and multivariate analyses were used to explore if any hospital characteristics predicted presence of breastfeeding education topics in written information provided at discharge. Results: An average of 25.4 of 39 criteria (65.2%, ranging from 30.7%-97.4%) were included in packets submitted by all 48 facilities. Exploratory multivariate analyses did not show relationships of hospital characteristics to contents of packets. Each facility received a 2-page report noting strengths, suggestions for improvement, and individual scores on all 39 criteria. Conclusion: Discharge packet contents varied widely; whereas some institutions’ information met and/or exceeded recommended content, others were limited and/or missing information. These analyses provide a thorough review of discharge packet content for all facilities in Massachusetts; however, further study is needed to identify the implications of such variation for breastfeeding outcomes.
Abrogated cardioprotective effect of ischemic preconditioning in ovariectomized rat heart
Authors: Goyal A , Semwal BC , Yadav HN 
Published: August 2015

Background: Ischemic heart disease is the leading cause of death in postmenopausal women. The expression of caveolin, a membrane protein and a negative regulator of nitric oxide (NO), increases after menopause. The present study was designed to determine the effect of daidzein (DDZ), a phytoestrogen in attenuated cardioprotective effect of ischemic preconditioning (IPC) in ovariectomized rat heart. Methods: Heart was isolated from ovariectomized rat and mounted on Langendorff’s apparatus, subjected to 30 min ischemia and 120 min reperfusion. IPC was mediated by four cycles of 5 min ischemia and 5 min reperfusion. The infarct size was estimated using triphenyltetrazolium chloride stain, and coronary effluent was analyzed for lactate dehydrogenase and creatine kinase MB (CK-MB) release to assess the degree of myocardial injury. The release of NO was estimated indirectly by measuring the release of nitrite in coronary effluent. Results: IPC-induced cardioprotection was significantly attenuated in ovariectomized rats as compared to normal rats, which was restored by treatment of DDZ, a caveolin inhibitor (0.2 mg/kg subcutaneously) for 1 week. However, this observed cardioprotection was significantly attenuated by perfusion of l-nitroarginine methyl ester, an endothelial nitric oxide synthase (eNOS) inhibitor (100 µM/L) and glibenclamide, an adenosine triphosphate-sensitive potassium ion channel blocker (10 µM/L) alone or in combination, noted in terms of increase in myocardial infarct size, release of LDH and CK-MB, and also decrease in the release of NO. Conclusion: Thus, it is suggested that DDZ restores the attenuated cardioprotective effect in ovariectomized rat heart, which may be due to downregulation of caveolin and subsequent increase in the activity of eNOS.
Facility Mammography Volume in Relation to Breast Cancer Screening Outcomes
Authors: Onega Tracy , Goldman L. Elizabeth , Walker Rod L. , Miglioretti Diana L. , Buist Diana SM , Taplin Stephen , Geller Berta M. , Hill Deirdre A. , Smith-Bindman Rebecca 
Published: August 2015

Objectives To clarify the relationship between facility-level mammography interpretive volume and breast cancer screening outcomes. Methods We calculated annual mammography interpretive volumes from 2000–2009 for 116 facilities participating in the U.S. Breast Cancer Surveillance Consortium (BCSC). Radiology, pathology, cancer registry, and women’s self-report information were used to determine the indication for each exam, cancer characteristics, and patient characteristics. We examined the effect of annual total volume and percentage of mammograms that were screening on cancer detection rates using multinomial logistic regression adjusting for age, race/ethnicity, time since last mammogram, and BCSC registries. “Good prognosis” tumours were defined as screen-detected invasive cancers that were <15 mm, early stage, and lymph node negative at diagnosis. Results From 3,098,481 screening mammograms, 9,899 cancers were screen-detected within one year of the exam. Approximately 80% of facilities had annual total interpretive volumes of >2,000 mammograms, and 42% had >5,000. Higher total volume facilities were significantly more likely to diagnose invasive tumours with good prognoses (odds ratio [OR] 1.32; 95% confidence interval [CI] 1.10–1.60, for total volume of 5,000–10,000/year v. 1,000–2,000/year; p-for-trend <0.001). A concomitant decrease in tumours with poor prognosis was seen (OR 0.78; 95%CI 0.63–0.98 for total volume of 5,000–10,000/year v. 1,000–2,000/year). Conclusions Mammography facilities with higher total interpretive volumes detected more good prognosis invasive tumours and fewer poor prognosis invasive tumours, suggesting that women attending these facilities may be more likely to benefit from screening.
Injectable anaesthesia for adult cat and kitten castration: effects of medetomidine, dexmedetomidine and atipamezole on recovery
Authors: Bruniges Natalie , Taylor Polly M , Yates David 
Published: August 2015

Objectives Rapid recovery from injectable anaesthesia benefits cat shelter neutering programmes. The effects of medetomidine, dexmedetomidine and atipamezole on recovery were evaluated in adult cats and kittens (⩽6 months old). Methods One hundred healthy male cats (age range 2–66 months, weight range 0.7–5.3 kg) admitted forneutering were randomly allocated to groups of 25. Anaesthesia was induced with 60 mg/m2 ketamine, 180 µg/m2 buprenorphine, 3 mg/m2 midazolam and either 600 µg/m2 medetomidine (groups M and MA) or 300 µg/m2 dexmedetomidine (groups D and DA) intramuscularly (IM). Groups MA and DA also received 1.5 mg/m2 atipamezole IM after 40 mins. Preparation time, surgical time, and times to sternal recumbency and standing were recorded. Data were analysed using the Kruskall–Wallis test, unpaired t-tests and ANOVA. Statistical significance was deemed to be P ⩽0.05. Results Groups did not differ significantly in age, body weight, preparation or surgical time. The time to sternal recumbency in group MA (64 ± 34 mins) was less than in group M (129 ± 32 mins), and in group DA it was less than in group D (54 ± 6 mins vs 110 ± 27 mins) ( P <0.001). There were no differences in duration of recovery to sternal recumbency between groups M and D or MA and DA. The time to standing in group MA (79 ± 51 mins) was less than in group M (150 ± 38 mins) ( P <0.001), and in group DA it was less than in group D (70 ± 22 mins vs 126 ± 27 mins) ( P <0.01). Time to standing in group D (126 ± 27 mins) was less than in group M (150 ± 38 mins) (P <0.05). Time to standing in groups DA and MA were not different. Kittens recovered faster than adults after atipamezole. Minimal adverse effects were seen. Conclusions and relevance Atipamezole reliably reduced recovery time after anaesthesia incorporating either dexmedetomidine or medetomidine; however, the choice of dexmedetomidine or medetomidine had little effect. Recovery was faster in kittens.