bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Biomechanical and Clinical Comparison of Midshaft Clavicle Fixation Performed With Either Two Or Three Screws On Each Side Of The Plate
Authors: Larsen Christopher , Sleasman Brian , Chudik Steven 
Published: August 2015

Objectives: Plate fixation with six cortices of purchase (three screws) on each side of the fracture has been the standard of care when operatively treating displaced midshaft clavicle fractures. The use of locking plates and screws may afford equivalent biomechanical strength and clinical outcomes with only four cortices of purchase (two screws) on each side of the fracture. The purpose of this study is to compare the biomechanical and clinical performance of three-screw and two-screw constructs for displaced midshaft clavicle fractures. Methods: Biomechanical studies employing cantilever bending, deemed most physiologic of midshaft clavicle fracture models, have demonstrated that plate bending and fracture through the end screw hole are the common modes of failure. After simulating midshaft fractures in 10 pairs of embalmed cadaveric clavicles, the biomechanically inferior lateral fragments were randomly assigned to plate fixation with either three non-locking screws or two locking screws. Cyclic tensile loads (10 N to 75 N in a sinusoidal pattern at a rate of 1 Hz) were applied for 5 minutes along the long axis of the clavicle. Then, the constructs were loaded to failure at a rate of 0.5 mm/s with pullout forces applied parallel to the long axis of the screws. Additionally, we retrospectively identified 41 patients who had midshaft clavicle fractures surgically repaired with a minimum follow-up of 6 months: 21 patients were treated with three-screw constructs and 20 patients with two-screw constructs. Patient reported outcomes, radiographic time to union, and complication rates were compared. Results: Biomechanically, there were no significant differences in cyclic displacement (p=0.17), stiffness (p=0.94), yield load (p=0.65), or ultimate load (p=0.622) between the two groups. Clinically, there were no significant differences in American Shoulder and Elbow Surgeons score (ASES) (p=0.35), Constant score (p=0.34), Visual Analog Scale (VAS) pain score (p=0.34), Single Assessment Numeric Evaluation (SANE) score (p=0.99), or average time to union (p=0.74). Complication rates (painful hardware, non-union, hardware failure) trended toward being higher in the three-screw group (p=0.20). Conclusion: Plate fixation of displaced midshaft clavicle fractures with four cortices of purchase using two locking screws performs biomechanically and clinically equivalent to fixation with six cortices of purchase using three non-locking screws. Potential beneficial clinical implications include decreased surgical exposure, morbidity, time, and cost. Particularly, with regards to midshaft clavicle fractures, the reduction of the required number of points of cortical fixation from six to four allows the surgeon, in most instances, to use shorter and non contoured straight plates, eliminating the extra time and technical difficulty typically required to fit longer contoured plates to the variable and complex anatomy of the clavicle.
Dynamometer Elbow Strength and Endurance Testing After Distal Biceps Reconstruction w/Allograft
Authors: McGee Alan , Strauss Eric Jason , Jazrawi Laith M. 
Published: August 2015

Objectives: The purpose of the current study is to investigate the functional strength outcomes of late distal biceps reconstruction using allograft tissue. Methods: Patients who underwent distal biceps reconstruction with allograft tissue between May 2007 and May 2013 were identified. Charts were retrospectively reviewed for post-operative complications, gross flexion and supination strength, and range of motion (ROM). Isokinetic strength and endurance in elbow flexion and forearm supination were measured in both arms. Tests were conducted using a dynamometer at 60o per second for isokinetic strength and 240o per second for endurance. Isometric strength testing was also measured for elbow flexion and forearm supination. Paired t tests were used for statistical analysis. Results: Ten patients with a mean age of 48 years (range 42 - 61 years) were included in the study. Distal biceps reconstruction was performed using an Achilles tendon allograft in 9 patients and a combination of tibialis anterior allograft and gracilis allograft in 1 patient. Of the reconstructions, 50% involved the dominant arm. Full ROM was observed in all patients at the time of their final follow up assessment. The mean follow-up for dynamometer strength testing was 34 months (range 13-81 months). No statistical differences were noted between data obtained from operative and contralateral extremities. The average peak torque of the operative limb (38.5± 5.9 Nm) was 91.7% of that of the contralateral limb (41.8±4.9 Nm) in flexion and 93.4% (operative, 5.7±1.3 Nm; contralateral, 6.1± 1.0 Nm) in supination. No significant differences were found in fatigue index between operative or contralateral limbs for flexion (operative, 34.1±17.1%; contralateral, 30.8±17.1%; p = 0.29) or supination (operative, 38.2±16.5%; contralateral, 42.1±11.9%; p = 0.65). . The only complication observed was a transient PIN palsy in one patient which resolved by 3 months post-operatively. All patients reported postoperative cosmetic deformity but found their gross appearance acceptable. Conclusion: Late reconstruction for chronic distal biceps rupture using allograft tissue is a safe and effective solution for symptomatic patients with functional demands in forearm supination and elbow flexion. Dynamometer testing shows near normal return of strength and endurance of both elbow flexion and supination following the procedure.
Monitoring unfractionated heparin in children: a parallel-cohort randomized controlled trial comparing 2 dose protocols
Authors: Hanslik Andreas , Kitzmüller Erwin , Tran Ulrich S. , Thom Katharina , Karapetian Hratsch , Prutsch Nicole , Voitl Jasmin , Michel-Behnke Ina , Newall Fiona , Male Christoph 
Published: August 2015

Key Points
Anti-Xa, aPTT, and ACT discriminate well between different heparin dose protocols but the assays are poorly correlated with each other. The heparin effect was lower in younger children. This influence of age was dose-dependent and more pronounced at low- vs high-dose heparin.
Contralateral breast cancer can represent a metastatic spread of the first primary tumor: determination of clonal relationship between contralateral breast cancers using next-generation whole genome sequencing
Authors: Alkner Sara , Tang Man-Hung Eric , Brueffer Christian , Dahlgren Malin , Chen Yilun , Olsson Eleonor , Winter Christof , Baker Sara , Ehinger Anna , Rydén Lisa , Saal Lao H. , Fernö Mårten , Gruvberger-Saal Sofia K. 
Published: August 2015

Abstract
Introduction
By convention, a contralateral breast cancer (CBC) is treated as a new primary tumor, independent of the first cancer (BC1). Although there have been indications that the second tumor (BC2) sometimes may represent a metastatic spread of BC1, this has never been conclusively shown. We sought to apply next-generation sequencing to determine a “genetic barcode” for each tumor and reveal the clonal relationship of CBCs.

Methods
Ten CBC patients with detailed clinical information and available fresh frozen tumor tissue were studied. Using low-coverage whole genome DNA-sequencing data for each tumor, chromosomal rearrangements were enumerated and copy number profiles were generated. Comparisons between tumors provided an estimate of clonal relatedness for tumor pairs within individual patients.

Results
Between 15–256 rearrangements were detected in each tumor (median 87). For one patient, 76 % (68 out of 90) of the rearrangements were shared between BC1 and BC2, highly consistent with what has been seen for true primary-metastasis pairs (>50 %) and thus confirming a common clonal origin of the two tumors. For most of the remaining cases, BC1 and BC2 had similarly low overlap as unmatched randomized pairs of tumors from different individuals, suggesting the CBC to represent a new independent primary tumor.

Conclusion
Using rearrangement fingerprinting, we show for the first time with certainty that a contralateral BC2 can represent a metastatic spread of BC1. Given the poor prognosis of a generalized disease compared to a new primary tumor, these women need to be identified at diagnosis of CBC for appropriate determination of treatment. Our approach generates a promising new method to assess clonal relationship between tumors. Additional studies are required to confirm the frequency of CBCs representing metastatic events.
Systematic synthesis of barriers and facilitators to service user-led care planning
Authors: Bee Penny , Price Owen , Baker John , Lovell Karina 
Published: August 2015

BackgroundService user (patient) involvement in care planning is a principle enshrined by mental health policy yet often attracts criticism from patients and carers in practice.AimsTo examine how user-involved care planning is operationalised within mental health services and to establish where, how and why challenges to service user involvement occur.MethodSystematic evidence synthesis.ResultsSynthesis of data from 117 studies suggests that service user involvement fails because the patients' frame of reference diverges from that of providers. Service users and carers attributed highest value to the relational aspects of care planning. Health professionals inconsistently acknowledged the quality of the care planning process, tending instead to define service user involvement in terms of quantifiable service-led outcomes.ConclusionsService user-involved care planning is typically operationalised as a series of practice-based activities compliant with auditor standards. Meaningful involvement demands new patient-centred definitions of care planning quality. New organisational initiatives should validate time spent with service users and display more tangible and flexible commitments to meeting their needs.
Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: Systematic review
Authors: Bhui Kamaldeep S. , Aslam Rabeea'h W. , Palinski Andrea , McCabe Rose , Johnson Mark R. D. , Weich Scott , Singh Swaran P. , Knapp Martin , Ardino Vittoria , Szczepura Ala 
Published: August 2015

BackgroundCommunication may be an influential determinant of inequality of access to, engagement with and benefit from psychiatric services.AimsTo review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services.MethodSystematic review and evidence synthesis (PROSPERO registration: CRD42011001661). Data sources included the published and the ‘grey’ literature. A survey of experts and a consultation with patients and carers all contributed to the evidence synthesis, interpretation and recommendations.ResultsTwenty-one studies were included in our analysis. The trials showed benefits mainly for depressive symptoms, experiences of care, knowledge, stigma, adherence to prescribed medication, insight and alliance. The effect sizes were smaller for better-quality trials (range ofd0.18–0.75) than for moderate- or lower-quality studies (range ofd0.18–4.3). The review found only two studies offering weak economic evidence.ConclusionsCulturally adapted psychotherapies, and ethnographic and motivational assessment leading to psychotherapies were effective and favoured by patients and carers. Further trials are needed from outside of the UK and USA, as are economic evaluations and studies of routine psychiatric care practices.
Prediction of Allogeneic Hematopoietic Stem-Cell Transplantation Mortality 100 Days After Transplantation Using a Machine Learning Algorithm: A European Group for Blood and Marrow Transplantation Acute Leukemia Working Party Retrospective Data Mining Study
Authors: Shouval Roni , Labopin Myriam , Bondi Ori , Mishan-Shamay Hila , Shimoni Avichai , Ciceri Fabio , Esteve Jordi , Giebel Sebastian , Gorin Norbert C. , Schmid Christoph , Polge Emmanuelle , Aljurf Mahmoud , Kroger Nicolaus , Craddock Charles , Bacigalupo Andrea , Cornelissen Jan J. , Baron Frederic , Unger Ron , Nagler Arnon , Mohty Mohamad 
Published: August 2015

Purpose Allogeneic hematopoietic stem-cell transplantation (HSCT) is potentially curative for acute leukemia (AL), but carries considerable risk. Machine learning algorithms, which are part of the data mining (DM) approach, may serve for transplantation-related mortality risk prediction. Patients and Methods This work is a retrospective DM study on a cohort of 28,236 adult HSCT recipients from the AL registry of the European Group for Blood and Marrow Transplantation. The primary objective was prediction of overall mortality (OM) at 100 days after HSCT. Secondary objectives were estimation of nonrelapse mortality, leukemia-free survival, and overall survival at 2 years. Donor, recipient, and procedural characteristics were analyzed. The alternating decision tree machine learning algorithm was applied for model development on 70% of the data set and validated on the remaining data. Results OM prevalence at day 100 was 13.9% (n = 3,936). Of the 20 variables considered, 10 were selected by the model for OM prediction, and several interactions were discovered. By using a logistic transformation function, the crude score was transformed into individual probabilities for 100-day OM (range, 3% to 68%). The model's discrimination for the primary objective performed better than the European Group for Blood and Marrow Transplantation score (area under the receiver operating characteristics curve, 0.701 v 0.646; P < .001). Calibration was excellent. Scores assigned were also predictive of secondary objectives. Conclusion The alternating decision tree model provides a robust tool for risk evaluation of patients with AL before HSCT, and is available online ( http://bioinfo.lnx.biu.ac.il/∼bondi/web1.html ). It is presented as a continuous probabilistic score for the prediction of day 100 OM, extending prediction to 2 years. The DM method has proved useful for clinical prediction in HSCT.
Prognostic Significance of Diffuse Large B-Cell Lymphoma Cell of Origin Determined by Digital Gene Expression in Formalin-Fixed Paraffin-Embedded Tissue Biopsies
Authors: Scott David W. , Mottok Anja , Ennishi Daisuke , Wright George W. , Farinha Pedro , Ben-Neriah Susana , Kridel Robert , Barry Garrett S. , Hother Christoffer , Abrisqueta Pau , Boyle Merrill , Meissner Barbara , Telenius Adele , Savage Kerry J. , Sehn Laurie H. , Slack Graham W. , Steidl Christian , Staudt Louis M. , Connors Joseph M. , Rimsza Lisa M. , Gascoyne Randy D. 
Published: August 2015

Purpose To evaluate the prognostic impact of cell-of-origin (COO) subgroups, assigned using the recently described gene expression–based Lymph2Cx assay in comparison with International Prognostic Index (IPI) score and MYC/BCL2 coexpression status (dual expressers). Patients and Methods Reproducibility of COO assignment using the Lymph2Cx assay was tested employing repeated sampling within tumor biopsies and changes in reagent lots. The assay was then applied to pretreatment formalin-fixed paraffin-embedded tissue (FFPET) biopsies from 344 patients with de novo diffuse large B-cell lymphoma (DLBCL) uniformly treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) at the British Columbia Cancer Agency. MYC and BCL2 protein expression was assessed using immunohistochemistry on tissue microarrays. Results The Lymph2Cx assay provided concordant COO calls in 96% of 49 repeatedly sampled tumor biopsies and in 100% of 83 FFPET biopsies tested across reagent lots. Critically, no frank misclassification (activated B-cell–like DLBCL to germinal center B-cell–like DLBCL or vice versa) was observed. Patients with activated B-cell–like DLBCL had significantly inferior outcomes compared with patients with germinal center B-cell–like DLBCL (log-rank P < .001 for time to progression, progression-free survival, disease-specific survival, and overall survival). In pairwise multivariable analyses, COO was associated with outcomes independent of IPI score and MYC/BCL2 immunohistochemistry. The prognostic significance of COO was particularly evident in patients with intermediate IPI scores and the non–MYC-positive/BCL2-positive subgroup (log-rank P < .001 for time to progression). Conclusion Assignment of DLBCL COO by the Lymph2Cx assay using FFPET biopsies identifies patient groups with significantly different outcomes after R-CHOP, independent of IPI score and MYC/BCL2 dual expression.
Use and Effectiveness of Intraperitoneal Chemotherapy for Treatment of Ovarian Cancer
Authors: Wright Alexi A. , Cronin Angel , Milne Dana E. , Bookman Michael A. , Burger Robert A. , Cohn David E. , Cristea Mihaela C. , Griggs Jennifer J. , Keating Nancy L. , Levenback Charles F. , Mantia-Smaldone Gina , Matulonis Ursula A. , Meyer Larissa A. , Niland Joyce C. , Weeks Jane C. , O'Malley David M. 
Published: August 2015

Purpose A 2006 randomized trial demonstrated a 16-month survival benefit with intraperitoneal and intravenous (IP/IV) chemotherapy administered to patients who had ovarian cancer, compared with IV chemotherapy alone, but more treatment-related toxicities. The objective of this study was to examine the use and effectiveness of IP/IV chemotherapy in clinical practice. Patients and Methods Prospective cohort study of 823 women with stage III, optimally cytoreduced ovarian cancer diagnosed at six National Comprehensive Cancer Network institutions. We examined IP/IV chemotherapy use in all patients diagnosed between 2003 and 2012 (N = 823), and overall survival and treatment-related toxicities with Cox regression and logistic regression, respectively, in a propensity score–matched sample (n = 402) of patients diagnosed from 2006 to 2012, excluding trial participants, to minimize selection bias. Results Use of IP/IV chemotherapy increased from 0% to 33% between 2003 and 2006, increased to 50% from 2007 to 2008, and plateaued thereafter. Between 2006 and 2012, adoption of IP/IV chemotherapy varied by institution from 4% to 67% (P < .001) and 43% of patients received modified IP/IV regimens at treatment initiation. In the propensity score–matched sample, IP/IV chemotherapy was associated with significantly improved overall survival (3-year overall survival, 81% v 71%; hazard ratio, 0.68; 95% CI, 0.47 to 0.99), compared with IV chemotherapy, but also more frequent alterations in chemotherapy delivery route (adjusted rates discontinuation or change, 20.4% v 10.0%; adjusted odds ratio, 2.83; 95% CI, 1.47 to 5.47). Conclusion Although the use of IP/IV chemotherapy increased significantly at National Comprehensive Cancer Network centers between 2003 and 2012, fewer than 50% of eligible patients received it. Increasing IP/IV chemotherapy use in clinical practice may be an important and underused strategy to improve ovarian cancer outcomes.
Size Effect of Carbon-Supported Pd Nanoparticles in the Hydrogen Production from Formic Acid
Authors: Navlani-García Miriam , Mori Kohsuke , Wen Meicheng , Kuwahara Yasutaka , Yamashita Hiromi 
Published: August 2015

Abstract
Particle size dependence in the H2 production from formic acid was investigated over Pd/C catalysts with nanoparticle sizes ranging from 2.7 to 5.5 nm. A volcano type relationship between catalytic activity and nanoparticle size was obtained and the average size of 3.9 nm exhibited the highest activity under mild reaction conditions.
Diagnosis of cystic fibrosis following the NHS newborn blood spot screening programme
Authors: Watts Sally , Rizzo Roberta 
Published: August 2015

This case describes an unexpected genotypic diagnosis of cystic fibrosis (CF) following an initial finding on the Newborn Screening Programme that the baby was a carrier for the condition. A couple was referred for genetic counselling after routine newborn screening identified that their daughter carried the most common cystic fibrosis mutation in the Caucasian European population; p.Phe508del. The baby was therefore diagnosed as a CF carrier. A paediatric assessment and sweat test were normal. Following genetic testing, her father was found to carry the same mutation, but unexpectedly her mother was found to carry a rarer CF variant (p.Pro750Leu), which is not included in the newborn screening testing panel. This raised the possibility that the baby was at risk of having inherited both mutations. Subsequent testing found that the baby had a genotypic diagnosis of CF as she had two genetic changes that cause the condition; however, the baby did not have a phenotypic diagnosis as she was not manifesting any symptoms of the disease. This case report discusses the implications of the unexpected result for the family and raises the awareness of the possibility of unexpected outcomes from genetic testing for health professionals involved in antenatal and postnatal care.
Attitudes to immunisation in pregnancy among women in the UK targeted by such programmes
Authors: Campbell Helen , Van Hoek Albert Jan , Bedford Helen , Craig Laura , Yeowell Anna-Lisa , Green David , Yarwood Joanne , Ramsay Mary , Amirthalingam Gayatri 
Published: August 2015

Introduction: Vaccines in pregnancy can minimise diseases with associated high morbidity and mortality in pregnant women, their unborn and newly born infants. Immunisations against influenza and pertussis are routinely offered in pregnancy in a number of countries including the UK, US, Australia and Belgium, but vaccine uptake could be improved. Methods: In January 2013, an online survey of pregnant women and women with children under 2 years of age was undertaken. The survey focused on vaccination in pregnancy. Results and conclusions: Of 1892 respondents, the majority indicated they definitely, or probably, would accept a nationally-approved vaccine offered by their midwife or GP during pregnancy for their own protection (94%) and/or to protect their baby when it was born (96%). Vaccine safety for the baby and for the woman, vaccine effectiveness and perceived seriousness of the disease remain key considerations for women. Health professionals, midwives in particular, are pivotal in informing women, promoting the vaccine and discussing concerns.
Effects of sports climbing on muscle performance and balance for patients with multiple sclerosis: A case series
Authors: Jolk Christoph , Dalgas Ulrik , Osada Nani , Platen Petra , Marziniak Martin 
Published: August 2015

Background/Aims: The potential benefits of sports climbing for many diseases have not been investigated. The aim of this case series was to examine whether sports climbing is feasible and whether it can influence isometric muscle performance and balance in people with multiple sclerosis (MS). Methods: Over a 5-week period, six patients (mean Expanded Disability Status Scale score: 2.1 ± 0.8) with MS performed a total of five climbing sessions. Isometric muscle performance was evaluated for the knee extensors, while balance was evaluated based on balance board performance. The climbing exercises were individually tailored and patients were instructed by the trainer to try more difficult routes during each session to ensure progression. Results: All patients included in this study completed the 5-week programme, and exercise adherence was 100%. The isometric muscle strength of their knee extensors was found to have improved by 23.4% (p<0.05). The difference in muscle strength between the stronger and weaker leg was not affected after 5 weeks of climbing. Climbing did not have any significant impact on balance. Conclusions: Sports climbing appears feasible for people with mild relapsing remitting MS and results suggest improvements in knee extensor muscle performance.