bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medial patellofemoral ligament reconstruction for patellar instability in patients with hypermobility
Authors: Howells N. R. , Eldridge J. D. 
Published: November 2012

Hypermobility is an acknowledged risk factor for patellar instability. In this case control study the influence of hypermobility on clinical outcome following medial patellofemoral ligament (MPFL) reconstruction for patellar instability was studied.A total of 25 patients with hypermobility as determined by the Beighton criteria were assessed and compared with a control group of 50 patients who were matched for age, gender, indication for surgery and degree of trochlear dysplasia. The patients with hypermobility had a Beighton Score of ≥ 6; the control patients had a score of < 4. All patients underwent MPFL reconstruction performed using semitendinosus autograft and a standardised arthroscopically controlled technique. The mean age of the patients was 25 years (17 to 49) and the mean follow-up was 15 months (6 to 30).Patients with hypermobility had a significant improvement in function following surgery, with reasonable rates of satisfaction, perceived improvement, willingness to repeat and likelihood of recommendation. Functional improvements were significantly less than in control patients (p < 0.01).Joint hypermobility is not a contraindication to MPFL reconstruction although caution is recommended in managing the expectations of patients with hypermobility before consideration of surgery.
The Kenya Orthopaedic Project
Authors: Cousins G. R. , Obolensky L. , McAllen C. , Acharya V. , Beebeejaun A. 
Published: November 2012

We report the results of six trauma and orthopaedic projects to Kenya in the last three years. The aims are to deliver both a trauma service and teaching within two hospitals; one a district hospital near Mount Kenya in Nanyuki, the other the largest public hospital in Kenya in Mombasa. The Kenya Orthopaedic Project team consists of a wide range of multidisciplinary professionals that allows the experience to be shared across those specialties. A follow-up clinic is held three months after each mission to review the patients. To our knowledge there are no reported outcomes in the literature for similar projects. A total of 211 operations have been performed and 400 patients seen during the projects. Most cases were fractures of the lower limb; we have been able to follow up 163 patients (77%) who underwent surgical treatment. We reflect on the results so far and discuss potential improvements for future missions.
Neonatal hyperthyrotropinemia is associated with low birth weight: a twin study
Authors: Zung Amnon , Yehieli Arie , Almashanu Shlomo 
Published: November 2012

ObjectiveContradictory reports ascribe neonatal hyperthyrotropinemia (HT) to prematurity or small weight for gestational age. We aimed to evaluate the association between neonatal HT and birth weight (BW), recovery rate of the disorder, and possible association with perinatal stress.DesignBased on a neonatal screening database, a retrospective twin study was designed where within-pair differences in thyroid function were evaluated while controlling for differences in gestational age and thyroid-affecting environmental confounders.MethodsTwo thousand five hundred and ninety-five twin pairs that were screened both for TSH and thyroxine (T4) over 3 years were included. TSH and T4levels were evaluated along with BW, birth order, gender, and 17-hydroxyprogesterone (17OHP) that was considered as a surrogate marker for stress.ResultsOf all the twin pairs, 7.2% had neonatal HT. Among 156 pairs, HT was more prevalent in the smaller twins (64%;P<0.001), especially in the discordant pairs (76%;P=0.001). Seventy-five percent of the twins demonstrated a recovery within the first few weeks of life. 17OHP levels were similarly distributed between twins with and without HT. In a cohort of 1534 twin pairs with normal thyroid function, mean TSH levels were significantly higher in the smaller than in the larger twin in the whole group (4.1±3.2 vs 3.8±2.9 mIU/l;P<0.001) and especially among discordant twins (4.7±3.4 vs 3.8±3.0 mIU/l;P<0.001).ConclusionsElevated TSH levels are associated with low BW, both in infants with HT and in normal neonates. A rapid recovery rate is expected in most cases.
Olfactory receptor 51E1 protein as a potential novel tissue biomarker for small intestine neuroendocrine carcinomas
Authors: Cui Tao , Tsolakis Apostolos V , Li Su-Chen , Cunningham Janet L , Lind Thomas , Öberg Kjell , Giandomenico Valeria 
Published: November 2012

ObjectiveLate diagnosis hinders proper management of small intestine neuroendocrine carcinoma (SI-NEC) patients. The olfactory receptor, family 51, subfamily E, member 1 (OR51E1) has been reported as a potential novel SI-NEC marker, without protein expression recognition. Thus, we further studied whether the encoded protein may be a novel SI-NEC clinical biomarker.DesignOR51E1 coding sequence was cloned using total RNA from SI-NEC patient specimens. Quantitative real-time PCR analysis explored OR51E1 expression in laser capture microdissected SI-NEC cells and adjacent microenvironment cells. Moreover, immunohistochemistry investigated OR51E1 protein expression on operation and biopsy material from primary SI-NECs, mesentery, and liver metastases from 70 patients. Furthermore, double immunofluorescence studies explored the potential co-localization of the vesicular monoamine transporter 1 (SLC18A1, generally referred to as VMAT1) and OR51E1 in the neoplastic cells and in the intestinal mucosa adjacent to the tumor.ResultsOR51E1 coding sequence analysis showed absence of mutation in SI-NEC patients at different stages of disease. OR51E1 expression was higher in microdissected SI-NEC cells than in the adjacent microenvironment cells. Furthermore, both membranous and cytoplasmic OR51E1 immunostaining patterns were detected in both primary SI-NECs and metastases. Briefly, 18/43 primary tumors, 7/28 mesentery metastases, and 6/18 liver metastases were ‘positive’ for OR51E1 in more than 50% of the tumor cells. In addition, co-localization studies showed that OR51E1 was expressed in >50% of the VMAT1 immunoreactive tumor cells and of the enterochromaffin cells in the intestinal mucosa adjacent to the tumor.ConclusionOR51E1 protein is a potential novel clinical tissue biomarker for SI-NECs. Moreover, we suggest its potential therapeutic molecular target development using solid tumor radioimmunotherapy.
Genomic Background and Generation Time Influence Deleterious Mutation Rates in Daphnia
Authors: Latta Leigh C , Morgan Kendall K , Weaver Casse S , Allen Desiree , Schaack Sarah , Lynch Michael 
Published: November 2012

Abstract
Understanding how genetic variation is generated and how selection shapes mutation rates over evolutionary time requires knowledge of the factors influencing mutation and its effects on quantitative traits. We explore the impact of two factors, genomic background and generation time, on deleterious mutation in Daphnia pulicaria, a cyclically parthenogenic aquatic microcrustacean, using parallel mutation-accumulation experiments. The deleterious mutational properties of life-history characters for individuals from two different populations, and for individuals maintained at two different generation times, were quantified and compared. Mutational properties varied between populations, especially for clutch size, suggesting that genomic background influences mutational properties for some characters. Generation time was found to have a greater effect on mutational properties, with higher per-generation deleterious mutation rates in lines with longer generation times. These results suggest that differences in genetic architecture among populations and species may be explained in part by demographic features that significantly influence generation time and therefore the rate of mutation.
Pediatric and Adolescent Tuberculosis in the United States, 2008–2010
Authors: Winston Carla A. , Menzies Heather J. 
Published: November 2012

OBJECTIVE:
We examined heterogeneity among children and adolescents diagnosed with tuberculosis (TB) in the United States, and we investigated potential international TB exposure risk.

METHODS:
We analyzed demographic and clinical characteristics by origin of birth for persons &lt;18 years with verified case of incident TB disease reported to National TB Surveillance System from 2008 to 2010. We describe newly available data on parent or guardian countries of origin and history of having lived internationally for pediatric patients with TB (&lt;15 years of age).

RESULTS:
Of 2660 children and adolescents diagnosed with TB during 2008–2010, 822 (31%) were foreign-born; Mexico was the most frequently reported country of foreign birth. Over half (52%) of foreign-born patients diagnosed with TB were adolescents aged 13 to 17 years who had lived in the United States on average &gt;3 years before TB diagnosis. Foreign-born pediatric patients with foreign-born parents were older (mean, 7.8 years) than foreign-born patients with US-born parents (4.2 years) or US-born patients (3.6 years). Among US-born pediatric patients, 66% had at least 1 foreign-born parent, which is &gt;3 times the proportion in the general population. Only 25% of pediatric patients with TB diagnosed in the United States had no known international connection through family or residence history.

CONCLUSIONS:
Three-quarters of pediatric patients with TB in the United States have potential TB exposures through foreign-born parents or residence outside the United States. Missed opportunities to prevent TB disease may occur if clinicians fail to assess all potential TB exposures during routine clinic visits.
3D Heterogeneous Integration using MEMS Devices for RF Applications
Authors: Nakazawa Fumihiko , Mi Xiaoyu , Shimanouchi Takeaki , Nakatani Tadashi , Katsuki Takashi , Inoue Hiroaki , Toyoda Osamu , Ueda Satoshi 
Published: November 2012

ABSTRACTThis paper presents novel 3D heterogeneous integrations using MEMS Devices for RF applications. We propose a 3D heterogeneous integration method that combines the advantages of LTCC, passive integration, and MEMS technologies. The basic concept is to form a large-size LTCC wiring wafer and then to form high-Q passives or MEMS filters directly on the wafer surface. Other functional devices such as ICs, SAWs, and MEMS switches are mounted above the surface-formed devices. A miniaturized duplexer consisted of IPD, SAW, and film bulk acoustic resonator (FBAR); and a next generation duplexer module consisted of an MEMS tunable filter and a piezoelectric transducer (PZT)-actuated RF MEMS switch were constructed to demonstrate its feasibility and effectiveness.
Polysilicon Nanowires for chemical sensing applications
Authors: Jacques E. , Ni L. , Salaün A. C. , Rogel R. , Pichon L. 
Published: November 2012

ABSTRACTPolycrystalline silicon nanowires are synthesized using a classical fabrication method commonly used in microelectronic industry: the sidewall spacer formation technique. Assets of this technological process rest on low cost lithographic tools use, classical silicon planar technology compatibility and the possibility to get by direct patterning numerous parallel nanowires with precise location on the substrate. Grounded and suspended polycrystalline silicon nanowires with a curvature radius as low as 150nm are integrated into resistors and used as gas (ammonia) sensors. Results show potential use of these nanowires for charged chemical species detection with an increase of the sensitivity with the increase of SiNWs exchange surface with the environment.
A New One-Dimensional Flow Theory of the Jet Pump for Pumping Crude Oil with Different Viscosities and Densities Using Water Powered Flow
Authors: Abdou Hesham A.M. 
Published: November 2012

Abstract
Many researches had been carried out on the water jet pumps during the last few decades, and discussed the effect of changing the pump geometric parameters on its performance. Some other researches investigated pump performance with Two-phase (liquid-gas) and (liquid-solid) flow. In spite of the several researches, which investigated the case of liquid-liquid flow (almost as water-water), neither of them did have examined the case in which the secondary flow liquid differs from the power flow liquid in density and viscosity, which is the main objective of this paper. The subject is treated experimentally on a special test rig, with the primary fluid jet water and the secondary fluid of different types of oils. Performance of the jet pump and static wall pressure inside the mixing chamber, were measured as a function of the mixture Reynolds number. A one-dimensional analysis is also carried out, taking into account the difference of the viscosity and density of the two liquids (each primary and secondary fluids).
One-Dimensional Equations for the Jet Pump Performance
The one-dimensional flow assumptions are:-
1- Streams are one-dimensional at the entrance and exit of the mixing chamber.
2- Mixing is completed in the mixing chamber area.
3- Spacing between the nozzle exit and inlet of mixing chamber is zero, which is attainable due to the small nozzle diameter, relative to the large diameter of the mixing chamber. Momentum and continuity equations [3] were applied to different sections of the jet pump, namely the suction, inlet and outlet of the mixing chamber and the outlet of the diffuser. From this, the relationships between M, N & h and the performance of the jet pump were determined.
Considering an Integrated Nephrology Care Delivery Model
Authors: Hamm L. Lee , Hostetter Thomas H. , Shaffer Rachel N. 
Published: November 2012

Summary
In 2012, 27 organizations will initiate participation in the Medicare Shared Savings Program as Accountable Care Organizations. This level of participation reflects the response of Centers for Medicare and Medicaid Services to criticism that the program as outlined in the proposed rule was overly burdensome, prescriptive, and too risky. Centers for Medicare and Medicaid Service made significant changes in the final rule, making the Accountable Care Organization program more attractive to these participants. However, none of these changes addressed the serious concerns raised by subspecialty societies—including the American Society of Nephrology—regarding care of patients with multiple chronic comorbidities and complex and end stage conditions. Virtually all of these concerns remain unaddressed, and consequently, Accountable Care Organizations will require guidance and partnership from the nephrology community to ensure that these patients are identified and receive the individualized care that they require. Although the final rule fell short of addressing the needs of patients with kidney disease, the Centers for Medicare and Medicaid Innovation presents an opportunity to test the potentially beneficial concepts of the Accountable Care Organization program within this patient population. The American Society of Nephrology Accountable Care Organization Task Force developed a set of principles that must be reflected in a possible pilot program or demonstration project of an integrated nephrology care delivery model. These principles include preserving a leadership role for nephrologists, encompassing care for patients with later-stage CKD and kidney transplants as well as ESRD, enabling the participation of a diversity of dialysis provider sizes and types, facilitating research, and establishing monitoring systems to identify and address preferential patient selection or changes in outcomes.
A Woman with GN Presenting during Pregnancy
Authors: Hou Susan 
Published: November 2012

Summary
The combination of kidney disease and pregnancy has long been recognized as a high-risk situation. When renal disease is recognized for the first time during pregnancy, it presents unique problems for both the obstetric and the renal teams. Particularly difficult can be distinguishing preeclampsia from preexisting kidney disease in women presenting for the first time with hypertension, proteinuria, and reduced GFR during pregnancy. Decision-making regarding performing a kidney biopsy and treatment of glomerular disease during pregnancy is often much more complicated by safety concerns for both the mother and the developing fetus.
Albuminuria and Rapid Loss of GFR and Risk of New Hip and Pelvic Fractures
Authors: Barzilay Joshua I. , Gao Peggy , Clase Catherine M. , Mente Andrew , Mann Johannes F.E. , Sleight Peter , Yusuf Salim , Teo Koon K. 
Published: November 2012

Summary

Background and objectives
The microvascular circulation plays an important role in bone health. This study examines whether albuminuria, a marker of renal microvascular disease, is associated with incident hip and pelvic fractures.

Design, setting, participants, & measurements
This study reanalyzed data from the Ongoing Telmisartan Alone and in combination with Ramipril Global End Point Trial/Telmisartan Randomized Assessment Study in Angiotensin-Converting Enzyme Intolerant Subjects with Cardiovascular Disease trials, which examined the impact of renin angiotensin system blockade on cardiovascular outcomes (n=28,601). Albuminuria was defined as an albumin-to-creatinine ratio≥30 mg/g (n=4597). Cox proportional hazards models were used to determine the association of albuminuria with fracture risk adjusted for known risk factors for fractures, estimated GFR, and rapid decline in estimated GFR (≥5%/yr).

Results
There were 276 hip and pelvic fractures during a mean of 4.6 years of follow-up. Participants with baseline albuminuria had a significantly increased risk of fracture compared with participants without albuminuria (unadjusted hazard ratio=1.62 [1.22, 2.15], P<0.001; adjusted hazard ratio=1.36 [1.01, 1.84], P=0.05). A dose-dependent relationship was observed, with macroalbuminuria having a large fracture risk (unadjusted hazard ratio=2.01 [1.21, 3.35], P=0.007; adjusted hazard ratio=1.71 [1.007, 2.91], P=0.05) and microalbuminuria associating with borderline or no statistical significance (unadjusted hazard ratio=1.52 [1.10, 2.09], P=0.01; adjusted hazard ratio=1.28 [0.92, 1.78], P=0.15). Estimated GFR was not a predictor of fracture in any model, but rapid loss of estimated GFR over the first 2 years of follow-up predicted subsequent fracture (adjusted hazard ratio=1.47 [1.05, 2.04], P=0.02).

Conclusions
Albuminuria, especially macroalbuminuria, and rapid decline of estimated GFR predict hip and pelvic fractures. These findings support a theoretical model of a relationship between underlying causes of microalbuminuria and bone disease.
Pitfalls of calculating hospital readmission rates based on nonvalidated administrative data sets
Authors: Amin Beejal Y. , Tu Tsung-Hsi , Schairer William W. , Na Lumine , Takemoto Steven , Berven Sigurd , Deviren Vedat , Ames Christopher , Chou Dean , Mummaneni Praveen V. 
Published: November 2012

Object
Administrative databases are increasingly being used to establish benchmarks for quality of care and to compare performance across peer hospitals. As proposals for accountable care organizations are being developed, readmission rates will be increasingly scrutinized. The purpose of the present study was to assess whether the all-cause readmissions rate appropriately reflects the University of California, San Francisco (UCSF) Medical Center hospital's clinically relevant readmission rate for spine surgery patients and to identify predictors of readmission.

Methods
Data for 5780 consecutive patient encounters managed by 10 spine surgeons at UCSF Medical Center from October 2007 to June 2011 were abstracted from the University HealthSystem Consortium (UHC) using the Clinical Data Base/Resource Manager. Of these 5780 patient encounters, 281 patients (4.9%) were rehospitalized within 30 days of the previous discharge date. The authors performed an independent chart review to determine clinically relevant reasons for readmission and extracted hospital administrative data to calculate direct costs. Univariate logistic regression analysis was used to evaluate possible predictors of readmission. The two-sample t-test was used to examine the difference in direct cost between readmission and nonreadmission cases.

Results
The main reasons for readmission were infection (39.8%), nonoperative management (13.4%), and planned staged surgery (12.4%). The current all-cause readmission algorithm resulted in an artificially high readmission rate from the clinician's point of view. Based on the authors' manual chart review, 69 cases (25% of the 281 total readmissions) should be excluded because 39 cases (13.9%) were planned staged procedures; 16 cases (5.7%) were unrelated to spine surgery; and 14 surgical cases (5.0%) were cancelled or rescheduled at index admission due to unpredictable reasons. When these 69 cases are excluded, the direct cost of readmission is reduced by 29%. The cost variance is in excess of $3 million. Predictors of readmission were admission status (p < 0.0001), length of stay (p = 0.0001), risk of death (p < 0.0001), and age (p = 0.021).

Conclusions
The authors' findings identify the potential pitfalls in the calculation of readmission rates from administrative data sets. Benchmarking algorithms for defining hospitals' readmission rates must take into account planned staged surgery and eliminate unrelated reasons for readmission. When this is implemented in the calculation method, the readmission rate will be more accurate. Current tools overestimate the clinically relevant readmission rate and cost.
(Re) découvrir les multiples facettes des usages mobiles
Authors: Silber Georges-André 
Published: November 2012

Résumé Le mobile et les applications qui vont de pair ont envahi aujourd’hui toutes les sphères de nos activités professionnelles et personnelles. Ce marché, en plein essor et dont l’enjeu économique est considérable, supplante peu à peu les applications web classiques. Mais comme toute nouveauté technologique, la mobilité engendre des excès et des garde-fous – notamment législatifs - seront sans doute nécessaires. Les applications documentaires présentées dans ce dossier démontrent à la fois l’inventivité et la vitalité de ce secteur, que ce soit dans des domaines aussi variés que le droit, l’information des citoyens, la géolocalisation ou encore l’immobilier ! Les professionnels de l’information tentés par l’aventure trouveront assurément dans ces pages des perspectives enrichissantes et de nouveaux chantiers à explorer.
Histoire(s) de la médiatisation de l'amour chez les écrivaines françaises contemporaines
Authors: Sauzon Virginie 
Published: November 2012

Résumé À en croire certains discours désabusés, les relations amoureuses se trouveraient aujourd’hui irrémédiablement dégradées par divers changements sociaux récents, parmi lesquels l’exacerbation de nos désirs individualistes et la trop grande importance accordée à la sexualité. Cet article se propose de montrer que le désenchantement, particulièrement souligné (car politisé) chez plusieurs écrivaines contemporaines, vient moins d’un changement fondamental du rapport intime que de la permanence de discours amoureux normatifs. Ces auteures jouent en effet d’une intertextualité engagée, en mettant en scène différentes médiatisations possibles de l’amour pour mieux en montrer, contexte féministe à l’appui, l’enjeu idéologique : confiner encore et toujours les femmes amoureuses à un rôle hétéro-normatif, romantique et respectable.