bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing elearning and classroom instruction on HIV/AIDS knowledge uptake and internalizing among South African and Irish pupils
Authors: van Zyl Hendra , Visser Pieter , van Wyk Elmarie , Laubscher Ria 
Published: February 2013

Objective: Innovative public health approaches are required to improve human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) education and prevention among adolescents, one of the most vulnerable groups to HIV/AIDS. Consequently, elearning and classroom instruction was assessed for HIV/AIDS knowledge uptake and internalizing among South African and Irish pupils between the ages of 11 and 16 years. Method: An HIV/AIDS intervention was implemented based on a quasi-experimental design using experimental and control groups. Experimental group pupils underwent an elearning programme and the control group used the same material in workbooks in a classroom setting. The McNemar test assessed change in both groups’ knowledge levels from baseline to post-intervention. A theoretical framework guided by the conflict theory and health belief model strengthened the learning material. Discussions took place in the classroom and in an eforum; the latter was qualitatively analysed using thematic content analysis. Results: A significant increase ( P < 0.01) in HIV/AIDS knowledge uptake was experienced by the experimental group compared to a decline of 1.6% in the control group from baseline to post-intervention. Internalization of HIV/AIDS knowledge emerged in the eforum among experimental group pupils, while the classroom discussions faced structural barriers. Learning outcomes were demonstrated by higher marks achieved in the experimental than control group brochures, the outcome of the learning process. Conclusion: Elearning proved a superior technique to classroom instruction for HIV/AIDS knowledge uptake and internalizing and should be considered for wider implementation.
Association between bispectral index and age and use of sedative drugs in high spinal anaesthesia
Authors: Yi Yuri , Heo Daeyoung , Son Hee-Jeong , Joo Young , Lee Sang-Jin , Hwang Byeongmun 
Published: February 2013

Objectives A prospective, randomized, double-blind study using bispectral index values to objectively quantify the sedative effect of high spinal anaesthesia in patients stratified according to age, and to determine whether sedative drugs are associated with additional adverse respiratory and haemodynamic effects in older patients. Methods Patients who were electively scheduled for lower limb or abdominal surgery were recruited and allocated into one of three groups according to their age and whether midazolam and fentanyl were used: younger (20–40 years); and older (61–80 years) with or without midazolam and fentanyl intravenous infusion. Results The study recruited a total of 90 patients ( n = 30 per group). Intraoperative bispectral index values were significantly lower than preoperative values in all groups. Patients in the older age group had significantly lower intraoperative bispectral index values than younger patients. Older patients were significantly more likely to experience respiratory depression (arterial oxyhaemoglobin saturation <90%) than younger patients. Conclusions The sedative effect of high spinal anaesthesia is greater in older patients than in younger patients, with an increase in respiratory instability.
Isolation and Characterization of 2 New Human Rotator Cuff and Long Head of Biceps Tendon Cells Possessing Stem Cell–Like Self-Renewal and Multipotential Differentiation Capacity
Authors: Randelli Pietro , Conforti Erika , Piccoli Marco , Ragone Vincenza , Creo Pasquale , Cirillo Federica , Masuzzo Pamela , Tringali Cristina , Cabitza Paolo , Tettamanti Guido , Gagliano Nicoletta , Anastasia Luigi , Bergante Sonia , Ghiroldi Andrea 
Published: February 2013

Background: Stem cell therapy is expected to offer new alternatives to the traditional therapies of rotator cuff tendon tears. In particular, resident, tissue-specific, adult stem cells seem to have a higher regenerative potential for the tissue where they reside. Hypothesis: Rotator cuff tendon and long head of the biceps tendon possess a resident stem cell population that, when properly stimulated, may be induced to proliferate, thus being potentially usable for tendon regeneration. Study Design: Controlled laboratory study. Methods: Human tendon samples from the supraspinatus and the long head of the biceps were collected during rotator cuff tendon surgeries from 26 patients, washed with phosphate-buffered saline, cut into small pieces, and digested with collagenase type I and dispase. After centrifugation, cell pellets were resuspended in appropriate culture medium and plated. Adherent cells were cultured, phenotypically characterized, and then compared with human bone marrow stromal cells (BMSCs), as an example of adult stem cells, and human dermal fibroblasts, as normal proliferating cells with no stem cell properties. Results: Two new adult stem cell populations from the supraspinatus and long head of the biceps tendons were isolated, characterized, and cultured in vitro. Cells showed adult stem cell characteristics (ie, they were self-renewing in vitro, clonogenic, and multipotent), as they could be induced to differentiate into different cell types—namely, osteoblasts, adipocytes, and skeletal muscle cells. Conclusion: This work demonstrated that human rotator cuff tendon stem cells and human long head of the biceps tendon stem cells can be isolated and possess a high regenerative potential, which is comparable with that of BMSCs. Moreover, comparative analysis of the sphingolipid pattern of isolated cells with that of BMSCs and fibroblasts revealed the possibility of using this class of lipids as new possible markers of the cell differentiation status. Clinical Relevance: Rotator cuff and long head of the biceps tendons contain a stem cell population that can proliferate in vitro and could constitute an easily accessible stem cell source to develop novel therapies for tendon regeneration.
Less-Invasive Semitendinosus Tendon Graft Augmentation for the Reconstruction of Chronic Tears of the Achilles Tendon
Authors: Maffulli Nicola , Del Buono Angelo , Spiezia Filippo , Maffulli Gayle D. , Longo Umile Giuseppe , Denaro Vincenzo 
Published: February 2013

Background: Less-extensive and gentler exposure and dissection of deep soft tissues could reduce the times of recovery and rehabilitation after Achilles tendon reconstruction. Hypothesis: A minimally invasive semitendinosus autologous graft reconstruction of the Achilles tendon preserves skin integrity and reduces wound breakdown. Study Design: Case series; Level of evidence, 4. Methods: A total of 26 patients underwent minimally invasive semitendinosus autologous graft reconstruction for chronic ruptures to the Achilles tendon. Patients underwent a comparison of preoperative versus postoperative maximum calf circumference and isometric plantarflexion strength and evaluation of postoperative complications. The Achilles Tendon Total Rupture Score (ATRS) was administered at the final follow-up appointment. Results: All patients were reviewed at an average of 8.2 years (range, 7-10 years) from surgery. No patient was lost to follow-up. At final follow-up, the maximum calf circumference was significantly higher than preoperatively but significantly lower than the contralateral side. The isometric plantarflexion strength in the operated leg was lower than in the uninjured one. The mean ATRS was 88. Two patients developed a superficial wound infection, both healing within 2 months from the index surgery after systemic antibiotics and local dressings. One patient developed scar adhesion to the distal wound. All patients returned to their preinjury working occupation; 22 patients returned to their preinjury level of activity at a mean of 6.7 months after surgery. Conclusion: This technique is minimally invasive, is safe, and allows most of the patients to return to preinjury daily and sport activities within 9 months from surgery.
Predictive Risk Assessment for Major Amputation After Tibiotalocalcaneal Arthrodesis
Authors: DeVries J. George , Berlet Gregory C. , Hyer Christopher F. 
Published: February 2013

Background: Tibiotalocalcaneal (TTC) arthrodesis using a nail has been shown to be an effective salvage technique; however, there is a risk of major amputation. A better understanding of the relative risk of amputation after TTC fusion and the factors that influence this could help the preoperative consultation and guide discussion on the economics of limb salvage. Methods: One hundred seventy-nine limbs were treated with TTC fusion with an intramedullary nail. A comprehensive chart and radiographic review was pulled from our intramedullary nail database. Patients were divided into those who went on to eventual amputation and those with successful salvage of their limb. Variables from the database were used to build a statistical model with a biostatistician. Final results were presented, and a formula to determine probability of amputation was created. Results: There were 21 limbs that were eventually treated with major amputation. This represents an overall salvage rate of 88.2% (158/179 patients). Age was a factor in amputation risk, and the highest risk factor for amputation was diabetes with an odds ratio of 7.01 and 95% confidence, P = .0019. The odds of amputation were 6.2 times and 3 times greater for patients undergoing revisions and those with preoperative ulcers, respectively. The probability of amputation could be found preoperatively by using the derived equation: ex/(1 + ex) where x is a factor of age, diabetes, revision, and ulceration. Conclusion: TTC arthrodesis with a retrograde intramedullary nail has a high rate of limb salvage across a wide range of indications and medical comorbidities. In this patient cohort, diabetes was the most notable risk for amputation, followed by revision surgery, preoperative ulceration, and age. A model has been built to help predict the risk of amputation. Level of Evidence: Level II, prognostic.
Comparison of Three Different Fixation Methods of Calcaneal Osteotomies
Authors: Abbasian Ali , Zaidi Razi , Guha Abhijit , Goldberg Andrew , Cullen Nicholas , Singh Dishan 
Published: February 2013

Background: There are various methods available to fix a calcaneal osteotomy, ranging from screws to plates and staples. It is not clear if one method is superior to the other. In this series we compare the complications and union rates of 3 different methods of fixation. Methods: A retrospective review of the records of a consecutive series of patients who had a calcaneal osteotomy was undertaken. All patients had their osteotomy by the same technique, however the subsequent fixation was performed using 3 different methods: a lateral locking plate, a headless, or a headed screw. The screws were placed through a separate stab incision inserted from the infero-posterior heel. Records were kept of subsequent symptoms from the hardware and need for hardware removal as well as any complications. When screws were inserted, the entry point in relation to the weight-bearing surface of the calcaneus was also recorded. Sixty-seven osteotomies were investigated, of which 17 were fixed using a headed screw, 18 using a headless screw, and the remaining 32 were fixed using a lateral plate. Results: There was an overall 97% union rate. The only 2 cases of delayed union were both fixed using a lateral plate. Overall, 47% of the headed screws, 11% of the headless screws, and 6% of the lateral plates were removed to address symptoms that were suspected to arise from the hardware. There was a 10% rate of wound complication in the lateral plate cohort. There were no cases of sural nerve injury or neuroma. No correlation was found between entry position of screw and subsequent hardware symptoms. Conclusions: Calcaneal osteotomies have high union rates regardless of fixation method. Fixation using a headed screw is associated with a high rate of secondary screw removal. This was unrelated to the position of the screw in relation to the weight-bearing surface of the calcaneus in our series. Hardware problems were less frequent in the headless screw or the lateral plate groups; however, the incidence of local wound complications and radiological delayed union was higher in the group fixed with a lateral plate. This may be related to the greater soft tissue dissection and lesser compression achieved at the osteotomy site. Level of Evidence: Level III, retrospective case control study.
Neutrophil–Lymphocyte Ratio and the Platelet–Lymphocyte Ratio Predict the Limb Survival in Critical Limb Ischemia
Authors: Taşoğlu İrfan , Sert Doğan , Colak Necmettin , Uzun Alper , Songur Murat , Ecevit Ata 
Published: February 2013

Background: The objective of this study was to evaluate whether admission neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) might reflect amputation in patients with critical limb ischemia (CLI) who could not get surgical or radiological (percutaneous transluminal angioplasty) revascularization. Methods: A total of 104 patients with nonreconstructable CLI over a 5-year period were collected prospectively. Results: Admission NLR levels of ≥3.2 and a PLR of ≥160 were found to represent the optimal cutoff values to risk stratification of patients. If both levels were elevated, patients had a median overall limb survival of 22 months. For cases where both levels were less than the cutoff values, the median overall limb survival time was not reached but was greater than 60 months. Conclusions: Admission NLR and PLR both merit further evaluation as prognostic indices in patients with CLI.
Endovascular Versus Open Repair of Popliteal Artery Aneurysms
Authors: Galiñanes Edgar Luis , Dombrovskiy Viktor Y. , Graham Alan M. , Vogel Todd R. 
Published: February 2013

Objective: The management of popliteal artery aneurysms (PAAs) has undergone significant transition from open surgery to endovascular graft placement with few longitudinal data evaluating outcomes. Methods: The Centers of Medicare & Medicaid Services Inpatient claims (2005-2007) were queried with a diagnosis of lower extremity artery aneurysm in association with elective Current Procedural Terminology codes for open (OPEN group) and endovascular (ENDO group) repair. Results: A total of 2962 patients were identified. Endovascular interventions significantly increased over the time of the study (11.7% vs 23.6%, P < .0001). Overall complication rates for OPEN and ENDO groups did not differ significantly (11.3% vs 9.3%; P = .017). No differences in the 30- and 90-day mortality rates were found between OPEN versus ENDO groups. The ENDO group had greater 30- and 90-day reinterventions (4.6% vs 2.1%, P = .001 and 11.8% vs 7.4%, P = .0007, respectively). Length of stay (4.5 days vs 2.5 days, P < .0001) and charges ($43 180 vs $35 540, P < .0001) were greater for OPEN group. Conclusion: Despite a significant increase in the utilization of endovascular repair of PAAs, endovascular repair was associated with greater reinterventions over time and did not offer a mortality or cost benefit.
Shewanella oneidensisHfq promotes exponential phase growth, stationary phase culture density, and cell survival
Authors: Brennan Christopher M , Keane Meghan L , Hunt Taylor M , Goulet Matthew T , Mazzucca Nicholas Q , Sexton Zachary , Mezoian Taylor , Douglas Katherine E , Osborn Jessica M , Pellock Brett J 
Published: February 2013

Abstract

Background
Hfq is an RNA chaperone protein that has been broadly implicated in sRNA function in bacteria. Here we describe the construction and characterization of a null allele of the gene that encodes the RNA chaperone Hfq in Shewanella oneidensis strain MR-1, a dissimilatory metal reducing bacterium.

Results
Loss of hfq in S. oneidensis results in a variety of mutant phenotypes, all of which are fully complemented by addition of a plasmid-borne copy of the wild type hfq gene. Aerobic cultures of the hfq∆ mutant grow more slowly through exponential phase than wild type cultures, and hfq∆ cultures reach a terminal cell density in stationary phase that is ~2/3 of that observed in wild type cultures. We have observed a similar growth phenotype when the hfq∆ mutant is cultured under anaerobic conditions with fumarate as the terminal electron acceptor, and we have found that the hfq∆ mutant is defective in Cr(VI) reduction. Finally, the hfq∆ mutant exhibits a striking loss of colony forming units in extended stationary phase and is highly sensitive to oxidative stress induced by H2O2 or methyl viologen (paraquat).

Conclusions
The hfq mutant in S. oneidensis exhibits pleiotropic phenotypes, including a defect in metal reduction. Our results also suggest that hfq mutant phenotypes in S. oneidensis may be at least partially due to increased sensitivity to oxidative stress.
Age-related normal structural and functional ventricular values in cardiac function assessed by magnetic resonance
Authors: Fiechter Michael , Fuchs Tobias A , Gebhard Catherine , Stehli Julia , Klaeser Bernd , Stähli Barbara E , Manka Robert , Manes Costantina , Tanner Felix C , Gaemperli Oliver , Kaufmann Philipp A 
Published: February 2013

Abstract

Background
The heart is subject to structural and functional changes with advancing age. However, the magnitude of cardiac age-dependent transformation has not been conclusively elucidated.

Methods
This retrospective cardiac magnetic resonance (CMR) study included 183 subjects with normal structural and functional ventricular values. End systolic volume (ESV), end diastolic volume (EDV), and ejection fraction (EF) were obtained from the left and the right ventricle in breath-hold cine CMR. Patients were classified into four age groups (20–29, 30–49, 50–69, and ≥70 years) and cardiac measurements were compared using Pearson’s rank correlation over the four different groups.

Results
With advanced age a slight but significant decrease in ESV (r=−0.41 for both ventricles, P<0.001) and EDV (r=−0.39 for left ventricle, r=−0.35 for right ventricle, P<0.001) were observed associated with a significant increase in left (r=0.28, P<0.001) and right (r=0.27, P<0.01) ventricular EF reaching a maximal increase in EF of +8.4% (P<0.001) for the left and +6.1% (P<0.01) for the right ventricle in the oldest compared to the youngest patient group. Left ventricular myocardial mass significantly decreased over the four different age groups (P<0.05).

Conclusions
The aging process is associated with significant changes in left and right ventricular EF, ESV and EDV in subjects with no cardiac functional and structural abnormalities. These findings underline the importance of using age adapted values as standard of reference when evaluating CMR studies.
A prospective randomized controlled multicenter trial comparing antibiotic therapy with appendectomy in the treatment of uncomplicated acute appendicitis (APPAC trial)
Authors: Paajanen Hannu , Grönroos Juha M , Rautio Tero , Nordström Pia , Aarnio Markku , Rantanen Tuomo , Hurme Saija , Dean Kirsti , Jartti Airi , Mecklin Jukka-Pekka , Sand Juhani , Salminen Paulina 
Published: February 2013

Abstract

Background
Although the standard treatment of acute appendicitis (AA) consists of an early appendectomy, there has recently been both an interest and an increase in the use of antibiotic therapy as the primary treatment for uncomplicated AA. However, the use of antibiotic therapy in the treatment of uncomplicated AA is still controversial.

Methods/design
The APPAC trial is a randomized prospective controlled, open label, non-inferiority multicenter trial designed to compare antibiotic therapy (ertapenem) with emergency appendectomy in the treatment of uncomplicated AA. The primary endpoint of the study is the success of the randomized treatment. In the antibiotic treatment arm successful treatment is defined as being discharged from the hospital without the need for surgical intervention and no recurrent appendicitis during a minimum follow-up of one-year (treatment efficacy). Treatment efficacy in the operative treatment arm is defined as successful appendectomy evaluated to be 100%. Secondary endpoints are post-intervention complications, overall morbidity and mortality, the length of hospital stay and sick leave, treatment costs and pain scores (VAS, visual analoque scale). A maximum of 610 adult patients (aged 18–60 years) with a CT scan confirmed uncomplicated AA will be enrolled from six hospitals and randomized by a closed envelope method in a 1:1 ratio either to undergo emergency appendectomy or to receive ertapenem (1 g per day) for three days continued by oral levofloxacin (500 mg per day) plus metronidazole (1.5 g per day) for seven days. Follow-up by a telephone interview will be at 1 week, 2 months and 1, 3, 5 and 10 years; the primary and secondary endpoints of the trial will be evaluated at each time point.

Discussion
The APPAC trial aims to provide level I evidence to support the hypothesis that approximately 75–85% of patients with uncomplicated AA can be treated with effective antibiotic therapy avoiding unnecessary appendectomies and the related operative morbidity, also resulting in major cost savings.

Trial registration
Clinicaltrials.govhttp://NCT01022567
Evaluation of bioluminescence-based assays of anti-malarial drug activity
Authors: Hasenkamp Sandra , Sidaway Adam , Devine Oliver , Roye Richard , Horrocks Paul 
Published: February 2013

Abstract

Background
Transgenic Plasmodium falciparum expressing luciferase offers an attractive bioluminescence-based assay platform for the investigation of the pharmacological properties of anti-malarial drugs. Here a side-by-side comparison of bioluminescence and fluorescence-based assays, utilizing a luciferase reporter cassette that confers a strong temporal pattern of luciferase expression during the S-phase of intraerythrocytic development, is reported.

Methods
Key assay parameters for a range of commercially available luminogenic substrates are determined and compared to those measured using a Malaria Sybr Green I fluorescence assay. In addition, the short-term temporal effects of anti-malarial compounds are evaluated using both bioluminescent and fluorescent assay platforms.

Results
The Z’, % coefficient of variation and 50% inhibition concentrations are essentially the same for bioluminescent and fluorescent assays in transgenic parasites generated in both chloroquine-sensitive and -resistant genetic backgrounds. Bioluminescent assays, irrespective of the luminogenic agent employed, do, however, offer significantly enhanced signal-to-noise ratios. Moreover, the bioluminescent assay is more dynamic in terms of determining temporal effects immediately following drug perturbation.

Conclusion
This study suggests that opportunities for bioluminescence-based assays lie not in the measurement of 50% inhibition concentrations, where the cheaper fluorescence assay performs excellently and is not restricted by the need to genetically modify the parasite clone under investigation. Instead, assays that use the dynamic response of the luciferase reporter for semi-automated screening of additional pharmacological properties, such as relative rate-of-kill and lethal dose estimation, are a more attractive development opportunity.