bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Imaging Features and Technique on US-guided Tattoo Ink Marking of Axillary Lymph Nodes Removed at Sentinel Lymph Node Biopsy in Women With Breast Cancer
Authors: Pajcini Marlen , Wapnir Irene , Tsai Jacqueline , Edquilang Joanne , DeMartini Wendy , Ikeda Debra 
Published: August 2021

Abstract

Objective
To describe tattoo ink marking of axillary lymph nodes (TIMAN) and the elements leading to successful removal at sentinel lymph node biopsy (SLNB).

Methods
An IRB-approved retrospective image review was conducted of breast cancer patients who underwent SLNB after TIMAN from February 2013 to August 2017, noting patient and tattooed lymph node (TLN) features, initial biopsy type, time to surgery, if the TLN was identified at surgery, and correlation with the SLN. Cases were divided into two groups: the presurgical group, which had primary surgery, and the pre-neoadjuvant chemotherapy (NACT) group, which underwent surgery after completing NACT.

Results
Of 30 patients who underwent 32 TIMAN procedures, 10 (33.3%) were presurgical and 20 (66.7%) were pre-NACT. The average lymph node (LN) depth from the skin was 1.6 cm, with an average of 0.3 mL of tattoo ink injected. Of 32 procedures, 29 (90.6%) had US images demonstrating the injection. Of these, 10 (34.5%) were injected in the LN cortex surface and 19 (65.5%) in the middle cortex. Seven (24.1%) were injected in the LN lateral aspect, 12 (41.4%) in the mid aspect, and 10 (34.5%) in the medial aspect. Of 32 LNs, 28 (87.5%) were tattooed immediately after initial biopsy and 4 (12.5%) at a later date. At SLNB, all 32 (100%) TLNs were identified, all correlated with the SLN, and 10 (31.3%) were positive for cancer.

Conclusion
Using an average of 0.3 mL of tattoo ink, all TLNs were successfully identified for removal at surgery, despite variability in LN and injection factors.
The Threshold-Crossing Effect: Just-Below Pricing Discourages Consumers to Upgrade
Authors: Kim Junha , Malkoc Selin A , Goodman Joseph K 
Published: August 2021

Abstract
Managers often set prices just-below a round number (e.g., $39)—a strategy that lowers price perceptions and increases sales. The authors question this conventional wisdom in a common consumer context: upgrade decisions (e.g., whether to upgrade a rental car or hotel room). Seven studies—including one field study—provide empirical evidence for a threshold-crossing effect. When a base product is priced at or just-above a threshold, consumers are more likely to upgrade and spend more money (studies 1–3) because they perceive the upgrade option as less expensive (study 4), and they place less weight on price (study 5). Testing theoretically motivated and managerially relevant boundary conditions, studies find that the threshold-crossing effect is mitigated under sequential choice (study 6) and when an upgrade price crosses an upper threshold (study 7). These studies demonstrate that a small increase in price on a base product can decrease price perceptions of an upgrade option and, thus, increase consumers’ likelihood to upgrade. Results suggest that just-below pricing, while sometimes advantageous at first, may not always be an optimal strategy for managers trying to encourage consumers to ultimately choose an upgrade option.
Short-term outcomes following mini-open repair of chronic gluteus medius tendon tears using a double-row technique
Authors: Uso Marc Barrera , Bothorel Hugo , Poultsides Lazaros , Christofilopoulos Panayiotis 
Published: August 2021

ABSTRACT
Gluteal tendon tears represent a common but underreported cause of lateral hip pain and dysfunction. In case of conservative management failure, a surgical procedure must be performed to relieve patient symptoms. Current operative treatments, either open or endoscopic, have been however associated with different drawbacks which led to the introduction of the mini-open technique. The aim of this study was to evaluate and report the short-term outcomes of patients operated through the aforementioned surgical technique for gluteus medius (GM) chronic tears. We retrospectively analysed the records of 14 consecutive patients operated at the La Tour hospital by mini-open repair using a double-row technique for full-thickness GM chronic tears. Intra- and post-operative complications were recorded. The pre- and post-operative pain on visual analogue scale (pVAS), modified Harris Hip score (mHHS), abduction strength and gait dysfunction were assessed for all patients. Pre- and post-operative values were compared to evaluate whether improvements were statistically significant and clinically relevant. The study cohort comprised 13 women (93%) and 1 man (3%) aged 62.4 ± 18.0 at index surgery. No intra- or post-operative complications were noted. Compared to pre-operative values, patients reported a significant improvement in mHHS (59.1 ± 7.1 vs 92.7 ± 4.6) and pVAS (7.4 ± 1.0 vs 1.3 ± 1.3) at last follow-up. Patients exhibited a perfect improvement in muscle strength (3.6 ± 0.5 vs 5.0 ± 0.0), and the proportion of patients with a positive Trendelenburg sign decreased from 71% to 0%. Mini-open repair of chronic GM tendon tears using a double-row technique demonstrated excellent clinical and functional outcomes at short follow-up.
Level of Evidence IV.
Neutral responses of plant community Ca concentration to nitrogen enrichment in a semiarid grassland
Authors: Hou Shuang-Li , Lü Xiao-Tao , Yang Jun-Jie 
Published: August 2021

AbstractCalcium (Ca) is an essential nutrient for plant growth and Ca concentrations in forage have important implications for ruminant diet and health. It remains an open question whether forage Ca concentration would be decreased by increasing nitrogen (N) deposition. We manipulated the increasing rates of N addition (2008–2015) in a semiarid grassland, northern China. Plant Ca concentrations for all species were examined in each plot under N treatment. The Ca concentrations at functional group and community levels were calculated based on the concentration of each species presented and their relative biomass in each plot. We found that community-level Ca concentration remained stable across a gradient of wide-ranged N addition rates, although Ca concentration at both species and functional group levels showed negative responses to N enrichment. Given that forbs had higher Ca concentration than grasses, the increasing relative biomass of forbs canceled out the negative responses of species-level and functional group-level Ca concentration. Our results further showed that community Ca pool showed a positive but saturating response to N addition, with a threshold at the rate of 10 g N m−2 yr−1. Our findings highlight the role of changes in plant relative biomass in controlling the responses of forage Ca concentration and stock to N enrichment.
Explaining variation in productivity requires intraspecific variability in plant height among communities
Authors: Zhang Li , Liu Xiang , Zhou Shurong , Shipley Bill 
Published: August 2021

AbstractWhile recent studies have shown the importance of intraspecific trait variation in the processes of community assembly, we still know little about the contributions of intraspecific trait variability to ecosystem functions. Here, we conducted a functional group removal experiment in an alpine meadow in Qinghai-Tibetan Plateau over 4 years to investigate the relative importance of inter- and intraspecific variability in plant height for productivity. We split total variability in plant height within each of 75 manipulated communities into interspecific variability (TVinter) and intraspecific variability within a community (ITVwithin). Community-weighted mean height among communities was decomposed into fixed community-weighted mean (CWMfixed) and intraspecific variability among communities (ITVamong). We constructed a series of generalized additive mixed models and piecewise structural equation modeling to determine how trait variability (i.e. TVinter, ITVwithin, CWMfixed and ITVamong) indirectly mediated the changes in productivity in response to functional group removal. Community productivity was not only affected directly by treatment manipulations, but also increased with both inter- and intraspecific variability (i.e. CWMfixed and ITVamong) in plant height indirectly. This suggests that both the ‘selection effect’ and a ‘shade-avoidance syndrome’ can incur higher CWMfixed and ITVamong, and may simultaneously operate to regulate productivity. Our findings provide new evidence that, besides interspecific variability, intraspecific trait variability in plant height also plays a role in maintaining net primary productivity.
Avelumab in newly diagnosed glioblastoma
Authors: Jacques Francois H , Nicholas Garth , Lorimer Ian A J , Sikati Foko Victorine , Prevost Jasmine , Dumais Nathalie , Milne Katy , Nelson Brad H , Woulfe John , Jansen Gerard , Apedaile B Erik 
Published: August 2021

AbstractBackgroundGlioblastoma (GBM) is known to use both local and systemic immunosuppressive strategies. One such strategy is the expression of the immune checkpoint protein programmed cell death ligand-1 (PD-L1) by both tumor cells and tumor-associated immune cells. Recent phase III trials using IgG4 antibodies targeting PD-1, the ligand for PD-L1, failed to show any benefit. Avelumab is an IgG1 monoclonal antibody targeting PD-L1. In contrast to the previously tested immune checkpoint inhibitors, it can directly bind tumor cells and immune cells expressing PD-L1 and can induce antibody-dependent cellular cytotoxicity.MethodsWe conducted a single center, open label, phase II study where avelumab 10 mg/kg IV Q2W was added concurrently to the first monthly temozolomide cycle in patients with newly diagnosed GBM. Immunohistochemical analyses were performed on surgery samples. The primary objective was safety. Secondary objectives were efficacy outcomes according to the immunotherapy Response Assessment in Neuro Oncology criteria, progression free survival (PFS), and overall survival (OS). Exploratory objectives aimed at determining prognostic biomarkers.ResultsThirty patients were started on therapy and two were lost to follow-up. Median follow-up time (reverse Kaplan-Meier) was 41.7 months (IQR: 28.3–43.4). Three (10.0%) patients had a related or possibly related treatment emergent adverse event that lead to transient or permanent discontinuation of avelumab. Eight (26.7%) patients had one or more immune-related adverse events, and 8 (26.7%) patients had an infusion-related reaction. The overall response rate was 23.3%, median PFS was 9.7 months, and the median OS was 15.3 months. No pretreatment biomarkers showed any predictive value.ConclusionsThe addition of avelumab to standard therapy in patients with GBM was not associated with any new safety signal. There was no apparent improvement in OS.Trial RegistrationNCT03047473 Registered February 9, 2017.
Hypoglossal Nerve Schwannoma With Severe Brainstem Compression: Microsurgical Excision by Extreme Lateral Approach: 2-Dimensional Operative Video
Authors: Zeeshan Qazi , Balasubramanian Sneha Chitra , Carrasco Hernandez Juan P , Shenoy Varadaraya S , Abecassis Isaac Josh , Sekhar Laligam N 
Published: August 2021

Abstract
A 37-yr-old male presented with a history of left-sided tongue atrophy and fasciculations and weakness of upper limbs for 3 mo. Magnetic resonance imaging (MRI) revealed a large, partially cystic tumor with severe compression of the brainstem and spinal cord, with expansion and erosion of the hypoglossal canal. Computed tomography (CT) angiography showed the left vertebral artery to be anteriorly displaced by the tumor.
A retrosigmoid craniotomy and craniectomy were performed followed by mastoidectomy with unroofing the posterior aspect of the sigmoid sinus. The foramen magnum was completely unroofed. The hypoglossal canal was exposed with a diamond drill and an ultrasonic bone curette, and a tumor was seen within the expanded canal. C1 lamina was removed partially in the lateral aspect, and the occipital condyle was partially removed. After opening the dura mater, the tumor was found to be stretching the eleventh cranial nerve. The tumor was debulked, and dissected from the cranial nerve fibers. The vertebral artery, anterior spinal artery, and other branches displaced by the tumor were carefully preserved. The tumor was removed from the hypoglossal canal with a curette. The patient recovered well, with the resolution of his upper limb weakness. Patient modified Rankin Scale was 1 at 6-mo follow-up. The postoperative MRI showed a small remnant inside the hypoglossal canal, and it was treated by radiosurgery.
This 2-dimensional video demonstrates the technique of complete microsurgical removal of a complex tumor with preservation of cranial nerves and vertebral artery.
Informed consent was obtained from the patient prior to the surgery, which included videotaping of the procedure and its distribution for educational purposes. Also, all relevant patient identifiers have been removed from the video and accompanying radiology slides.
Completion Posterior Quadrant Disconnection After Failed Temporal Lobectomy: 2-Dimensional Operative Video
Authors: Patel Saarang , Markosian Christopher , Dominguez Jose F , Taha Firas A , Tomycz Luke D 
Published: August 2021

Abstract
Epilepsy is a chronic seizure disorder that affects about 1% of the global population.
1
When seizure freedom cannot be obtained solely through antiseizure medicines (ASMs), the condition is termed medically refractory epilepsy (MRE).
2,3
Though posterior quadrant disconnection (PQD) is underutilized in our experience, it is a highly effective surgical procedure for MRE restricted to the temporal, parietal, and/or occipital lobes.
4-12
In this operative video, we demonstrate a right-sided completion PQD following failed temporal lobectomy in an 8-yr-old female with focal MRE. We review technical nuances, including (1) extension/revision of prior scalp incision, (2) placement of subdural strip for the identification of phase reversal and central sulcus, (3) disconnection of parietal and occipital lobes, (4) extension of the corticectomy to the pia overlying the falcotentorial junction and into the prior temporal lobectomy defect, and (5) posterior disconnection of the corpus callosum. Postoperatively, the patient experienced subtle left-arm weakness and central fever, both of which resolved. An external ventricular drain (EVD) was placed in the ventricle/operative cavity and left for 3 to 4 d until the draining cerebrospinal fluid (CSF) cleared. As of 3-mo follow-up, she has been seizure-free without complications. In summary, PQD is a safe and effective treatment option for MRE that can be utilized not only as an initial operation but also after failed surgery.
Appropriate patient consent was obtained to perform this procedure and present this clinical case and surgical video for academic purposes.
Image at 4:00 licensed under CC BY-2.5, 2006, modified from http://upload.wikimedia.org/wikipedia/commons/7/70/Lateral_head_skull.jpg (flipped and rotated). Image at 4:42, Public Domain: Gray H. Anatomy of the Human Body. 1918. Bartleby.com, https://commons.wikimedia.org/wiki/File:Lobes_of_the_brain_NL.svg; flipped, modified. Image at 6:42, Public Domain: House EL, Pansky B. A Functional Approach to Neuroanatomy. 1960. McGraw-Hill Book Company; https://upload.wikimedia.wikipedia.commons/5/52/Lawrence_1960_2.3.png; modified.
High-Quality Complete Genome Resource of Tomato Rhizosphere StrainPseudomonas donghuensisP482, a Representative of a Species with Biocontrol Activity Against Plant Pathogens
Authors: Krzyżanowska Dorota M. , Iwanicki Adam , Czajkowski Robert , Jafra Sylwia 
Published: August 2021

Strain P482 was isolated from a tomato rhizosphere and classified as Pseudomonas donghuensis. The P. donghuensis species was first established in 2015 and currently consists of only four strains: P482, HYST, SVBP6, and 22G5. P. donghuensis strains antagonize plant pathogens, including bacteria, fungi, and oomycetes, and, therefore, are of high interest regarding their biological control potential to combat plant diseases. The antimicrobial activity of P. donghuensis P482 is based on the production of iron-scavenging compound 7-hydroxytropolone, antifungal volatile organic compounds, and as-yet-unidentified secondary metabolites. Here, we report a complete genome resource for P. donghuensis strain P482. The genome consists of a single chromosome (5,656,185 bp) with 5,258 open reading frames (5,158 protein-coding genes, 74 transfer RNAs, 22 ribosomal RNAs, 3 noncoding RNAs, and 1 transfer-messenger RNA) and no plasmid. We believe that information on the first high-quality, complete genome of P. donghuensis will provide resources for analyses targeting the biological control potential of this species and understanding the traits essential for plant–microbe interaction.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Cervical Cancer Risk and Screening Among Women Seeking Assistance With Basic Needs
Authors: Kuroki Lindsay M. , Massad L. Stewart , Woolfolk Candice , Thompson Tess , McQueen Amy , Kreuter Matthew W. 
Published: August 2021

(Abstracted from Am J Obstet Gynecol 2021;224(4):368.e1–368.e8)
In the United States, more than 50% of cervical cancers occur in inadequately screened patients. Social and structural determinants of health contribute to inadequate screening rates.
Now Is Our Time to Act: Why Academic Medicine Must Embrace Community Collaboration as Its Fourth Mission
Authors: Alberti Philip , Fair Malika , Skorton David J. 
Published: August 2021

In his Leadership Plenary at the Association of American Medical Colleges (AAMC) annual meeting, “Learn Serve Lead 2020: The Virtual Experience,” president and CEO David Skorton emphasized that the traditional tripartite mission of academic medicine—medical education, clinical care, and research—is no longer enough to achieve health justice for all. Today, collaborating with diverse communities deserves equal weight among academic medicine’s missions. This means going beyond “delivering care” to establishing and expanding ongoing, two-way community dialogues that push the envelope of what is possible in service to what is needed. It means appreciating community assets and creating ongoing pathways for listening to and learning from the needs, lived experiences, perspectives, and wisdom of patients, families, and communities. It means working with community-based organizations in true partnership to identify and address needs, and jointly develop, test, and implement solutions. This requires bringing medical care and public/population health concepts together and addressing upstream fundamental causes of health inequities.
The authors call on academic medical institutions to do more to build a strong network of collaborators across public and population health, government, community groups, and the private sector. We in academic medicine must hold ourselves accountable for weaving community collaborations consistently throughout research, medical education, and clinical care. The authors recognize the AAMC can do better to support its member institutions in doing so and discuss new initiatives that signify a shift in emphasis through the association’s new strategic plan and AAMC Center for Health Justice. The authors believe every area of academic medicine could grow and better serve communities by listening and engaging more and bringing medical care, public health, and other sectors closer together.
Associations Between Neck and Shoulder Pain and Neuropathic Pain in a Middle-aged Community-living Population
Authors: Machino Masaaki , Ando Kei , Kobayashi Kazuyoshi , Nakashima Hiroaki , Ito Sadayuki , Morozumi Masayoshi , Kanbara Shunsuke , Segi Naoki , Tomita Hiroyuki , Koshimizu Hiroyuki , Seki Taisuke , Ishizuka Shinya , Takegami Yasuhiko , Hasegawa Yukiharu , Imagama Shiro 
Published: August 2021

Study Design.
A cross-sectional study.

Objective.
The present study aimed to investigate the prevalence of NeP in subjects suffering from NSP to reveal the impact of NeP on the health-related QOL (HRQOL) in middle-aged and elderly people with NSP in a health checkup.

Summary of Background Data.
No previous studies have established the relationship between NSP and NeP as potential risk factors contributing to a decreased QOL in the general population.

Methods.
The present study involved 203 participants (men: 84, women: 119; mean age: 63.3 yr). For each subject, anthro-pometric measurements, physical function examinations, and blood testing were performed. A cut-off score of >0 on the short-form spine painDETECT questionnaire defined the presence of NeP. Subsequently, the NSP (+) subjects were divided into 2 sub-groups: the NeP (+) and NeP (−) groups. For the assessment of QOL, the short form 36 health survey and the EuroQol 5 dimension 5 level version (EQ-5D-5L) tool were used.

Results.
The study included 100 NSP (+) and 103 NSP (−) subjects. Among the NSP (+) subjects, 46 and 54 subjects were found to be NeP (+) and NeP (−), respectively. For the short form 36 health survey, the multivariate regression analysis revealed that the prevalence of NeP was associated with a lower physical QOL (OR 3.56) and lower mental QOL (OR 4.04). Similarly, the NeP prevalence was found to be the predictor for low QOL scores in EQ-5D-5L (EQ-5D-5L index value <0.875; OR 3.61).

Conclusion.
The prevalence of NeP was reported to be 46.0% in healthy middle-aged and elderly population suffering from NSP, where it was associated with poor HRQOL. Therefore, strategies aimed at alleviating NeP may contribute significantly to the improvement of QOL in middle-aged and elderly people with NSP.

Level of Evidence: 2
Risk of Dementia and Structural Brain Changes Following Nonneurological Infections During 9-Year Follow-Up*
Authors: Peters van Ton Annemieke M. , Meijer-van Leijsen Esther M. C. , Bergkamp Mayra I. , Bronkhorst Ewald M. , Pickkers Peter , de Leeuw Frank-Erik , Tuladhar Anil M. , Abdo Wilson F. 
Published: August 2021

OBJECTIVES:
Given the strong association between systemic inflammation and cognitive decline, we aimed to determine whether nonneurologic infections are associated with accelerated cognitive decline and structural changes in the brain using pre- and post-infection neuropsychologic assessments and repeated brain MR images.

DESIGN:
Additional analysis of the prospective observational Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort study.

SETTING:
Single-center study at the Radboud university medical center, Nijmegen, The Netherlands, between January 2006 and September 2015.

PATIENTS:
Five-hundred three participants (50–85 yr old) with cerebral small vessel disease were included and followed for 9 years.

MEASUREMENTS AND MAIN RESULTS:
Participants underwent repeated cognitive measurements and brain MRI. Infectious events were collected. Sepsis episodes were analyzed, and additionally, patients were stratified in three groups: having had a severe infectious episode (e.g., sepsis or hospitalization for infection), a mild, or no infectious episode. Development of dementia, trajectories of cognition, and structural brain changes on MRI in the subsequent follow-up periods were compared between the groups. Complete infectious data were available from 331 patients (mean age 64 ± 8 yr, 57% males). Twenty-nine participants (9%) suffered from a sepsis episode, 69 (21%) from a severe, 201 (61%) from a mild, and 61 (18%) had no infectious episode during follow-up. After correction for age, baseline cognition, and brain volume, each sepsis episode remained associated with an 82% increased risk to develop dementia within the follow-up period (hazard ratio, 1.82; 95% CI, 1.07–3.10; p = 0.027). Infections had no effect on the trajectory of structural changes to the brain after correction for baseline differences.

CONCLUSIONS:
In this 9-year observational follow-up study, sepsis episodes were associated with subsequent development of dementia. Nonneurologic infections had no effect on the trajectory of structural cerebral changes.