bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tidal stripping and the structure of dwarf galaxies in the Local Group
Authors: Fattahi Azadeh , Navarro Julio F , Frenk Carlos S , Oman Kyle A , Sawala Till , Schaller Matthieu 
Published: February 2018

AbstractThe shallow faint-end slope of the galaxy mass function is usually reproduced in Λ cold dark matter (ΛCDM) galaxy formation models by assuming that the fraction of baryons that turn into stars drops steeply with decreasing halo mass and essentially vanishes in haloes with maximum circular velocities Vmax &lt; 20–30 km s−1. Dark-matter-dominated dwarfs should therefore have characteristic velocities of about that value, unless they are small enough to probe only the rising part of the halo circular velocity curve (i.e. half-mass radii, r1/2 ≪ 1 kpc). Many dwarfs have properties in disagreement with this prediction: they are large enough to probe their halo Vmax but their characteristic velocities are well below 20 km s−1. These ‘cold faint giants’ (an extreme example is the recently discovered Crater 2 Milky Way satellite) can only be reconciled with our ΛCDM models if they are the remnants of once massive objects heavily affected by tidal stripping. We examine this possibility using the APOSTLE cosmological hydrodynamical simulations of the Local Group. Assuming that low-velocity-dispersion satellites have been affected by stripping, we infer their progenitor masses, radii, and velocity dispersions, and find them in remarkable agreement with those of isolated dwarfs. Tidal stripping also explains the large scatter in the mass discrepancy–acceleration relation in the dwarf galaxy regime: tides remove preferentially dark matter from satellite galaxies, lowering their accelerations below the amin ∼ 10−11 m s−2 minimum expected for isolated dwarfs. In many cases, the resulting velocity dispersions are inconsistent with the predictions from Modified Newtonian Dynamics, a result that poses a possibly insurmountable challenge to that scenario.
Comparison of Methicillin-resistant Versus Susceptible Staphylococcus aureus Pediatric Osteomyelitis
Authors: Davis William T. , Gilbert Shawn R. 
Published: February 2018

Background:
The incidence of methicillin-resistant Staphylococcus aureus (MRSA) pediatric osteomyelitis has risen and been associated with a more severe clinical course than methicillin-susceptible Staphylococcus aureus (MSSA) infections. National databases have been underutilized to describe these trends. We compared demographics, clinical course, and outcomes for patients with MRSA versus MSSA osteomyelitis.

Methods:
We queried the 2009 and 2012 Healthcare Cost and Utilization Project Kids Inpatient Database for discharge records with diagnosis codes for osteomyelitis and S. aureus. We explored demographics predicting MRSA and evaluated MRSA versus MSSA as predictors of clinical outcomes including surgery, sepsis, thrombophlebitis, length of stay, and total charges.

Results:
A total of 4214 discharge records were included. Of those, 2602 (61.7%) had MSSA and 1612 (38.3%) had MRSA infections. Patients at Southern and Midwestern hospitals were more likely to have MRSA than those at Northeastern hospitals. Medicaid patients’ odds of MRSA were higher than those with private insurance, and black patients were more likely to have MRSA compared with white patients. MRSA patients were more likely to undergo multiple surgeries compared with MSSA patients and were more likely to have complications including severe sepsis, thrombophlebitis, and pulmonary embolism. Patients with MRSA had longer lengths of stay than those with MSSA and higher total charges after controlling for length of stay.

Conclusion:
Review of a national database demonstrates MRSA is more prevalent in the South and Midwest regions and among black patients. MRSA patients have more surgeries, complications, and longer lengths of stay.

Level of Evidence:
Level III.
Hormonal, metabolic, and endometrial safety of testosterone vaginal cream versus estrogens for the treatment of vulvovaginal atrophy in postmenopausal women: a randomized, placebo-controlled study
Authors: Fernandes Tatiane , Pedro Adriana O. , Baccaro Luiz F. , Costa-Paiva Lucia H. 
Published: February 2018

Abstract

Objective:
The aim of the study was to evaluate the laboratory and endometrial safety of topical testosterone versus topical estrogen for the treatment of vaginal atrophy in postmenopausal women.

Methods:
This was a randomized, placebo-controlled trial of 60 postmenopausal women aged 40 to 70 years at the Menopause Clinic of CAISM UNICAMP. Women were randomized into three vaginal treatment groups: estrogen, testosterone, or placebo. The treatment was applied 3 times a week for 12 weeks. Hormonal laboratory values of follicle-stimulating hormone, luteinizing hormone, estradiol, estrone, androstenedione, total testosterone, free testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and sex hormone-binding globulin were assessed at baseline and at 6 and 12 weeks. Metabolic laboratory values of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transpeptidase were also assessed at baseline and at 6 and 12 weeks. Endometrial safety was assessed using ultrasonography at baseline and at 12 weeks.

Results:
After 12 weeks of treatment, there were no significant differences in hormonal or metabolic laboratory values among all three groups. Two participants in the estrogen group had increased serum estradiol after 12 weeks of treatment. No change in endometrial thickening was reported in all three groups.

Conclusions:
Twelve weeks of treatment with topical testosterone or estrogen in postmenopausal women with symptoms of vaginal atrophy demonstrated laboratory and endometrial safety when compared with placebo.
Does Robotic Beating Heart Connector Totally Endoscopic Coronary Artery Bypass Bridge the Gender Gap in Coronary Bypass Surgery?
Authors: Kitahara Hiroto , McCrorey Mackenzie , Patel Brooke , Nisivaco Sarah , Balkhy Husam H. 
Published: February 2018

Objective Previous studies have shown that women carry a higher risk of morbidity and mortality after coronary artery bypass surgery. We investigated gender differences in risk factors and outcomes in our patients undergoing robotic beating heart connector totally endoscopic coronary artery bypass. Methods From July 2013 to April 2017, patients undergoing connector totally endoscopic coronary artery bypass were reviewed. We compared the outcomes of men versus women. Results A total of 192 men and 71 women underwent connector totally endoscopic coronary artery bypass. The mean ± SD age was 65.4 ± 10.6 years. The Society of Thoracic Surgeons score was higher in women than men (median = 1.46 vs 0.73, P = 0.001), and women had a higher rate of peripheral vascular disease (22.5% vs 9.9%, P = 0.007). Intraoperative data in women and men were similar except for the rate of multi-vessel connector totally endoscopic coronary artery bypass and the rate of bilateral internal mammary artery use, which were both lower in women (49.3% vs 64.6%, P = 0.024, and 42.3% vs 56.8%, P = 0.036, respectively). The mean ± SD length of hospital stay (women vs men: 3.99 ± 4.00 vs 3.39 ± 2.42, P = 0.324) was comparable. The 30-day mortality in women and men was 0% (0/71) and 2.1% (4/192), respectively ( P = 0.577). The morbidity and mortality of single- or multi-vessel connector totally endoscopic coronary artery bypass were similar between men and women. Conclusions We conclude that the morbidity and mortality in women after robotic beating heart connector totally endoscopic coronary artery bypass in our center were similar to those seen in men.
Long-Term Outcome of Patients Undergoing Minimally Invasive Direct Coronary Artery Bypass Surgery
Authors: Farid Shakil , Ali Jason M. , Stohlner Victoria , Alam Ruhina , Schofield Peter , Nashef Samer , De Silva Ravi 
Published: February 2018

Objective The primary objective was to investigate the long-term survival of patients who underwent single-vessel coronary revascularization with minimally invasive direct coronary artery bypass surgery with or without hybrid revascularization. The secondary outcome measures were repeat revascularization either by coronary artery bypass grafting or by percutaneous coronary intervention and the incidence of myocardial infarction or recurrent angina. Methods This is a retrospective study of prospectively collected data of patients who underwent minimally invasive direct coronary artery bypass procedure in our center between January 2001 and December 2015. Procedures were performed either through small left anterolateral thoracotomy or lower midline sternotomy. Results A total of 182 patients were identified: 100 underwent minimally invasive direct coronary artery bypass to the left anterior descending artery and 82 underwent hybrid revascularization (percutaneous coronary intervention to coronary arteries other than the left anterior descending artery along with minimally invasive direct coronary artery bypass to the left anterior descending artery). The mean ± SD age was 62 ± 10.1 years. Preoperatively 82% were male, and 72.5% patients had good left ventricular function. The median follow-up period was 10.9 years. There was no inhospital or 30-day mortality. The 10-year actuarial survival was 84.8%. Freedom from repeat revascularization was 98.9% at 1 year and 89.9% at 10 years. At follow-up, freedom from myocardial infarction was 96.7% whereas freedom from angina was 92.9%. Conclusions Within the limitations imposed by retrospective analyses, our study demonstrates excellent long-term outcome in patients undergoing minimally invasive direct coronary artery bypass with or without hybrid revascularization. For isolated left anterior descending artery disease minimally invasive direct coronary artery bypass should be considered, whereas hybrid revascularization (percutaneous coronary intervention and minimally invasive direct coronary artery bypass) should be considered for multivessel disease.
Infliximab Plus Intravenous Immunoglobulin (IVIG) Versus IVIG Alone as Initial Therapy in Children With Kawasaki Disease Presenting With Coronary Artery Lesions
Authors: Jone Pei-Ni , Anderson Marsha S. , Mulvahill Matthew J. , Heizer Heather , Glodé Mary P. , Dominguez Samuel R. 
Published: February 2018

Background:
We previously demonstrated that 80% of Kawasaki disease (KD) patients who develop coronary artery lesions (CALs) have them at diagnosis. We postulated that KD patients presenting with CALs represent a group that may benefit from more aggressive initial therapy. Infliximab has been shown to decrease inflammation in KD patients when added to standard therapy. We compared outcomes of KD patients with CALs initially treated with intravenous immunoglobulin (IVIG) alone versus IVIG plus infliximab.

Methods:
Medical records of KD patients from January 2009 to July 2016 were retrospectively reviewed. CALs were defined as a left anterior descending or right coronary artery Z score ≥2.5. KD patients with CALs on initial echocardiogram treated with IVIG alone were compared with those treated with IVIG plus infliximab. Clinical characteristics were compared between groups using Wilcoxon rank-sum test, χ2 test and Fischer’s exact tests; length of stay was analyzed using log-normal regression and need for additional therapy using logistic regression. Effect of treatment on CALs between groups was assessed using linear mixed models.

Results:
Sixty-nine KD patients with CALs at presentation were included. Fifteen of 34 (44%) patients treated with IVIG alone required additional therapy compared with 4 of 35 (11%) patients treated with IVIG plus infliximab (P = 0.003). There were no significant differences between treatment groups for length of stay, CALs or C-reactive protein fall.

Conclusions:
IVIG plus infliximab as initial therapy reduces the need for additional therapy in KD patients presenting with CALs. Intensified initial therapy, consisting of infliximab plus IVIG, could be considered for this group of KD patients.
Moraxella Species Bacteremia in Cancer Patients
Authors: Denham James Dustin , Nanjappa Sowmya , Greene John N. 
Published: February 2018

Abstract

Moraxella is a genus of gram-negative diplococci considered to be an important cause of upper respiratory tract disease in humans. Bacteremia caused by Moraxella species, however, remains rare and tends to occur in individuals with a compromised immune system. We reviewed all cultures positive for Moraxella species at an academic cancer hospital between the years of 2011 and 2016. We also performed a literature review of Moraxella species bacteremia in cancer patients in the decade between 2006 and 2016. At the H. Lee Moffitt Cancer Center, between 2011 and 2016, there were 41 positive cultures (from all sites) for Moraxella species. Of these 41 cultures, only 3 were positive blood cultures. Our findings indicate that bacteremia caused by Moraxella species can range in severity from fever and chills to frank sepsis. As has been noted in other publications, the source of the bacteremia is not always clinically apparent, but upper and lower respiratory sources seem to predominate. None of the patients presented in this case series died of their bacteremia. The 2 publications discovered in our literature review similarly describe 2 nonfatal cases of Moraxella osloensis bacteremia: 1 case in a patient with a recent diagnosis of acute myeloid leukemia and 1 case in a patient with an unspecified lung cancer.
Clostridium Perfringens Infection With Massive Hemolysis
Authors: Wilson Paul A. , Tierney Lex , Varadhan Hemalatha 
Published: February 2018

AbstractClostridium perfringensinfection is rarely complicated by severe hemolysis caused by the microbial alpha-toxin, a phospholipase. Patients with this complication usually have a hepatobiliary or colonic source of infection. The mortality rate is extremely high when massive hemolysis supervenes, and the duration of illness from symptom onset to death is often only hours. We describe a patient with a liver abscess,C perfringensbacteremia, and massive hemolysis with severe multiorgan failure. He survived with supportive treatment including aggressive transfusion of packed red cells, systemic antibiotics, and surgical intervention. A literature review disclosed 45 cases of arbitrarily defined massive hemolysis, with 41/45 (91.1%) mortality and a median survival time of 6 hours from symptom onset in those patients who died. There were no reported survivors in cases of hemolysis due toC perfringenssepticemia of the severity seen in our patient. A search of the area pathology service database identified 132 cases ofC perfringensbacteremia during the period January 2001 to December 2016. Although there were no well-confirmed (by laboratory testing) cases of massive hemolysis in these patients, 4 of 132 patients (3%) died suddenly with blood samples that were not analyzed because of marked visual hemolysis.
The Impact of a Health Information Technology–Focused Patient-centered Medical Neighborhood Program Among Medicare Beneficiaries in Primary Care Practices
Authors: Orzol Sean , Keith Rosalind , Hossain Mynti , Barna Michael , Peterson G. Greg , Day Timothy , Gilman Boyd , Blue Laura , Kranker Keith , Stewart Kate A. , Hoag Sheila , Moreno Lorenzo 
Published: February 2018

Background:
The Center for Medicare & Medicaid Innovation (CMMI) tests new models of paying for or delivering health care services and expands models that improve health outcomes while lowering medical spending. CMMI gave TransforMED, a national learning and dissemination contractor, a 3-year Health Care Innovation Award (HCIA) to integrate health information technology systems into physician practices. This paper estimates impacts of TransforMED’s HCIA-funded program on patient outcomes and Medicare parts A and B spending.

Research Design:
We compared outcomes for Medicare fee-for-service (FFS) beneficiaries served by 87 treatment practices to outcomes for Medicare FFS beneficiaries served by 286 matched comparison practices, adjusting for differences in outcomes between the 2 groups during a 1-year baseline period. We estimated impacts in 3 evaluation outcome domains: quality-of-care processes, service use, and spending.

Results:
We estimated the program led to a 7.1% reduction in inpatient admissions and a 5.7% decrease in the outpatient emergency department visits. However, there was no evidence of statistically significant effects in outcomes in either the quality-of-care processes or spending domains.

Conclusions:
These results indicate that TransforMED’s program reduced service use for Medicare FFS beneficiaries, but also show that the program did not have statistically significant favorable impacts in the quality-of-care processes or spending domains. These results suggest that providing practices with population health management and cost-reporting software—along with technical assistance for how to use them—can complement practices’ own patient-centered medical home transformation efforts and add meaningfully to their impacts on service use.
Care Experiences Among Medicare Beneficiaries With and Without a Personal Physician
Authors: Martsolf Grant R. , Elliott Marc N. , Haviland Amelia M. , Burkhart Q , Orr Nate , Gaillot Sarah , Saliba Debra 
Published: February 2018

Background:
Having a “personal” physician is a critical element to care continuity. Little is known about which older adults are more likely to lack personal physicians and if their care experiences differ from those with a personal physician.

Objective:
The objective of this study was to describe care experiences and characteristics associated with not having a personal physician.

Research Design:
We compare rates of lacking a personal physician across subgroups. Using doubly robust propensity-score–weighted regression, we compare patient experience among beneficiaries with and without a personal physician.

Subjects:
A total of 272,463 nationally representative beneficiaries age 65+ responding to the 2012 Medicare CAHPS survey.

Measures:
Beneficiary characteristics, having a personal physician, 4 patient experience measures.

Results:
Five percent of respondents reported no personal physician. Lacking a personal physician was more common for men, racial/ethnic minorities (eg, 16% of American Indian/Alaska Natives), and the younger and less educated. Those without a personal physician reported substantially poorer experiences on 4 measures (P<0.001); these differences are larger than those observed by key demographic characteristics. Beneficiaries without a personal physician were more than 3 times as likely to have not seen any health care provider in the last 6 months.

Conclusions:
Even with the access provided by Medicare, a small but nontrivial proportion of seniors report having no personal physician. Those without a personal physician report substantially worse patient experiences and lacking a personal physician is more common for some vulnerable groups. This may underlie some previously observed disparities. Efforts should be made to encourage and help seniors without personal physicians to select one.
Hemolysis and immune regulation
Authors: Zhong Hui , Yazdanbakhsh Karina 
Published: February 2018

Purpose of review
Hemolytic anemias caused by premature destruction of red blood cells occur in many disorders including hemoglobinopathies, autoimmune conditions, during infection or following reaction to drugs or transfusions. Recent studies which will be reviewed here have uncovered several novel mechanisms by which hemolysis can alter immunological functions and increase the risk of severe complications in hemolytic disorders.

Recent findings
Plasma-free heme can induce the formation of neutrophil extracellular traps (NETs) through reactive oxygen species signaling. Although NETs protect the host against infections, in patients with sickle disease, they are associated with vaso-occlusive crises. Heme may increase host susceptibility to infections by inducing heme oxygenase 1 (HO-1) in immature neutrophils, thereby inhibiting oxidative burst required for clearance of engulfed bacteria. In addition, heme impairs macrophage phagocytosis and microbial clearance through inhibition of cytoskeletal remodeling. Hemolysis can also favor anti-inflammatory immune cell polarization by inhibiting dendritic cell maturation necessary for effector T-cell responses, inducing differentiation of monocytes into red pulp macrophages, important for iron recycling from senescent erythrocytes, and driving regulatory T-cell expansion through modulation of HO-1 expression in nonclassical monocytes.

Summary
Hemolysis breakdown products show remarkable effects on the regulation of immune cell differentiation and function.
Intraoperative Cervical Treatment Does Not Affect the Prevalence of Vaginal Bleeding 1 Year Postoperatively After Subtotal Hysterectomy: A Register Study From the Swedish National Register for Gynecological Surgery
Authors: Borendal Wodlin Ninnie 
Published: February 2018

(Abstracted from Acta Obstet Gynecol Scand 2017;96(12):1430–1437)
A subtotal hysterectomy implies retaining the cervix. Women who undergo this procedure are more likely to present with persistent vaginal bleeding (PVB) after surgery.
Evaluation and Management of Maternal Congenital Heart Disease: A Review
Authors: Hopkins Maeve K. , Goldstein Sarah A. , Ward Cary C. , Kuller Jeffrey A. 
Published: February 2018

Objective
Congenital heart defects represent the most common major congenital anomalies. The objective of this review was to define the most common forms of congenital heart disease (CHD) in pregnancy, outline preconception counseling, discuss the associated morbidity and mortality of each lesion, and review current recommendations for management of CHD in pregnancy.

Evidence Acquisition
A MEDLINE search of “congenital heart disease in pregnancy” and specific conditions in pregnancy including “ventricular septal defect,” “atrial septal defect,” “left outflow obstruction,” “right outflow obstruction,” “tetralogy of Fallot,” and “transposition of the great vessels” was performed.

Results
The evidence included in the review contains 18 retrospective studies, 8 meta-analyses or systematic reviews or expert opinions, 5 case reports including surgical case reports, 2 prospective studies, and 2 clinical texts.

Conclusions
Given advances in surgical and medical management, women with a history of congenital cardiac defects are more frequently reaching childbearing age and requiring obstetric care. Many women with CHD can have successful pregnancies, although there are a few conditions that confer significant maternal risk, and pregnancy may even be contraindicated. Appropriate care for women with CHD requires a knowledge of cardiac physiology in pregnancy, the common lesions of CHD, and coordinated care from cardiology and maternal-fetal medicine specialists.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to compare pregnancy risks among varying types of the most common maternal CHD; apply criteria of relative and absolute contraindications to pregnancy when performing preconception counseling to women with CHD; interpret for patients and other health providers the prognosis, management, and expectations of pregnancies with women with the most common types of CHD; and select relevant imaging studies, tests, and appropriate consultations and referrals when caring for women with maternal CHD.