bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metacognition, Formative Assessment, and Student Perspective: Learning About Metacognition Through In-Class Comparison of Response Systems
Authors: Brady Melanie , Forest Christopher P. 
Published: May 2018

Purpose
Educators influence learning context through, among other things, triadic reciprocal causation—a behavioral model used in social cognitive theory. Eliciting responses from learners during instruction may contribute to learning by engaging their metacognition. In this study, metacognition was examined based on learners’ experience with 2 different polling methods: student response systems (SRS), commonly known as “clickers,” and a low-technology response system (LTRS), where students raise labeled signs, each with a different response. Scale item results are reported.

Methods
Scales measuring the influence of metacognition from polling methods were administered, following treatment (SRS) and comparison method (LTRS), to first-year physician assistant (PA) students (n = 54). Statistical tests of significance and effect size for each item were compared.

Results
Performance outcomes suggest that the SRS enhances learning experiences more than low-technology polling. Self-reported surveys indicate that self-monitoring, note-taking, and understanding during lectures are significantly improved with the use of clickers. Peer and social comparison items did not demonstrate significance collectively, but survey results indicate that candidates compared themselves to their peers significantly more with the LTRS than with the SRS.

Conclusion
Findings support the practice of using an electronic SRS to poll PA students and enhance learning.
A locus at 7p14.3 predisposes to refractory celiac disease progression from celiac disease
Authors: Hrdlickova Barbara , Mulder Chris J. , Malamut Georgia , Meresse Bertrand , Platteel Mathieu , Kamatani Yoichiro , Ricaño-Ponce Isis , van Wanrooij Roy L.J. , Zorro Maria M. , Jan Bonder Marc , Gutierrez-Achury Javier , Cellier Christophe , Zhernakova Alexandra , Nijeboer Petula , Galan Pilar , Withoff Sebo , Lathrop Mark , Bouma Gerd , Xavier Ramnik J. , Jabri Bana , Bensussan Nadine C. , Wijmenga Cisca , Kumar Vinod 
Published: May 2018

Background
Approximately 5% of patients with celiac disease (CeD) do not respond to a gluten-free diet and progress to refractory celiac disease (RCD), a severe progression that is characterized by infiltration of intraepithelial T lymphocytes. Patients with RCD type II (RCDII) show clonal expansions of intraepithelial T lymphocytes that result in a poor prognosis and a high mortality rate through development of aggressive enteropathy-associated T-cell lymphoma. It is not known whether genetic variations play a role in severe progression of CeD to RCDII.

Patients and methods
We performed the first genome-wide association study to identify the causal genes for RCDII and the molecular pathways perturbed in RCDII. The genome-wide association study was performed in 38 Dutch patients with RCDII, and the 15 independent top-associated single nucleotide polymorphism (SNP) variants (P<5×10−5) were replicated in 56 independent French and Dutch patients with RCDII.

Results
After replication, SNP rs2041570 on chromosome 7 was significantly associated with progression to RCDII (P=2.37×10−8, odds ratio=2.36) but not with CeD susceptibility. SNP rs2041570 risk allele A was associated with lower levels of FAM188B expression in blood and small intestinal biopsies. Stratification of RCDII biopsies based on rs2041570 genotype showed differential expression of innate immune and antibacterial genes that are expressed in Paneth cells.

Conclusion
We have identified a novel SNP associated with the severe progression of CeD to RCDII. Our data suggest that genetic susceptibility to CeD might be distinct from the progression to RCDII and suggest a role for Paneth cells in RCDII progression.
Effects of Scleral-lens Tear Clearance on Corneal Edema and Post-lens Tear Dynamics: A Pilot Study
Authors: Tan Bo , Zhou Yixiu , Yuen Tiffany L. , Lin Kristina , Michaud Langis , Lin Meng C. 
Published: May 2018

SIGNIFICANCE
The present study with small-diameter scleral lenses (SLs) revealed that post-lens tear thickness (PoLTT) was significantly associated with post-lens tear mixing, but not with central corneal edema, after short-term SL wear.

PURPOSE
The aim of this study was to investigate the influence of SL tear clearance (PoLTT) on central corneal thickness and post-lens tear dynamics during 5-hour lens wear.

METHODS
Neophytes with no active ocular disease were fitted bilaterally with SLs (hofocon A; 15.6-mm diameter; ~438-μm thickness; 97 Dk; 1.44 refractive index) with various initial PoLTT values ranging from 74 to 543 μm. Central corneal thickness and PoLTT were measured using optical coherence tomography during lens wear. Tear mixing was assessed using fluorogram and “out-in” method.

RESULTS
The mean central corneal edema after 5-hour lens wear was 1.51% (95% confidence interval, 1.26 to 1.76%; P < .001), reached its peak at 2-hour post-lens insertion (1.65% [95% confidence interval, 1.45 to 1.85%]), and was independent of PoLTT. The fastest fluorescence decay of the post-lens tear film was observed superiorly. The fluorescence decay rate increased from center to periphery in all quadrants except superiorly. An inverse relationship was found between PoLTT and fluorescence decay rate at both 20-minute and 5-hour wear after lens insertion (P < .05). Excluding observations with out-in time exceeding 5 minutes, we found a direct relationship between PoLTT at 20 minutes after lens insertion and out-in time (P = .047). The % change in the PoLTT after 5-hour wear was greater with a thinner initial tear clearance than those with a thicker one (P = .034).

CONCLUSIONS
Within our study parameters, a thinner PoLTT under a small-diameter SL was associated with faster PoLTT mixing. However, there was no relationship between PoLTT and central corneal thickness during 5-hour SL wear.
A Random Dot Computer Video Game Improves Stereopsis
Authors: Portela-Camino Juan A. , Martín-González Santiago , Ruiz-Alcocer Javier , Illarramendi-Mendicute Igor , Garrido-Mercado Rafaela 
Published: May 2018

SIGNIFICANCE
Currently, treatments for amblyopia are occlusion or penalization of the stronger fellow eye. Fewer than 30% of patients improve stereoacuity using these treatments. In order to improve these outcomes, this group proposes a treatment to stimulate the stereoacuity through perceptual learning in a game format for use at home.

PURPOSE
The aim of this study was to determine whether perceptual learning with random dot stimuli (RDS) in the form of a computer video game improves stereopsis in patients with a history of amblyopia.

METHODS
Thirty-two stereo-deficient patients (7 to 14 years old) previously treated for amblyopia participated in a prospective, randomized, double-blind study. Participants followed a perceptual learning program at home using RDS software. In the experimental group, the demand of stereopsis was increased, until reaching the lowest detectable disparity. In the comparison group, the stimulation interval was a constant (840 to 750”). Stereoacuity was evaluated with the Randot Preschool Stereoacuity Test (RPST) and the Wirt Circles.

RESULTS
Median compliance was 100% (interquartile range [IQR] = 78.50 to 100). Log10 stereoacuity outcomes were significantly different between groups (RPST, P = .041; Wirt Circles Test, P = .009). Median stereoacuity improvement with RPST was 50% (IQR = 0.00 to 75%) and 0% (IQR = 0.00 to 7.5%), respectively, for experimental and comparison groups (P = .008). Wirt Circles improvement was 46.42% (IQR = 6.25 to 73.75%) and 0% (IQR = 0.00 to 57.50%), respectively, for experimental and comparison groups (P = .089). Stereoacuity improvement was not different between groups when success was considered a 70% gain in RPST (P = .113); it was statistically different when success was considered a gain of two levels on Wirt Circles and stereoacuity 140” or less (P = .023). Stereoacuity remained stable after 6 months when measured with RPST, whereas it worsened in two subjects when measured with Wirt Circles.

CONCLUSIONS
Direct stimulation of stereopsis at home using RDS in a game environment improves the stereoacuity in stereo-deficient subjects with a history of amblyopia.
Case Report: Optical Coherence Tomography Angiography in Morning Glory Disc Anomaly
Authors: Romano Francesco , Giuffrè Chiara , Arrigo Alessandro , Corbelli Eleonora , Battaglia Parodi Maurizio , Bandello Francesco 
Published: May 2018

SIGNIFICANCE
Morning glory disc anomaly is a congenital abnormality of the optic disc. Optical coherence tomography angiography shows vascular rarefaction of the superficial and deep capillary plexuses and increased vascularity of the radial peripapillary capillary plexus. We hypothesize that this congestion represents a compensatory mechanism to an abnormal vasculogenesis.

PURPOSE
The aim of this study was to describe the optic disc vascular alterations occurring at choriocapillaris and retinal vascular plexuses in a patient affected by bilateral morning glory disc anomaly with optical coherence tomography angiography.

CASE REPORT
A 24-year-old white man presented for clinical evaluation to our Department of Ophthalmology (San Raffaele Hospital, Milan) complaining of reduced vision in his left eye. Whereas his right eye was unremarkable (20/20), the visual acuity in the left one was limited to 20/30 Snellen equivalent. Funduscopic examination revealed bilateral funnel-shaped optic disc excavation, with a central mass of glial tissue and straight retinal vessels radially emerging from the disc margin, more evident in the left eye; this presentation was considered compatible with bilateral morning glory disc anomaly. Optical coherence tomography angiography of the optic disc disclosed prominent vascular rarefaction of the peripapillary superficial and deep capillary plexuses and choriocapillaris, with an increased vascularity of the radial peripapillary capillary network.

CONCLUSIONS
Based on these observations, we hypothesize that the congestion of the radial peripapillary capillary plexus might be a compensatory mechanism to the abnormal vasculogenesis occurring in the optic disc of patients affected by morning glory disc anomaly.
Catalyzing Novel Approaches to Rapid, Accurate, and Affordable Early Cancer Detection
Authors: Dhar Asif , Meagher Beth , Ryscavage Andrew 
Published: May 2018

Abstract
Inspired by the Cancer Moonshot, a dedicated team of professionals worked with leaders across the cancer ecosystem to look for an opportunity to radically reduce cancer mortality globally by focusing on early cancer detection. After an initial survey of cancer innovation, progress, and pitfalls, the team believed that if new rapid, affordable, and accurate early detection solutions were appropriately brought to market, it would be possible to intervene earlier when cancer is most treatable.
An extensive process began, informed by dozens of experts in the cancer ecosystem. The Cancer XPRIZE team designed a prize competition where “the winning team will develop a means to rapidly, accurately, and affordably screen for early cancers where intervention can reduce human suffering.”
The following outlines the Cancer XPRIZE's experience using a powerful approach—the radical prize design—to catch more cancers in time to make a difference saving lives, dollars, and suffering.
The First Year of the Food and Drug Administration Oncology Center of Excellence
Authors: Goldberg Kirsten B. , Blumenthal Gideon M. , Pazdur Richard 
Published: May 2018

Abstract
The Food and Drug Administration formally established the Oncology Center of Excellence (OCE) in January 2017, as authorized by the 21st Century Cures Act, to expedite the development and review of certain drugs, biologics, and devices for the treatment of cancer. In its first year, the OCE conducted the clinical reviews for several products, including the first 2 chimeric antigen receptor T-cell therapies approved for the treatment of advanced hematologic malignancies and an in vitro diagnostic next-generation sequencing panel, FoundationOne CDx. The OCE also worked with professional societies and patient advocates on efforts to modernize clinical trial eligibility criteria, resulting in recommendations regarding minimal age, brain metastases, organ dysfunction, and human immunodeficiency virus coinfection. Altogether in 2017, the Food and Drug Administration approved 16 new drug and biologic applications, 30 supplemental drug and biologic applications, and 2 biosimilar applications in oncology.
Therapeutic Effects of Human Adipose-Derived Products on Impaired Wound Healing in Irradiated Tissue
Authors: Wu Szu-Hsien , Shirado Takako , Mashiko Takanobu , Feng Jingwei , Asahi Rintaro , Kanayama Koji , Mori Masanori , Chi Daekwan , Sunaga Ataru , Sarukawa Shunji , Yoshimura Kotaro 
Published: May 2018

Background:
Clinical sequelae of irradiation result in tissue devitalization (e.g., ischemia, fibrosis, and atrophy) where wound healing capacity is impaired. Fat-derived products may work to treat such pathology.

Methods:
Nonlethal irradiation at various doses (5, 10, and 15 Gy) and frequencies (one to three times on sequential days) was delivered to dorsal skin of nude mice, and subsequent gross and microscopic changes were evaluated for up to 4 weeks. Cutaneous punch wounds were then created to compare wound healing in irradiated and nonirradiated states. Wounds were also locally injected with vehicle, cultured adipose-derived stem cells, centrifuged fat tissue, or micronized cellular adipose matrix, and the therapeutic impact was monitored for up to 15 days.

Results:
Nude mice given total doses greater than 15 Gy spontaneously developed skin ulcers, and radiation damage was dose-dependent; however, a fractionated irradiation protocol was able to reduce the damage. Histologic assessment revealed dose-dependent dermal fibrosis/thickening and subcutaneous atrophy. Dose-dependent (5 to 15 Gy) impairment of wound healing was also evident. At the highest dosage (15 Gy three times), open wounds persisted on day 15. However, wounds injected with cultured adipose-derived stem cells were nearly healed on day 12, and those treated with injection of centrifuged fat or micronized tissue healed faster than untreated controls (p < 0.05). There was no significant differences between treated groups.

Conclusions:
Tissue devitalization by irradiation was dose-dependent, although fractionated protocols helped to reduce it. Adipose-derived stem cells and other fat-derived products harboring adipose-derived stem cells successfully revitalized irradiated tissues and accelerated wound healing.
An Apparent Diffusion Coefficient Histogram Method Versus a Traditional 2-Dimensional Measurement Method for Identifying Non–Puerperal Mastitis From Breast Cancer at 3.0 T
Authors: Tang Qi , Li Qiang , Xie Dong , Chu Ketao , Liu Lidong , Liao Chengcheng , Qin Yunying , Wang Zheng , Su Danke 
Published: May 2018

Purpose
This study aimed to investigate the utility of a volumetric apparent diffusion coefficient (ADC) histogram method for distinguishing non–puerperal mastitis (NPM) from breast cancer (BC) and to compare this method with a traditional 2-dimensional measurement method.

Materials and Methods
Pretreatment diffusion-weighted imaging data at 3.0 T were obtained for 80 patients (NPM, n = 27; BC, n = 53) and were retrospectively assessed. Two readers measured ADC values according to 2 distinct region-of-interest (ROI) protocols. The first protocol included the generation of ADC histograms for each lesion, and various parameters were examined. In the second protocol, 3 freehand (TF) ROIs for local lesions were generated to obtain a mean ADC value (defined as ADC-ROITF). All of the ADC values were compared by an independent-samples t test or the Mann-Whitney U test. Receiver operating characteristic curves and a leave-one-out cross-validation method were also used to determine diagnostic deficiencies of the significant parameters.

Results
The ADC values for NPM were characterized by significantly higher mean, 5th to 95th percentiles, and maximum and mode ADCs compared with the corresponding ADCs for BC (all P < 0.05). However, the minimum, skewness, and kurtosis ADC values, as well as ADC-ROITF, did not significantly differ between the NPM and BC cases.

Conclusions
Thus, the generation of volumetric ADC histograms seems to be a superior method to the traditional 2-dimensional method that was examined, and it also seems to represent a promising image analysis method for distinguishing NPM from BC.
Cost-effectiveness of Routine Postoperative Retrograde Voiding Trials Following Pelvic Surgeries
Authors: Wang Rui , Soeteman Djøra I. , Hacker Michele R. , Lefevre Roger 
Published: May 2018

Objective
The aim of this study was to evaluate the cost-effectiveness of retrograde voiding trials in the management of postoperative voiding dysfunction.

Methods
We developed a disease simulation model to assess under which conditions routine retrograde voiding trial is the optimal strategy in terms of cost per quality-adjusted life-year and cost per case of chronic voiding dysfunction avoided. We varied the incidence of voiding dysfunction between 2% and 60%. We discounted future costs and utilities at 3% annually. We conducted 1- and 2-way sensitivity analyses on uncertain model parameters.

Results
The lifetime analysis showed that when the incidence of postoperative voiding dysfunction exceeded 12.2%, retrograde voiding trials were cost-effective, assuming a willingness-to-pay (WTP) for health of $100,000/quality-adjusted life-year. When the incidence exceeded 31.1%, retrograde voiding trials became the dominant strategy (less costly and more effective). For a simple hysterectomy with voiding dysfunction incidence of approximately 10%, lifetime cost is $230,069/case of chronic voiding dysfunction avoided; for a midurethral sling with voiding dysfunction incidence of approximately 20%, lifetime cost is $60,449/case avoided. Sensitivity analyses showed that WTP for health, the incidence of presentation to the emergency department (ED) for urinary retention and the incidence of chronic urinary retention following treatment in the ED had the greatest impact on the cost-effectiveness results.

Conclusions
Routine retrograde voiding trials following pelvic surgery can be cost-effective compared with expectant management when the incidence of voiding dysfunction exceeds 12.2%. These results were sensitive to WTP for health, incidence of ED visits for urinary retention, and incidence of chronic urinary retention following ED visits.
Long-term, patient-centered outcomes of lower-extremity vascular trauma
Authors: Perkins Zane B. , Yet Barbaros , Glasgow Simon , Marsh D. William R. , Tai Nigel R.M. , Rasmussen Todd E. 
Published: May 2018

OBJECTIVE
To describe the long-term outcomes of military lower-extremity vascular injuries, and the decision making of surgeons treating these injuries.

BACKGROUND
Lower-extremity vascular trauma is an important cause of preventable death and severe disability, and decisions on amputation or limb salvage can be difficult. Additionally, the complexity of the condition is not amenable to controlled study, and there is limited data to guide clinical decision making and establish sensible treatment expectations during rehabilitation.

METHODS
A cohort study of 554 US service members who sustained lower-extremity vascular injury in Iraq or Afghanistan (March 2003 to February 2012) was performed using the military's trauma registry, its electronic health record, patient interviews, and quality-of-life surveys. Long-term surgical and functional outcomes, and the timing and rationale of surgical decisions, were analyzed.

RESULTS
Of 579 injured extremities, 49 (8.5%) underwent primary amputation and 530 (91.5%) an initial attempt at salvage. Ninety extremities underwent secondary amputation, occurring in the early (n = 60; <30 days) or late (n = 30; >30 days) phases after injury. For salvage attempts, freedom from amputation 10 years after injury was 82.7% (79.1%–85.7%). Long-term physical and mental health outcomes were similar between service members who underwent reconstruction and those who underwent amputation.

CONCLUSION
This military experience provides data that will inform an array of military and civilian providers who care for patients with severe lower-extremity injury. While the majority salvage attempts endure, success is hindered by ischemia and necrosis during the acute stage and pain, dysfunction and infection in the later phases of recovery.

LEVEL OF EVIDENCE
Therapeutic/prognostic, level III.
Interrupted versus continuous fascial closure in patients undergoing emergent laparotomy: A randomized controlled trial
Authors: Peponis Thomas , Bohnen Jordan D. , Muse Sandra , Fuentes Eva , van der Wilden Gwendolyn M. , Mejaddam Ali , Alam Hasan , Kaafarani Haytham M.A. , Fagenholz Peter J. , King David R. , Yeh D. Dante , Velmahos George C. , de Moya Marc A. 
Published: May 2018

BACKGROUND
The optimal method of fascial closure, interrupted fascial closure (IFC) versus continuous fascial closure (CFC) has never been studied exclusively in the setting of emergency surgery. We hypothesized that IFC decreases postoperative incisional hernia development following emergent laparotomies.

METHODS
Between August 2008 and September 2015, patients undergoing emergent laparotomies were consented and randomly assigned to either IFC or CFC. Patients were followed up postoperatively for at least 3 months and assessed for incisional hernia, dehiscence, or wound infection. We excluded those with trauma, elective surgery, mesh in place, primary ventral hernia, previous abdominal surgery within 30 days, or those not expected to survive for more than 48 hours. Our primary endpoint was the incidence of postoperative incisional hernias.

RESULTS
One hundred thirty-six patients were randomly assigned to IFC (n = 67) or CFC (n = 69). Baseline characteristics were similar between the groups. No difference was noted in the length of the abdominal incision, or the peak inspiratory pressure after the closure. The median time needed for closure was significantly longer in the IFC group (22 minutes vs. 13 minutes, p < 0.001). Thirty-seven (55.2%) IFC and 41 (59.4%) CFC patients completed their follow-up visits. There was no statistically significant difference in baseline and intraoperative characteristics between those who completed follow-ups and those who did not. The median time from the day of surgery to the day of the last follow-up was similar between IFC and CFC (233 days vs. 216 days, p = 0.67), as were the rates of incisional hernia (13.5% versus 22.0%, p = 0.25), dehiscence (2.7% vs. 2.4%, p = 1.0), and surgical site infection (16.2% vs. 12.2%, p = 0.75).

CONCLUSION
There was no statistically detectable difference in postoperative hernia development between those undergoing IFC versus CFC after emergent laparotomies. However, this may be due to the relatively low sample size.

LEVEL OF EVIDENCE
Therapeutic/Care Management Study, level III.