bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Mortality in Patients With Muscle-Invasive Bladder Cancer Undergoing Cystectomy in the United States
Authors: Marqueen Kathryn E , Waingankar Nikhil , Sfakianos John P , Mehrazin Reza , Niglio Scot A , Audenet François , Jia Rachel , Mazumdar Madhu , Ferket Bart S , Galsky Matthew D 
Published: November 2018

Abstract

Background
Although radical cystectomy (RC) is a standard treatment for muscle-invasive bladder cancer (MIBC), for many patients the risks versus benefits of RC may favor other approaches. We sought to define the landscape of early postcystectomy mortality in the United States and identify patients at high risk using pretreatment variables.

Methods
We identified patients with MIBC (cT2-T4aN0M0) who underwent RC without perioperative chemotherapy within the National Cancer Database (2003–2012). Using multistate multivariable modeling, we calculated time spent in three health states: hospitalized, discharged, and death more than 90 days postcystectomy. Cross-validation was performed by geographic region. Time spent in each state was weighted by utility to determine 90-day quality-adjusted life days (QALDs).

Results
Among 7922 patients, 90-day mortality was 7.6% (8.0% for lower and 6.7% for higher volume hospitals). Increasing age, clinical T stage, Charlson Comorbidity Index, and lower volume were associated with higher 90-day mortality and were included in the model. Cross-validation revealed appropriate performance (C-statistics of 0.53–0.74; calibration slopes of 0.50–1.67). The model predicted 25% of patients had a 90-day mortality risk higher than 10%, and observed 90-day mortality in this group was 14.0% (95% CI = 12.5% to 15.6%). Mean quality-adjusted life days (QALDs) was 63 (range = 44–68).

Conclusions
RC is associated with relatively high early mortality risk. Pretreatment variables may identify patients at particularly high risk, which may inform clinical trial design, facilitate shared decision making, and enhance quality improvement initiatives.
Mating analyses of Trichophyton benhamiae offspring reveals linkage of genetic markers used in taxonomy
Authors: Burmester A , Hipler U-C , Elsner P , Wiegand C 
Published: November 2018

AbstractMating experiments were conducted with four clinical Trichophyton benhamiae isolates, genetically similar to the Trichophyton benhamiae CBS 112371, featuring the plus mating type and with two minus type strains. One minus type strain belonged to the white subgroup, and the other minus type strain, DSM 6916, showed genetic kinship to the yellow subgroup. Only two plus type strains were able to form mature, pigmented gymnothecia with DSM 6916. These two plus type strains demonstrated dark pigmentation and powdery mycelium on Takashio agar, whereas the other three strains exhibited a low degree of pigmentation on the same medium. All five plus strains were able to mate with the minus type strain of their own white subgroup. Cultures from single ascospore isolates showed highly variable morphology and pigmentation. Three genetic markers (ITS, mating type, EF1 alpha) were analyzed in polymerase chain reaction (PCR) experiments with optimized primers and PCR conditions to discriminate between subgroups. Furthermore, RAPD-PCR was used to generate a DSM 6916-specific DNA-fragment which served as an additional genetic marker. Assessing the isolates with recombinant genotypes, it was found that three genetic markers behave like linked genes. The recombination of plus mating type went together with ITS, EF1 alpha and RAPD marker of the DSM 6916 parental strain and was most frequently isolated, whereas plus types recombinants in this case were completely missing. This shows a high imbalance in mating type distribution of recombinants.
The fifth force in the local cosmic web
Authors: Desmond Harry , Ferreira Pedro G , Lavaux Guilhem , Jasche Jens 
Published: November 2018

ABSTRACT
Extensions of the standard models of particle physics and cosmology often lead to long-range fifth forces with properties dependent on gravitational environment. Fifth forces on astrophysical scales are best studied in the cosmic web where perturbation theory breaks down. We present constraints on chameleon- and symmetron-screened fifth forces with Yukawa coupling and megaparsec range – as well as unscreened fifth forces with differential coupling to galactic mass components – by searching for the displacements they predict between galaxies’ stars and gas. Taking data from the AlfalfaH i survey, identifying galaxies’ gravitational environments with the maps of Desmond et al. and forward modelling with a Bayesian likelihood framework, we set upper bounds on fifth-force strength relative to Newtonian gravity from ∼few × 10−4 (1σ) for range λC = 50 Mpc, to ∼0.1 for λC = 500 kpc. In f(R) gravity this requires fR0 ≲ few × 10−8. The analogous bounds without screening are ∼few × 10−4 and few × 10−3. These are the tightest and among the only fifth-force constraints on galaxy scales. We show how our results may be strengthened with future survey data and identify the key features of an observational programme for furthering fifth-force tests beyond the Solar system.
A3-A3 Anastomosis in the Management of Complex Anterior Cerebral Artery Aneurysms: Experience With in Situ Bypass and Lessons Learned From Pseudoaneurysm Cases
Authors: Ravina Kristine , Strickland Ben A , Rennert Robert C , Chien Mark , Mack William J , Amar Arun P , Russin Jonathan J 
Published: November 2018

Abstract

BACKGROUND
A3-A3 side-to-side bypass is an intracranial-to-intracranial (IC-IC) revascularization option when aneurysm treatment involves occlusion of one anterior cerebral artery (ACA).

OBJECTIVE
To describe applications of A3-A3 side-to-side bypass in the management of ACA true and pseudoaneurysms along with a review of pertinent literature.

METHODS
Six consecutive patients undergoing an A3-A3 bypass as part of their aneurysm management, representing a single-surgeon experience in a 2-yr period, were included in this retrospective review of a prospectively collected database.

RESULTS
Three male and three female patients with a median (range) age of 41.5 (11-69) years representing four ruptured and two unruptured aneurysms were included. Two of the aneurysms were communicating while four were postcommunicating from which three were pseudoaneurysms. Complete aneurysm obliteration was achieved in 5/6 cases. Bypass patency was evaluated in all cases intra- and postoperatively. Good outcomes (modified Rankin Scale score ≤ 2) at follow-up were observed in 4/6 patients. An improvement in mRS scores at the most recent follow-up as compared to preoperative status was achieved in three while scores remained the same in two patients. Ischemic complications related to aneurysm treatment were observed in two patients, both of which achieved good functional recovery upon follow-up. One patient deceased postoperatively due to progression of vasospasm-related infarcts.

CONCLUSION
A3-A3 bypass in the management of true as well as pseudoaneurysms of the ACA can achieve good postoperative outcomes in selected patients. Prompt diagnosis and aggressive surgical treatment needs to be pursued if a vessel injury with pseudoaneurysm formation is suspected.
Impact of troop leader training on the implementation of physical activity opportunities in Girl Scout troop meetings
Authors: Schlechter Chelsey R , Rosenkranz Richard R , Guagliano Justin M , Dzewaltowski David A 
Published: November 2018

Abstract
Girl Scouts (GS) is a setting with large reach to target increased moderate-to-vigorous physical activity (MVPA) in girls. The Scouting Nutrition and Activity Program (SNAP) increased MVPA during intervention troop meetings; therefore, further examination of implementation of SNAP components is warranted to determine the processes contributing to intervention success. The purpose of this study is to examine variability in implementation of an active recreation (AR) policy into GS troop meetings. Troop leaders (n = 7) were randomized to receive SNAP, an intervention training on implementing a policy promoting AR, or a standard control. Meetings (seven meetings/troop) were observed, and girls in attendance (n = 76, 9–13 years, mean ± SD = 10.51 ± 1.19 years) wore ActiGraph GT1M accelerometers. Two observers attended each meeting and recorded start/stop points of AR time segments, as well as other tasks (i.e., opening/closing, snack, and Girl Scout curriculum [GSC]). Time-segmented accelerometer data were analyzed using Evenson cut points and paired with observation data. Researchers observed 181 segments (mean/day ± SD = 3.77 ± 1.24). Intervention troops implemented more AR segments/day (mean/day = 0.86; 95% CI = 0.62–1.09) than control troops (mean/day = 0.18; 95% CI = 0.00–0.39). A greater percentage of time (%time) was spent in MVPA during AR segments (mean = 10.99; 95% CI = 7.16–14.82) compared with GSC segments (mean = 0.73; 95% CI = 0.00–4.10), opening/closing (mean = 3.96; 95% CI = 0.54–7.38), and snack (mean = 0.74; 95% CI = 0.00–4.10) segments, and during opening/closing segments compared with GSC and snack segments. Intervention troops implemented more AR segments than control troops. Troop meeting patterns of PA were influenced by task. Adding time segments conducive to PA could increase the %time spent in MVPA during GS troop meetings.
Drug Use-Related Normative Misperceptions and Behaviors Among Persons Seeking Heroin Withdrawal Management
Authors: Kenney Shannon R. , Anderson Bradley J. , Bailey Genie L. , Stein Michael D. 
Published: November 2018

Objective:
Normative perceptions about substance use are well-established predictors of substance use risk behaviors, yet no research to date has examined how people who use heroin perceive the drug use behaviors and their association with personal behaviors. In a sample of persons seeking heroin withdrawal, we compared normative beliefs (descriptive norms) about others’ drug use behaviors, and examined the association between normative beliefs and behaviors.

Method:
Participants (n = 241) were patients undergoing short-term inpatient heroin withdrawal management in Massachusetts. t-Tests were used to compare participants’ perceptions about various substance use behaviors among both US adults and persons seeking heroin withdrawal at the same site. We also examined associations between participants’ normative beliefs and personal substance use behaviors.

Results:
Participants significantly overestimated drug-related risk behaviors of adults nationally; overall, participants estimated that 44.7% had tried heroin, 37.6% had injected drugs in the past year, and 63.2% had smoked marijuana in the past month when actual national rates are 2.0%, 0.3%, and 5.5%, respectively. Participants also held significant misperceptions about contemporaneous patients in the heroin withdrawal program; behaviors about sharing works, diverting buprenorphine or methadone, and exchanging sex for drugs or money were most substantially overestimated. Normative perceptions were associated with a range of personal drug-using behaviors (eg, injection drug use, exchanging sex for drugs or money).

Conclusions:
Consistent with existing substance use norms research, participants in the current sample tended to overestimate others’ engagement in risky substance use, and these normative perceptions were associated with increased personal risk. Leveraging norms in heroin harm reduction interventions may hold substantial promise.
Evaluation of the efficacy of part-time versus full-time brace wear in subjects with adolescent idiopathic scoliosis (AIS): a review of literature
Authors: Karimi Mohammad Taghi , Rabczuk Timon , Kavyani Mahsa , Macgarry Anthony 
Published: November 2018

Background:
Scoliosis is a musculoskeletal disorder that can be managed by wearing an orthosis full or part time. It is not well understood whether the effectiveness of part-time orthotic management of spinal curve progression is as efficacious as full-time wear. The aim of this review was to determine the efficiency of part-time bracing (with a focus on night-time braces), compared to full-time bracing. Moreover, the study aimed to determine which part-time brace demonstrated the most efficacy.

Method:
A literature review was conducted via a Medline search in PubMed, ISI Web of knowledge, Scopus, Ebsco, Embasco, and Google Scholar. Key words (part time, night braces) were used in combination with adolescent idiopathic scoliosis. The quality of the selected papers was evaluated based on the Downs and Black tool.

Results:
Fifty papers were found. Following application of inclusion and exclusion criteria based on titles and abstracts, 19 papers were selected for final analysis. These papers were divided into three categories: (1) evaluation of the efficacy of night braces on progression of scoliotic curve (seven papers); (2) Comparison of efficacy between night and full-time bracing (10 studies); and (3) three-dimensional modeling and finite element analysis of part-time bracing.

Conclusions:
The Providence brace appears to provide an effective treatment approach to influence curve progression in scoliotic patients. However, it should be emphasized that its maximal effect is for lumbar, lumbosacral, and thoracic curves with a low apex. It is recommended to use the Charleston Bending brace only for patients with a single scoliotic curve. The efficacy of full-time bracing for double curves, thoracolumbar curves, and curves more than 35 degrees indicates that more than just a night brace is necessary. However, it seems that there is no difference between the effects of part-time and full-time bracing for curves of smaller magnitude (less than 35 degrees).
Outcome of ligamentotaxis and percutaneous screws for navicular fractures
Authors: Diab Hossam S. 
Published: November 2018

Background:
The tarsal navicular bone plays a pivotal role in hindfoot motion and gait and is considered as a keystone of the foot’s medial longitudinal arch. Despite being relatively uncommon, navicular fractures are difficult to treat and may end up with devastating complications. The purpose of this study was to evaluate the effectiveness of fracture reduction with ligamentotaxis and maintenance of the reduction through percutaneous screw fixation.

Methods:
Twelve patients with comminuted navicular fractures were surgically treated and enrolled in this prospective study. Patients were evaluated through Foot and Ankle Outcome score (FAOS) and Ankle-Hindfoot scale. A composite questionnaire, including the EuroQol-5D (EQ-5D) and Visual Analog Scale (VAS) for pain and satisfaction with the surgical result was executed.

Results:
All patients returned to their preinjury activity level at their final follow-up. Eleven patients presented excellent FAOS score of ≥90. The mean FAOS score for all patients included in the study was 92.91 (SD; 3.26, range 86 to 98), and the mean Ankle-Hindfoot scale was 92.67 (SD 2.84). The mean health-related quality of life (EQ-5D) index score was 9.50, with an overall satisfaction scale of 9.83 (SD 0.39).

Conclusions:
Adequate reduction of navicular fractures can be achieved with axial traction through temporary Steinmann pins in the calcaneus and medial cuneiform. Minimally invasive percutaneous screws can maintain reduction, with excellent functional outcome
The role of complement in antineutrophil cytoplasmic antibody-associated vasculitis
Authors: Wester Trejo Maria A.C. , Trouw Leendert A. , Bajema Ingeborg M. 
Published: November 2018

Purpose of review
To provide a comprehensive overview of the current insight into the role of complement activation in antineutrophil cytoplasmic antibody-associated vasculitis (AAV). In addition, the therapeutic options targeting the complement system in AAV are discussed.

Recent findings
It has become increasingly clear that complement, and more specifically signalling through the C5a receptor, contributes to the immunopathology of AAV. This has led to the design of clinical trials with a C5a receptor blocker. The first results show a reduction in tissue damage and a favourable safety profile, as other parts of the complement defence system are left intact.

Summary
Although AAV was initially regarded as a pauci-immune disease, it is now well established that, in addition to autoantibodies, complement plays an essential role in the disease process. Animal models delivered the first insight, but the effective therapeutic interventions using complement inhibitors provided the proof that indeed complement activation contributes to disease activity and tissue damage in human AAV.
Cost-Utility Analysis of Operative Versus Nonoperative Treatment of Thoracic Adolescent Idiopathic Scoliosis
Authors: Jain Amit , Marks Michelle C. , Kelly Michael P. , Lenke Lawrence G. , Errico Thomas J. , Lonner Baron S. , Newton Peter O. , Sponseller Paul D. 
Published: November 2018

Study Design.Cost-utility analysisObjective.To compare the cost utility of operativeversusnonoperative treatment of adolescent idiopathic scoliosis (AIS) and identity factors that influence cost-utility estimates.Summary of Background Data.AIS affects 1% to 3% of children aged 10 to 16 years. When the major coronal curve reaches 50°, operative treatment may be considered. The cost utility of operative treatment of AIS is unknown.Methods.A decision-analysis model comparing operativeversusnonoperative treatment was developed for a hypothetical 15-year-old skeletally mature girl with a 55° right thoracic (Lenke 1) curve. The AIS literature was reviewed to estimate the probability, health utility, and quality-adjusted life years (QALYs) for each event. For the conservative model, we assumed that operative treatment did not result directly in any QALYs gained, and the health utility in AIS patients was the same as the age-matched US population mean. Costs were inflation-adjusted at 3.22% per year to 2015 US dollars. Costs and benefits were discounted at 3%. Probabilistic sensitivity analysis was performed using mixed first-order and second-order Monte Carlo simulations. Incremental cost utility ratio (ICUR) and incremental net monetary benefit were calculated. One-way sensitivity analyses were performed by varying cost, probability, and QALY estimates.Results.Operative treatment was favored in 98.5% of simulations, with a median ICUR of $20,600/QALY (95% confidence interval, $20,500–$21,900) below the societal willingness-to-pay threshold (WTPT) of $50,000/QALY. The median incremental net monetary benefit associated with operative treatment was $15,100 (95% confidence interval, $14,800–$15,700). Operative treatment produced net monetary benefit across various WTPTs. Factors that most affected the ICUR were net costs associated with uncomplicated operative treatment, undergoing surgery during adulthood, and development of pulmonary complications.Conclusion.Cost-utility analysis suggests that operative treatment of AIS is favored over nonoperative treatment and falls below the $50,000/QALY WTPT for patients with Lenke 1 curves.Level of Evidence:2
30- and 90-Day Unplanned Readmission Rates, Causes, and Risk Factors After Cervical Fusion
Authors: Zaki Omar , Jain Nikhil , Yu Elizabeth M. , Khan Safdar N. 
Published: November 2018

Study Design.
Retrospective cohort study

Objective.
To study 30- and 90-day readmission rates, causes, and risk factors after anterior cervical discectomy and fusion (ACDF) and posterior cervical fusion (PCF).

Summary of Background Data.
Existing data on readmission after cervical fusion is majorly derived from national databases. Given their inherent limitations in accuracy, follow-up available, and missing data, we intend to add to literature from our institutional analysis.

Methods.
Patients who underwent ACDF and PCF for degenerative cervical pathology in 2013 and 2014 were identified for the study. Comprehensive chart review was performed to record demographics and clinical patient profile. Hospital readmission within 30 and 90 days was identified, and the causes and management were recorded. Binary logistic regression analysis was done to study risk factors for readmission. ACDF and PCF were studied separately.

Results.
Our analysis included a total of 549 patients, stratified as 389 ACDFs and 160 PCFs. The 30- and 90-day unplanned readmission rate was 5.1% and 7.7% after ACDF. These rates were 11.2% and 16.9% after PCF. The most common cause of readmission was systemic infection and sepsis after ACDF and PCF (31.4% and 25.8% of readmitted, respectively), followed by pulmonary complications after ACDF (14.3% of readmitted) and wound complications after PCF (19.4% of readmitted). Predictors of readmission after ACDF included heart failure, history of malignancy, history of deep vein thrombosis/pulmonary embolism, and any intraoperative complication. In the PCF cohort, history of ischemic heart disease, increasing number of fusion levels and longer length of stay were independently predictive.

Conclusion.
The rates, causes, and risk factors of readmission after ACDF and PCF have been identified. There is variation in published data regarding the incidence and risk factors for readmission after cervical fusion; however, majority of readmissions occur due to medical complications and systemic infection.

Level of Evidence: 3
Cervical and Cervicothoracic Sagittal Alignment According to Roussouly Thoracolumbar Subtypes
Authors: Theologis Alekos A. , Iyer Sravisht , Lenke Lawrence G. , Sides Brenda A. , Kim Han Jo , Kelly Michael P. 
Published: November 2018

Study Design.
Cross-sectional cohort.

Objective.
To determine normative radiographic sagittal cervical alignment in asymptomatic volunteers based on Roussouly thoracolumbar sagittal alignment subtypes.

Summary of Background Data.
Comprehension of differences in cervicothoracic alignment with respect to variations in thoracolumbar alignment is limited.

Methods.
Asymptomatic adults were recruited and the following parameters measured: PI, PT, SS, LL, orbital tilt, orbital slope, occipital slope and incidence, occiput-C2 lordosis, C2–7 lordosis, occiput-C7 lordosis, CBVA, T1 slope, cervicothoracic alignment, T2–5 kyphosis, and C2–C7 sagittal vertebral alignment (SVA). Each was classified into one of Roussouly's four thoracolumbar subtypes and cervical alignment parameters were compared between groups.

Results.
Eighty-seven individuals [male-23; female-64; average age 49 ± 16 yr (22–77 yr)] were included for analysis. The four groups were not different by age, sex, and body mass index (BMI). Lumbopelvic parameters (PI, SS, PT, LL) were different between Roussouly types. Average values for all patients included: CBVA (−1 ± 9°), occiput-C2 lordosis (28 ± 9°), occiput-C7 lordosis (39 ± 14°), C2–7 lordosis (11 ± 14°), C2-7 SVA (21 ± 9 mm), T1 slope (25 ± 9°), C6-T4 angle (5 ± 8°), T2-5 angle (16 ± 7°), thoracic kyphosis (47 ± 13°). No sagittal radiographic alignment measurements of the cervical spine and cervicothoracic junction were different between groups, except for the global cervical lordosis (occiput-C7 Cobb), which was found to be lowest for Roussouly type 2 (35 ± 14°) and highest for type 4 (48 ± 14°) (P = 0.01). Mean C2–C7 sagittal Cobb, T2–T5 sagittal Cobb, and T1 slope were not different between groups.

Conclusions.
In asymptomatic volunteers, normative sagittal alignment parameters of the cervical spine, cervicothoracic junction, and thoracic spine based on variations in thoracolumbar sagittal alignment, as proposed by Roussouly, are established. These data may guide surgical correction of cervicothoracic deformities to ensure appropriate restoration of normal cervicothoracic parameters to maintain good horizontal gaze and overall sagittal plane alignment.

Level of Evidence: 3