bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of thyroid status prior to transition to end-stage renal disease with early dialysis mortality
Authors: You Amy S , Sim John J , Kovesdy Csaba P , Streja Elani , Nguyen Danh V , Brent Gregory A , Kalantar-Zadeh Kamyar , Rhee Connie M 
Published: September 2018

AbstractBackgroundAdvanced chronic kidney disease (CKD) patients, including those receiving dialysis, have a high prevalence of thyroid dysfunction. Although hypothyroidism is associated with higher death risk in end-stage renal disease (ESRD) patients, no studies have examined whether thyroid status in the pre-ESRD period impacts mortality after dialysis initiation.MethodsAmong US veterans with CKD identified from the national Veterans Affairs database that transitioned to dialysis over the period from October 2007 to September 2011, we examined the association of pre-ESRD serum thyrotropin (TSH) levels averaged over the 1-year pre-dialysis (‘prelude’) period with all-cause mortality in the first year following dialysis initiation.ResultsAmong 15 335 patients in the 1-year prelude cohort, TSH levels &gt;5.0 mIU/L were associated with higher mortality in expanded case-mix Cox models (reference: TSH 0.5–5.0 mIU/L): adjusted hazard ratio (aHR) [95% confidence interval (CI) 1.20 (1.07–1.33). Similar findings were observed for TSH &gt;5.0 mIU/L and mortality in the 2- and 5-year cohorts: aHRs (95% CI) 1.11 (1.02–1.21) and 1.15 (1.07–1.24), respectively. Analyses of finer gradations of TSH in the 1-year prelude cohort demonstrated that incrementally higher levels &gt;5.0 mIU/L were associated with increasingly higher mortality in expanded case-mix models (reference: TSH 0.5–3.0 mIU/L): aHRs (95% CI) 1.18 (1.04–1.33) and 1.28 (1.03–1.59) for TSH levels &gt;5.0–10.0 mIU/L and &gt;10.0 mIU/L, respectively. In the 2- and 5-year cohorts, mortality associations persisted most strongly for those with TSH &gt;10.0 mIU/L, particularly after laboratory covariate adjustment.ConclusionsAmong new ESRD patients, there is a dose-dependent relationship between higher pre-ESRD TSH levels &gt;5.0 mIU/L and post-ESRD mortality. Further studies are needed to determine the impact of TSH reduction with thyroid hormone supplementation in this population.
Rapid Development of High-Level Resistance to Dolutegravir With Emergence of T97A Mutation in 2 Treatment-Experienced Individuals With Baseline Partial Sensitivity to Dolutegravir
Authors: George Jomy M , Kuriakose Safia S , Dee Nicola , Stoll Pam , Lalani Tahaniyat , Dewar Robin , Khan Muhammad A , Rehman Muhammad T , Grossman Zehava , Maldarelli Frank , Pau Alice K 
Published: September 2018

AbstractHIV integrase mutation T97A emerges after suboptimal therapy with integrase strand transfer inhibitors (INSTIs), but the contribution of T97A to dolutegravir resistance remains uncertain. Here we report &gt;10-fold increase in dolutegravir resistance after the single addition of T97A in 2 individuals with prior INSTI resistance receiving dolutegravir salvage therapy.
Expanding the Spectrum of Robotic Assistance in Cranial Neurosurgery
Authors: Pillai Ashok , Ratnathankom Ayyadurai , Ramachandran Sreehari N , Udayakumaran Suhas , Subhash Pramod , Krishnadas Arjun 
Published: September 2018

Abstract

BACKGROUND
Robotic automation and haptic guidance have multiple applications in neurosurgery.

OBJECTIVE
To define the spectrum of cranial procedures potentially benefiting from robotic assistance in a university hospital neurosurgical practice setting.

METHODS
Procedures utilizing robotic assistance during a 24-mo period were retrospectively analyzed and classified as stereotactic or endoscopic based on the mode utilized in the ROSA system (Zimmer Biomet, Warsaw, Indiana). Machine log file data were retrospectively analyzed to compare registration accuracy using 3 different methods: (1) facial laser scanning, (2) bone fiduciary, or (3) skin fiduciary.

RESULTS
Two hundred seven cranial neurosurgical procedures utilizing robotic assistance were performed in a 24-mo period. One hundred forty-five procedures utilizing the stereotactic mode included 33% stereotactic biopsy, 31% Stereo-EEG electrode insertion, 20% cranial navigation, 7% stereotactic catheter placement, 6% craniofacial stereotactic wire placement, 2% deep brain stimulation lead placement, and 1% stereotactic radiofrequency ablation. Sixty-two procedures utilizing the haptic endoscope guidance mode consisted of 48% transnasal endoscopic, 29% ventriculoscopic, and 23% endoport tubular access. Statistically significant differences in registration accuracies were observed with 0.521 ± 0.135 mm (n = 132) for facial laser scanning, 1.026 ± 0.398 mm for bone fiduciary (n = 22), and 1.750 ± 0.967 mm for skin fiduciary (n = 30; ANOVA, P < .001).

CONCLUSION
The combination of accurate, automated stereotaxy with image and haptic guidance can be applied to a wide range of cranial neurosurgical procedures. The facial laser scanning method offered the best registration accuracy for the ROSA system based on our retrospective analysis.
Optical follow-up observation of Fast Radio Burst 151230
Authors: Tominaga Nozomu , Niino Yuu , Totani Tomonori , Yasuda Naoki , Furusawa Hisanori , Tanaka Masayuki , Bhandari Shivani , Dodson Richard , Keane Evan , Morokuma Tomoki , Petroff Emily , Possenti Andrea 
Published: September 2018

Abstract
The origin of fast radio bursts (FRBs), bright millisecond radio transients, is still somewhat of a mystery. Several theoretical models expect that the FRB accompanies an optical afterglow (e.g., Totani et al., 2013, PASJ, 65, L12; Kashiyama 2013, ApJ, 776, L39). In order to investigate the origin of FRBs, we perform gri-band follow-up observations of FRB 151230 (estimated $z$ ≲ 0.8) with Subaru/Hyper Suprime-Cam at 8, 11, and 14 days after discovery. The follow-up observation reaches a 50% completeness magnitude of 26.5 mag for point sources, which is the deepest optical follow-up of FRBs to-date. We find 13 counterpart candidates with variabilities during the observation. We investigate their properties with multi-color and multi-wavelength observations and archival catalogs. Two candidates are excluded by the non-detection of FRB 151230 in the other radio feed horns that operated simultaneously to the detection, as well as the inconsistency between the photometric redshift and that derived from the dispersion measure of FRB 151230. Eight further candidates are consistent with optical variability seen in active galactic nuclei (AGNs). Two more candidates are well fitted with transient templates (Type IIn supernovae), and the final candidate is poorly fitted with all of our transient templates and is located off-center of an extended source. It can only be reproduced with rapid transients with a faint peak and rapid decline, and the probability of chance coincidence is ∼3.6%. We also find that none of our candidates are consistent with Type Ia supernovae, which rules out the association of Type Ia supernovae to FRB 151230 at $z$ ≤ 0.6 and limits the dispersion measure of the host galaxy to ≲300 pc cm−3 in a Type Ia supernova scenario.
Police Chiefs and Their Political Bosses: Discussions in Ontario
Authors: Stenning Philip 
Published: September 2018

Abstract
In this article, I review debates about relations between police chiefs and their governing authorities in Ontario over the last 70 years, beginning with the enactment of the Ontario Police Act in 1946, through its replacement by the Ontario Police Services Act in 1990, to the enactment of a new Police Services Act in 2018. I discuss how the respective roles and responsibilities of municipal and regional police chiefs and their police governing authorities, and the relationships between them, have evolved and changed over this period. I also discuss comparable developments in the relations between commissioners of the Ontario Provincial Police and provincial ministers responsible for policing in the province during the same period. The arguments and justifications that have been advanced for these developments by politicians, commissions of inquiry, police scholars, and representative bodies of police chiefs and police governing authorities, as well as in key court decisions, are reviewed, and their implications for the concept of ‘police independence’ are discussed. I conclude that although that concept has been the subject of much critique during these years, it so far remains intact as the key principle underlying police governance and accountability in Ontario.
Nasal challenges in allergen immunotherapy trials
Authors: Tenn Mark W. , Rawls Matthew , Ellis Anne K. 
Published: September 2018

Purpose of review
The nasal allergen challenge (NAC) model can be a valuable diagnostic tool for allergic rhinitis. Alongside its clinical use, NACs can be used as primary and secondary endpoints in studies evaluating allergen immunotherapy (AIT) products for allergic rhinitis treatment. This review will discuss the technical aspects of the NAC model and provide a summary of recent studies using NACs to assess existing and new AIT treatments.

Recent findings
Over the last 2 years, both titrated and single-dose nasal challenge protocols have been used to evaluate immunotherapies targeting grass, birch, house dust mite, and cat allergens. Early efficacy and dose-finding trials showed improvements in allergic symptoms and nasal tolerance to allergens after AIT treatment with standardized extracts or modified forms of whole allergen. NACs were also used in two proof-of-concept studies to illustrate the efficacy of intralymphatic immunotherapy with two concomitant allergens and subcutaneous immunotherapy with Fel d 1-specific IgG-blocking antibodies.

Summary
Along with existing therapies, nasal challenges are useful in evaluating AIT treatments in the very early stages of clinical development. However, because of the variety in challenge techniques and symptom assessments available, special attention must be placed in the protocol design in order to compare the study results with existing NAC publications.
Medication Treatment With Methadone or Buprenorphine: Differential Reasons for Premature Discharge
Authors: Proctor Steven L. , Birch Autumn , Herschman Philip L. 
Published: September 2018

Objectives:
Medication treatment with methadone or buprenorphine has shown demonstrated effectiveness for opioid dependence; while premature discharge is associated with adverse outcomes. Specific reasons for premature discharge generally fall into 2 broad categories (ie, patient- and program-initiated). Previous studies have typically failed to distinguish between different types of discharge reasons among patients who leave treatment early. This study sought to determine whether type of medication was associated with differential discharge reasons among medication treatment patients who were prematurely discharged.

Methods:
Data were derived from electronic health records for 5486 patients prematurely discharged from 41 for-profit licensed opioid treatment programs in the United States from 2012 to 2013. All patients were treated with methadone or buprenorphine. Patients were studied through retrospective chart review until premature discharge.

Results:
Buprenorphine patients who left treatment prematurely were 2.18 times (95% confidence interval [CI] 1.89–2.53) more likely to be discharged against medical advice relative to methadone patients after controlling for intake differences. Methadone patients were 1.76 times (95% CI 1.47–2.10) more likely to be administratively discharged after adjustment for covariates.

Conclusions:
Further research is warranted to determine whether individually-tailored strategies may improve retention for certain patients based on medication. Ongoing review of program rules and policies may benefit methadone patients, who are nearly twice as likely to be discharged for an administrative, program-initiated reason. Strategies including contingency management, motivational incentives, and psychoeducation regarding the advantages of retention may benefit buprenorphine patients who are over 2 times more likely to leave treatment early due to a patient-initiated reason.
Minimizing Spine Autofusion With the Use of Semiconstrained Growing Rods for Early Onset Scoliosis in Children
Authors: Bouthors Charles , Izatt Maree T. , Adam Clayton J. , Pearcy Mark J. , Labrom Robert D. , Askin Geoffrey N. 
Published: September 2018

Background:
A new growing rod (GR) design, the semiconstrained growing rod (SCGR), with the added advantage of axial rotation freedom within the components, has been introduced at our center which has been shown to be growth friendly. We hypothesize that the SCGR system would reduce autofusion in vivo, thereby maximizing the coronal plane correction, T1-S1 growth, and the final correction achieved at definitive fusion for children with an early onset scoliosis.

Methods:
In total, 28 patients had either single or dual 5.5 mm diameter SCGR placed minimally invasively through a submuscular approach. Surgical lengthening procedures occurred approximately every 6 months until the definitive fusion procedure was performed for 18 patients. Scoliosis, kyphosis, and lordosis angles, T1-S1 trunk length, and any complications encountered were evaluated.

Results:
For the full cohort, before GR insertion, the mean major Cobb curve angle was 72.4 degrees (SD, 18.8; range, 45 to 120), mean T1-S1 trunk length was 282 mm (SD, 59; range, 129 to 365), and at the latest follow-up (mean 6.9 y, SD 3.3, range 2.0 to 13.0), 38.8 degrees (SD, 17.5; range 10 to 90) and 377 mm (SD, 62; range, 225 to 487), respectively. For the subset of 18 patients who have had their final instrumented fusion surgery, the definitive surgery procedure alone produced a correction of the major Cobb curve angle by mean 20.3 degrees (SD, 16.1; P<0.0001), and an increase in the T1-S1 trunk length of mean 31.7 mm (SD, 23.1; P<0.0001). There were 14 complications involving 11 of the 28 patients, giving rise to 5 unplanned surgical interventions and 1 case where GR treatment was abandoned.

Conclusions:
SCGR patients exhibited statistically significant increase in T1-S1 trunk length and statistically significant decrease in the severity of scoliosis over the course of GR treatment and again, importantly, with the definitive fusion surgery, suggesting that autofusion had been minimized during GR treatment with relatively low complication rates.

Level of Evidence:
Level IV—case series.
Transepiphyseal (Type VII) Ankle Fracture Versus Os Subfibulare in Pediatric Ankle Injuries
Authors: Sugi Michelle T. , Tileston Kali , Krygier Jeffery E. , Gamble James 
Published: September 2018

Background:
Pediatric ankle injuries are common, giving rise to ∼17% of all physeal injuries. An os subfibulare in a child with an ankle sprain may be confused with a type VII transepiphyseal fracture. Here, we evaluate the clinical and radiographic features of type VII transepiphyseal fractures to those of os subfibulare presenting with acute ankle trauma with the hypothesis that radiographs are necessary for final diagnosis and neither clinical history nor examination would be diagnostic.

Methods:
We performed an internal review board-approved, retrospective chart review of patients identified with a traumatic os subfibulare or type VII ankle fracture over an 18-month period. Charts were reviewed for demographics, mechanism, and clinical findings on initial presentation. Radiographic measurements of the distal fibular fragment as well as epiphysis were made on presenting ankle series radiographs.

Results:
A total of 23 patients were identified. Eleven patients had a traumatic type VII ankle fracture and 12 had trauma associated with an os subfibulare on initial radiographs. The history and clinical presentations were similar and were nondiagnostic. The ratio of the width of the fibula at its largest point on the anterior posterior view to the width of the fibular fragment was significantly larger in the type VII ankle fractures (P=0.05). All os subfibulare were located within the inferior third of the epiphysis, whereas all type VII fractures were either at the equator or within the middle third of the fibular epiphysis.

Conclusions:
Radiographs, not clinical presentation, can differentiate an os subfibulare from a type VII transepiphyseal fracture. Children with type VII fractures have a long, irregular fracture line within the middle third of the distal fibular epiphysis. Those with an ankle sprain and os subfibulare have a smooth-edged ossicle of relatively short length located within the inferior pole of the epiphysis. Furthermore, the radiographic width of the fragment in the type VII fractures is significantly larger in width than the os subfibulare.

Level of Evidence:
Level II.
Height-Width Ratio of Proximal Femoral Epiphysis: Estimation of Lateral Pillar Involvement in Bilateral Perthes Disease
Authors: Woratanarat Patarawan , Lorungroj Khongchai , Dechosilpa Chayanee , Jaovisidha Suphaneewan , Danpakdeekul Nattaporn , Woratanarat Thira , Thakkinstian Ammarin 
Published: September 2018

Background:
The standard evaluation of epiphyseal involvement in Perthes disease is lateral pillar classification. However, it needs to be compared with contralateral normal hip leading to limited use in bilateral disease. We, therefore, develop a ratio between epiphyseal height and metaphyseal width of affected hips to estimate lateral pillar involvement. This study aimed to assess the height-width ratio of the proximal femoral epiphysis in non-Perthes children, and to find the relationship between the height-width ratio and lateral pillar classification in Perthes disease.

Methods:
A cross-sectional study was conducted between 2009 and 2015. Phase I included children aged 2 to 15 years who did not have Perthes disease. Phase II included children aged 2 to 15 years who had Perthes disease. Other abnormal proximal femoral epiphysis was excluded. Lateral pillar height and metaphyseal width were independently measured twice by 2 assessors in each phase. Intraobserver and interobserver levels of agreement, height-width ratio and cut-off points to differentiate lateral pillar types were determined.

Results:
There were 69 children (87 hip radiographs) who had non-Perthes hips, and 18 boys with Perthes disease (20 hip radiographs). Height-width ratio in the non-Perthes group increased from 0.38 to 0.48 at 2 to 10 years of age and remained constant until maturity. Average height-width ratio in lateral pillar A/non-Perthes hip was 0.47±0.05, lateral pillar B or B/C 0.32±0.05, and lateral pillar C 0.18±0.05. Intraobserver and interobserver level of agreements of height-width ratio in Perthes disease were 0.007 (95% confidence interval, −0.030 to 0.043) and 0.006 (95% confidence interval, −0.119 to 0.107), respectively. Cut-off values to differentiate lateral pillar A and B or B/C was 0.40, and to differentiate lateral pillar B or B/C, and C was 0.25 with 90% accuracy and area under receiver operating characteristic curve of 0.9.

Conclusions:
Height-width ratio is useful for grading severity in unilateral and bilateral Perthes disease. It has excellent reliability and validity with exact cutoff values to estimate lateral pillar classification.

Level of Evidence:
Level II—diagnostic study.
Epidemiology of Slipped Capital Femoral Epiphysis in Ontario, Canada
Authors: Ravinsky Robert , Rofaiel James , Escott Benjamin G. , Lim Zachary , Ravi Bheeshma , Howard Andrew 
Published: September 2018

Background:
Slipped capital femoral epiphysis (SCFE) is a well-characterized disorder of the hip seen in adolescent patients. It is characterized by deformity secondary to failure through the proximal femoral growth plate, which results in posterior-inferior displacement of the epiphysis on the proximal femoral metaphysis. Long-term sequelae of SCFE may include osteonecrosis, residual deformity, leg length discrepancy, degenerative joint disease, and chronic pain. The long-term consequences of SCFE may be the source of significant morbidity for the patient, and depending of the local incidence of this condition, may represent a significant expenditure of health care resources. Historically, the true incidence of SCFE within Ontario has been approximated using US-based studies of arguably comparable patient populations. In our study, we aimed to characterize the epidemiology of SCFE in the province of Ontario.

Methods:
We used a prospectively collected, not-for-profit Ontario research database to identify recorded cases of SCFE between April 1, 2002 and March 31, 2011. Specifically, we identified all hospital discharges with an ICD-9 or 10 diagnostic codes for SCFE in the Canadian Institute for Health Information Discharge Abstract database.

Results:
Over the 10-year study period, there were 648 cases of SCFE with an average annual incidence rate of 5.68/100,000 in Ontario.

Conclusions:
We have observed a trend toward decreasing incidence rates of SCFE in Ontario over the last 10 years. The determination for the underlying causes for the changing trends of SCFE may be relevant for initiating public health campaigns directed at reducing the incidence of SCFE

Level of Evidence:
Level IV—epidemiological study.
Micrographic Surgery and Dermatologic Oncology Fellowship Selection Criteria
Authors: Feng Hao , Belkin Daniel A. , Feng Paula W. , Geronemus Roy G. 
Published: September 2018

BACKGROUND
Obtaining a fellowship position for Micrographic Surgery and Dermatologic Oncology (MSDO) is becoming very competitive. Applicant qualities desired by MSDO fellowship directors have not been previously explored in a systematic way.

OBJECTIVE
To characterize the prevailing practices of selecting MSDO fellows.

METHODS AND MATERIALS
Cross-sectional study based on an anonymous online survey of MSDO fellowship directors.

RESULTS
There were 34 completed surveys. Selection criteria with the highest importance to fellowship directors were the ability to work well and get along with others, interview, work ethic, and letter of recommendation from the Mohs micrographic surgery director at the applicant's residency. The criteria with the lowest importance were advanced degrees, medical licensing examination scores, and membership in Alpha Omega Alpha. Specific applicant factors that were looked upon most positively by fellowship directors include applicant from own institution and applicant's personal reasons and circumstances, whereas factors that were most unfavorable include applicant's desire to practice in the same city/area as the fellowship location and graduate of foreign medical school.

CONCLUSION
Although variations existed, MSDO fellowship directors collectively placed greater importance on criteria that reflect interpersonal skills than on objective measures of academic performance, which highlights the importance of “fit.”