bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcallosal, Transchoroidal Resection of a Recurrent Craniopharyngioma
Authors: Jean Walter 
Published: February 2018

Objective To demonstrate the transchoroidal approach for the resection of a recurrent craniopharyngioma.
Design Video case report.
Setting Microsurgical resection.
Participant The patient was a 27-year-old woman with a history of a craniopharyngioma, resected twice during the year prior to presentation to our unit. Both operations were done via the left anterolateral corridor, and afterward, she was blind in the left eye and was treated with Desmopressin (DDAVP) for diabetes insipidus (DI). Serial magnetic resonance imaging (MRI) showed progression of the tumor residual, and she was referred for further surgical intervention.
Main Outcome Measures Pre- and postoperative MRIs measured the degree of resection.
Results For this, her third surgery, a transcallosal, transchoroidal approach, was chosen to offer the widest possible exposure. Given her history, an aggressive total resection was the best strategy. The patient was placed supine with the head neutral. A right frontal craniotomy allowed access to the interhemispheric fissure. By opening the corpus callosum, the left lateral ventricle was entered. The transchoroidal approach started with dissection of the tenia fornicis to open the choroidal fissure. After this, sufficient exposure to the posterior parts of the tumor was gained. Resection proceeded to the bottom of the tumor, exposing the basilar apex and interpeduncular cistern, and continued back anteriorly. In the end, a microscopic total resection was achieved. With a long hospital stay to treat her brittle DI, the patient slowly returned to neurological baseline.
Conclusion The transchoroidal approach is an effective way to remove large tumors in the third ventricle.The link to the video can be found at: https://youtu.be/2-Aqjaay8dg.
The Utility of Repeat Midtrimester Anatomy Ultrasound for Anomaly Detection
Authors: Wood S. , Owen John , Jenkins Sheri , Harper Lorie 
Published: February 2018

Introduction Although guidelines recommend repeat ultrasound in the setting of an incomplete fetal anatomic survey, the clinical utility of this practice has not been established. As such, we aimed to assess the yield of repeat ultrasound for anomaly detection following an incomplete survey.
Materials and Methods This is a retrospective cohort study of all singletons who underwent a midtrimester anatomic ultrasound at University of Alabama at Birmingham (UAB) from 2006 to 2014. Patients with an incomplete ultrasound underwent repeat examinations until completion. The population was divided into cohorts FIRST, SECOND, and THIRD, corresponding to the ultrasound at which the exam was deemed complete. Each detected anomaly was tallied. The number of ultrasounds needed to detect an anomaly was then assessed per group.
Results Of 15,768 ultrasounds performed on 13,740 patients, 11,828 exams were completed on first attempt; 1,796 patients required a second, while 116 patients required a third scan or more. We detected 324 anomalies; 93.8% in FIRST, 5.9% in SECOND, and 0.3% in THIRD. The number of scans needed to detect an anomaly was 39, 189, and 348 for FIRST, SECOND, and THIRD, respectively.
Conclusion Over 90% of anomalies are detected on the initial fetal anatomic survey. The incremental diagnostic yield then decreases, requiring appreciably more repeat scans to detect one anomaly.
Variability in the Clock Face View Description of Femoral Tunnel Placement in ACL Reconstruction Using MRI-Based Bony Models
Authors: Patel Kushal , Hosseini Ali , Li Guoan , Gill Thomas , Bravman Jonathan , Kraeutler Matthew 
Published: February 2018

AbstractThough controversial, the “clock face view” of the intercondylar notch remains a way some surgeons communicate regarding placement of the femoral tunnel in anterior cruciate ligament reconstruction. The purpose of this study was to quantify the differences in angle measurement between several previous descriptions of the clock face view by using a new reference standard. Three-Tesla magnetic resonance imaging (MRI) was used to scan 10 human knees to create three-dimensional MRI-based bony models which were used for measurements. A standardized clock face view was developed with the knee flexed to 90° using the junction of the cartilage and cortex of the medial and lateral surfaces of medial and lateral femoral condyles as the 3 o'clock and 9 o'clock, respectively, with the 12 o'clock established as the midpoint of the roof of the intercondylar notch. With the knee viewed at 90° of flexion, an “idealized” femoral tunnel position was plotted on the medial wall of the lateral femoral condyle at 30° (corresponding to the 10 o'clock or 2 o'clock position). The clock faces as described by Edwards et al, Heming et al, and Mochizuki et al were each then overlaid on this same model and the difference in measurement calculated. The average angles measured when the previously described clock faces were projected onto the idealized clock face view comparing a mark made at 30° were 47.7°, 7.2°, and 49.8° for the methods described by Edwards et al, Heming et al, and Mochizuki et al, respectively (all p < 0.001). Significant variation exists between angle measurements in simulated femoral tunnel placement based on the varying descriptions of the intercondylar clock face.
Heparin-Induced Thrombocytopenia during Obstetric Hospital Admissions
Authors: Sagaram Deepika , Siddiq Zainab , Eisenberger Andrew , Ananth Cande , Wright Jason , D'Alton Mary , Friedman Alexander 
Published: February 2018

Introduction The rate of heparin-induced thrombocytopenia (HIT) on a population basis is unknown. The objective of this study was to characterize the risk for HIT during antepartum, delivery, and postpartum hospitalizations in the United States.
Materials and Methods A large administrative database was used to determine the risk of HIT in hospitalized obstetric patients who received unfractionated heparin (UFH) or low molecular weight heparin (LMWH). Patients were presumed to have HIT if they were exposed to UFH or LMWH, received a diagnosis of HIT, and were administered a medication for the treatment of HIT including bivalirudin, argatroban, fondaparinux, or lepirudin. We queried severe complications of HIT including arterial thrombosis, limb amputation, heart failure, and death.
Results We identified 66,468 antepartum hospitalizations, 66,741 delivery hospitalizations, and 16,325 postpartum readmissions where women received pharmacologic prophylaxis. Of these, 10 antepartum admissions, 1 delivery admission, and 14 postpartum readmissions involved a diagnosis of HIT with treatment of bivalirudin, argatroban, fondaparinux, or lepirudin. There were no deaths and no diagnoses of arterial thrombosis, limb amputation, heart failure, and death.
Conclusion Risk for HIT among hospitalized obstetric patients is low. In this cohort, no cases of death or severe complications were noted in relation to the diagnosis.
Endoscopic Transsphenoidal Salvage Surgery for Symptomatic Residual Cystic Craniopharyngioma after Radiotherapy
Authors: Emanuelli Enzo , Frasson Giuliana , Cazzador Diego , Borsetto Daniele , Denaro Luca 
Published: February 2018

Objectives Ideal treatment of craniopharyngiomas is still controversial. Radiotherapy (RT) is considered effective for recurrences or after subtotal tumor removal (STR). About 40 to 50% of patients may experience tumor cyst expansion soon after RT; in these cases, the role of salvage surgery is debated.
Design Operative video.
Setting Tertiary care center.
Participants An 11-year-old boy diagnosed with persistent craniopharyngioma. In 2015, the patient underwent right frontotemporal craniotomy for STR at another center, complicated by panhypopituitarism. Two years later, fractionated 54-Gy RT was performed on growing residual tumor. After 3 months, he was admitted to our hospital due to persistent malaise, vomiting, pulsating headache, and epistaxis. Ophthalmologic evaluation evidenced left homonymous hemianopsia.
Results A contrast-enhanced magnetic resonance imaging (MRI) showed a 27-mm cystic component enlarging from the cranial end of the persistent craniopharyngioma lesion, extending into the third ventricle. Biventricular hydrocephalus and brain midline shift to the right were present. Compared with the early post-RT MRI, the cystic component of the tumor demonstrated growth. The patient underwent external ventricular drainage placement for emergent treatment of hydrocephalus and endoscopic transsphenoidal surgery. After cystic content drainage, the lesion was completely removed with its capsule. A “gasket seal” technique was performed for skull base reconstruction, with autologous fascia lata, septal bone, and mucoperiosteum from inferior turbinate. Histologic examination confirmed the craniopharyngioma diagnosis. Postoperative MRI showed resolution of the hydrocephalus and complete tumor removal.
Conclusion Although shrinkage of cystic components of craniopharyngioma residuals may occur within 5 to 6 months after RT, salvage surgery is indicated in symptomatic patients.The link to the video can be found at https://youtu.be/4x6Qe76bf60.
Thymic involution and rising disease incidence with age
Authors: Palmer Sam , Albergante Luca , Blackburn Clare C. , Newman T. J. 
Published: February 2018

Significance
Understanding the risk factors of carcinogenesis is a major goal of biomedical research. Historically, the focus has been on the role of somatic mutations, and the reason for cancer typically occurring late in life is predominantly attributed to a gradual accumulation of such mutations. We challenge that view and propose that the decline of the immune system is the primary reason why cancer is an age-related disease. The immunological model featured here captures risk profiles for many cancer types and infectious diseases, suggesting that therapies reversing T cell exhaustion or restoring T cell production will be promising avenues of treatment.
Capping protein regulates actin dynamics during cytokinetic midbody maturation
Authors: Terry Stephen J. , Donà Federico , Osenberg Paul , Carlton Jeremy G. , Eggert Ulrike S. 
Published: February 2018

Significance
Actin dynamics drive many steps of cell division. Here, we show that the actin capping protein (CP) is unexpectedly involved in midbody maturation, a poorly understood phase of the cell cycle where cells remodel their intercellular bridges to prepare for separation. The loss of CP results in excessive filamentous actin throughout the cell cycle, but only postfurrowing cytokinesis is inhibited. We propose that optimal actin filament function is achieved by a balance between CP-dependent filament capping and formin-driven polymerization. This raises the intriguing possibility that cells utilize specific types of actin filament networks to progress through division. This finding has profound implications on understanding actin-dependent processes such as cell division, migration, adhesion, and morphogenesis.
Finite-size effects in the short-time height distribution of the Kardar–Parisi–Zhang equation
Authors: Smith Naftali R , Meerson Baruch , Sasorov Pavel 
Published: February 2018

Abstract
We use the optimal fluctuation method to evaluate the short-time probability distribution

P

(
H
,
L
,
t
)

of height at a single point,

H
=
h

(
x
=
0
,
t
)

, of the evolving Kardar–Parisi–Zhang (KPZ) interface

h

(
x
,
t
)

on a ring of length 2L. The process starts from a flat interface. At short times typical (small) height fluctuations are unaffected by the KPZ nonlinearity and belong to the Edwards–Wilkinson universality class. The nonlinearity, however, strongly affects the (asymmetric) tails of

P

(
H
)

. At large

L

/

t

the faster-decaying tail has a double structure: it is L-independent,

−
ln

P

∼

|
H
|

5

/

2

/

t

1

/

2

, at intermediately large

|
H
|

, and L-dependent,

−
ln

P

∼

|
H
|

2

L

/

t

, at very large

|
H
|

. The transition between these two regimes is sharp and, in the large

L

/

t

limit, behaves as a fractional-order phase transition. The transition point

H
=

H

c

+

depends on

L

/

t

. At small

L

/

t

, the double structure of the faster tail disappears, and only the very large-H tail,

−
ln

P

∼

|
H
|

2

L

/

t

, is observed. The slower-decaying tail does not show any L-dependence at large

L

/

t

, where it coincides with the slower tail of the GOE Tracy–Widom distribution. At small

L

/

t

this tail also has a double structure. The transition between the two regimes occurs at a value of height

H
=

H

c

−

which depends on

L

/

t

. At

L

/

t

→
0

the transition behaves as a mean-field-like second-order phase transition. At

|
H
|
<
|

H
c

−

|

the slower tail behaves as

−
ln

P

∼

|
H
|

2

L

/

t

, whereas at

|
H
|
>
|

H
c

−

|

it coincides with the slower tail of the GOE Tracy–Widom distribution.
KMgene: a unified R package for gene-based association analysis for complex traits
Authors: Yan Qi , Fang Zhou , Chen Wei 
Published: February 2018

Abstract

Summary
In this report, we introduce an R package KMgene for performing gene-based association tests for familial, multivariate or longitudinal traits using kernel machine (KM) regression under a generalized linear mixed model framework. Extensive simulations were performed to evaluate the validity of the approaches implemented in KMgene.

Availability and implementation
http://cran.r-project.org/web/packages/KMgene.

Supplementary information
Supplementary data are available at Bioinformatics online.
HIITE: HIV-1 incidence and infection time estimator
Authors: Park Sung Yong , Love Tanzy M T , Kapoor Shivankur , Lee Ha Youn 
Published: February 2018

Abstract

Motivation
Around 2.1 million new HIV-1 infections were reported in 2015, alerting that the HIV-1 epidemic remains a significant global health challenge. Precise incidence assessment strengthens epidemic monitoring efforts and guides strategy optimization for prevention programs. Estimating the onset time of HIV-1 infection can facilitate optimal clinical management and identify key populations largely responsible for epidemic spread and thereby infer HIV-1 transmission chains. Our goal is to develop a genomic assay estimating the incidence and infection time in a single cross-sectional survey setting.

Results
We created a web-based platform, HIV-1 incidence and infection time estimator (HIITE), which processes envelope gene sequences using hierarchical clustering algorithms and informs the stage of infection, along with time since infection for incident cases. HIITE’s performance was evaluated using 585 incident and 305 chronic specimens’ envelope gene sequences collected from global cohorts including HIV-1 vaccine trial participants. HIITE precisely identified chronically infected individuals as being chronic with an error less than 1% and correctly classified 94% of recently infected individuals as being incident. Using a mixed-effect model, an incident specimen’s time since infection was estimated from its single lineage diversity, showing 14% prediction error for time since infection. HIITE is the first algorithm to inform two key metrics from a single time point sequence sample. HIITE has the capacity for assessing not only population-level epidemic spread but also individual-level transmission events from a single survey, advancing HIV prevention and intervention programs.

Availability and implementation
Web-based HIITE and source code of HIITE are available at http://www.hayounlee.org/software.html.

Supplementary information
Supplementary data are available at Bioinformatics online.
Incidence of Healthcare-Associated Influenza-Like Illness After a Primary Care Encounter Among Young Children
Authors: Feemster Kristen , Localio Russell , Grundmeier Robert , Metlay Joshua P , Coffin Susan E 
Published: February 2018

AbstractBackgroundDespite potential respiratory virus transmission in pediatric clinics, little is known about the risk of healthcare-associated viral infections attributable to outpatient encounters. We evaluated whether exposure to a pediatric clinic visit was associated with subsequent influenza-like illness (ILI).MethodsUsing electronic health record data, we conducted a retrospective cohort study of all children aged <6 years who presented to a provider in a 29-clinic pediatric primary care network for a non–ILI-related encounter over 2 respiratory virus seasons (September 1, 2012, to April 30, 2014). We defined a risk period for potential healthcare-associated (HA) ILI of 1 to 8 days after a non-ILI clinic visit and identified all cases of ILI to compare the incidences of ILI visits 1 to 8 days after a non-ILI encounter and those of visits >8 days after a non-ILI encounter.ResultsAmong 149987 children <6 years of age (mean age, 2.5 years) with ≥1 non-ILI visit during the study period, 531928 total encounters and 13951 (2.9%) ILI encounters were identified; 1941 (13.9%) occurred within the HA-ILI risk window. The incidence rate ratios (IRRs) for ILI 1 to 8 days after compared with ILI >8 days after a non-ILI visit during season 1 were 1.36 (95% confidence interval, 1.22–1.52) among children ≥2 years of age and 1.01 (95% confidence interval, 0.93–1.09) among children <2 years of age. Estimates remained consistent during season 2 and with a risk window of 3, 4, or 9 days.ConclusionsPediatric clinic visits during a respiratory virus season were significantly associated with an increased incidence of subsequent ILI among children aged 2 to 6 years but not among those aged <2 years. These findings support the hypothesis that respiratory virus transmission in a pediatric clinic can result in HA ILI in young children.
Incidence, Etiology, and Outcomes of Community-Acquired Pneumonia: A Population-Based Study
Authors: Bjarnason Agnar , Westin Johan , Lindh Magnus , Andersson Lars-Magnus , Kristinsson Karl G , Löve Arthur , Baldursson Olafur , Gottfredsson Magnus 
Published: February 2018

Abstract

Background
The microbial etiology of community-acquired pneumonia (CAP) is often unclear in clinical practice, and previous studies have produced variable results. Population-based studies examining etiology and incidence are lacking. This study examined the incidence and etiology of CAP requiring hospitalization in a population-based cohort as well as risk factors and outcomes for specific etiologies.

Methods
Consecutive admissions due to CAP in Reykjavik, Iceland were studied. Etiologic testing was performed with cultures, urine-antigen detection, and polymerase chain reaction analysis of airway samples. Outcomes were length of stay, intensive care unit admission, assisted ventilation, and mortality.

Results
The inclusion rate was 95%. The incidence of CAP requiring hospitalization was 20.6 cases per 10000 adults/year. A potential pathogen was detected in 52% (164 of 310) of admissions and in 74% (43 of 58) with complete sample sets. Streptococcuspneumoniae was the most common pathogen (61 of 310, 20%; incidence: 4.1/10000). Viruses were identified in 15% (47 of 310; incidence: 3.1/10000), Mycoplasmapneumoniae were identified in 12% (36 of 310; incidence: 2.4/10000), and multiple pathogens were identified in 10% (30 of 310; incidence: 2.0/10000). Recent antimicrobial therapy was associated with increased detection of M pneumoniae (P &lt; .001), whereas a lack of recent antimicrobial therapy was associated with increased detection of S pneumoniae (P = .02). Symptoms and outcomes were similar irrespective of microbial etiology.

Conclusions
Pneumococci, M pneumoniae, and viruses are the most common pathogens associated with CAP requiring hospital admission, and they all have a similar incidence that increases with age. Symptoms do not correlate with specific agents, and outcomes are similar irrespective of pathogens identified.
Customized Pessary Fabrication Using Three-Dimensional Printing Technology
Authors: Barsky Michael , Kelley Robert , Bhora Faiz Y. , Hardart Anne 
Published: February 2018

BACKGROUND:
Pessaries are a treatment option for pelvic organ prolapse, stress urinary incontinence (SUI), and cervical incompetence. An effective pessary is comfortable, corrects the presenting problem, does not cause adverse effects, and is easy to remove. Discomfort and poor fit limit the usefulness of pessaries for many women. Each patient presents with unique anatomy and thus the effectiveness of commercially available pessaries may be limited by lack of customization.

METHOD:
A patient presenting with SUI and failed commercial pessary fittings desired nonsurgical treatment. Using a mold fabricated with a three-dimensional printer and polylactic acid filament, a medical-grade silicone pessary was custom-made for the patient.

EXPERIENCE:
The silicone pessary was placed vaginally in the patient for a period of 48 hours. The patient did not report any discomfort or bladder leakage. In addition, the pessary did not dislodge with coughing, sneezing, or straining. After removal, a speculum examination showed normal epithelium.

CONCLUSION:
We report the successful insertion of a customized three-dimensional–printed pessary in a patient with SUI. Three-dimensional–printed pessaries are feasible and their utility may extend to the patient with anatomy incompatible with commercially available pessaries.
Second-Stage Duration and Outcomes Among Women Who Labored After a Prior Cesarean Delivery
Authors: Hehir Mark P. , Rouse Dwight J. , Miller Russell S. , Ananth Cande V. , Wright Jason D. , Siddiq Zainab , D'Alton Mary E. , Friedman Alexander M. 
Published: February 2018

OBJECTIVE:
To characterize probabilities of vaginal delivery based on second-stage duration along with maternal and neonatal risks for women undergoing labor after cesarean delivery.

METHODS:
This unplanned secondary analysis of the Maternal-Fetal Medicine Units Cesarean Registry, a prospective observational cohort, assessed outcomes in women with a prior uterine scar and included women with a previous cesarean delivery without prior vaginal delivery who reached the second stage of labor. The primary outcome was mode of delivery by second-stage duration. Secondary outcomes included assessment of individual adverse maternal (chorioamnionitis, atony, endometritis, hysterectomy, uterine rupture or dehiscence, and red cell transfusion) and neonatal (cord pH less than 7.10, Apgar score less than 6 at 5 minutes, neonatal intensive care unit admission, and ventilatory support) outcomes.

RESULTS:
Of 4,579 women with a previous cesarean delivery who reached the second stage of labor, 4,147 (90.6%) delivered vaginally. As second stage increased, successful vaginal delivery rates decreased: 97.3% at less than 1 hour (95% CI 96.6–97.9%), 91.5% at 1 to less than 2 hours (95% CI 89.8–93.1%), 78.5% at 2 to less than 3 hours (95% CI 74.5–82.1%), 62.3% at 3 to less than 4 hours (95% CI 55.2–69.1%), and 45.6% at 4 hours or greater (95% CI 37.7–53.7%). Risk of all adverse maternal outcomes increased with the length of the second stage. Specifically, risk of uterine rupture or dehiscence increased with second-stage length from less than 1 hour (0.7%), 1 to less than 2 hours (1.4%), 2 to less than 3 hours (1.5%), to 3 hours or greater (3.1%) (P<.001 for differential risk across the second stage). Risk of neonatal outcomes did not differ significantly by second-stage length.

CONCLUSION:
Although many women with a longer second stage (greater than 3 hours) will achieve successful vaginal delivery, these patients may be at increased risk for adverse maternal outcomes and should have close observation of fetal heart rate monitoring, maternal vital signs, and symptoms suggestive of uterine rupture or dehiscence.