bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-Effectiveness Analysis of Demineralized Bone Matrix and rhBMP-2 versus Autologous Iliac Crest Bone Grafting in Alveolar Cleft Patients
Authors: Mehta Sagar , Blagg Ross , Willcockson James , Gociman Barbu , Yamashiro Duane , Siddiqi Faizi 
Published: August 2018

Background:
The standard of care for patients with alveolar cleft deformities is autologous bone grafting using iliac crest bone graft (ICBG). The combination of demineralized bone matrix with recombinant human bone morphogenetic protein-2 (DBX/rhBMP-2), as a substitute for ICGB, has been shown to have similar bony incorporation within the maxilla without donor-site morbidity. It has been argued that one of the drawbacks of using DBX/rhBMP-2 is the higher cost. The aim of this study was to compare the cost, operative time, and hospital length of stay associated with these two treatment modalities.

Methods:
A chart review was conducted for 71 patients who underwent secondary alveolar cleft reconstruction. Forty patients received ICBG and 31 patients underwent reconstruction using DBX/rhBMP-2. Operative costs, operative time, and hospital length of stay were compared between the two groups.

Results:
The average total operative cost was $6892 in the ICBG surgery population versus $4836 in the DBX/rhBMP-2 population (p < 0.01). Statistically significant decreases in anesthesia, pharmacy, and operating room costs were found in patients who underwent the DBX/rhBMP-2 surgery. Operative time decreased from an average of 97.3 minutes to 67.0 minutes (p < 0.01), and length of inpatient stay decreased from an average of 29.8 hours to 9.3 hours (p < 0.01).

Conclusion:
In the treatment of alveolar cleft deformities, operative material costs were greater in the DBX/rhBMP-2 group but—secondary to decreased hospital, anesthesia, pharmacy, and operating room costs—DBX/rhBMP-2 was more cost-effective than ICBG.
Abandoning the Supraorbital Bandeau in Anterior Craniosynostosis Repairs, for a Single-Segment Reconstruction
Authors: Fearon Jeffrey A. , Ditthakasem Kanlaya , Garcia Jose Castro , Herbert Morley 
Published: August 2018

Background:
Following correction of anterior sutural fusions, long-term forehead irregularities may arise. Based on the premise that frontal reconstructions using a seamless construct might produce better long-term aesthetic results, the supraorbital bandeau was abandoned for a single-piece frontal reconstruction. The purpose of this review was to compare outcomes and complications between children who underwent reconstruction with the traditional supraorbital bandeau and those who underwent reconstruction with a single bony segment.

Methods:
A retrospective sequential chart review was performed of all children undergoing anterior sutural fusion repairs to compare supraorbital bandeau to single-segment reconstructions. Length of surgery, blood loss, hospital stay, and complications were assessed. Aesthetic outcomes and reoperation rates were also examined.

Results:
Over 10 years, 199 patients with anterior sutural fusions underwent correction: 124 with a single-piece frontal reconstruction and 75 with traditional supraorbital bandeaus. Outcome analyses revealed no significant differences between techniques with respect to blood loss, surgical times, complication rates, and hospital length of stay. A preliminary analysis suggested lower reoperation rates (0 percent versus 2.7 percent) and more favorable aesthetic rankings for those treated with a single segment, although the follow-up for this group was significantly shorter compared with those treated with a supraorbital bandeau (16 months versus 43 months).

Conclusions:
Abandoning the traditional supraorbital bandeau for a simplified single-segment frontal reconstruction has the potential to result in improved forehead aesthetics, although longer term evaluations are needed. This review suggests that this technical variation does not appear to be associated with longer surgical times, increased blood loss, or higher complication rates.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Ankle Arthrodesis with Free Vascularized Fibula Autograft Using Saphenous Vein Grafts: A Case Series
Authors: Piccolo Paulo P. , Ben-Amotz Oded , Ashley Blair , Wapner Keith L. , Levin L. Scott 
Published: August 2018

Background:
In select high-risk cases of ankle arthrodesis, conventional techniques may lead to a high incidence of failure because of a combination of multiple operations; high risk of infection; avascular, often bulky allografts; and poor soft-tissue quality. In high-risk distal limb salvage, the authors have performed ankle arthrodesis using a free vascularized fibula graft from the ipsilateral limb with saphenous vein grafts.

Methods:
The authors present data from six patients. The cause of the defect was avascular necrosis of the talus (n = 4), osteomyelitis (n = 1), and failed total ankle replacement (n = 1). The ipsilateral fibula was used in all cases as a free vascularized graft. Nonviable bone and soft tissue were débrided, and the fibula was shortened to size and impacted into the cavitary space spanning the distance between the tibia, talus, and calcaneus. The pedicle distally was anastomosed to saphenous vein grafts and proximally anastomosed to the divided peroneal vessels.

Results:
The flap success rate was 83 percent (n = 5). The complication rate was 83 percent; complications included flap loss (intraoperative arterial thrombosis), loss of skin island, hematoma, and arterial thrombosis. Despite one flap failure and a high complication rate, successful union was obtained in all patients. All patients achieved full weight-bearing status by a mean of 4 months after surgery (range, 3 to 7 months). There were no amputations.

Conclusions:
Vascularized free fibula graft is a reliable option for ankle arthrodesis in complex salvage situations. Using a saphenous vein graft to perform the anastomosis with the divided peroneal vessels proximally should be considered.
Outcomes following Autologous Fat Grafting for Oncologic Head and Neck Reconstruction
Authors: Karmali Riaz J. , Hanson Summer E. , Nguyen Alexander T. , Skoracki Roman J. , Hanasono Matthew M. 
Published: August 2018

Background:
The aims of this study were to examine the surgical, oncologic, and aesthetic outcomes of patients undergoing autologous fat grafting for oncologic head and neck reconstruction.

Methods:
A review was performed of 119 consecutive patients undergoing autologous fat grafting for oncologic head and neck reconstruction from 2005 to 2014. Aesthetic outcomes were rated by a group of 10 plastic surgeons and 10 laypersons using a five-point Likert scale.

Results:
A total of 190 fat grafting procedures were performed in 116 patients. Of these, 69 percent had received radiation therapy before their reconstructive surgery. The average number of treatments per patient was 1.6 ± 1 (range, 1 to 6), with a mean injection volume of 24.8 ± 20.2 ml. The mean follow-up time from the first fat grafting procedure was 35.8 ± 23.1 months. Complications occurred in 6 percent, none of which required a return to the operating room or hospital admission. Oncologic recurrence was observed in six patients (three local, one regional, and two distant). Locoregional recurrences were in areas outside of where the fat was grafted. Aesthetic analysis revealed that both plastic surgeons and laypersons thought patients appeared closer to normal following autologous fat grafting.

Conclusion:
This study suggests that autologous fat grafting plays a valuable role in enhancing aesthetic outcomes either by complementing or replacing reconstructive flaps for oncologic head and neck reconstruction while having both low complication rates and no evidence of being associated with cancer recurrence.
Fractional Carbon Dioxide Laser in Patients with Skin Phototypes III to VI and Facial Burn Sequelae: 1-Year Follow-Up
Authors: Salles Alessandra Grassi , Luitgards Bruno Ferreira , Moraes Luciana Borsoi , Remigio Adelina Fátima do Nascimento , Zampieri Ligia Araújo , Gemperli Rolf 
Published: August 2018

Background:
Fractional carbon dioxide laser treatment in postburn scars is safe and effective, but high rates of hypochromia (35 percent) have been described in patients with skin phototypes V and VI after 2 months. The authors evaluated the efficacy and safety of fractional carbon dioxide laser treatment of burn scars in skin phototypes III to VI after 1 year, focusing on the incidence of hypochromia.

Methods:
A case series of 20 patients had skin phototypes III to VI with facial burn sequelae. They underwent three sessions of fractional laser. Laser fluence was increased in patients with no hypochromia and reepithelialization time of less than 15 days. Scars were evaluated after 2 months and 1 year by a five-item scale: color, hydration, surface irregularities, volume, and distensibility.

Results:
The mean time for reepithelialization was 13.3 days (range, 2 to 40 days). The average final score of the scale increased from 4.4 before treatment to 7.33 after 1 year for physicians, and from 5.35 to 7.5 for patients. There was also an increase in the subjective score, which patients used to assess their skin. Two months after treatment, 60 percent of patients presented with punctate hypochromia. After 1 year, only 15 percent of patients still had mild hypochromia; all of them had skin phototypes V and VI. Nevertheless, they were satisfied with overall bleaching of the skin.

Conclusions:
Fractional carbon dioxide laser improved skin quality. Late punctate hypopigmentation should be considered a possible complication in patients with skin phototypes V and VI.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Integrated Genomic Analysis of Hypoxia Genes across Cancer Types Identifies Significant Associations with Cancer Hallmarks
Authors: Yang Lingjian , Forker Laura , Fjeldbo Christina S. , Bristow Robert G. , Lyng Heidi , West Catharine M. L. 
Published: August 2018

ABSTRACTHypoxia is a generic micro-environmental factor in most solid tumours. While most published literature focused onin vitroor single tumour type investigations, we carried out the first multi-omics pan cancer analysis of hypoxia with the aim of gaining a comprehensive understanding of its implication in tumour biology. A core set of 52 mRNAs were curated based on experimentally validated hypoxia gene sets from multiple cancer types. The 52 mRNAs collectively stratified high- and low-hypoxia tumours from The Cancer Genome Atlas (TCGA) database (9698 primary tumours) in each of the 32 cancer types available. High- hypoxia tumours had high expression of not only mRNA but also protein and microRNA markers of hypoxia. In a pan cancer transcriptomic analysis, ≥70% of the known cancer hallmark pathways were enriched in high-hypoxia tumours, most notably epithelial mesenchymal transition potential, proliferation (G2M checkpoint, E2F targets, MYC targets) and immunology response. In a multi-omics analysis, gene expression-determined high- hypoxia tumours had a higher non-silent mutation rate, DNA damage repair deficiency and leukocyte infiltration. The associations largely remained significant after correcting for confounding factors, showing a profound impact of hypoxia in tumour evolution across cancer types. High-hypoxia tumours determined using the core gene set had a poor prognosis in 16/32 cancer types, with statistical significances remaining in five after adjusting for tumour stage and omics biomarkers. In summary, this first comprehensivein vivomap of hypoxia in cancers highlights the importance of this micro-environmental factor in driving tumour progression.
Methyl-CpG-binding domain 9 (MBD9) is required for H2A.Z incorporation into chromatin at a subset of H2A.Z-enriched regions in the Arabidopsis genome
Authors: Sijacic Paja , Holder Dylan H. , Bajic Marko , Deal Roger B. 
Published: August 2018

ABSTRACTThe SWR1 chromatin remodeling complex, which deposits the histone variant H2A.Z into nucleosomes, has been characterized in yeast and animals but had not been purified from plants. We used the conserved SWR1 subunit ACTIN RELATED PROTEIN 6 (ARP6) as bait in tandem affinity purification experiments to isolate associated proteins from Arabidopsis thaliana. We identified all 11 subunits found in yeast SWR1 and the homologous mammalian SRCAP complexes, demonstrating that this complex is conserved in plants. We also identified several additional proteins not previously associated with SWR1, including Methyl-CpG-BINDING DOMAIN 9 (MBD9). Since mbd9 mutant plants were phenotypically similar to arp6 mutants, we further explored a potential role for MBD9 in H2A.Z deposition. We found that MBD9 is required for proper H2A.Z incorporation at thousands of discrete sites, which represent a subset of the regions normally enriched with H2A.Z. Genetic analyses showed that arp6;mbd9 double mutants have far more severe phenotypes than either single mutant. In conjunction with the finding that MBD9 does not appear to be a core subunit of the Arabidopsis SWR1 complex, this suggests that MBD9 also has important roles beyond H2A.Z deposition. Our data establish the SWR1 complex as being conserved across eukaryotes and also provide new insights into the mechanisms that target H2A.Z to chromatin.
Naked Mole-Rat Cells are Susceptible to Malignant Transformation bySV40LTand Oncogenic Ras
Authors: Hadi Fazal , Kulaberoglu Yavuz , Lazarus Kyren A. , Beattie Paul , Smith Ewan St. John , Khaled Walid T. 
Published: August 2018

AbstractThe Naked Mole-Rat,Hetercephalus glaber, is a mouse-sized subterranean rodent native to East Africa. Research on NMRs is intensifying in an effort to gain leverage from their unusual physiology, long-life span and cancer resistance. Few studies have attempted to explain the reasons behind NMRs cancer resistance, but most prominently Tian et al. reported that NMR cells produce high-molecular weight hyaluronan as a potential cause for the NMR’s cancer resistance. Tian et al. have shown that NMR cells are resistant to transformation by SV40 Large T Antigen (SV40LT) and oncogenic HRAS (HRASG12V), a combination of oncogenes sufficient to transform mouse and rat fibroblasts. We have developed a single lentiviral vector to deliver both these oncogenes and generated multiple cell lines from five different tissues and nine different NMRs, and report here that contrary to Tian et al.’s observation, NMR cells are susceptible to oncogenic transformation bySV40LTandHRAS. Our data thus point to a non-cell autonomous mechanism underlying the remarkable cancer resistance of NMRs. Identifying these non-cell autonomous mechanisms could have implications on our understanding of human cancer development.
Credit access and technical efficiency of smallholder farmers in Northern Ghana
Authors: Nkegbe Paul Kwame 
Published: August 2018

Purpose
The purpose of this paper is to examine the relationship between credit access and technical efficiency of smallholder crop farmers in northern Ghana.

Design/methodology/approach
The study uses a random sample of 445 farming households in the three northern regions of Ghana. The two-stage double bootstrap DEA approach was used to consistently estimate technical efficiency scores as well as the determinants.

Findings
The results revealed that, given the current technology, there is substantial yield or productivity gap among the sample of producers in northern Ghana used for the study. This is because producers can reduce input use by over 50.0 percent while still achieving the same output levels. It is further revealed that proportion of household income from off-farm activities, distance of farm from homestead, location and credit access are significant determinants of technical efficiency.

Originality/value
The current study differs from previous studies in two basic ways. First, it takes into account the fact that smallholder farmers practise mixed or inter-cropping by using value of output so that various crops on a given plot of the farmer can be aggregated; and second, a nonparametric approach is adopted so that the inherent inconsistencies in using the two-step model within a parametric framework can be avoided.
The impact of types of trust in the public sector – a case study approach
Authors: Höglund Linda , Mårtensson Maria , Safari Aswo 
Published: August 2018

PurposeThe purpose of this paper is to study how different types of trust develop and change over time in the collaboration between an organization and its board.Design/methodology/approachThis paper is a response to a recent call to apply the concept of trust in understanding the collaboration between a public organization, its board, and other stakeholders. Here, the authors study a single case, and based on a longitudinal in-depth case study method covering the period of 2003–2015, the authors have conducted 27 interviews, including the CEO and all the board members.FindingsThe authors introduce and advance the concept of trust in the public sector literature on board work. This paper shows that trust is complex and multidimensional at different units of analysis. The types of trust discussed in this paper are cognitive, affective, contractual, competence, and goodwill. Different types of trust are developed to make the collaboration between a governed organization and its board to work.Research limitations/implicationsBecause this paper uses the case study method and only studies one single case, the findings of this paper might be questioned on the issue of generalization.Originality/valueThe authors conceptualize and adopt trust as a multidimensional, dynamic concept, and with different units of analyses, capture the nature of the collaboration between a public organization and its board, and its complexity.
Performance measurement design: a contingency perspective from the Italian regional healthcare services
Authors: Spanò Rosanna , Cicellin Mariavittoria , Scuotto Adriana 
Published: August 2018

Purpose
In the last few decades, the effectiveness of the evaluation of human resources and their performances has become a crucial theme in the debates of the public sector. The purpose of this paper is to analyze key design characteristics of performance management system (PMS) that may be effectively adopted and deployed by management to enable the assessment for a health system improvement.

Design/methodology/approach
This paper falls under the field of studies that focuses on the design and implementation of PMS in the healthcare sector. This research adopted a qualitative approach across the case study method to understand the role of different contextual factors and their impact upon the design of PMS. Mainly drawing on previous studies on the Italian regional health systems, a target region has been selected for these purposes.

Findings
As a result, the new PMS was effectively working and was structured with a balanced focus on the region and the single healthcare organizations. The need for improving the information systems within the healthcare organizations was strongly emphasized. The crucial element of the new PMS was the transparency about the assessment procedures.

Originality/value
This paper contributes to the debate on factors that can influence the design of PMS in healthcare. Relying on a contingent approach, the authors put forward the need of a more comprehensive and integrated frameworks encompassing organic conception of PMSs, as well as of the interdependencies among their components.
Determinants of elite athletes’ extrinsic and intrinsic career success
Authors: Hallmann Kirstin , Breuer Christoph , Ilgner Michael , Giel Thomas , Rossi Lea 
Published: August 2018

PurposeThe purpose of this paper is to identify the determinants of success of elite athletes by applying the concept of career success to a sporting context. The concept of career success includes extrinsic (i.e. tangible) career accomplishments like medals as well as intrinsic factors referring to subjective judgements about career attainments. Thereby, a holistic perspective is taken which has not been studied extensively before.Design/methodology/approachBased on previous literature, a theoretical model was derived outlining how human capital, motivation, organisational characteristics and socio-demographics affect both intrinsic and extrinsic career success. To measure the impact of these factors, primary (n=1,249) and secondary data of elite athletes were collected. Regression analyses indicated that all factors included in the theoretical model were associated with extrinsic and intrinsic success.FindingsInstitutional support was an important driver for intrinsic career success while financial support affected extrinsic career success. There was no significant influence of extrinsic career success on intrinsic career success.Practical implicationsThese findings imply that policy makers should offer enhanced dual career options, such as mentoring programmes, aspects like sport-psychological support and nutrition counselling, and long-term, stable financial support for athletes to maximise career success.Originality/valueThis paper applies the construct of career success to sports. A focus on the athletes’ intrinsic career success is placed as this area has been neglected in past research.
MicroRNA‐92a inhibits macrophage antiviral response by targeting retinoic acid inducible gene‐I
Authors: Sheng Yuanjian , Wang Yong , Lu Wei , Zhou Yunlian , Dong Guijuan , Ge Xiaoxing , Song Yinjing , Zhang Yuanyuan 
Published: August 2018

ABSTRACTMicroRNAs are short, non‐coding RNAs that have been shown to regulate a wide range of biological processes, including host antiviral immune responses. In the present study, microRNA‐92a (miR‐92a) was identified as a negative regulator in macrophage‐mediated antiviral responses. Overexpression of miR‐92a decreases vesicular stomatitis virus (VSV)‐induced production of type‐I IFNs and facilitates viral replication in macrophages. The mechanism is that miR‐92a directly targets RIG‐I and reduces its expression, thereby attenuating VSV‐triggered activation of TBK‐binding kinase 1 and IRF3, both of which are crucial for initiating transcription of type‐I IFN genes. Our results demonstrate for the first time the novel role of miR‐92a in suppressing antiviral innate immunity.
The smallest ssDNA phage infecting a marine bacterium
Authors: Zhan Yuanchao , Chen Feng 
Published: August 2018

SummaryIn the marine environment, only a few lytic single‐stranded DNA (ssDNA) phages have been isolated and characterized, despite the fact that diverse ssDNA bacteriophages have been discovered via metagenomic studies. In this study, we isolated and characterized a new ssDNA phage, vB_RpoMi‐Mini, which infects a marine bacterium Ruegeria pomeroyi DSS‐3. With a genome size of 4248 bp and only four putative open reading frames (ORF), vB_RpoMi‐Mini becomes the smallest ssDNA phage among the known ssDNA phage isolates and represents the DNA bacteriophage with the least number of ORFs. Genome‐wide analysis reveals that bacteriophage Mini is distantly related to the known ssDNA phages and belongs to an unclassified ssDNA phage within the Microviridae family. The presence of peptidase in vB_RpoMi‐Mini genome further implies that horizontal gene transfer could be an important driving force in the evolution of ssDNA phages. Bacteriophage Mini seems to have lost the spike protein commonly seen in ssDNA phages, suggesting that ssDNA phage can be more diverse than previously thought. Metagenomic analysis indicates that Mini‐like phages are widely distributed in the environments. The discovery of vB_RpoMi‐Mini expands our understanding of ssDNA phages in nature, and also indicates our dearth of knowledge regarding of ssDNA phages.