bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oncologic Trends, Outcomes, and Risk Factors for Locoregional Recurrence: An Analysis of Tumor-to-Nipple Distance and Critical Factors in Therapeutic Nipple-Sparing Mastectomy
Authors: Frey Jordan D. , Salibian Ara A. , Lee Jiyon , Harris Kristin , Axelrod Deborah M. , Guth Amber A. , Shapiro Richard L. , Schnabel Freya R. , Karp Nolan S. , Choi Mihye 
Published: March 2019

Background:
Oncologic outcomes with nipple-sparing mastectomy continue to be established. The authors examine oncologic trends, outcomes, and risk factors, including tumor-to-nipple distance, in therapeutic nipple-sparing mastectomies.

Methods:
Demographics, outcomes, and overall trends for all nipple-sparing mastectomies performed for a therapeutic indication from 2006 to 2017 were analyzed. Oncologic outcomes were investigated with specific focus on recurrence and associated factors, including tumor-to-nipple distance.

Results:
A total of 496 therapeutic nipple-sparing mastectomies were performed, with an average follow-up time of 48.25 months. The most common tumor types were invasive carcinoma (52.4 percent) and ductal carcinoma in situ (50.4 percent). Sentinel lymph node sampling was performed in 79.8 percent of nipple-sparing mastectomies; 4.1 percent had positive frozen sentinel lymph node biopsy results, whereas 15.7 percent had positive nodal status on permanent pathologic examination. The most common pathologic cancer stage was stage IA (42.5 percent) followed by stage 0 (31.3 percent). The rate of local recurrence was 1.6 percent (n = 8), and the rate of regional recurrence was 0.6 percent (n = 3). In all, 171 nipple-sparing mastectomies had magnetic resonance imaging available with which to assess tumor-to-nipple distance. Tumor-to-nipple distance of 1 cm or less (25.0 percent versus 2.4 percent; p = 0.0031/p = 0.1129) and of 2 cm or less (8.7 percent versus 2.0 percent; p = 0.0218/p = 0.1345) trended to higher rates of locoregional recurrence. In univariate analysis, tumor-to-nipple distance of 1 cm or less was the only significant risk factor for recurrence (OR, 13.5833; p = 0.0385). No factors were significant in regression analysis.

Conclusions:
In early stage and in situ breast carcinoma, therapeutic nipple-sparing mastectomy appears oncologically safe, with a locoregional recurrence rate of 2.0 percent. Tumor-to-nipple distances of 1 cm or less and 2 cm or less trended to higher recurrence rates.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Impact of Using Alternative Graft Function Endpoints: A Secondary Analysis of a Kidney Transplant Trial
Authors: Fergusson Nicholas A. , Ramsay Tim , Chassé Michaël , English Shane W. , Knoll Greg A. 
Published: March 2019

Background
Nephrology trials assessing the impact of interventions on “standard” outcomes, such as doubling of creatinine, end-stage renal disease (ESRD), and/or death, are difficult to conduct given the time required for endpoints to accrue. The objective of this study was to determine if using lesser declines in kidney function would alter the interpretation of a previous randomized controlled trial.

Methods
This study was a secondary analysis of a kidney transplant trial comparing the use of a 40% or greater, 30% or greater, or 20% or greater decline in estimated glomerular filtration rate (eGFR) as a substitute for doubling of serum creatinine. Declines in eGFR were determined relative to baseline. This trial enrolled 212 kidney transplant patients with proteinuria and assessed the clinical impact of ramipril versus placebo on a primary outcome of doubling of serum creatinine, ESRD, or death. In this analysis, the declines in eGFR replaced doubling of creatinine in the composite endpoint.

Results
Mean trial follow-up was 41 months. A time-to-event composite of death, ESRD, or a 40% or greater, 30% or greater, or 20% or greater eGFR decline occurred in 45 (26 placebo vs 19 ramipril), 68 (35 vs 33), and 99 (50 vs 49) patients, respectively. Substituting these eGFR declines for doubling of serum creatinine resulted in an increase of 12, 35, and 66 endpoints compared with the original trial. In all 3 eGFR declines, ramipril treatment was not associated with any statistically significant differences despite the increase in events.

Conclusions
Substituting doubling of serum creatinine for lesser eGFR percentage decline thresholds did not alter trial interpretation but did increase the number of events.
Optical Coherence Tomography Angiography of a Pale Optic Disc in Demyelinating Optic Neuritis and Ischemic Optic Neuropathy
Authors: Fard Masoud Aghsaei , Yadegari Samira , Ghahvechian Hosein , Moghimi Sasan , Soltani-Moghaddam Reza , Subramanian Prem S. 
Published: March 2019

Background:
In the setting of a pale optic disc, distinguishing a previous episode of optic neuritis (ON) from that of nonarteritic anterior ischemic optic neuropathy (NAION) may be difficult on clinical examination. Differences in peripapillary vascular network structures, if present, might be of diagnostic utility.

Methods:
Thirty-five eyes with demyelinating ON, 33 eyes with NAION, and 81 eyes of normal subjects were imaged with optical coherence tomography angiography (OCT-A) to assess peripapillary vascular density (VD). In addition, OCT was used to measure peripapillary retinal nerve fiber layer (RNFL) thickness. Areas under the receiver operating characteristic curves were used to differentiate ON vs NAION.

Results:
NAION eyes had significantly thinner RNFL thickness than ON eyes. Age-adjusted analysis showed that the peripapillary VD values were significantly reduced in NAION (48.3 ± 7.4%) and ON eyes (54.7 ± 6.1%) compared with healthy controls (62.1 ± 4.6%); pairwise comparisons showed statistically significant differences among all 3 groups. After adjustment for severity of optic nerve injury according to mean RNFL thickness, all VD parameters were not significantly different between ON and NAION eyes. The area under the receiver operating characteristic curves for differentiating NAION from ON eyes was similar for VD (0.75) and RNFL thickness (0.74).

Conclusions:
Peripapillary VD measurement performs as well as RNFL thickness for distinguishing previous episodes ON and NAION. VD decline might be secondary to RNFL damage and, therefore, VD data have a limited role differentiating these 2 disorders.
Rates and Patient Characteristics of Electroconvulsive Therapy in China and Comparisons With the United States
Authors: Ma Yarong , Rosenheck Robert , Fan Ni , He Hongbo 
Published: March 2019

Objective
Recent studies have expressed concern about the infrequent and declining use of electroconvulsive therapy (ECT) in the United States. However, it is not known whether the US experience reflects changing global practice or one that varies between countries. This observational study examined use of ECT in the largest psychiatric hospital in China's third largest city over a 4-year period, 2014 to 2017.

Methods
Unduplicated electronic medical records concerning all inpatients with psychiatric diagnoses were examined. Electroconvulsive therapy utilization rates, correlates of ECT use, and its association with readmission within the 6 months following discharge were evaluated using bivariate and multivariate logistic regression analyses.

Results
Of 13,831 hospitalized patients, 2460 (17.8%) received ECT. Logistic regression analysis showed ECT utilization was independently associated with being female, younger age, being employed, nonlocal residence, involuntary admission, having no health insurance, longer length of stay, and the diagnoses of bipolar disorder and major depressive disorder. Use of ECT has increased since 2014 but was not significantly related to readmission 6 months after discharge.

Conclusions
Electroconvulsive therapy use appears to be substantially higher in China than in the United States and is associated with indicators of higher rather than lower functioning as reflected by independent associations with youth, employment, and fewer past hospitalizations, but also with behavioral noncompliance as reflected by involuntary admission, and has increased in recent years. Understanding United States–China discrepancies may further international understanding of the diverse roles of ECT in psychiatric practice.
Development of a drug repressible β-catenin mutant mouse to examine effect of activated β-catenin signaling on long-term maintenance of mammary tumor growth
Authors: Gorman Jennifer L. , Adams Jessica R. , Jones Emma M. , Egan Sean E. , Woodgett James R. 
Published: March 2019

AbstractStabilized β-catenin expression is a well described initiator of mammary tumorigenesis in the mouse and elevated nuclear expression of this protein has been observed in human triple-negative tumor samples. However, the importance of stabilized β-catenin to continued tumor growth after initiation, and in the context of other driver mutations, has yet to be elucidated. To ascertain the importance of stabilized β-catenin after tumor initiation, we generated a novel transgenic mouse model, utilizing the tet-off system, to control expression of a stabilized mutant of β-catenin. Pups from early litters carrying one allele of regulatable stabilized β-catenin at the Rosa26 locus, but not targeted by Cre, were smaller in size compared with wildtype littermates and also developed skin lesions, requiring euthanasia. Maintenance of breeding cages on doxycycline chow allowed for healthy transgenic pups to survive past 3 weeks of age and 6 animal cohorts were established. We used two different mammary Cre strains, WAP-Cre and MMTV-NLST-Cre, crossed with regulatable, stabilized β-catenin (bcatFL) animals, as well as animals expressing mutated p53-R270H. While mammary tumors developed in animals expressing Cre-targeted regulatable bcatFL, the penetrance and growth kinetics were lower than observed with other mammary mouse models expressing stabilized β-catenin. Since fewer animals developed tumors, we focused analysis on the effect of turning off stabilized β-catenin expression following tumor initiation. In the animals examined, a delay in tumor growth, but not regression, was observed in animals expressing Cretargeted bcatFL as well as those expressing both bcatFL and p53-R270H. These results indicate that in a less aggressive β-catenin model, additional mutations likely provide independence from the initiating event.
HDX-MS reveals structural determinants for RORγ hyperactivation by synthetic agonists
Authors: Strutzenberg Timothy S. , Garcia-Ordonez Ruben , Novick Scott , Park HaJeung , Chang Mi Ra , Doebellin Christelle , He Yuanjun , Patouret Rémi , Kamenecka Theodore M. , Griffin Patrick R. 
Published: March 2019

ABSTRACTMembers of the nuclear receptor (NR) superfamily regulate both physiological and pathophysiological processes ranging from development and metabolism1 to inflammation2 and cancer3. As ligand-gated transcription factors, synthetic small molecules targeting NRs are often deployed as therapeutics to correct aberrant NR signaling or as chemical probes to explore the role of the receptor in physiology4. However, nearly half of NRs do not have specific cognate ligands or its unclear if they possess ligand dependent activities and these receptors are called orphans. Here we demonstrate that ligand-dependent action of the orphan nuclear receptor RORγ can be defined by selectively disrupting putative endogenous—but not synthetic—ligand binding. Furthermore, the characterization of a library of RORγ modulators reveals that structural dynamics of the receptor assessed by HDX-MS correlate with activity in biochemical and cell-based assays. These findings are corroborated with X-ray co-crystallography and site-directed mutagenesis to collectively reveal the structural determinants of RORγ ligand-dependent activation, critical for designing full agonists for application in cancer immunotherapy. Combined these observations support a model of receptor activation to more accurately describe RORγ pharmacology. Likewise, this ‘bump-and-hole’ inspired approach could be extended to other orphan NRs to explore the ligand-dependent activities that are important for defining pharmacology.
Infection of Plasmodiophora brassicae changes the fungal endophyte community of tumourous stem mustard roots as revealed by high-throughput sequencing and culture-dependent methods
Authors: Tian Xueliang , Wang Diandong , Mao Zhenchuan , Pan Limei , Liao Jingjing , Cai Zhaoming 
Published: March 2019

AbstractDiverse fungal endophytes live in plants and are shaped by some abiotic and biotic stresses. Plant disease as particular biotic stress possibly gives an impact on the communities of fungal endophytes. In this study, clubroot disease caused by an obligate biotroph protist, Plasmodiophora brassicae, was considered to analyze its influence on the fungal endophyte community using an internal transcribed spacer (ITS) through high-throughput sequencing and culture-dependent methods. The results show that the diversity of the endophyte community in the healthy roots was much higher than the clubroots. Ascomycota was the dominant group of endophytes (including Phoma, Mortierella, Penicillium, etc.) in the healthy roots while P. brassicae was the dominant taxon in the clubroots. Hierarchical clustering, principal component analysis (PCA) and principal coordinates analysis (PCoA) indicated significant differences between the endophyte communities in the healthy roots and clubroots. Linear discriminant analysis effect size (LefSe) analysis showed that the dominant genera could be regarded as potential biomarkers. The endophyte community in the healthy roots had a more complex network compared with the clubroots. Also, many plant pathogenic Fusarium were isolated from the clubroots by the culture-dependent method. The outcome of this study illustrates that P. brassicae infection may change the fungal endophyte community associated with the roots of tumourous stem mustard and facilitates the entry of soil pathogen into the roots.
Barriers and enablers of inclusion for young autistic learners: lessons from the Polish experiences of teachers and related professionals
Authors: Hersh Marion , Elley Sharon 
Published: March 2019

Purpose
The purpose of this paper is to present new empirical data on the experiences of 120 teachers and professionals working with autistic children and young people across different settings in Poland where autism research on inclusive education is scarce. It explores the relationship of inclusive education to the social and neurodiversity models of disability. It makes evidence-based recommendations for good practice and modelling and evaluating future education and inclusion practices.

Design/methodology/approach
It uses a survey approach involving a combination of qualitative and quantitative data collection and embeds practical findings in theory, including the relationship of inclusive education to the social and neurodiversity models of disability.

Findings
The findings include the barriers teachers and related professionals experience in facilitating inclusive teaching and learning and how the following would be useful to autistic students: opportunities to exercise responsibilities and take leadership roles; social as well as educational inclusion; provision of a safe environment; regular funded autism training in work time; and appropriate use of additional classroom teachers.

Research limitations/implications
A survey-based approach has limitations.

Practical implications
Opportunities to exercise responsibilities and take leadership roles; social as well as educational inclusion; provision of a safe environment; regular funded autism training in work time; and appropriate use of additional classroom teachers.

Social implications
This study can be useful in the development of social skills and communication, social and educational inclusion.

Originality/value
Polish teachers’ attitudes, experiences and support needs, including some previously overlooked issues, are related to the broader international context beyond Poland. Analysis of the findings is used to derive evidence-based recommendations for good practice and modelling, and evaluating future education and inclusion practices.
Children as actors of tomorrow’s hypermarket experience
Authors: De-Juan-Vigaray Maria D. , Hota Monali 
Published: March 2019

Purpose
The purpose of this paper is to see how children aged 7–11 years can become the actors of tomorrow’s hypermarket experience by providing a review of past research on children as retail consumers, with a specific reference to their customer experience.

Design/methodology/approach
The literature review will be organised by presenting a “child hypermarket customer experience” model. Finally, a conceptual and methodological critique of past research will be presented followed by the revised model and conclusions.

Findings
The literature review finds six independent variables presented in the model: customer satisfaction, in-store conflicts, buying intention, purchase basket value, loyalty and average time spent in store measure a positive hypermarket shopping experience for children. There are then six types of mediators presented in the updated model: type of product, product offering, pocket money amount, environment, technology (games, tablets) and experiential marketing that mediate the impact of these independent variables on children as the actors of tomorrow’s hypermarket experience.

Research limitations/implications
This paper is conceptual in nature. Future research should empirically validate the conceptual model developed in the paper for children 7–11 years of age.

Practical implications
The conceptual discussion shows that hypermarket managers can use technology such as games and tablets not only to reduce the conflicts between parents and children in hypermarkets but also positively impact on the average time spent in the store. Further, the discussion shows that hypermarket managers can offer children the experience they expect with the use of specific experiential stimuli adapted to children in “children’s aisles” such as toys, children’s clothing, children’s hi-tech and children’s books. They can also theme the experience for children using memorabilia and the engagement of senses. Managerial research should empirically validate this for children 7–11 years of age.

Originality/value
This is the first study that conceptually creates a model of children as the actors of tomorrow’s hypermarket experience. This is something that empirically researched will enhance the understanding of young consumers’ behaviour in the retail process in this advanced age of retailing.
Care leavers’ views about transition: a literature review
Authors: Atkinson Cathy , Hyde Rebekah 
Published: March 2019

PurposeConsiderable attention has been given to the vulnerability of young people leaving care in the UK in their transition to adulthood. To date, however, there has been limited focus on the perceptions of care leavers about what factors enable and inhibit effective practice. The paper aims to discuss these issues.Design/methodology/approachThis systematic literature review sought to elicit the views of UK care leavers in identifying barriers and facilitators to the process of transition to adulthood. Qualitative studies in the care-leaving field were identified, of which seven met inclusion criteria and were included in the final synthesis.FindingsThe findings yielded a range of facilitators, including authentic and consistent relationships with those acting in the role of corporate parent; and flexible systems, which accommodated personal readiness for leaving care. Barriers included insufficient recognition of, and a lack of support for, the psychological dimensions of transition, exacerbated by insufficient support networks.Research limitations/implicationsThis literature search yielded seven qualitative papers, some with small sample sizes, meaning that the findings may not be representative of a wider population or directly relevant to international contexts.Practical implicationsSuggestions for enhancing the transition process are posited. In particular, the potential usefulness of an “interdependence” transition approach for UK care leavers is proposed.Originality/valueThis study analyses qualitative data, thus constituting a response to policy calls for care leaver views to be central to transition processes.
Co‐workers' voice climate and affective commitment towards the team: A test of mediation and moderation
Authors: Ohana Marc , Stinglhamber Florence 
Published: March 2019

AbstractThis article examines the consequences of co‐workers' voice climate, defined as a shared perception regarding how individuals who work together within the same unit and who do not have formal authority over each other judge the ability to participate in decision making inside teams. We argue that co‐workers' voice climate may influence individuals' perception of quality of social exchange with the team, operationalised through team–member exchange. These high‐quality exchanges with the team should, in turn, promote higher individual affective commitment towards the team. Furthermore, we hypothesised that the social exchange with the supervisor, operationalised through leader–member exchange, buffers the effect of co‐workers' voice climate on team–member exchange. These hypotheses were tested using a sample of 183 employees belonging to 31 teams. Our findings supported the theoretical model that was proposed, attesting to the importance of considering co‐workers' justice climate in the prediction of individual work attitudes. The theoretical and practical implications of these results are discussed.
Controlled Release of Peppermint Oil from Paraffin‐Coated Activated Carbon Contained in Sachets to Inhibit Mold Growth During Long Term Storage of Brown Rice
Authors: Chaemsanit Siriporn , Sukmas Sirimas , Matan Narumol , Matan Nirundorn 
Published: March 2019

AbstractThe aim of the study was to control the release of peppermint oil (700 µL/L) by coating activated carbon (AC) contained in sachets with different solutions (tapioca starch, corn starch, gelatine, carnauba, paraffin, and mixed carnauba–paraffin) for inhibiting the growth of Aspergillus flavus on brown rice (BR). Paraffin‐coated AC with adsorbed peppermint oil was then applied to extend the shelf life of BR during long‐term storage (60 days) at 30 ± 2 °C. The mechanism of peppermint oil vapor release in this system was also studied using GC–MS. The result revealed that paraffin‐coated AC with adsorbed peppermint oil present in sachets showed the highest antifungal activity against A. flavus growing on the surface of BR. In addition, paraffin‐coated AC with adsorbed peppermint oil could prolong the shelf life of BR from 10 days (control) to at least 60 days under tropical climatic conditions. Moreover, storage of BR in the presence of sachets containing paraffin‐coated AC with adsorbed peppermint oil at a concentration of 700 µL/L revealed no significant effects on major rice quality‐related factors, such as moisture content, color, water uptake percentage, and gelatinization temperature. Peppermint oil component analysis by GC–MS indicated that paraffin could trap some minor components of peppermint oil and allow the major components such as menthone, menthol, and alpha‐pinene, which are compounds that play an important role in mold growth inhibition, to be exposed to air. Thus, this research demonstrated the potential of paraffin‐coated AC containing adsorbed peppermint oil for controlling the growth of molds during prolonged rice storage.Practical ApplicationParaffin‐coated activated carbon with adsorbed peppermint oil has the potential to be commercially applied to brown rice grains for facilitating long‐term storage. This technique is beneficial for avoiding the occurrence of negative sensorial factors when peppermint oil vapors are used. This process is interesting and easy to apply during large‐scale implementation of a rice storage system.