bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innovation in Residency Selection: The AAMC Standardized Video Interview
Authors: Bird Steven B. , Hern H. Gene , Blomkalns Andra , Deiorio Nicole M. , Haywood Yolanda , Hiller Katherine M. , Dunleavy Dana , Dowd Keith 
Published: March 2019

Purpose
Innovative tools are needed to shift residency selection toward a more holistic process that balances academic achievement with other competencies important for success in residency. The authors evaluated the feasibility of the AAMC Standardized Video Interview (SVI) and evidence of the validity of SVI total scores.

Method
The SVI, developed by the Association of American Medical Colleges, consists of six questions designed to assess applicants’ interpersonal and communication skills and knowledge of professionalism. Study 1 was conducted in 2016 for research purposes. Study 2 was an operational pilot administration in 2017; SVI data were available for use in residency selection by emergency medicine programs for the 2018 application cycle. Descriptive statistics, correlations, and standardized mean differences were used to examine data.

Results
Study 1 included 855 applicants; Study 2 included 3,532 applicants. SVI total scores were relatively normally distributed. There were small correlations between SVI total scores and United States Medical Licensing Examination Step exam scores, Alpha Omega Alpha Honor Medical Society membership, and Gold Humanism Honor Society membership. There were no-to-small group differences in SVI total scores by gender and race/ethnicity, and small-to-medium differences by applicant type.

Conclusions
Findings provide initial evidence of the validity of SVI total scores and suggest that these scores provide different information than academic metrics. Use of the SVI, as part of a holistic screening process, may help program directors widen the pool of applicants invited to in-person interviews and may signal that programs value interpersonal and communication skills and professionalism.
Current role of primary surgical treatment in patients with head and neck squamous cell carcinoma
Authors: Bozec Alexandre , Culié Dorian , Poissonnet Gilles , Dassonville Olivier 
Published: March 2019

Purpose of review
The objective of this review article is to discuss the current role of surgery as the primary treatment modality in patients with head and neck squamous cell carcinoma (HNSCC).

Recent findings
HNSCC represents one of the cancer locations where the primary treatment modality is the most under discussion. Indeed, the respective roles of primary surgical resection followed, as necessary, by adjuvant radiotherapy or definitive chemoradiotherapy remain controversial. The results of organ preservation trials and the drastic rise in the incidence of human papillomavirus-induced oropharyngeal tumors, which are known to be highly radiosensitive, have led to an increasing use of chemoradiation-based therapies in HNSCC patients. However, no chemoradiation-based protocol has shown better oncologic outcomes than radical primary surgery. Moreover, development of minimally invasive surgical techniques, such as transoral robotic surgery, and advances in head and neck microvascular reconstruction have considerably improved the clinical outcomes of the patients and have led to a reconsideration of the role of primary surgery in HNSCC patients.

Summary
Surgery should be the primary treatment modality for most resectable oral cavity cancers and for T4a laryngeal/hypopharyngeal cancers. Primary surgery could also be the preferred modality of treatment for most early (T1–T2, N0) laryngeal and hypo/oropharyngeal carcinomas when this strategy offers an opportunity to reserve radiotherapy for a potential recurrence or second primary tumor. Primary surgery should also be considered in patients with locally advanced human papillomavirus-negative oropharyngeal carcinoma.
Ultrasound Assessment of Subcutaneous Abdominal Fat Thickness After Treatments With a High-Intensity Focused Electromagnetic Field Device: A Multicenter Study
Authors: Katz Bruce , Bard Robert , Goldfarb Richard , Shiloh Aaron , Kenolova Dilyana 
Published: March 2019

BACKGROUND
High-intensity focused electromagnetic (HIFEM) technology is intended for muscle toning, firming, and strengthening.

OBJECTIVE
The goal of this study is to quantify the effect of HIFEM treatments on subcutaneous fat.

MATERIALS AND METHODS
A total of 33 patients participated in the study. Each subject underwent 4 treatments on the abdomen with the HIFEM device. Ultrasound images were obtained measuring the thickness of the subcutaneous fat from 4 standardized measurement points. Ultrasound images were taken before treatment and at 1-month and 3-month follow-up visits. Photographs were captured using both 2D and 3D cameras. Weight measurements were taken, as well as surveys assessing both patient comfort, satisfaction, and adverse events.

RESULTS
A significant reduction in the subcutaneous fat thickness across the abdomen was observed, averaging 19.0%/4.47 ± 3.23 mm (p < .01) at 1 month after treatment and 23.3%/5.78 ± 4.07 mm 3 months after treatment. At 1 month, the most significant reduction in subcutaneous fat was measured subumbilically (26.6%/6.25 ± 4.70 mm; p < .01) and epiumbilically (21.6%/5.08 ± 3.69 mm; p < .01). No discomfort was reported, and 91% of study participants were satisfied with their result.

CONCLUSION
Based on the ultrasonographic and photographic observations, the authors conclude that the application of an HIFEM field is an effective option for the noninvasive treatment of subcutaneous fat.
CHOROIDAL NEVUS TRANSFORMATION INTO MELANOMA PER MILLIMETER INCREMENT IN THICKNESS USING MULTIMODAL IMAGING IN 2355 CASES
Authors: Shields Carol L. , Dalvin Lauren A. , Yu Michael D. , Ancona-Lezama David , Di Nicola Maura , Williams Basil K. , Lucio-Alvarez J. Antonio , Ang Su Mae , Maloney Sean M. , Welch R. Joel , Shields Jerry A. 
Published: March 2019

Purpose:
To analyze risk of nevus transformation into melanoma per millimeter increment.

Methods:
Retrospective analysis of 3,806 choroidal nevi for transformation into melanoma per incremental millimeter thickness (flat [≤1.0 mm], thin [1.1–2.0 mm], thicker [2.1–3.0 mm], and thickest [>3.0 mm])

Results:
The median nevus thickness was 1.4 mm, and nevi were categorized (flat, thin, thicker, and thickest) in 1,140 (30%), 2052 (54%), 555 (15%), and 59 (<1%), respectively. There were differences in tumor diameter (2.5, 4.8, 7.5, and 9.3 mm; P < 0.01), optical coherence tomography detection of overlying subretinal fluid (<1, 4, 15, and 11%; P < 0.01), overlying retinal edema (<1, 3, 14, and 25%; P < 0.01), overlying drusen (23, 49, 64, and 64%; P < 0.01), overlying retinal pigment epithelial detachment (1, 4, 4, and 9%; P < 0.01), and overlying lipofuscin hyperautofluoresence (<1, 3, 6, and 7%; P < 0.01). Choroidal nevus transformation into melanoma (n = 90/2,355 cases, 3.8%) was found by Kaplan–Meier 7-year estimates (2.2, 6.1, 31.7, and 34.5%; P < 0.0001) and by hazard ratio (HR) compared with nevus ≤1.0 mm (not available, 4.7 [P = 0.01], 35.7 [P < 0.0001], and 52.0 [P < 0.0001]). For all thicknesses, those with growth displayed increase in mean basal diameter of 2.4 mm and thickness of 1.1 mm, optical coherence tomography increase in subretinal fluid (65%), autofluorescence increase in lipofuscin (40%), and ultrasonography increase in hollowness (30%). Multivariable risk factors, recalled by the mnemonic “To Find Small Ocular Melanoma Doing IMaging” (TFSOM-DIM) representing Thickness >2 mm (ultrasonography), Fluid subretinal (optical coherence tomography), Symptom vision loss (Va), Orange pigment (autofluorescence), Melanoma hollow (ultrasonography), and DIaMeter >5 mm, revealed factors per incremental thickness category (compared with flat) including thin (Fluid overlying, HR 6.1; DIaMeter >5 mm, HR 3.3), thicker (Fluid subretinal ≤3 mm from nevus, HR 5.7; Melanoma acoustic hollowness, HR 2.7), and thickest (Orange pigment, HR 9.1).

Conclusion:
Each incremental increase in choroidal nevus thickness demonstrated risk of growth into melanoma with HR (compared with flat) 4.7 for thin, 35.7 for thicker, and 52.0 for thickest. The increase from ≤2.0 mm to >2.0 mm thickness conferred the greatest rise for transformation.
Fibrin Glue–Assisted Closure of Macroperforation in Predescemetic Deep Anterior Lamellar Keratoplasty With a Donor Obtained From Small Incision Lenticule Extraction
Authors: Jacob Soosan , Dhawan Pallavi , Tsatsos Michael , Agarwal Amar , Narasimhan Smita , Kumar Arun 
Published: March 2019

Purpose:
To report a case with multiple macroperforations and a double anterior chamber (AC) after predescemetic deep anterior lamellar keratoplasty.

Methods:
A patient was referred after undergoing complicated excision of pseudopterygium that extended onto the cornea. At presentation, an eccentric lamellar patch graft extending over the pupillary axis with a double AC was seen. Surgical intervention showed a predescemetic plane of dissection with 2 macroperforations and iris plugging of the peripheral perforations. Suturing and fibrin glue alone did not seal the macroperforation, and a donor lenticule from small incision lenticule extraction (SMILE) was used to close the larger perforation using fibrin glue. A trephine was then used to mark a larger area of predescemetic dissection that included the original patch graft. A donor corneal graft was sutured after stripping Descemet membrane (DM).

Results:
Postoperatively, the double AC resolved, and vision improved to 0.50 decimal equivalent (20/40) by 3 weeks. At 18-month postoperative follow-up, corrected distance visual acuity (CDVA) was 0.67 (20/30). The donor graft remained clear, and the SMILE lenticule with underlying sutures could be visualized.

Conclusions:
A donor lenticule from SMILE surgery is a useful adjunct to seal macroperforations in deep anterior lamellar keratoplasty because the thin uniform lamellar tissue is easily applied using fibrin glue and gives uniform and good apposition on both host and donor sides. It can be used immediately without further preparation unlike hand-fashioned patch grafts.
Doxycycline Injection for Sclerotherapy of Lower Eyelid Festoons and Malar Edema: Preliminary Results
Authors: Godfrey Kyle J. , Kally Peter , Dunbar Kristen E. , Campbell Ashley A. , Callahan Alison B. , Lo Christopher , Freund Robert , Lisman Richard D. 
Published: March 2019

Purpose:
To investigate the safety and efficacy of direct, intralesional doxycycline hyclate injection for improving the appearance of cosmetically significant lower eyelid festoons and malar edema.

Methods:
An Institutional Review Board approved, retrospective review was performed of 15 consecutive patients with malar edema and/or festoons injected with doxycycline hyclate at a concentration of 10 mg/ml. Pre- and postinjection photographs were reviewed and graded on a scale of 0 to 3 (0: no festoon; 1: small festoon; 2: medium festoon; 3: large festoon) by 2 masked physician observers. Patients were excluded from the final analysis if they received an alternate dose concentration, had incomplete photographic records, or did not follow up. Student t test was used for statistical analysis.

Results:
Twenty consecutive treatment areas of 11 patients were included in the analysis. Final follow up ranged from 3 to 104 weeks, with a mean follow up of 22.5 weeks. The average (standard deviation) initial festoon grade of 2.5 (0.58) decreased to 0.9 (0.82) with a p value of <0.001. The average number of injections performed per side was 1.4 (range: 1–2). The mean volume per injection was 0.72 ml (range: 0.15–2.0 ml). Commonly documented subjective complaints were burning sensation with injection, pain, bruising, and erythema. There were no other dermatologic or visual complications following treatment.

Conclusions:
These preliminary results suggest that intralesional injections of doxycycline hyclate at a concentration of 10 mg/ml may be an effective treatment option for cosmetically significant lower eyelid festoons and malar edema. Future prospective studies with increased patient numbers, increasing concentrations, combination therapies with local anesthetic or regional nerve blocks, and longer follow up are needed to validate these results and determine optimal injection technique.
Evaluation of Folate Receptor-Mediated Cervical Dyeing as a Method for Detection of Cervical Lesions
Authors: Zhao Yun , Li Mingzhu , Li Yali , Lv Qiubo , Chen Fei , Li Bin , Zhang Zhenyu , Guo Hongyan , Lu Dan , Wang Fengying , Zhai Jianjun , Feng Limin , Lai Ailuan , Li Hongxia , Yao Chen , Wei Lihui 
Published: March 2019

Objectives
The aim of the study was to evaluate the performance of a folate receptor–mediated tumor detection (FRD) assay for detection of cervical high-grade lesions.

Materials and Method
A total of 1504 patients with abnormal cytology and/or positive human papillomavirus (HPV) testing during primary screening from November 2014 to August 2015 were enrolled. The patients were recruited from the Peking University People's Hospital and 12 other hospitals. Folate receptor–mediated tumor detection was applied in all the patients before colposcopy to compare the detection rate, sensitivity, specificity, positive predictive value, negative predictive value, and coincidence rate with HPV and cytology tests according to the pathologic diagnosis.

Results
In the total of 1504 patients, 503 patients were negative for intraepithelial lesion or malignancy, 440 patients were cervical intraepithelial neoplasia (CIN) 1, 254 patients were CIN 2, 257 patients were CIN 3, 46 patients were squamous cell carcinoma, and 4 patients were adenocarcinoma in situ. The sensitivity of FRD was 77.72%, which was less than cytology (80.39%) and HPV testing (95.54%). The specificity of FRD was 60.02%, which was greater than cytology (30.12%) and HPV testing (14.95%). The coincidence rate of FRD to the pathologic diagnosis (66.62%) was also significantly greater than atypical squamous cells of undetermined significance cytology and above (48.87%) and HPV testing (45.01%, p < .0001). The detection rate of FRD for all grades of lesions increased with the severity of lesions.

Conclusions
Folate receptor–mediated tumor detection has a slightly lower sensitivity and a higher specificity than cytology and HPV testing for detection of CIN 2+. Simplicity of FRD requires less professional skill. Folate receptor–mediated tumor detection could be a candidate test for cervical cancer screening especially in low- and middle-income countries. However, FRD still needs more clinical trial data to demonstrate its ability in general screening population.
The Association of Nurse Practitioner Scope-of-Practice Laws With Emergency Department Use
Authors: McMichael Benjamin J. , Spetz Joanne , Buerhaus Peter I. 
Published: March 2019

Background:
Overuse and inappropriate use of emergency departments (EDs) remains an important issue in health policy. After implementation of Medicaid expansion, many states experienced an increase in ED use, but the magnitude varied. Differential access to primary care might explain such variation.

Objective:
To determine whether the increase in ED use among Medicaid enrollees following Medicaid expansion was smaller in states that allowed greater access to primary care providers by permitting nurse practitioners (NPs) to practice without physician oversight.

Research Design:
Examining data on ED use by Medicaid beneficiaries, we estimated random effects models to examine changes in ED visits. Models for 8 different clinical conditions were estimated, with each model including a linear time trend, indicators for Medicaid expansion and for the absence of physician oversight requirements, and an interaction between these 2 indicators.

Results:
States requiring physician oversight of NPs had a 28% increase in ED visits relative to the preexpansion period, while states allowing NP practice without physician oversight had only a 7% increase. The increase in the share of visits covered by Medicaid in no-oversight states was 40% of the size of the increase in oversight states.

Conclusions:
Allowing NPs to practice without physician oversight was associated with a reduction in the magnitude of increase in ED use following Medicaid expansion. States that restrict NP practice should weigh the costs of maintaining these restrictions against the potential benefits of lower ED use. States considering Medicaid expansion should also consider relaxing NP scope-of-practice laws.
Retooling of Paper-based Outcome Measures to Electronic Format
Authors: Hannan Edward L. , Barrett Stacey C. , Samadashvili Zaza , Schmaltz Stephen P. 
Published: March 2019

Background:
Risk adjustment is critical in the comparison of quality of care and health care outcomes for providers. Electronic health records (EHRs) have the potential to eliminate the need for costly and time-consuming manual data abstraction of patient outcomes and risk factors necessary for risk adjustment.

Methods:
Leading EHR vendors and hospital focus groups were asked to review risk factors in the New York State (NYS) coronary artery bypass graft (CABG) surgery statistical models for mortality and readmission and assess feasibility of EHR data capture. Risk models based only on registry data elements that can be captured by EHRs (one for easily obtained data and one for data obtained with more difficulty) were developed and compared with the NYS models for different years.

Results:
Only 6 data elements could be extracted from the EHR, and outlier hospitals differed substantially for readmission but not for mortality. At the patient level, measures of fit and predictive ability indicated that the EHR models are inferior to the NYS CABG surgery risk model [eg, c-statistics of 0.76 vs. 0.71 (P<0.001) and 0.76 vs. 0.74 (P=0.009) for mortality in 2010], although the correlation of the predicted probabilities between the NYS and EHR models was high, ranging from 0.96 to 0.98.

Conclusions:
A simplified risk model using EHR data elements could not capture most of the risk factors in the NYS CABG surgery risk models, many outlier hospitals were different for readmissions, and patient-level measures of fit were inferior.
Seizure Prediction Models in the Neonatal Intensive Care Unit
Authors: Sansevere Arnold J. , Kapur Kush , Peters Jurriaan M. , Fernández Ivan Sánchez , Loddenkemper Tobias , Soul Janet S. 
Published: March 2019

Purpose:
Conventional video-EEG monitoring is required to diagnose seizures accurately in neonates. This tool is resource-intense and has limited availability in many centers. Seizure prediction models could help allocate resources by improving efficiency in which conventional video-EEG monitoring is used to detect subclinical seizures. The aim of this retrospective study was to create a neonate-specific seizure prediction model using clinical characteristics and EEG background findings.

Methods:
We conducted a 3-year retrospective study of all consecutive neonates who underwent conventional video-EEG monitoring at a tertiary care pediatric hospital. Variables including age, EEG indication, high-risk clinical characteristics, and EEG background informed seizure prediction models based on a multivariable logistic regression model. A Cox proportional hazard regression model was used to construct time to first EEG seizure.

Results:
Prediction models with clinical variables or background EEG features alone versus combined clinical and background EEG features were created from 210 neonates who met inclusion criteria. The combined clinical and EEG model had a higher area under the curve for combined sensitivity and specificity to 83.0% when compared to the clinical model (76.4%) or EEG model (66.2%). The same trend of higher sensitivity of the combined model was found for time to seizure outcome.

Conclusions:
While both clinical and EEG background features were predictive of neonatal seizures, the combination improved overall prediction of seizure occurrence and prediction of time to first seizure as compared with prediction models based solely on clinical or EEG features alone. With prospective validation, this model may improve efficiency of patient-oriented EEG monitoring.
A genomic analysis and transcriptomic atlas of gene expression inPsoroptes ovisreveals feeding- and stage-specific patterns of allergen expression
Authors: Burgess Stewart TG , Marr Edward J , Bartley Kathryn , Nunn Francesca G , Down Rachel E , Weaver Robert J , Prickett Jessica C , Dunn Jackie , Rombauts Stephane , Van Leeuwen Thomas , Van de Peer Yves , Nisbet Alasdair J 
Published: March 2019

ABSTRACTPsoroptic mange, caused by infestation with the ectoparasitic mite,Psoroptes ovis, is highly contagious, resulting in intense pruritus and represents a major welfare and economic concern for the livestock industry Worldwide. Control relies on injectable endectocides and organophosphate dips, but concerns over residues, environmental contamination, and the development of resistance threaten the sustainability of this approach, highlighting interest in alternative control methods. However, development of vaccines and identification of chemotherapeutic targets is hampered by the lack ofP. ovistranscriptomic and genomic resources. Building on the recent publication of theP. ovisdraft genome, here we present a genomic analysis and transcriptomic atlas of gene expression inP. ovisrevealing feeding- and stage-specific patterns of gene expression, including novel multigene families and allergens. Network-based clustering revealed 14 gene clusters demonstrating either single- or multi-stage specific gene expression patterns, with 3,075 female-specific, 890 male-specific and 112, 217 and 526 transcripts showing larval, protonymph and tritonymph specific-expression, respectively. Detailed analysis ofP. ovisallergens revealed stage-specific patterns of allergen gene expression, many of which were also enriched in “fed” mites and tritonymphs, highlighting an important feeding-related allergenicity in this developmental stage. Pair-wise analysis of differential expression between life-cycle stages identified patterns of sex-biased gene expression and also identified novelP. ovismultigene families including known allergens and novel genes with high levels of stage-specific expression. The genomic and transcriptomic atlas described here represents a unique resource for the acarid-research community, whilst the OrcAE platform makes this freely available, facilitating further community-led curation of the draftP. ovisgenome.