bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Radiographic Outcomes After Arthroscopic Lamina-Specific Double-Row Repair of Large Delaminated Rotator Cuff Tears in Active Patients
Authors: Mori Daisuke , Kizaki Kazuha , Funakoshi Noboru , Yamashita Fumiharu , Mizuno Yasuyuki , Shirai Takaaki , Kobayashi Masahiko 
Published: April 2019

Background: The presence of delamination and a larger rotator cuff tear (RCT) size have been associated with poorer outcomes in rotator cuff repair. Therefore, we developed a new surgical procedure, arthroscopic lamina-specific double-row fixation (ALSDR), for the repair of large delaminated RCTs. Purpose: To investigate the clinical outcomes, magnetic resonance imaging findings, and satisfaction with several variables after ALSDR for large delaminated RCTs. Study Design: Case series; Level of evidence, 4. Methods: A total of 30 active patients (mean age, 59.1 years) undergoing ALSDR were assessed by a numeric rating scale (NRS; 0-10) for pain, surgery, work, and exercise as well as American Shoulder and Elbow Surgeons (ASES), Constant, and Simple Shoulder Test (SST) scores at a mean of 65.9 months postoperatively. Rotator cuff integrity was determined by magnetic resonance imaging. The Spearman correlation coefficient (ρ) was used to determine the correlation between clinical and NRS scores. Results: Five patients (16.7%) had a retear. Each of the postoperative functional and NRS scores except the NRS work score was significantly better in the healed shoulders than in the shoulders with a retear ( P < .001). The NRS pain score showed a significant negative correlation with ASES, Constant, and SST scores (ρ = −0.775, −0.668, and −0.742, respectively; P < .001 for all). The NRS surgery score had a positive correlation with Constant and SST scores (ρ = 0.393 [ P = .032] and ρ = 0.456 [ P = .011], respectively). The NRS work score had a positive correlation with ASES, Constant, and SST scores (ρ = 0.382 [ P = .037], ρ = 0.386 [ P = .035], and ρ = 0.414 [ P = .023], respectively). The NRS exercise score had a positive correlation with ASES, Constant, and SST scores (ρ = 0.567 [ P = .001], ρ = 0.511 [ P = .004], and ρ = 0.639 [ P < .001], respectively). Conclusion: Our results showed that there was a significant correlation between clinical and NRS scores. The results indicate that ALSDR can provide a high degree of functionality and can be a useful alternative treatment for active patients with large delaminated RCTs.
An Economic Evaluation of a Comprehensive School-Based Caries Prevention Program
Authors: Huang S.S. , Ruff R.R. , Niederman R. 
Published: April 2019

Introduction: Current economic evaluations of school-based caries prevention programs (SCPPs) do not compare multiple types of SCPPs against each other and do not consider teeth beyond permanent first molars. Objectives: To assess the cost-effectiveness of a comprehensive SCPP relative to an SCPP focused on delivering sealants for permanent first molars only and to a default of no SCPP. Based on a societal perspective, a simulation model was used that compared the health and cost impacts on 1) permanent first molars only and 2) all posterior teeth. Methods: To calibrate the model, we used data from CariedAway, a comprehensive SCPP that used glass ionomer to prevent and arrest active decay among children. We then evaluated the incremental cost-effectiveness of implementing 3 alternate school-based approaches (comprehensive, sealant only, and no program) on only first molars and all posterior teeth. Probabilistic, 1-, and 2-way sensitivity analyses are included for robustness. Cost-effectiveness is assessed with a threshold of $54,639 per averted disability-adjusted life year (DALY). Results: We first compared the 3 programs under the assumption of treating only first molars. This assessment indicated that CariedAway was less cost-effective than school-based sealant programs (SSPs): the resulting incremental cost-effectiveness ratio (ICER) for CariedAway versus SSPs was $283,455 per averted DALY. However, when the model was extended to include CariedAway’s treatment of all posterior teeth, CariedAway was not only cost-effective but also cost-saving relative to SSPs (ICER, –$943,460.88 per averted DALY; net cost, –$261.45) and no SCPP (ICER, –$400,645.52 per averted DALY; net cost, –$239.77). Conclusions: This study finds that economic evaluations assessing only cost and health impacts on permanent first molars may underestimate the cost-effectiveness of comprehensive SCPPs 1) preventing and arresting decay and 2) treating all teeth. Hence, there is an urgent need for economic evaluations of SCPPs to assess cost and health impacts across teeth beyond only permanent first molars. Knowledge Transfer Statement: The results of this study can be used by policy makers to understand how to evaluate economic evaluations of school-based caries prevention programs and what factors to consider when deciding on what types of programs to implement.
The influence of desilication/dealumination processes on the physicochemical properties of clinoptilolite
Authors: Wojciechowska Kamila 
Published: April 2019

AbstractA clinoptilolite was exposed to treatments with acid and base solutions that caused desilication, dealumination or a combination of both. The mineralogical and physicochemical properties of clinoptilolite were studied by X-ray diffraction, X-ray fluorescence, Brunauer–Emmett–Teller specific surface area, differential thermogravimetry, Fourier-transform infrared spectroscopy and scanning electron microscopy methods. The studies provided insight into the structural and textural properties of the treated zeolite. The applied post-synthesis modification techniques proved to be effective for the generation of secondary mesopores.
Constraints on the Equations of State of stiff anisotropic minerals: rutile, and the implications for rutile elastic barometry
Authors: Zaffiro Gabriele , Angel Ross J. , Alvaro Matteo 
Published: April 2019

AbstractWe present an assessment of the thermo-elastic behaviour of rutile based on X-ray diffraction data and direct elastic measurements available in the literature. The data confirms that the quasi-harmonic approximation is not valid for rutile because rutile exhibits substantial anisotropic thermal pressure, meaning that the unit-cell parameters change significantly along isochors. Simultaneous fitting of both the diffraction and elasticity data yields parameters ofKTR0= 205.14(15) GPa,KSR0= 207.30(14) GPa,$K_{TR0}^{\prime} $= 6.9(4) in a 3rd-order Birch-Murnaghan Equation of State for compression, αV0= 2.526(16) × 10–5K–1, Einstein temperature θE= 328(12) K, Anderson-Grüneisen parameter δT= 7.6(6), with a fixed thermal Grüneisen parameter γ = 1.4 to describe the thermal expansion and variation of bulk modulus with temperature at room pressure. This Equation of State fits all of the available data up to 7.3 GPa at room temperature, and up to 1100 K at room pressure within its uncertainties. We also present a series of formulations and a simple protocol to obtain thermodynamically consistent Equations of State for the volume and the unit-cell parameters for stiff materials, such as rutile. In combination with published data for garnets, the Equation of State for rutile indicates that rutile inclusions trapped inside garnets in metamorphic rocks should exhibit negative residual pressures when measured at room conditions.
Does anthropometric status at 6 months predict the over-dispersion of malaria infections in children aged 6–18 months? A prospective cohort study
Authors: Bendabenda Jaden , Patson Noel , Hallamaa Lotta , Ashorn Ulla , Dewey Kathryn G. , Ashorn Per , Maleta Kenneth 
Published: April 2019

AbstractBackgroundIn malaria-endemic settings, a small proportion of children suffer repeated malaria infections, contributing to most of the malaria cases, yet underlying factors are not fully understood. This study was aimed to determine whether undernutrition predicts this over-dispersion of malaria infections in children aged 6–18 months in settings of high malaria and undernutrition prevalence.MethodsProspective cohort study, conducted in Mangochi, Malawi. Six-months-old infants were enrolled and had length-for-age z-scores (LAZ), weight-for-age z-scores (WAZ), and weight-for-length z-scores (WLZ) assessed. Data were collected for ‘presumed’, clinical, and rapid diagnostic test (RDT)-confirmed malaria until 18 months. Malaria microscopy was done at 6 and 18 months. Negative binomial regression was used for malaria incidence and modified Poisson regression for malaria prevalence.ResultsOf the 2723 children enrolled, 2561 (94%) had anthropometry and malaria data. The mean (standard deviation [SD]) of LAZ, WAZ, and WLZ at 6 months were − 1.4 (1.1), − 0.7 (1.2), and 0.3 (1.1), respectively. The mean (SD) incidences of ‘presumed’, clinical, and RDT-confirmed malaria from 6 to 18 months were: 1.1 (1.6), 0.4 (0.8), and 1.3 (2.0) episodes/year, respectively. Prevalence of malaria parasitaemia was 4.8% at 6 months and 9.6% at 18 months. Higher WLZ at 6 months was associated with lower prevalence of malaria parasitaemia at 18 months (prevalence ratio [PR] = 0.80, 95% confidence interval [CI] 0.67 to 0.94, p = 0.007), but not with incidences of ‘presumed’ malaria (incidence rate ratio [IRR] = 0.97, 95% CI 0.92 to 1.02, p = 0.190), clinical malaria (IRR = 1.03, 95% CI 0.94 to 1.12, p = 0.571), RDT-confirmed malaria (IRR = 1.00, 95% CI 0.94 to 1.06, p = 0.950). LAZ and WAZ at 6 months were not associated with malaria outcomes. Household assets, maternal education, and food insecurity were significantly associated with malaria. There were significant variations in hospital-diagnosed malaria by study site.ConclusionIn children aged 6–18 months living in malaria-endemic settings, LAZ, WAZ, and WLZ do not predict malaria incidence. However, WLZ may be associated with prevalence of malaria. Socio-economic and micro-geographic factors may explain the variations in malaria, but these require further study.Trial registrationNCT00945698. Registered July 24, 2009,https://clinicaltrials.gov/ct2/show/NCT00945698, NCT01239693. Registered Nov 11, 2010,https://clinicaltrials.gov/ct2/show/NCT01239693
Clinician Perspectives on Electronic Health Records, Communication, and Patient Safety Across Diverse Medical Oncology Practices
Authors: Patel Minal R. , Friese Christopher R. , Mendelsohn-Victor Kari , Fauer Alex J. , Ghosh Bidisha , Bedard Louise , Griggs Jennifer J. , Manojlovich Milisa 
Published: April 2019

PURPOSE: We know little about how increased technological sophistication of clinical practices affects safety of chemotherapy delivery in the outpatient setting. This study investigated to what degree electronic health records (EHRs), satisfaction with technology, and quality of clinician-to-clinician communication enable a safety culture. METHODS: We measured actions consistent with a safety culture, satisfaction with practice technology, and quality of clinician communication using validated instruments among 297 oncology nurses and prescribers in a statewide collaborative. We constructed an index to reflect practice reliance on EHRs (1 = “all paper” to 5 = “all electronic”). Linear regression models (with robust SEs to account for clustering) examined relationships between independent variables of interest and safety. Models were adjusted for clinician age. RESULTS: The survey response rate was 68% (76% for nurses and 59% for prescribers). The mean (standard deviation) safety score was 5.3 (1.1), with a practice-level range of 4.9 to 5.4. Prescribers reported fewer safety actions than nurses. Higher satisfaction with technology and higher-quality clinician communication were significantly associated with increased safety actions, whereas increased reliance on EHRs was significantly associated with lower safety actions. CONCLUSION: Practices vary in their performance of patient safety actions. Supporting clinicians to integrate technology and strengthen communication are promising intervention targets. The inverse relationship between reliance on EHRs and safety suggests that technology may not facilitate clinicians’ ability to attend to patient safety. Efforts to improve cancer care quality should focus on more seamless integration of EHRs into routine care delivery and emphasize increasing the capacity of all care clinicians to communicate effectively and coordinate efforts when administering high-risk treatments in ambulatory settings.
Clinical Factors Associated With Cost in Head and Neck Cancer: Implications for a Bundled Payment Model
Authors: Tom Martin C. , Ross Richard B. , Koyfman Shlomo A. , Adelstein David J. , Lorenz Robert R. , Burkey Brian B. , Shah Chirag , Suh John H. , Bolwell Brian J. , Savage Craig , Platz Scott , Ward Matthew C. 
Published: April 2019

PURPOSE: To determine which factors influence cost in head and neck cancer (HNC) to inform the development of a bundled payment model (BPM). METHODS: Patients with stages 0 to IVB (by American Joint Commission on Cancer, 7th edition) HNC of various sites and histology treated definitively at a single tertiary care center during 2013 were included. Clinical variables and direct cost data were obtained, and their associations were investigated using χ2, t, Wilcoxon rank sum, and analysis of variance testing. Results were used to develop a BPM. RESULTS: One hundred fifty patients were included; 87% were white, 74% were men, 48% had oropharyngeal cancer, and 58% had stage IVA disease. Treatment consisted of surgery alone (17%), radiation alone (11%), surgery plus radiation (14%), chemoradiation (45%), and surgery plus chemoradiation (13%). On multivariable analysis, both increasing group stage and number of treatment modalities used were significantly associated with higher cost. Given that stage often dictates treatment, we developed three cost tiers that were based on overall treatment modality. Tier A, the least costly, consisted of single-modality therapy with either surgery alone or radiation alone (median cost divided by the median overall cost of treatment, 0.54; 25th to 75th percentile range, 0.29 to 1.02), followed by tier B, which consisted of bimodality therapy with either chemoradiation or surgery plus radiation (1.03; range, 0.81 to 1.35), followed by tier C, which consisted of trimodality therapy with surgery plus chemoradiation (1.43; range, 1.10 to 1.96). CONCLUSION: The number of treatment modalities required is the primary driver of cost in HNC. These data can simplify development of a comprehensive HNC BPM.
Plasma Free Cortisol in States of Normal and Altered Binding Globulins: Implications for Adrenal Insufficiency Diagnosis
Authors: Dichtel Laura E , Schorr Melanie , Loures de Assis Claudia , Rao Elizabeth M , Sims Jessica K , Corey Kathleen E , Kohli Puja , Sluss Patrick M , McPhaul Michael J , Miller Karen K 
Published: April 2019

Abstract

Context
Accurate diagnosis of adrenal insufficiency is critical because there are risks associated with overdiagnosis and underdiagnosis. Data using liquid chromatography tandem mass spectrometry (LC/MS/MS) free cortisol (FC) assays in states of high or low cortisol-binding globulin (CBG) levels, including cirrhosis, critical illness, and oral estrogen use, are needed.

Design
Cross-sectional.

Objective
Determine the relationship between CBG and albumin as well as total cortisol (TC) and FC in states of normal and abnormal CBG. Establish the FC level by LC/MS/MS that best predicts TC of <18 μg/dL (497 nmol/L) (standard adrenal insufficiency diagnostic cutoff) in healthy individuals.

Subjects
This study included a total of 338 subjects in four groups: healthy control (HC) subjects (n = 243), patients with cirrhosis (n = 38), intensive care unit patients (ICU) (n = 26), and oral contraceptive (OCP) users (n = 31).

Main Outcome Measure(s)
FC and TC by LC/MS/MS, albumin by spectrophotometry, and CBG by ELISA.

Results
TC correlated with FC in the ICU (R = 0.91), HC (R = 0.90), cirrhosis (R = 0.86), and OCP (R = 0.70) groups (all P < 0.0001). In receiver operator curve analysis in the HC group, FC of 0.9 μg/dL (24.8 nmol/L) predicted TC of <18 μg/dL (497 nmol/L; 98% sensitivity, 91% specificity; AUC, 0.98; P < 0.0001). Decreasing the cutoff to 0.7 μg/dL led to a small decrease in sensitivity (92%) with similar specificity (91%).

Conclusions
A cutoff FC of <0.9 μg/dL (25 nmol/L) in this LC/MS/MS assay predicts TC of <18 μg/dL (497 nmol/L) with excellent sensitivity and specificity. This FC cutoff may be helpful in ruling out adrenal insufficiency in patients with binding globulin derangements.
Detection of Colorectal Cancer in Circulating Cell-Free DNA by Methylated CpG Tandem Amplification and Sequencing
Authors: Li Jingyi , Zhou Xin , Liu Xiaomeng , Ren Jie , Wang Jilian , Wang Wendong , Zheng Yuxuan , Shi Xinyun , Sun Tao , Li Zhifei , Kang Anding , Tang Fuchou , Wen Lu , Fu Wei 
Published: April 2019

Abstract

BACKGROUND
Aberrant DNA hypermethylation of CpG islands occurs frequently throughout the genome in human colorectal cancer (CRC). A genome-wide DNA hypermethylation analysis technique using circulating cell-free DNA (cfDNA) is attractive for the noninvasive early detection of CRC and discrimination between CRC and other cancer types.

METHODS
We applied the methylated CpG tandem amplification and sequencing (MCTA-Seq) method, with a fully methylated molecules algorithm, to plasma samples from patients with CRC (n = 147) and controls (n = 136), as well as cancer and adjacent noncancerous tissue samples (n = 66). We also comparatively analyzed plasma samples from patients with hepatocellular carcinoma (HCC; n = 36).

RESULTS
Dozens of DNA hypermethylation markers including known (e.g., SEPT9 and IKZF1) and novel (e.g., EMBP1, KCNQ5, CHST11, APBB1IP, and TJP2) genes were identified for effectively detecting CRC in cfDNA. A panel of 80 markers discriminated early-stage CRC patients and controls with a clinical sensitivity of 74% and clinical specificity of 90%. Patients with early-stage CRC and HCC could be discriminated at clinical sensitivities of approximately 70% by another panel of 128 markers.

CONCLUSIONS
MCTA-Seq is a promising method for the noninvasive detection of CRC.
Novel Circulating miRNA Signatures for Early Detection of Pancreatic Neoplasia
Authors: Vila-Navarro Elena , Duran-Sanchon Saray , Vila-Casadesús Maria , Moreira Leticia , Ginès Àngels , Cuatrecasas Miriam , Lozano Juan José , Bujanda Luis , Castells Antoni , Gironella Meritxell 
Published: April 2019

OBJECTIVES:
Pancreatic ductal adenocarcinoma (PDAC) presents the lowest survival rate of all cancers because only 6% of patients reach five-year survival. Alterations in the expression of several microRNAs (miRNAs) occur in the tumor of PDAC and in preneoplastic lesions as the called intraductal papillary mucinous neoplasm (IPMN). Here, we aimed at identifying which miRNAs are significantly altered in liquid biopsies from patients with PDAC and IPMN to find new noninvasive biomarkers for early detection of PDAC.

METHODS:
We analyzed by real-time quantitative reverse transcription-PCR (qRT-PCR) the expression of 17 circulating miRNAs, previously found to be significantly overexpressed in tissue pancreatic neoplasms, in a set of 182 plasma samples (94 PDAC, 19 IPMN, 18 chronic pancreatitis, and 51 disease-free controls). Then, we analyzed CA19.9 levels in the same plasma set, and we assessed the diagnostic values of differentially expressed miRNAs, CA19.9, and all possible combinations.

RESULTS:
Of note, 16, 14, and 9 miRNAs were significantly increased in PDAC, IPMN, and chronic pancreatitis, respectively, compared with control plasmas. miR-21-5p, miR-33a-3p, miR-320a, and miR-93-5p showed the highest discriminating capacity for pancreatic neoplasia (PDAC or IPMN) with an area under the receiver operating characteristic curve (AUC) of 0.86, 0.85, 0.85, and 0.80, respectively. 2-miRNA combinations improved these performances reaching AUC = 0.90 for “miR-33a-3p+miR-320a.” Addition of CA19.9 increased the diagnostic potential of miRNA signatures even further achieving an AUC of 0.95 (93% sensitivity and 85% specificity) for the combination of “miR-33a-3p+miR-320a+CA19.9.”

CONCLUSIONS:
Novel signatures combining miRNAs and CA19.9 could be used as noninvasive biomarkers for early detection of PDAC.
Investigation of the effect of local vibration on injection pain in invasive dental filling treatments<p>Lokal vibrasyon uygulamasının invaziv diş dolgu tedavilerinde enjeksiyon ağrısına etkisinin incelenmesi
Authors: Alp Hayriye Baltaoğlu , Karabekiroğlu Said 
Published: April 2019

Research problem: Dental injection and the fear of pain are among the reasons why dental patients are delayed treatment and do not come to their appointments. njection of local anesthesia is one of the most important issues that cause pain and anxiety, which may lead to unpleasant experiences in patients (2) .This may also discourage clinicians or prevent them from working comfortably.The pain relief mechanism of the vibration can be explained by the door-control theory demonstrated by Melzack and Wall. Metod:In the first study group (Group 1), topical anesthesia (20% benzocaine) was applied with sterile cotton pellet and it was kept for 1 min. In the second group (Group 2), vibration was induced by vibration device which was formed by modified toothbrush with tongue cleaner. In the third group (Group 3); First, 1 min topical anesthesia was applied for 1 min.Results:According to the results of this study, it was observed that topical anesthesia with vibration resulted in lower VAS score than other methods.Extended English summary is in the end of Full Text PDF (TURKISH) file. ÖzetAraştırma problem: Dental enjeksiyon ve ağrı korkusu, diş hastalarının tedaviyi geciktirme ve randevularına gelmeme nedenleri arasındadır.(1) Lokal anestezi enjeksiyonu hastalarda hoş olmayan deneyimler yaşamasına neden olabilen, ağrı ve anksiyete yaratan en önemli konulardan biridir(2).Bu durum aynı zamanda klinisyenlerin de cesaretlerini kırabilir, yada rahat çalışmasını engelleyebilir.Vibrasyonun ağrıyı giderme mekanizması Melzack ve Wall’un gösterdiği kapı-kontrol teorisi ile açıklanabilir. Derideki reseptörlerden alınan dokunma ve vibrasyon duyusunun, A-β sinir lifleri aracılığıyla medullaspinalistekiintermedier inhibitör nöronları uyarması ile açıklamışlardır.Metod: İlk çalışma grubunda (Grup 1) steril pamuk pelet yardımı ile topikal anestezi (20% benzocaine) uygulandı ve 1 dk bekletildi. İkinci grupta (Grup 2), kurutulan bölgeye şarjlı diş fırçasının dil temizleyici ile modifiye edilmesiyle oluşturulan vibrasyon cihazı ile 1 dk titreşim verildi. Üçüncü grupta ise (Grup 3); önce 1 dk vibrasyon uygulandı ardından 1 dk topikal anestezi uygulandı.Sonuç: Bu çalışmanın sonuçlarına göre titreşim ile beraber topikal anestezi uygulanmasının diğer yöntemlere göre daha düşük VAS skoru sonuçları ortaya çıkardığı görülmüştür.
PERANCANGAN PERANGKAT KERAS ALAT UJI BIPOLAR JUNCTION TRANSISTOR BERBASIS MIKROKONTROLER
Authors: Perkasa Dedy Bagus , Andromeda Trias , Riyadi Munawar A 
Published: April 2019

Transistor bipolar merupakan piranti elektronika yang banyak digunakan dalam teknologi elektronika. Salah satu penggunaan transistor adalah sebagai amplifier audio. Pada rangkaian digital transistor digunakan sebagai saklar berkecepatan tinggi. Agar transistor bekerja dengan optimal, pemasangan transistor dalam rangkaian harus benar. Untuk itu, posisi kaki-kaki pin transistor dan nilai parameter yang ada pada transistor perlu diperhatikan. Alat bantu atau tester yang handal diperlukan untuk mengetahui letak pin pada transistor. Penelitian ini merancang suatu perangkat keras yang dapat digunakan untuk membaca jenis, letak kaki, nilai penguatan, dan tegangan maju transistor BJT (Bipolar Junction Transistor). Perangkat keras ini dirancang menggunakan mikrokontroller dan resistor untuk analisis titik kerja transistor. Pengujian dilakukan dengan menguji beberapa transistor BJT dengan tipe yang berbeda-beda. Hasil pengujian menunjukkan bahwa perangkat telah dapat bekerja dengan baik.