bluuebunny/crossref_metadata_2025_split huggingface dataset:
Educational and interactive informed consent process for treatment of unruptured intracranial aneurysms
Authors: Park Jaechan , Son Wonsoo , Park Ki-Su , Kang Dong-Hun , Lee Joomi , Oh Chang Wan , Kwon O-Ki , Kim Taesun , Kim Chang-Hyun 
Published: May 2016

OBJECTIVE
For patients with unruptured intracranial aneurysms (UIAs), the information transfer that precedes informed consent needs to be in-depth and detailed, as most patients with a UIA have no symptoms, yet the risks related to treatment are relatively high. Thus, in this study an educational and interactive program was proposed for patients with UIAs to improve the informed consent process and assess the level of comprehension.

METHODS
A total of 110 patients with UIAs underwent the proposed educational and interactive informed consent (EIIC) process and were enrolled in this study. The EIIC process combines patient education using information booklets, a cartoon book, a video, an initial physician-patient interview, answering a questionnaire, a second physician-patient interview based on the questionnaire results, and finally consent. After the first physician-patient interview that provides the patient with specific information, including his or her angiographic characteristics, medical condition, and recommended treatment, the patient is requested to answer a questionnaire composed of 3 parts: demographic information, including the patient's age, sex, and years of education; 13 medical questions to assess the patient's knowledge about his or her UIA; and an evaluation of the usefulness of the educational resources. The control group consisted of 65 patients from 3 other tertiary university hospitals where the EIIC process was not used.

RESULTS
The questionnaire scores of the EIIC group ranged from 7 to 13 (mean ± SD: 11.9 ± 1.3) and were significantly higher than those for the controls (10.2 ± 1.9, p < 0.001). The better comprehension of the patients in the EIIC group was remarkable as they were significantly older than those in the control group (62.7 ± 8.3 years vs 55.9 ± 10.5 years, respectively; p < 0.001). For both the EIIC group and the control group, a Pearson correlation analysis revealed a positive correlation (r = 0.232 for the EIIC group, r = 0.603 for controls) between the years of education and the questionnaire score (p = 0.015 for the EIIC group, p < 0.001 for the controls), whereas no correlation was found between the patient age and the questionnaire score. For the EIIC group, the verbal information from the attending physician was selected by 90 patients (81.8%) as the most useful and informative educational method, while the most effective reinforcement of this verbal communication was the video (n = 86; 78.2%), information booklets (n = 16; 14.5%), the Internet (n = 7; 6.4%), and the cartoon book (n = 1; 0.9%).

CONCLUSIONS
The proposed standardized EIIC process resulted in good patient comprehension about UIAs. The verbal information from the attending physician was the most informative, and the video was the most effective reinforcement of the verbal communication. The patient level of comprehension was shown to be correlated with years of education.
Risk factors for revision surgery following primary adult spinal deformity surgery in patients 65 years and older
Authors: Puvanesarajah Varun , Shen Francis H. , Cancienne Jourdan M. , Novicoff Wendy M. , Jain Amit , Shimer Adam L. , Hassanzadeh Hamid 
Published: May 2016

OBJECTIVE
Surgical correction of adult spinal deformity (ASD) is a complex undertaking with high revision rates. The elderly population is poorly studied with regard to revision surgery, yet senior citizens constitute a rapidly expanding surgical demographic. Previous studies aimed at elucidating appropriate risk factors for revision surgery have been limited by small cohort sizes. The purpose of this study was to assess factors that modify the risk of revision surgery in elderly patients with ASD.

METHODS
The PearlDiver database (2005–2012) was used to determine revision rates in elderly ASD patients treated with a primary thoracolumbar posterolateral fusion of 8 or more levels. Analyzed risk factors included demographics, comorbid conditions, and surgical factors. Significant univariate predictors were further analyzed with multivariate analysis. The causes of revision at each year of follow-up were determined.

RESULTS
A total of 2293 patients who had been treated with posterolateral fusion of 8 or more levels were identified. At the 1-year follow-up, 241 (10.5%) patients had been treated with revision surgery, while 424 (18.5%) had revision surgery within 5 years. On univariate analysis, obesity was found to be a significant predictor of revision surgery at 1 year, while bone morphogenetic protein (BMP) use was found to significantly decrease revision surgery at 4 and 5 years of followup. Diabetes mellitus, osteoporosis, and smoking history were all significant univariate predictors of increased revision risk at multiple years of follow-up. Multivariate analysis at 5 years of follow-up revealed that osteoporosis (OR 1.98, 95% CI 1.60–2.46, p < 0.0001) and BMP use (OR 0.70, 95% CI 0.56–0.88, p = 0.002) were significantly associated with an increased and decreased revision risk, respectively. Smoking history trended toward significance (OR 1.37, 95% CI 1.10–1.70, p = 0.005). Instrument failure was consistently the most commonly cited reason for revision. Five years following surgery, it was estimated that the cohort had 68.8% survivorship.

CONCLUSIONS
For elderly patients with ASD, osteoporosis increases the risk of revision surgery, while BMP use decreases the risk. Other comorbidities were not found to be significant predictors of long-term revision rates. It is expected that within 5 years following the index procedure, over 30% of patients will require revision surgery.
Long-term hemorrhagic risk in pediatric patients with arteriovenous malformations
Authors: Yang Wuyang , Anderson-Keightly Heather , Westbroek Erick M. , Caplan Justin M. , Rong Xiaoming , Hung Alice L. , Colby Geoffrey P. , Coon Alexander L. , Tamargo Rafael J. , Huang Judy , Ahn Edward S. 
Published: May 2016

OBJECTIVE
Compared with the general population, the specific natural history of arteriovenous malformations (AVMs) in pediatric patients is less well understood. Furthermore, few pediatric studies have compared posttreatment hemorrhagic risk and functional outcome across different treatment modalities. The objective of this study was to elucidate these points.

METHODS
The authors retrospectively reviewed all pediatric patients with AVMs evaluated at their institution between 1990 and 2013. The AVM natural history was represented by hemorrhagic risk during the observation period. For treated patients, the observation period was defined as the interval between diagnosis and treatment. Posttreatment hemorrhagic risk and functional outcomes were also assessed.

RESULTS
A total of 124 pediatric patients with AVMs were evaluated, and 90 patients (72.6%) were retained through follow-up. The average patient age was 13.3 ± 3.8 years, with a mean follow-up period of 9.95 years. The overall AVM obliteration rate was 59.7%. Radiosurgery had an obliteration rate of 49.0%. Thirteen patients were managed conservatively. Four patients under observation hemorrhaged during a total interval of 429.4 patient-years, translating to an annual risk of 0.9%. Posttreatment hemorrhagic risk by treatment modalities were categorized as follows: surgery ± embolization (0.0%), radiosurgery ± embolization (0.8%), embolization alone (2.8%), surgery + radiosurgery ± embolization (3.5%), and observation (0.8%). A significantly higher risk of posttreatment hemorrhage was observed for patients with hemorrhagic presentation (p = 0.043) in multivariate analysis. Seizure presentation, frontal lobe location, nonheadache presentation, and treatment modality were significantly associated with increased risk of poor functional outcomes.

CONCLUSIONS
In this study of pediatric patients with AVMs, the natural history of hemorrhage was relatively low at 0.9%. Resection remained the optimal management for hemorrhage control and functional outcome perseverance in these pediatric patients with AVMs. AVM obliteration is a valid treatment goal, especially for patients with ruptured presentation, to prevent further hemorrhages later in life.
A RICH GLOBULAR CLUSTER SYSTEM IN DRAGONFLY 17: ARE ULTRA-DIFFUSE GALAXIES PURE STELLAR HALOS?*
Authors: Peng Eric W. , Lim Sungsoon 
Published: May 2016

ABSTRACT
Observations of nearby galaxy clusters at low surface brightness have identified galaxies with low luminosities, but sizes as large as L
⋆ galaxies, leading them to be dubbed “ultra-diffuse galaxies” (UDGs). The survival of UDGs in dense environments like the Coma cluster suggests that UDGs could reside in much more massive dark halos. We report the detection of a substantial population of globular clusters (GCs) around a Coma UDG, Dragonfly 17 (DF17). We find that DF17 has a high GC specific frequency of S
N = 26 ± 13. The GC system is extended, with an effective radius of 12″ ± 2″, or 5.6 ± 0.9 kpc at Coma distance, 70% larger than the galaxy itself. We also estimate the mean of the GC luminosity function to infer a distance of

97

−
14

+
17

Mpc, providing redshift-independent confirmation that one of these UDGs is in the Coma cluster. The presence of a rich GC system in DF17 indicates that, despite its low stellar density, star formation was intense enough to form many massive star clusters. If DF17's ratio of total GC mass to total halo mass is similar to those in other galaxies, then DF17 has an inferred total mass of ∼1011
M
⊙, only ∼10% the mass of the Milky Way, but extremely dominated by dark matter, with M/L
V ≈ 1000. We suggest that UDGs like DF17 may be “pure stellar halos,” i.e., galaxies that formed their stellar halo components, but then suffered an early cessation in star formation that prevented the formation of any substantial central disk or bulge.
MEASURING TYPE IA SUPERNOVA POPULATIONS OF STRETCH AND COLOR AND PREDICTING DISTANCE BIASES
Authors: Scolnic D. , Kessler R. 
Published: May 2016

ABSTRACT
Simulations of Type Ia supernovae (SNe Ia) surveys are a critical tool for correcting biases in the analysis of SNe Ia to infer cosmological parameters. Large-scale Monte Carlo simulations include a thorough treatment of observation history, measurement noise, intrinsic scatter models, and selection effects. In this Letter, we improve simulations with a robust technique to evaluate the underlying populations of SN Ia color and stretch that correlate with luminosity. In typical analyses, the standardized SN Ia brightness is determined from linear “Tripp” relations between the light curve color and luminosity and between stretch and luminosity. However, this solution produces Hubble residual biases because intrinsic scatter and measurement noise result in measured color and stretch values that do not follow the Tripp relation. We find a 10σ bias (up to 0.3 mag) in Hubble residuals versus color and 5σ bias (up to 0.2 mag) in Hubble residuals versus stretch in a joint sample of 920 spectroscopically confirmed SN Ia from PS1, SNLS, SDSS, and several low-z surveys. After we determine the underlying color and stretch distributions, we use simulations to predict and correct the biases in the data. We show that removing these biases has a small impact on the low-z sample, but reduces the intrinsic scatter σ
int from 0.101 to 0.083 in the combined PS1, SNLS, and SDSS sample. Past estimates of the underlying populations were too broad, leading to a small bias in the equation of state of dark energy w of Δw = 0.005.
Forming a Consensus: Data and Guidance for Physicians Treating Diabetic Macular Edema
Authors: Puliafito Carmen A. , Cousins Scott W. , Bacharach Jason , Gonzalez Victor H. , Holekamp Nancy M. , Merrill Pauline T. , Ohr Matthew P. , Parrish Richard K. , Riemann Christopher D. 
Published: May 2016

The diabetic macular edema (DME) treatment paradigm has evolved as the understanding of the disease pathology has grown. Since 2012, four pharmacotherapies have been approved by the U.S. Food and Drug Administration for the treatment of DME. First-line treatment of DME with anti–vascular endothelial growth factor [VEGF] agents has become the gold standard; however, an appreciable percentage of patients do not respond to anti-VEGF therapies. In patients who inadequately respond to anti-VEGF therapies, the underlying disease pathology may be mediated by a multitude of growth factors and inflammatory cytokines. For these patients, corticosteroids are an attractive treatment option because they not only downregulate VEGF, but also an array of cytokines. The phase 3 MEAD and FAME trials demonstrated significant visual acuity improvements associated with dexamethasone and fluocinolone acetonide, respectively, in patients with DME; however, class-specific adverse events, including increased intraocular pressure and cataract development, must be considered before use.
A panel of experts gathered during the 2015 annual meeting of the American Academy of Ophthalmology for a roundtable discussion focused on patient selection and adverse event management associated with the use of the 0.19 mg fluocinolone acetonide intravitreal implant.

[
Ophthalmic Surg Lasers Imaging Retina
. 2016;47:S5–S15.]
Visual Impairment in Pseudoxanthoma Elasticum: A Survey of 53 Patients from Turkey
Authors: Hocaoglu Mumin , Karacorlu Murat , Sayman Muslubas Isil , Arf Serra , Ozdemir Hakan , Uysal Omer 
Published: May 2016

Purpose To estimate the age at onset and severity of ophthalmologic aspects of pseudoxanthoma elasticum (PXE). Methods Medical records of 53 patients with PXE were evaluated. Findings at initial presentation, including refraction, best-corrected visual acuity (BCVA), and biomicroscopic and funduscopic examination were explored. Results The mean age of the patients at time of presentation was 43 years. The male-to-female ratio was 2.8:1. The mean age at occurrence of the first visual symptoms and retinal complications associated with choroidal neovascularization (CNV) was 42 years. Active subfoveal CNV or choroidal scar formation at the time of presentation was observed in 80 eyes (75%) of 49 patients (mean age 43 years). Twenty-seven patients (51%) (mean age 43 years) had BCVA ≤20/200 in at least one eye. Ten patients (19%) had BCVA ≤20/200 in both eyes (mean age 48 years). Twenty patients (41%) presenting with subfoveal chorioretinal scar or an active subfoveal CNV reported a spontaneous decline in visual acuity before age 40. Conclusions Subfoveal CNV was a frequent finding responsible for the poor visual acuity of patients with PXE. Its formation was not strictly age-dependent, and in patients under 40 years of age could be underestimated. More trials are needed to determine clinical recommendations for follow-up of young patients with PXE.
Effect of the Mineralizer Solution in the Hydrothermal Synthesis of Gadolinium-Doped (10% mol Gd) Ceria Nanopowders
Authors: Dell'Agli Gianfranco , Spiridigliozzi Luca , Marocco Antonello , Accardo Grazia , Ferone Claudio , Cioffi Raffaele 
Published: May 2016

Background Gadolinium-doped ceria is an attractive electrolyte material for potential application in solid oxide fuel cells (SOFCs) operating at intermediate temperatures typically with 10%-20% substitution of Ce+4 by Gd+3. In particular, 10% gadolinium-doped ceria seems to have the highest values of conductivities among the other dopant compositions. Methods Nanosized powders of gadolinium-doped ceria were prepared by hydrothermal treatment using coprecipitate as a precursor and in the presence of 3 different mineralizer solutions. The powders obtained were characterized by X-ray diffraction analysis, scanning electron microscopy, transmission electron microscopy and thermal analysis, while the electrical behavior of the corresponding pellets were ascertained by AC impedance spectroscopy. Results Nanocrystalline gadolinium-doped ceria powders with fluorite cubic crystal structure were obtained by hydrothermal treatment. Independent of the mineralizer used, these powders were able to produce very dense ceramics, especially when selecting an optimized sintering cycle. In contrast, the electrical behavior of the samples was influenced by the mineralizer solution, and the samples synthesized in the neutral and alkaline solutions showed higher values of electrical conductivity, in the range of temperatures of interest. Conclusions By the coprecipitation method, it has been possible to synthesize nanosized gadolinium-doped cerium oxide in a fluorite structure, stable in a wide range of temperatures. Hydrothermal treatment directly on the as-synthesized coprecipitates, without any drying step, had a very positive effect on the powders, which can be sintered with a high degree of densification, especially with an optimized sintering cycle. Furthermore, the electrical behavior of these samples was very interesting, especially for the samples synthesized using neutral mineralizer solution and basic mineralizer solution.
Aportes de las prácticas educativas implementadas por madres líderes al reconocimiento de sujetos sociales
Authors: González ZaBala Sandra Patricia , Rodríguez Rivera Naví 
Published: May 2016

El presente artículo, es resultado del trabajo investigativo desarrollado con madres líderes del Programa Más Familias en Acción- Medellín Solidaria, pertenecientes a la comuna 13- San Javier de la ciudad de Medellín. El cual, tuvo por objetivo realizar un acercamiento a los significados construidos por éstas frente a su rol y como lo anterior contribuye a la superación de la pobreza extrema, posibilitando así, la generación de reflexiones que permitieran consolidar y afianzar cada vez más el acompañamiento que se viene realizando con cada una de ellas. Lo anterior, permitió identificar como el liderazgo construido por las mujeres está relacionado con su capacidad para creer, dirigirse, auto-liderarse y ser agentes de su propio desarrollo. Simultáneamente, estos aspectos, les permiten ir confluyendo procesos organizativos y comunitarios en sus territorios, buscando transmitir y transformar desde las necesidades evidenciadas en sus propios hogares, pero también desde el interés por construir maneras de encuentro alrededor de espacios que son comunes y de descubrir potencialidades en dicho camino.
Acopio y comercialización de chía en el municipio de Jalapa, Nueva Segovia por parte de la empresa Central American Commodities Trading en el ciclo productivo 2013-2014
Authors: Mendoza Jerling Damarys , Arróliga Kasandra Jubelky , Hernández Tania Rafaela , Castillo Herrera Beverly 
Published: May 2016

El presente trabajo se enfoca en el proceso de acopio y comercialización de chía en la empresa Central American Commodities Trading proponiendo estrategias empresariales que mejoren este proceso. Según el nivel de conocimiento es una investigación aplicada y según el enfoque filosófico es una investigación cualitativa. El universo de estudio lo constituye la empresa CAC Trading con sede central en la ciudad de Managua y sucursales en los municipios de Sébaco, Matagalpa, Jalapa, Jícaro y Wiwilí. Las técnicas de recolección de datos son entrevista, observación, investigación documental. Las entrevistas fueron aplicadas a personas con conocimientos desarrollados en acopio y comercialización, asistencia técnica y exportación. Los principales resultados reflejan el proceso de acopio desde el punto de vista de empresa y los productores, sistema de pesaje, principales compradores en la exportación.
El papel estratégico de la política de género en educación
Authors: López Herrera Eduardo 
Published: May 2016

Sin lugar a dudas, la igualdad de oportunidades de hombres y mujeres en los diferentes ámbitos de la sociedad, sienta las bases para impulsar el desarrollo, sobre todo reconociendo el invaluable papel de la mujer, como un sujeto alrededor del cual giran muchas acciones y en particular, el interés de que sus hijos sean algo en la vida, pero que muchas veces son sueños truncados por las limitantes estructurales que padecen y que están relacionadas con la subordinación histórica ante el sexo opuesto y el peso de siglos de una sociedad patriarcal.
Sonographic Determination of Type in a Fetal Imperforate Anus
Authors: Lee Mi-Young , Won Hye-Sung , Shim Jae-Yoon , Lee Pil-Ryang , Kim Ahm , Lee Byong Sop , Kim Ellen Ai-Rhan , Cho Hyun Jin 
Published: May 2016

ObjectivesThe purpose of this study was to determine the type of an imperforate anus by using sonography in the prenatal period.MethodsThis retrospective study evaluated the fetal anus in all pregnant women, including low‐ and high‐risk populations, between February 2010 and November 2013. High‐type imperforate anuses were diagnosed by prenatal sonography when the anal sphincter muscles and anal canal mucosa were not visible. Low‐type imperforate anuses were prenatally suspected when at least 1 of the following was present: (1) a small anus; (2) no visible anal mucosa; or (3) close location of the genitalia by the anus without a visible perineal body, particularly in a female fetus.ResultsAmong the 9499 fetuses, 41 were prenatally suspected of having an imperforate anus, and 32 were confirmed to have this disorder. During the same study period, there were 11 false‐negative cases, for a diagnostic sensitivity rate of 74%. All 9 fetuses who were confirmed to have a normal anus were prenatally suspected of having a low‐type imperforate anus. Among the 32 fetuses with a confirmed imperforate anus, 19 were confirmed to have a high or intermediate type and 13 to have a low type. The type in 3 fetuses was incorrectly determined prenatally.ConclusionsAlthough an imperforate anus is not always diagnosed prenatally, its type can be determined by prenatal sonography.
Inherited structure and coupled crust‐mantle lithosphere evolution: Numerical models of Central Australia
Authors: Heron Philip J. , Pysklywec Russell N. 
Published: May 2016

AbstractContinents have a rich tectonic history that have left lasting crustal impressions. In analyzing Central Australian intraplate orogenesis, complex continental features make it difficult to identify the controls of inherited structure. Here the tectonics of two types of inherited structures (e.g., a thermally enhanced or a rheologically strengthened region) are compared in numerical simulations of continental compression with and without “glacial buzzsaw” erosion. We find that although both inherited structures produce deformation in the upper crust that is confined to areas where material contrasts, patterns of deformation in the deep lithosphere differ significantly. Furthermore, our models infer that glacial buzzsaw erosion has little impact at depth. This tectonic isolation of the mantle lithosphere from glacial processes may further assist in the identification of a controlling inherited structure in intraplate orogenesis. Our models are interpreted in the context of Central Australian tectonics (specifically the Petermann and Alice Springs orogenies).
Nickel Confined in the Interlayer Region of Birnessite: an Active Electrocatalyst for Water Oxidation
Authors: Thenuwara Akila C. , Cerkez Elizabeth B. , Shumlas Samantha L. , Attanayake Nuwan H. , McKendry Ian G. , Frazer Laszlo , Borguet Eric , Kang Qing , Remsing Richard C. , Klein Michael L. , Zdilla Michael J. , Strongin Daniel R. 
Published: May 2016

AbstractWe report a synthetic method to enhance the electrocatalytic activity of birnessite for the oxygen evolution reaction (OER) by intercalating Ni2+ ions into the interlayer region. Electrocatalytic studies showed that nickel (7.7 atomic %)‐intercalated birnessite exhibits an overpotential (η) of 400 mV for OER at an anodic current of 10 mA cm−2. This η is significantly lower than the η values for birnessite (η≈700 mV) and the active OER catalyst β‐Ni(OH)2 (η≈550 mV). Molecular dynamics simulations suggest that a competition among the interactions between the nickel cation, water, and birnessite promote redox chemistry in the spatially confined interlayer region.