bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public Reporting of Hospital-Level Cancer Surgical Volumes in California: An Opportunity to Inform Decision Making and Improve Quality
Authors: Clarke Christina A. , Asch Steven M. , Baker Laurence , Bilimoria Karl , Dudley R. Adams , Fong Niya , Holliday-Hanson Merry L. , Hopkins David S.P. , Imholz Elizabeth M. , Malin Jennifer , Moy Lisa , O’Sullivan Maryann , Parker Joseph P. , Saigal Christopher S. , Spurlock Bruce , Teleki Stephanie , Zingmond David , Lang Lance 
Published: September 2016

Purpose: Most patients, providers, and payers make decisions about cancer hospitals without any objective data regarding quality or outcomes. We developed two online resources allowing users to search and compare timely data regarding hospital cancer surgery volumes. Methods: Hospital cancer surgery volumes for all California hospitals were calculated using ICD-9 coded hospital discharge summary data. Cancer surgeries included (bladder, brain, breast, colon, esophagus, liver, lung, pancreas, prostate, rectum, and stomach) were selected on the basis of a rigorous literature review to confirm sufficient evidence of a positive association between volume and mortality. The literature could not identify threshold numbers of surgeries associated with better or worse outcomes. A multidisciplinary working group oversaw the project and ensured sound methodology. Results: In California in 2014, about 60% of surgeries were performed at top-quintile–volume hospitals, but the per-hospital median numbers of surgeries for esophageal, pancreatic, stomach, liver, or bladder cancer surgeries were four or fewer. At least 670 patients received cancer surgery at hospitals that performed only one or two surgeries for a particular cancer type; 72% of those patients lived within 50 miles of a top-quintile–volume hospital. Conclusion: There is clear potential for more readily available information about hospital volumes to help patient, providers, and payers choose cancer surgery hospitals. Our successful public reporting of hospital volumes in California represents an important first step toward making publicly available even more provider-specific data regarding cancer care quality, costs, and outcomes, so those data can inform decision-making and encourage quality improvement.
Increase in Cancer Center Staff Effort Related to Electronic Patient Portal Use
Authors: Laccetti Andrew L. , Chen Beibei , Cai Jennifer , Gates Samantha , Xie Yang , Lee Simon J. Craddock , Gerber David E. 
Published: September 2016

Purpose: Electronic portals provide patients with real-time access to personal health records. Use of this technology by individuals with cancer is particularly intensive. We therefore examined patterns of use of electronic portals by clinic staff at a National Cancer Institute–designated comprehensive cancer center. Methods: We identified and characterized cancer center providers and clinic staff who performed electronic activities related to MyChart, the institution’s personal health records portal, from 2009 to 2014. Total MyChart actions and messages received were quantified and characterized according to type, timing, and staff category. Results: Two hundred eighty-nine employees were included in our analysis: 85 nurses (29%), 79 ancillary staff (27%), 49 clerical/managerial staff (17%), 47 physicians (16%), and 29 advanced practice providers (10%). These individuals performed 740,613 MyChart actions and received 117,799 messages. Seventy-seven percent of actions were performed by nurses, 11% by ancillary staff, 6% by advanced practice providers, 5% by physicians, and 1% by clerical/managerial staff. From 2011 to 2014, staff MyChart activity increased approximately 10-fold. On average, 6.3 staff MyChart actions were performed per patient-initiated message. In 2014, nurses performed an average of 3,838 MyChart actions and received an average of 589 messages, compared with 591 actions and 87 messages in 2011 ( P < .001). Sixteen percent of all actions occurred outside clinic hours. Conclusion: Cancer center employee effort related to an electronic patient portal has increased markedly over time, particularly among nursing staff. Because further uptake of this technology is expected, it is critical to consider potential effects on clinical resources, employee and patient satisfaction, and patient safety.
No Exit: Identifying Avoidable Terminal Oncology Intensive Care Unit Hospitalizations
Authors: Daly Bobby , Hantel Andrew , Wroblewski Kristen , Balachandran Jay S. , Chow Selina , DeBoer Rebecca , Fleming Gini F. , Hahn Olwen M. , Kline Justin , Liu Hongtao , Patel Bhakti K. , Verma Anshu , Witt Leah J. , Fukui Mayumi , Kumar Aditi , Howell Michael D. , Polite Blase N. 
Published: September 2016

Purpose: Terminal oncology intensive care unit (ICU) hospitalizations are associated with high costs and inferior quality of care. This study identifies and characterizes potentially avoidable terminal admissions of oncology patients to ICUs. Methods: This was a retrospective case series of patients cared for in an academic medical center’s ambulatory oncology practice who died in an ICU during July 1, 2012 to June 30, 2013. An oncologist, intensivist, and hospitalist reviewed each patient’s electronic health record from 3 months preceding terminal hospitalization until death. The primary outcome was the proportion of terminal ICU hospitalizations identified as potentially avoidable by two or more reviewers. Univariate and multivariate analysis were performed to identify characteristics associated with avoidable terminal ICU hospitalizations. Results: Seventy-two patients met inclusion criteria. The majority had solid tumor malignancies (71%), poor performance status (51%), and multiple encounters with the health care system. Despite high-intensity health care utilization, only 25% had documented advance directives. During a 4-day median ICU length of stay, 81% were intubated and 39% had cardiopulmonary resuscitation. Forty-seven percent of these hospitalizations were identified as potentially avoidable. Avoidable hospitalizations were associated with factors including: worse performance status before admission (median 2 v 1; P = .01), worse Charlson comorbidity score (median 8.5 v 7.0, P = .04), reason for hospitalization (P = .006), and number of prior hospitalizations (median 2 v 1; P = .05). Conclusion: Given the high frequency of avoidable terminal ICU hospitalizations, health care leaders should develop strategies to prospectively identify patients at high risk and formulate interventions to improve end-of-life care.
Mechanisms Underlying the Pathogenesis of Isolated Impaired Glucose Tolerance in Humans
Authors: Varghese Ron T. , Dalla Man Chiara , Sharma Anu , Viegas Ivan , Barosa Cristina , Marques Catia , Shah Meera , Miles John M. , Rizza Robert A. , Jones John G. , Cobelli Claudio , Vella Adrian 
Published: September 2016

Context:
Prediabetes is a heterogeneous disorder classified on the basis of fasting glucose concentrations and 2-hour glucose tolerance.

Objective:
We sought to determine the relative contributions of insulin secretion and action to the pathogenesis of isolated impaired glucose tolerance (IGT).

Design:
The study consisted of an oral glucose tolerance test and a euglycemic clamp performed in two cohorts matched for anthropometric characteristics and fasting glucose but discordant for glucose tolerance.

Setting:
An inpatient clinical research unit at an academic medical center.

Patients or Other Participants:
Twenty-five subjects who had normal fasting glucose (NFG) and normal glucose tolerance (NGT) and 19 NFG/IGT subjects participated in this study.

Intervention(s):
Subjects underwent a seven-sample oral glucose tolerance test and a 4-hour euglycemic, hyperinsulinemic clamp on separate occasions. Glucose turnover during the clamp was measured using tracers, and endogenous hormone secretion was inhibited by somatostatin.

Main Outcome Measures:
We sought to determine whether hepatic glucose metabolism, specifically the contribution of gluconeogenesis to endogenous glucose production, differed between subjects with NFG/NGT and those with NFG/IGT.

Results:
Endogenous glucose production did not differ between groups before or during the clamp. Insulin-stimulated glucose disappearance was lower in NFG/IGT (24.6 ± 2.2 vs 35.0 ± 3.6 μmol/kg/min; P = .03). The disposition index was decreased in NFG/IGT (681 ± 102 vs 2231 ± 413 × 10−14 dL/kg/min2 per pmol/L; P &lt; .001).

Conclusions:
We conclude that innate defects in the regulation of glycogenolysis and gluconeogenesis do not contribute to NFG/IGT. However, insulin-stimulated glucose disposal is impaired, exacerbating defects in β-cell function.
Identification of Multiple Gene Mutations Accounts for a new Genetic Architecture of Primary Ovarian Insufficiency
Authors: Bouilly Justine , Beau Isabelle , Barraud Sara , Bernard Valérie , Azibi Kemal , Fagart Jérôme , Fèvre Anne , Todeschini Anne Laure , Veitia Reiner A. , Beldjord Chérif , Delemer Brigitte , Dodé Catherine , Young Jacques , Binart Nadine 
Published: September 2016

Context:
Idiopathic primary ovarian insufficiency (POI) is a major cause of amenorrhea and infertility. POI affects 1% of women before age 40 years, and several genetic causes have been reported. To date, POI has been considered a monogenic disorder.

Objective:
The aim of this study was to identify novel gene variations and to investigate if individuals with POI harbor mutation in multiple loci.

Patients and Methods:
One hundred well-phenotyped POI patients were systematically screened for variants in 19 known POI loci (and potential candidate genes) using next-generation sequencing.

Results:
At least one rare protein-altering gene variant was identified in 19 patients, including missense mutations in new candidate genes, namely SMC1β and REC8 (involved in the cohesin complex) and LHX8, a gene encoding a transcription factor. Novel or recurrent deleterious mutations were also detected in the known POI candidate genes NOBOX, FOXL2, SOHLH1, FIGLA, GDF9, BMP15, and GALT. Seven patients harbor mutations in two loci, and this digenicity seems to influence the age of symptom onset.

Conclusions:
Genetic anomalies in women with POI are more frequent than previously believed. Digenic findings in several cases suggest that POI is not a purely monogenic disorder and points to a role of digenicity. The genotype-phenotype correlations in some kindreds suggest that a synergistic effect of several mutations may underlie the POI phenotype.
The Relationship Between Preoperative Clinical Presentation and Quantitative Magnetic Resonance Imaging Features in Patients With Degenerative Cervical Myelopathy
Authors: Nouri Aria , Tetreault Lindsay , Dalzell Kristian , Zamorano Juan J. , Fehlings Michael G. 
Published: September 2016

Abstract

BACKGROUND: Degenerative cervical myelopathy encompasses a group of conditions resulting in progressive spinal cord injury through static and dynamic compression. Although a constellation of changes can present on magnetic resonance imaging (MRI), the clinical significance of these findings remains a subject of controversy and discussion.

OBJECTIVE: To investigate the relationship between clinical presentation and quantitative MRI features in patients with degenerative cervical myelopathy.

METHODS: A secondary analysis of MRI and clinical data from 114 patients enrolled in a prospective, multicenter study was conducted. MRIs were assessed for maximum spinal cord compression (MSCC), maximum canal compromise (MCC), signal changes, and a signal change ratio (SCR). MRI features were compared between patients with and those without myelopathy symptoms with the use of t tests. Correlations between MRI features and duration of symptoms were assessed with the Spearman ρ.

RESULTS: Numb hands and Hoffmann sign were associated with greater MSCC (P < .05); broad-based, unstable gait, impairment of gait, and Hoffmann sign were associated with greater MCC (P < .05); and numb hands, Hoffmann sign, Babinski sign, lower limb spasticity, hyperreflexia, and T1 hypointensity were associated with greater SCR (P < .05). Patients with a T2 signal hyperintensity had greater MSCC and MCC (P < .001).

CONCLUSION: MSCC was associated with upper limb manifestations, and SCR was associated with upper limb, lower limb, and general neurological deficits. Hoffmann sign occurred more commonly in patients with a greater MSCC, MCC and SCR. The Lhermitte phenomenon presented more commonly in patients with a lower SCR and may be an early indicator of mild spinal cord involvement. Research to validate these findings is required.
The interplay between obesity and cancer: a fly view
Authors: Hirabayashi Susumu 
Published: September 2016

ABSTRACT
Accumulating epidemiological evidence indicates a strong clinical association between obesity and an increased risk of cancer. The global pandemic of obesity indicates a public health trend towards a substantial increase in cancer incidence and mortality. However, the mechanisms that link obesity to cancer remain incompletely understood. The fruit fly Drosophila melanogaster has been increasingly used to model an expanding spectrum of human diseases. Fly models provide a genetically simpler system that is ideal for use as a first step towards dissecting disease interactions. Recently, the combining of fly models of diet-induced obesity with models of cancer has provided a novel model system in which to study the biological mechanisms that underlie the connections between obesity and cancer. In this Review, I summarize recent advances, made using Drosophila, in our understanding of the interplay between diet, obesity, insulin resistance and cancer. I also discuss how the biological mechanisms and therapeutic targets that have been identified in fly studies could be utilized to develop preventative interventions and treatment strategies for obesity-associated cancers.
Recent advances in cardiac magnetic resonance
Authors: Greulich Simon , Arai Andrew E. , Sechtem Udo , Mahrholdt Heiko 
Published: September 2016

Cardiac magnetic resonance (CMR) is a non-invasive imaging modality that has rapidly emerged during the last few years and has become a valuable, well-established clinical tool. Beside the evaluation of anatomy and function, CMR has its strengths in providing detailed non-invasive myocardial tissue characterization, for which it is considered the current diagnostic gold standard.Late gadolinium enhancement (LGE), with its capability to detect necrosis and to separate ischemic from non-ischemic cardiomyopathies by distinct LGE patterns, offers unique clinical possibilities. The presence of LGE has also proven to be a good predictor of an adverse outcome in various studies.T2-weighted (T2w) images, which are supposed to identify areas of edema and inflammation, are another CMR approach to tissue characterization. However, T2w images have not held their promise owing to several technical limitations and potential physiological concerns.Newer mapping techniques may overcome some of these limitations: they assess quantitatively myocardial tissue properties in absolute terms and show promising results in studies for characterization of diffuse fibrosis (T1 mapping) and/or inflammatory processes (T2 mapping). However, these techniques are still research tools and are not part of the clinical routine yet.T2* CMR has had significant impact in the management of thalassemia because it is possible to image the amount of iron in the heart and the liver, improving both diagnostic imaging and the management of patients with thalassemia.CMR findings frequently have clinical impact on further patient management, and CMR seems to be cost effective in the clinical routine.
Effect of femoral canal shape on mechanical stress distribution and adaptive bone remodelling around a cementless tapered-wedge stem
Authors: Oba M. , Inaba Y. , Kobayashi N. , Ike H. , Tezuka T. , Saito T. 
Published: September 2016

ObjectivesIn total hip arthroplasty (THA), the cementless, tapered-wedge stem design contributes to achieving initial stability and providing optimal load transfer in the proximal femur. However, loading conditions on the femur following THA are also influenced by femoral structure. Therefore, we determined the effects of tapered-wedge stems on the load distribution of the femur using subject-specific finite element models of femurs with various canal shapes.Patients and MethodsWe studied 20 femurs, including seven champagne flute-type femurs, five stovepipe-type femurs, and eight intermediate-type femurs, in patients who had undergone cementless THA using the Accolade TMZF stem at our institution. Subject–specific finite element (FE) models of pre- and post-operative femurs with stems were constructed and used to perform FE analyses (FEAs) to simulate single-leg stance. FEA predictions were compared with changes in bone mineral density (BMD) measured for each patient during the first post-operative year.ResultsStovepipe models implanted with large-size stems had significantly lower equivalent stress on the proximal-medial area of the femur compared with champagne-flute and intermediate models, with a significant loss of BMD in the corresponding area at one year post-operatively.ConclusionsThe stovepipe femurs required a large-size stem to obtain an optimal fit of the stem. The FEA result and post-operative BMD change of the femur suggest that the combination of a large-size Accolade TMZF stem and stovepipe femur may be associated with proximal stress shielding. Cite this article: M. Oba, Y. Inaba, N. Kobayashi, H. Ike, T. Tezuka, T. Saito. Effect of femoral canal shape on mechanical stress distribution and adaptive bone remodelling around a cementless tapered-wedge stem. Bone Joint Res 2016;5:362–369. DOI: 10.1302/2046-3758.59.2000525.
Estimasi jumlah biomassa lamun di Pulau Pramuka, Karya dan Kotok Besar, Kepulauan Seribu, Jakarta
Authors: Mardiansyah Assuyuti Yayan , Farhan Rijaluddin Alfan , Ramadhan Firdaus , Bayu Zikrillah Reza 
Published: September 2016

Abstract. The research was conducted in Kotok Besar, Karya and Pramuka Islands, Seribu Islands, Jakarta Province from May to July 2013. The aims of the research were to examine the percent cover, composition of vegetation and estimation of seagrass leaves biomass. The squares transect (0.25 m2) was utilized to calculate the seagrass percent cover data. Seagrass data were converted to total cover and biomass formula to estimate the seagrass leaves biomass. The result of our study showed there are 4 species of seagrass occurred in Kotok Besar Island, while 6 species were recorded in Karya and Pramuka Islands. Cymodocea rotundata had the higher value of seagrass cover percentage in Kotok Besar, Karya and Pramuka Islands, while the lower values were Halodule uninervis and Halophila ovalis. In addition, the highest value of seagrass leaves biomass from those islands is Enhalus acoroides and the lower value was Halophila ovalis inKotok Besar and Pramuka Islands, and Halodule uninervis in Karya Island.Keywords: Composition of vegetation, estimated of biomass, seagrass, Seribu Islands Abstrak. Penelitian ini dilakukan di Pulau Kotok Besar, Karya dan Pramuka Kepulauan Seribu-Provinsi Jakarta mulai Mei sampai Juli 2013. Tujuan dari penelitian ini adalah mengetahui komposisi vegetasi lamun dan estimasi jumlah biomassa daun lamun di pulau Kotok Besar, Karya dan Pramuka kepulauan Seribu-Provinsi Jakarta. Penelitian ini dilakukan dengan mengguakan transek kuadrat (0,25 m2) untuk mengetahui persentase penutupan lamun. Data lamun yang diperoleh dikonversikan pada persamaan total penutupan dan estimasi biomasa untuk mengestimasi biomassa daun lamun. Hasil dari penelitian, terdapat 4 jenis lamun yang diperoleh di pulau Kotok Besar dan 6 jenis di pulau Karya dan Pramuka. Persen penutupan tertinggi pada pulau Kotok Besar, Karya dan Pramuka adalah jenis lamun Cymodocea rotundata, sedangkan yang terendah dari masing-masing pulau adalah Halodule uninervis dan Halophila ovalis secara berurutan. Estimasi biomassa daun lamun dengan nilai tertinggi adalah Enhalus acoroides dari ketiga pulau dan terendah adalah Halophila ovalis untuk pulau Kotok Besar dan Pramuka, dan Halodule uninervis untuk pulau Karya.Kata kunci: Komposisi vegetasi, estimasi biomassa, lamun, Kepulauan Seribu
PROSES KREATIF PENGARANG CHICKLIT DAN TEENLIT INDONESIA
Authors: Noor Redyanto 
Published: September 2016

An author creative process includes the issue of why and how the author wrote the novel. Among the chicklit and Teenlit novelists there are similar supporting factors, namely talent, hobby, intelligence, and daily life experience around them. The Supporting factors are then combined with skills, methods and storytelling which spontaneous and honest.They never thought about storytelling techniques when writing a novel. They do not think about the structure of fiction such as the grooves, figure-characterizations, backgrounds, storytelling, and so on.The creative process of the authors can not be separated from the influence of life in their surrounding environment that provides reality as a source of inspiration to write the story. The reality is in the form of social problems, personal problems, society, humanity, divinity, and so on. All sorts of information and experience are gained through association and access to information technology. All are quickly and simultaneously enrich the treasury of their knowledge so that they can talk anywhere, anytime, and about anything. Thus, the young chicklit and Teenlit novelists become successful and famous is not in a sudden and without a process. Nor because special facilities given by publisher or certain parties, but through hard work. Lot of terms and conditions that they can meet through their struggle.Thus, it can be concluded that the creative process of chicklit and Teenlit novelist is a blend of natural talent, hobby, intelligence, and life experience, supporting by intelligence, hard work, a wealth of experience, breadth of relationships, social sensitivity, the ability of storytelling and writing skills.
„In einem gewissen Sinne politisch belastet“. Bevölkerungswissenschaft und Bevölkerungspolitik zwischen Entwicklungshilfe und bundesrepublikanischer Sozialpolitik (1960er und 1970er Jahre)
Authors: Hartmann Heinrich A. 
Published: September 2016

Zusammenfassung
In der Nachkriegszeit gehörte die Bevölkerungspolitik zu den belasteten Bereichen deutscher Politik, die in Westdeutschland kaum offen adressiert wurden. Die verschiedenen Bundesregierungen vermieden es, in diesem Bereich direkt tätig zu werden. Dennoch war diese Abgrenzung keineswegs absolut: In einigen Politikbereichen gab es Kontinuitäten, die etwa im Bereich der Familienpolitik bereits in den 1950er Jahren wieder eine gewisse, wenn auch bescheidene Rolle in der westdeutschen Sozialpolitik zu spielen begannen. Doch einen wirklichen Impuls erlebte das Feld weniger aus den innerdeutschen sozialpolitischen Kontexten heraus als vielmehr durch das neue Feld der Entwicklungspolitik und durch die Sorgen um eine globale Bevölkerungsexplosion. Der Aufsatz zeigt, dass dieser Bereich seit den 1960er Jahren mehr und mehr Aufmerksamkeit erfuhr und von der Bundesregierung genutzt wurde, um sich vorsichtig auch im Feld der Entwicklungshilfe neu zu positionieren. Dabei wirkte dieses Feld auf der einen Seite als neuer institutioneller Rahmen für einige frühere Experten. Andererseits war allerdings der entwicklungspolitische Zusammenhang auch entscheidender Impuls für Diskurse und neue Institutionen, die paradoxerweise den Stellenwert der bevölkerungswissenschaftlichen Ansatzpunkte in der bundesdeutschen Sozialpolitik stärkten. So wirkte sich die Diskussion der globalen Bevölkerungsdiskussion etwa auf die Debatten um die Legalisierung von Abtreibung oder auf den Aufbau eines neuen Instituts für Bevölkerungswissenschaften aus. Obwohl die Ängste vor globaler Überbevölkerung und vor zurückgehenden Geburtenraten entgegengesetzt schienen, trugen doch beide wesentlich zur Integration bevölkerungspolitischer Handlungsfelder in den Katalog bundesdeutscher Sozialpolitik bei.