bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of Nonexudative Choroidal Neovascularization Secondary to Angioid Streaks Using Optical Coherence Tomography Angiography
Authors: Andreanos Konstantinos D. , Rotsos Tryfon , Koutsandrea Chryssanthi , Kymionis Georgios D. , Georgalas Ilias , Ladas Ioannis D. 
Published: June 2017

Purpose To present a case of nonexudative choroidal neovascularization secondary to angioid streaks in a patient with pseudoxanthoma elasticum. The lesion was monitored over an 8-month period with the use of optical coherence tomography angiography. Methods Case report. Results The neovascular tissue area increased by 0.160 mm2 over a period of 8 months without any sign of exudation seen on optical coherence tomography or fluorescein angiography. Conclusions To our knowledge, this is the first report of a nonexudative choroidal neovascularization secondary to angioid streaks. Given that once a patient with angioid streaks develops choroidal neovascularization in one eye there is a high risk of bilateral involvement within a short amount of time, optical coherence tomography angiography can prove a useful tool for monitoring such lesions over time.
A Microscopic View of Gaseous Microbubbles Passing a Filter Screen
Authors: Johagen Daniel , Svenmarker Pontus , Jonsson Per , Svenmarker Staffan 
Published: June 2017

Purpose The aim of this study was to investigate the filtration efficacy of a 38-μm 1-layer screen filter based on Doppler registrations and video recordings of gaseous microbubbles (GME) observed in a microscope. Methods: The relative filtration efficacy (RFE) was calculated from 20 (n = 20) sequential bursts of air introduced into the Plasmodex® primed test circuit. Results The main findings indicate that the RFE decreased (p = 0.00), with increasing flow rates (100–300 mL/ min) through the filter screen. This reaction was most accentuated for GME below the size of 100 μm, where counts of GME paradoxically increased after filtration, indicating GME fragmentation. For GME sized between 100–250 μm, the RFE was constantly >60%, independently of the flow rate level. The video recording documenting the GME interactions with the screen filter confirmed the experimental findings. Conclusions The 38-μm 1-layer screen filter investigated in this experimental setup was unable to trap gaseous microbubbles effectively, especially for GME below 100 μm in size and in conjunction with high flow rates.
Epidemiology-Based Assessment of Tumor Marker Overordering in Breast Cancer: An Algorithm to Examine Different Disease Conditions
Authors: Trevisiol Chiara , Gion Massimo , Dittadi Ruggero , Zappa Marco , Fabricio Aline S.C. 
Published: June 2017

Laboratory tests are frequently overused and have elevated inappropriateness rates. We previously developed a model to investigate the rate of utilization of tumor markers (TMs) in outpatients as an indirect indicator of inappropriateness. The model was based on the comparison between the number of actually ordered and expected tests, with the latter estimated on the basis of both epidemiological data and recommendations of available clinical practice guidelines. In this paper we propose an algorithm to distinguish prevalent cases without evidence of disease from those with metastatic spread, on the basis of both epidemiological and clinical information. The algorithm allows for a more precise prediction of the expected TM requests per year, to be compared with the actual number of requested TMs in order to assess possibly inappropriate overordering rates. Moreover, the implementation of the algorithm renders the epidemiologically based model more flexible to develop accurate indicators for appropriateness in the use of TMs in different stages of disease and for different clinical questions. A practical application with CA15.3 requests in breast cancer is presented.
In Vitro Degradation of Polydimethylsiloxanes in Breast Implant Applications
Authors: Ramião Nilza G. , Martins Pedro S. , Barroso Maria L. , Santos Diana C. , Fernandes Antonio A. 
Published: June 2017

Background The durability of breast implant material is associated with failure probability, increasing with time from implantation. The current study avoided the bias introduced by biological factors, to systematically investigate the degradation over time of shell materials. The same fundamental physical and chemical conditions were maintained (temperature and pH) throughout the study, to decouple biological aspects from the degradation process. Methods Six virgin implants of 2 brands were submitted to the in vitro degradation process, mechanical testing of shell materials, surface change analysis (via scanning electron microscopy [SEM]) and chemical composition analysis by Fourier transform infrared (FTIR) spectroscopy. Results FTIR results showed that the principal chemical bonds of the material remained intact after 12 weeks of degradation. Apparently the implants’ shell structures remained unchanged. Despite this observation, there were statistically significant differences between strain at failure at different time points for the shells of both brands, translated into a stiffening of the material over time. Conclusions Material stiffening is reported as an indicator of material degradation. This altered mechanical behavior, added to the mechanical friction from tissue–tissue and tissue–implant contact and to the external mechanical loading (physical activity), may alter the material performance in women's bodies. Ultimately these changes may affect the implants’ durability. Further work is needed to understand the biological aspects of the degradation process and their impact on implant durability.
Pregnancy after Orthotopic Ovarian Tissue Transplantation Using N-hexyl-2-cyanoacrylate
Authors: Fabregues Francisco , Calafell Josep Maria , Manau Dolors , Borras Aina , Peñarrubia Joana , Casals Gemma , Peralta Sara , Creus Montserrat , Iglesias Sara , Yaghi Samer , Carmona Francisco 
Published: June 2017

Cryopreservation of ovarian tissue in advance of cytotoxic therapies and later transplantation of the tissue is being performed increasingly often, and the total success rates in terms of pregnancy and delivery have been described in case series. Most pregnancies were achieved after orthotopic transplantation of tissue (in the peritoneum or the remaining ovary); however, treatment of the transplantation site during surgery is controversial. In this observational case-series study, we include four patients who underwent ovarian tissue transplantation between 2012 and 2016 by laparoscopy. Previously ovarian tissue was cryopreserved with slow freezing protocol prior to chemo- and/or radiotherapy. After cancer remission, the cryopreserved ovarian tissues were orthotopically re-transplanted in the ovarian medulla by laparoscopy, using N-hexyl-2-cyanoacrylate as an absorbable adhesion barrier. All patients regained ovarian function between 8 and 24 weeks after transplantation, as shown by follicle development and estrogen production. In patients 1 and 2 the ovarian function ended one year after transplantation. Patient 3 has regular menstrual cycles 2 years after the transplant and patient 4 currently has an ongoing spontaneous pregnancy. The use of N-hexyl-2 cyanoacrylate can facilitate the placement of ovarian pieces in orthotopic transplantation by laparoscopy without affecting the restoration and duration of ovarian activity.
Surprising Complete Response of Intramedullary Spinal Cord Metastasis from Breast Cancer: A Case Report and Literature Review
Authors: Aiello Dario , Mazzola Rosario , Gregucci Fabiana , Ricchetti Francesco , Levra Niccolò Giaj , Romano Luigi , Carbognin Giovanni , Salgarello Matteo , Beltramello Alberto , Alongi Filippo 
Published: June 2017

Purpose Intramedullary spinal cord metastases (ISCM) are considered rare but their incidence is rising. Most ISCM cases are recognized to occur in patients with stage IV lung cancer or breast cancer (BC). Methods We report a rare case of cervical BC-ISCM in 60-year-old woman, documented by magnetic resonance imaging and positron emission tomography–computed tomography and treated with volumetric modulated arc therapy with daily image-guided radiation therapy (VMAT/IGRT). Results An unexpected clinical and radiologic complete response in absence of neurologic side effects was recorded 4 months after VMAT/IGRT. Conclusions The present case report shows the feasibility of advanced RT and its optimal response in a case of ISCM from BC. Despite the short follow-up, in comparison with available literature data concerning the management of BC-ISCM, we found an early complete response, in contrast with other reported experiences.
Human Epididymis: Structural Pattern, Total Length and Inner Surface Area
Authors: Skandhan Kalanghot P. , Soni Ashutosh , Joshi Anantkumar , Avni Kalanghot P.S. , Gupta Bansi Dhar 
Published: June 2017

Introduction The organ epididymis is secured the name considering it functioned as an appendix to the testis; earlier testis was called as didymi. Regarding the length of human epididymis, several values are attributed by different authors. The present study was aimed to find out the pattern, total length and inner surface area of human epididymis. Materials and Methods The study was conducted by employing microsurgical procedures on five testes from unclaimed human dead bodies. Results Caput was formed by few tubes interconnecting at three levels. These tubes led to corpus, which in turn was having more number of tubes interconnecting at different levels. Tubules were many looking like a mesh. United tubes of corpus form the single tube to form cauda. Epididymis length was 30.48 cm. Inner surface area was 818.16 mm2. Conclusions Reported values of others seem to be a modified version from that of animals. Authors believe that organic revolutionary changes in man led to a reduction in the length of epididymis.
Nostoi and Nostalgia in Heartbreak House
Authors: Slater Niall W. 
Published: June 2017

ABSTRACT
While Shaw called Heartbreak House his King Lear, highlighting the play's Shakespearean connections, a number of classical literary sources also inform the play's structure. His master metaphor of England as a ship draws deeply on the classical trope of the ship of state, which originated in Greek lyric (Alcaeus, Theognis, but also Aeschylus) and was most notably instantiated in Plato's Republic 6.488a–489c. Into this seafaring design he has woven much epic, particularly through multiple avatars of Odysseus: Captain Shotover escaped from a Circe-like wife and returned home, Hector Hushabye with Iliadic name but Odyssean talent for lying and self-fabrication, even Boss Mangan and Billy Dunn as manqué storytellers. Further entangling the plot are the multiple nostoi (returns home) of Shotover, Ariadne, and Billy, along with the metaphorical nostos of Ellie—and the nostalgia for a lost England.
Factors Motivating Medical Students in Selecting a Career Specialty: Relevance for a Robust Orthopaedic Pipeline
Authors: Rao Raj D. , Khatib Omar N. , Agarwal Arnav 
Published: June 2017

Introduction:
Selection of a career specialty by medical students is a complex and individualized decision. Our goals were to understand the factors that influenced medical students in selecting their career specialty, identify the stage at which this decision was made, and understand the role of demographics, mentors, and curricula in this process.

Methods:
Medical students from 10 institutions participated in a web-based survey. Results were stratified by sex, race/ethnicity, and level of interest in orthopaedic surgery.

Results:
A total of 657 students responded to the survey. Specialty content (mean rating, 8.4/10) and quality of life/lifestyle/stress level (7.5/10) were the primary motivating factors in selecting a specialty. Interest in orthopaedic surgery was lower in women than in men (2.7 versus 3.9; P < 0.01) and was equivalent among race/ethnicity groups. Although 27% of students reported moderate or extensive medical school curriculum exposure to orthopaedics, this education did not sway them toward the specialty.

Conclusions:
Levels of interest in orthopaedics among medical students may be lower than generally assumed. Increasing the attractiveness of the specialty will require a multifaceted approach, including recognition of lifestyle factors, adjustments in the orthopaedic clerkship to make the specialty more appealing, mentorship by orthopaedic faculty, and conversion of high levels of interest in the specialty among minority medical students into successful residency applications.

Level of Evidence:
IV
Characterization of Croatian Rape (Brassica sp.) Honey by Pollen Spectrum, Physicochemical Characteristics, and Multielement analysis by ICP-OES
Authors: Rajs Blanka Bilić , Flanjak Ivana , Mutić Jelena , Vukojević Vesna , Đurđić Slađana , Primorac Ljiljana 
Published: June 2017

Abstract
Rape (Brassica sp.) unifloral honey from Croatia was characterized by certain physicochemical parameters, micro- and macroelement content, and pollen spectrum, as determined in 21 honey samples. The Brassica sp. pollen type was predominant in the analyzed samples and ranged between 60 and 98%, with Trifolium spp., Robinia pseudoacacia, Rosaceae, Helianthus annuus, Salix spp., and Taraxacum officinale as the main accompanying pollen types. The electrical conductivity mean value was 0.22 ± 0.05 mS/cm and the glucose/fructose ratio mean value was 1.1 ± 0.07, whereas sucrose was absent in the samples. The most abundant macroelement was potassium (K) (268.49 mg/kg), followed by phosphorus (P) (60.23 mg/kg), calcium (Ca) (54.02 mg/kg), sodium (Na) (22.52 mg/kg), sulfur (S) (15.79 mg/kg), and magnesium (Mg) (12.58 mg/kg). Toxic elements were mainly bellow the LODs; only arsenic (As) concentration was detectable in higher amount (0.233 mg/kg), which may be related to the high arsenic concentration in the soil and groundwater of eastern Croatia. The differences between the two harvesting seasons observed in a large number of elements could be related to climatic and soil conditions and different nectar yields originating from the associated plant species.
Current Concepts in Diagnosis, Molecular Features, and Management of Lobular Carcinoma In Situ of the Breast With a Discussion of Morphologic Variants
Authors: Ginter Paula S. , D'Alfonso Timothy M. 
Published: June 2017

Context.—Lobular carcinoma in situ (LCIS) refers to a neoplastic proliferation of cells that characteristically shows loss of E-cadherin expression and has long been regarded as a risk factor for invasive breast cancer. Long-term outcome studies and molecular data have also implicated LCIS as a nonobligate precursor to invasive carcinoma. In the past few decades, pleomorphic and florid LCIS have been recognized as morphologic variants of LCIS with more-aggressive histopathologic features, less-favorable biomarker profiles, and more-complex molecular features compared with classic LCIS. There is still a lack of consensus regarding certain aspects of managing patients with LCIS.Objectives.—To review recently published literature on LCIS and to provide an overview of the current morphologic classification of LCIS, recent molecular advances, and trends in patient management.Data Sources.—Sources included peer-reviewed, published journal articles in PubMed (US National Library of Medicine, Bethesda, Maryland) and published guidelines from the National Comprehensive Cancer Network (Fort Washington, Pennsylvania).Conclusions.—Lobular carcinoma in situ represents a marker for increased risk of breast cancer, as well as a nonobligate precursor to invasive carcinoma. Morphologic variants of LCIS—florid and pleomorphic LCIS—are genetically more-complex lesions and are more likely to be associated with invasive carcinoma. Further investigation into which molecular alterations in LCIS are associated with progression to invasive carcinoma is needed to help guide medical and surgical management.
Magnetic signature of the 22June 1932 tsunami deposits (Jalisco,MexicanPacific coast)
Authors: Bógalo M. F. , Ramírez‐Herrera M.‐T. , Goguitchaichvili A. , Rey D. , Mohamed K. J. , Calvo‐Rathert M. , Corona N. 
Published: June 2017

AbstractRecent studies have demonstrated that rock‐magnetic analysis may provide additional information to distinguish and characterize extreme marine inundation events such as tsunamis. Rock‐magnetic proxies reinforce and improve the environmental evidences supplied by other methods, adding some decisive clues for the interpretation of the origin and genesis of the sedimentary deposits. Here we report rock‐magnetic, XRD, and SEM microscopy results obtained in the Palo Verde estuary (Colima Pacific coast, Mexico) in order to enhance the tools for identification and reconstruction of two tsunami‐induced deposits. The sedimentary sequence includes two sand units, a tsunami deposit (PV1) associated with the 22 June 1932 tsunami and a deeper sandy layer (PV2) related to a possible paleotsunami that occurred around 1300 C.E. Both sandy units are topped by finer grained units. Magnetic properties exhibit a significant correlation with the stratigraphy. High susceptibility (χ) and high saturation isothermal remanence (SIRM) values typical of high concentrations of (titano)magnetite are a distinctive feature of the most recent sandy tsunamigenic unit PV1 and the overlaying soil. The lower sandy tsunamigenic unit PV2 shows significantly lower χ and SIRM values, indicating lower concentration of (titano)magnetite in this unit and the overlaying clayey‐silt unit. The latter also shows a higher coercivity component associated with (titano)hematite. Magnetic grain‐size differences are also observed between PV1 and PV2 suggesting differences in hydraulic conditions at the time of deposition. The bulk mineralogical composition and sediment texture of these units also support the hypothesis of different provenances for each tsunamigenic unit as inferred from magnetic properties.
The role of the meridional sea surface temperature gradient in controlling the Caribbean low‐level jet
Authors: Maldonado Tito , Rutgersson Anna , Caballero Rodrigo , Pausata Francesco S. R. , Alfaro Eric , Amador Jorge 
Published: May 2017

AbstractThe Caribbean low‐level jet (CLLJ) is an important modulator of regional climate, especially precipitation, in the Caribbean and Central America. Previous work has inferred, due to their semiannual cycle, an association between CLLJ strength and meridional sea surface temperature (SST) gradients in the Caribbean Sea, suggesting that the SST gradients may control the intensity and vertical shear of the CLLJ. In addition, both the horizontal and vertical structure of the jet have been related to topographic effects via interaction with the mountains in Northern South America (NSA), including funneling effects and changes in the meridional geopotential gradient. Here we test these hypotheses, using an atmospheric general circulation model to perform a set of sensitivity experiments to examine the impact of both SST gradients and topography on the CLLJ. In one sensitivity experiment, we remove the meridional SST gradient over the Caribbean Sea and in the other, we flatten the mountains over NSA. Our results show that the SST gradient and topography have little or no impact on the jet intensity, vertical, and horizontal wind shears, contrary to previous works. However, our findings do not discount a possible one‐way coupling between the SST and the wind over the Caribbean Sea through friction force. We also examined an alternative approach based on barotropic instability to understand the CLLJ intensity, vertical, and horizontal wind shears. Our results show that the current hypothesis about the CLLJ must be reviewed in order to fully understand the atmospheric dynamics governing the Caribbean region.
A review of CO2 and associated carbon dynamics in headwater streams: A global perspective
Authors: Marx A. , Dusek J. , Jankovec J. , Sanda M. , Vogel T. , van Geldern R. , Hartmann J. , Barth J. A. C. 
Published: May 2017

AbstractTerrestrial carbon export via inland aquatic systems is a key process in the global carbon cycle. It includes loss of carbon to the atmosphere via outgassing from rivers, lakes, or reservoirs and carbon fixation in the water column as well as in sediments. This review focuses on headwater streams that are important because their stream biogeochemistry directly reflects carbon input from soils and groundwaters. Major drivers of carbon dioxide partial pressures (pCO2) in streams and mechanisms of terrestrial dissolved inorganic, organic and particulate organic carbon (DIC, DOC, and POC) influxes are summarized in this work. Our analysis indicates that the global river average pCO2 of 3100 ppmV is more often exceeded by contributions from small streams when compared to rivers with larger catchments (> 500 km2). Because of their large proportion in global river networks (> 96% of the total number of streams), headwaters contribute large—but still poorly quantified—amounts of CO2 to the atmosphere. Conservative estimates imply that globally 36% (i.e., 0.93 Pg C yr−1) of total CO2 outgassing from rivers and streams originate from headwaters. We also discuss challenges in determination of CO2 sources, concentrations, and fluxes. To overcome uncertainties of CO2 sources and its outgassing from headwater streams on the global scale, new investigations are needed that should include groundwater data. Such studies would also benefit from applications of integral CO2 outgassing isotope approaches and multiscale geophysical imaging techniques.
Confounding factors in determining causal soil moisture‐precipitation feedback
Authors: Tuttle Samuel E. , Salvucci Guido D. 
Published: June 2017

AbstractIdentification of causal links in the land‐atmosphere system is important for construction and testing of land surface and general circulation models. However, the land and atmosphere are highly coupled and linked by a vast number of complex, interdependent processes. Statistical methods, such as Granger causality, can help to identify feedbacks from observational data, independent of the different parameterizations of physical processes and spatiotemporal resolution effects that influence feedbacks in models. However, statistical causal identification methods can easily be misapplied, leading to erroneous conclusions about feedback strength and sign. Here, we discuss three factors that must be accounted for in determination of causal soil moisture‐precipitation feedback in observations and model output: seasonal and interannual variability, precipitation persistence, and endogeneity. The effect of neglecting these factors is demonstrated in simulated and observational data. The results show that long‐timescale variability and precipitation persistence can have a substantial effect on detected soil moisture‐precipitation feedback strength, while endogeneity has a smaller effect that is often masked by measurement error and thus is more likely to be an issue when analyzing model data or highly accurate observational data.