bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Atlanto-Occipital Dislocation, Retroclival Hematoma, and Hydrocephalus: Management and Survival in a Pediatric Patient
Authors: Lee Isaac , Vasquez Luis , Tyroch Alan , Trier Todd 
Published: March 2017

AbstractAtlanto-occipital dislocation (AOD) is an injury with high morbidity and mortality. We present a case of survival of a pediatric patient with the diagnoses of AOD, retroclival hematoma, and resulting hydrocephalus. The patient's cervical spine was stabilized until occipital-cervical fusion provided definitive treatment, and the hydrocephalus was treated with a ventriculostomy. The patient survived with no neurological deficits. A better understanding and awareness of the radiologic criteria of AOD will lead to earlier recognition of AOD and improved outcomes, even in the presence of complications from AOD. Surgical fixation should be used for definitive treatment of injuries with AOD.
Common nonmutationalNOTCH1activation in chronic lymphocytic leukemia
Authors: Fabbri Giulia , Holmes Antony B. , Viganotti Mara , Scuoppo Claudio , Belver Laura , Herranz Daniel , Yan Xiao-Jie , Kieso Yasmine , Rossi Davide , Gaidano Gianluca , Chiorazzi Nicholas , Ferrando Adolfo A. , Dalla-Favera Riccardo 
Published: March 2017

SignificanceA pathogenetic role ofNOTCH1in chronic lymphocytic leukemia (CLL) has been implied by the presence of deregulating mutations in a relatively small fraction of cases. Our results now indicate that ∼50% of CLL cases devoid of mutations express the active form of NOTCH1 ICN1 (intracellular portion of NOTCH1), thus implicating a much broader role of this transcription factor in the disease. ICN1+CLL cases display equivalent NOTCH1-dependent transcriptional responses regardless of the gene mutation status, indicating that the detection of ICN1 represents a reliable biomarker ofNOTCH1activation for diagnostic and therapeutic targeting. Finally, our results identify the NOTCH1-dependent transcriptional program in CLL cells, thus providing direct insights into the pathogenesis of a large fraction of CLL cases.
Cubic zincblende gallium nitride for green-wavelength light-emitting diodes
Authors: Lee Lok Yi 
Published: March 2017

Gallium nitride (GaN)-based light-emitting diodes (LEDs) are highly energy efficient and their widespread usage in lighting can induce significant worldwide electricity savings. To achieve white and colour-tuneable lighting, the mixing of light from red-, blue- and green-wavelength LEDs is desired. At present, the efficiency of green-wavelength LEDs is only about half of that of red- and blue-wavelength LEDs, which is also known as the ‘green gap’ problem. Cubic zincblende GaN has the potential to bridge the ‘green gap’ due to the theoretical absence of internal electric fields that plague the commonly used c-plane hexagonal wurtzite structure. This review first looks at the various methods of achieving metastable zincblende GaN, and examines the crystal defects present. Then the different components towards a full zincblende GaN LED structure, including p- and n-type doping, zincblende InGaN and AlGaN on GaN heterostructures, together with the problems that need to be overcome to achieve green-wavelength emissions are reviewed. This review was submitted as part of the 2017 Materials Literature Review Prize of the Institute of Materials, Minerals and Mining run by the Editorial Board of MST. Sponsorship of the prize by TWI Ltd is gratefully acknowledged
Effect of pulsed magnetic treatment on the corrosion of titanium
Authors: Babutskyi Anatolii , Chrysanthou Andreas , Smelina Marija , Stepanov Gennadii , Ziętara Maciej 
Published: March 2017

Results of corrosion tests of titanium in the initial state and after treatment using pulsed magnetic field are presented. It is shown that samples after treatment have better corrosion resistance due to the formation of denser and finer corrosion products with better adhesion to the substrate. Samples after treatment have more homogeneous microstructure due to a substantial increase of dislocations which are uniformly distributed. Mechanisms of dislocation multiplication and a model explaining the effect of the treatment on the corrosion are discussed. This paper is part of a themed issue on Materials in External Fields.
E-Science technologies in a workflow for personalized medicine using cancer screening as a case study
Authors: Spjuth Ola , Karlsson Andreas , Clements Mark , Humphreys Keith , Ivansson Emma , Dowling Jim , Eklund Martin , Jauhiainen Alexandra , Czene Kamila , Grönberg Henrik , Sparén Pär , Wiklund Fredrik , Cheddad Abbas , Pálsdóttir þorgerður , Rantalainen Mattias , Abrahamsson Linda , Laure Erwin , Litton Jan-Eric , Palmgren Juni 
Published: March 2017

Abstract
Objective:We provide an e-Science perspective on the workflow from risk factor discovery and classification of disease to evaluation of personalized intervention programs. As case studies, we use personalized prostate and breast cancer screenings.
Materials and Methods:We describe an e-Science initiative in Sweden, e-Science for Cancer Prevention and Control (eCPC), which supports biomarker discovery and offers decision support for personalized intervention strategies. The generic eCPC contribution is a workflow with 4 nodes applied iteratively, and the concept of e-Science signifies systematic use of tools from the mathematical, statistical, data, and computer sciences.
Results:The eCPC workflow is illustrated through 2 case studies. For prostate cancer, an in-house personalized screening tool, the Stockholm-3 model (S3M), is presented as an alternative to prostate-specific antigen testing alone. S3M is evaluated in a trial setting and plans for rollout in the population are discussed. For breast cancer, new biomarkers based on breast density and molecular profiles are developed and the US multicenter Women Informed to Screen Depending on Measures (WISDOM) trial is referred to for evaluation. While current eCPC data management uses a traditional data warehouse model, we discuss eCPC-developed features of a coherent data integration platform.
Discussion and Conclusion:E-Science tools are a key part of an evidence-based process for personalized medicine. This paper provides a structured workflow from data and models to evaluation of new personalized intervention strategies. The importance of multidisciplinary collaboration is emphasized. Importantly, the generic concepts of the suggested eCPC workflow are transferrable to other disease domains, although each disease will require tailored solutions.
Tumor Margin Assessment With Loupe Magnification Enables Greater Histological Clearance of Facial Basal Cell Carcinomas Compared With Clinical Examination Alone
Authors: Sugrue Conor M. , McInerney Niall , Joyce Cormac W. , Kelly Jack L. 
Published: March 2017

BACKGROUND
Surgical excision of facial basal cell carcinomas (BCCs) is a balance between oncological clearance and conservation of cosmetic and functionally sensitive tissues.

OBJECTIVE
To assess if loupe magnification (LM) can enhance the visual assessment of BCC tumor margins resulting in a greater histological clearance.

MATERIALS AND METHODS
This prospective study randomized patients with primary facial BCCs into preoperative tumor margin assessment with LM (study group) or clinical examination alone (control group). Basal cell carcinomas were excised with a predetermined surgical margin of either 2, 3,, or 4 mm. Mean histological margin, incomplete excision rate, and method of closure were recorded and compared between LM and control groups, across a range of surgical margins.

RESULTS
Ninety-four BCCs were excised from 93 patients, 47 BCCs in each group. The mean histological margin was larger in the study versus control group for each group (2-mm margin, 1.8 vs 1.4, 3-mm margin, 2.4 vs 2.3, 4-mm margin, and 3.1 vs 2.7), but only statistically significant in the 4-mm group (p = .032). There was no difference in method of closure between LM and control groups.

CONCLUSION
Loupe magnification improved tumor margin assessment for facial BCC enabling a greater diameter of histological clearance. The use of LM should become a standard practice for facial BCC excision.
Episode-of-Care Characteristics and Costs for Hip and Knee Replacement Surgery in Hospitals Belonging to the High Value Healthcare Collaborative Compared With Similar Hospitals in the Same Health Care Markets
Authors: Weeks William B. , Schoellkopf William J. , Ballard David J. , Kaplan Gary S. , James Brent , Weinstein James N. 
Published: March 2017

Background:
To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States.

Objective:
To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non–HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions.

Research Design:
This is a retrospective analysis of fee-for-service Medicare data from 2012 and 2013.

Subjects:
For hip arthroplasty, 4030 HVHC-member and 7572 non–HVHC-member, and for knee arthroplasty, 6542 HVHC-member and 13,900 non–HVHC-member fee-for-service Medicare patients aged 65 and older.

Measures:
Volumes, patient demographics, hospital stay characteristics, and acute and postacute care standardized costs for a 30-day episode of care.

Results:
HVHC-member hospitals differed from similar non–HVHC-member hospitals in the same health care markets when considering volumes of surgeries, patient demographics, Charlson scores, and patient distance to care during the index admission. There was little variation in acute care costs of hip or knee replacement surgery across health care markets; however, there was substantial variation in postacute care costs across those same markets. We saw less variation in postacute care costs within markets than across markets. Regression analyses showed that HVHC-member status was not associated with shorter lengths of stay, different complication rates, or lower total or postacute care costs for hip or knee replacement.

Conclusions:
Health care regions appear to be a more important predictor of episode costs of care than HVHC status.
Hospital Characteristics Associated With Risk-standardized Readmission Rates
Authors: Horwitz Leora I. , Bernheim Susannah M. , Ross Joseph S. , Herrin Jeph , Grady Jacqueline N. , Krumholz Harlan M. , Drye Elizabeth E. , Lin Zhenqiu 
Published: March 2017

Background:
Safety-net and teaching hospitals are somewhat more likely to be penalized for excess readmissions, but the association of other hospital characteristics with readmission rates is uncertain and may have relevance for hospital-centered interventions.

Objective:
To examine the independent association of 8 hospital characteristics with hospital-wide 30-day risk-standardized readmission rate (RSRR).

Design:
This is a retrospective cross-sectional multivariable analysis.

Subjects:
US hospitals.

Measures:
Centers for Medicare and Medicaid Services specification of hospital-wide RSRR from July 1, 2013 through June 30, 2014 with race and Medicaid dual-eligibility added.

Results:
We included 6,789,839 admissions to 4474 hospitals of Medicare fee-for-service beneficiaries aged over 64 years. In multivariable analyses, there was regional variation: hospitals in the mid-Atlantic region had the highest RSRRs [0.98 percentage points higher than hospitals in the Mountain region; 95% confidence interval (CI), 0.84–1.12]. For-profit hospitals had an average RSRR 0.38 percentage points (95% CI, 0.24–0.53) higher than public hospitals. Both urban and rural hospitals had higher RSRRs than those in medium metropolitan areas. Hospitals without advanced cardiac surgery capability had an average RSRR 0.27 percentage points (95% CI, 0.18–0.36) higher than those with. The ratio of registered nurses per hospital bed was not associated with RSRR. Variability in RSRRs among hospitals of similar type was much larger than aggregate differences between types of hospitals.

Conclusions:
Overall, larger, urban, academic facilities had modestly higher RSRRs than smaller, suburban, community hospitals, although there was a wide range of performance. The strong regional effect suggests that local practice patterns are an important influence. Disproportionately high readmission rates at for-profit hospitals may highlight the role of financial incentives favoring utilization.
Factor Structure of the Cultural Competence Items in the National Home and Hospice Care Survey
Authors: AbuDagga Azza , Mara Constance A. , Carle Adam C. , Weech-Maldonado Robert 
Published: March 2017

Background:
There is a need for validated measures of cultural competency practices in home health and hospice care (HHHC).

Objective:
To establish the factor structure of the cultural competency items included in the agency-component of the 2007 public-use National Home and Hospice Care Survey file.

Data Source:
We used weighted survey data from 1036 HHHC agencies.

Research Design and Participants:
We used exploratory factor analyses to identify a preliminary factor structure, and then performed confirmatory factor analysis to provide further support for identified factor structure.

Measures:
We examined 9 cultural competency items.

Results:
Exploratory factor analyses suggested an interpretable 2-factor solution: (1) the provision of mandatory cultural competency training; and (2) the provision of cultural competency communication practices. Each factor consisted of 3 items. The remaining 3 items did not load well on these factors. A similar, but more restrictive, confirmatory factor analysis model without cross-loadings supported the 2-factor model:

JOURNAL/mcar/04.03/00005650-201804000-00013/inline-formula1/v/2023-08-21T230356Z/r/image-tiff

=9.50, P=0.30, root mean square error of approximation (RMSEA)=0.01, comparative fit index (CFI)=0.99, Tucker-Lewis Index (TLI)=0.99.

Conclusions:
Two constructs with 3 items each appeared to be internally valid measures of cultural competency in this nationally representative survey of HHHC agencies: cultural competency training and cultural competency communication practices. These measures could be used by HHHC managers in quality improvement efforts and by policy makers in monitoring cultural competency practices.
Impact of rare variants in autosomal dominant hypercholesterolemia causing genes
Authors: Calandra Sebastiano , Tarugi Patrizia , Bertolini Stefano 
Published: March 2017

Purpose of review
The systematic analysis of the major candidate genes in autosomal dominant hypercholesterolemia (ADH) and the use of next-generation sequencing (NGS) technology have made possible the discovery of several rare gene variants whose pathogenic effect in most cases remains poorly defined.

Recent findings
One major advance in the field has been the adoption of a set of international guidelines for the assignment of pathogenicity to low-density lipoprotein receptor (LDLR) gene variants based on the use of softwares, complemented with data available from literature and public databases. The clinical impact of several novel rare variants in LDLR, APOB, PCSK9, APOE genes have been reported in large studies describing patients with ADH found to be homozygotes/compound heterozygotes, double heterozygotes, or simple heterozygotes. In-vitro functional studies have been conducted to clarify the effect of some rare ApoB variants on LDL binding to LDLR and the impact of a rare ApoE variant on the uptake of VLDL and LDL by hepatocytes.

Summary
The update of the ADH gene variants database and the classification of variants in categories of pathogenicity is a major advance in the understanding the pathophysiology of ADH and in the management of this disorder. The studies of molecularly characterized patients with ADH have emphasized the impact of a specific variant and the variable clinical expression of different genotypes. The functional studies of some variants have increased our understanding of the molecular bases of some forms of ADH.
Immunotherapy for food allergy
Authors: Reisacher William R. , Davison Wesley 
Published: March 2017

Purpose of review
The current review discusses strategies for administering specific immunotherapy (SIT) for the treatment of food allergy. It focuses on three delivery routes for food allergens, immunomodulatory adjuvants and allergen modifications.

Recent findings
Interest in SIT for food allergy has been increasing significantly. Sublingual immunotherapy is effective for desensitization with a very favorable adverse event profile. Epicutaneous immunotherapy is also effective, most notably in younger children, with a high rate of local reactions. Oral immunotherapy demonstrates high efficacy, but with a higher risk of gastrointestinal and systemic adverse events. The need for long-term application to sustain desensitization is currently unclear. Immunomodulatory adjuvants may be added to enhance or diminish the immunogenicity of proteins, whereas genetic modifications of food allergens are designed to limit the risk of adverse reactions and address the issues of standardization and supply.

Summary
SIT for food allergy is reaching the point where it may soon be used routinely in clinical practice. Current research focuses on new delivery routes and methods to enhance the effectiveness of the therapy while minimizing the risk of adverse reactions. Future efforts are underway to determine the optimal dose for each delivery method and the length of maintenance dosing required to retain the protective effect.
Pediatric solid tumors in Africa: different biology?
Authors: Nyagetuba John K.M. , Hansen Erik N. 
Published: March 2017

Purpose of review
To review the recent literature regarding biologic characteristics of pediatric solid tumors in African children.

Recent findings
Data regarding pediatric solid tumors in Africa, while increasing, remain sparse when considering the ethnic and geographic diversity of the continent. Recent work, especially regarding nephroblastoma in Kenya, has identified some biologic variability among local tribes but also when compared with North American tumors. In general, reports from across the continent reveal markedly poorer survival for pediatric patients with solid tumors when compared with high-resourced regions.

Summary
Multiple resource-related and infrastructure-related challenges contribute to poorer outcomes, and these require systematic, multidisciplinary, and structured solutions. Socioeconomic factors and limited access to care currently seem to drive the survival outcomes in children with solid cancers in Africa.
Central venous access in children: indications, devices, and risks
Authors: Ares Guillermo , Hunter Catherine J. 
Published: March 2017

Purpose of review
Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation.

Recent findings
Large systematic reviews of randomized trials suggest that ultrasound guidance for placement of CVCs in children is safer than using blind technique, at least for internal jugular vein access. Appropriate catheter tip placement is associated with decreased complications. Furthermore, the prophylactic use of ethanol lock between cycles of parenteral nutrition administration has reduced the rates of CLABSI. A recent randomized trial in pediatric CVCs showed a benefit with antibiotic-coated CVCs.

Summary
Based on the available evidence, multiple techniques for CVC placement are still valid, including the landmark technique based on practitioner experience, but ultrasound guidance has been shown to decrease complications from line placement. Adherence to CVC care protocols is essential in reducing infectious complications.
Symptomatic Acute-on-Chronic Subdural Hematoma
Authors: Castellani Rudy J. , Mojica-Sanchez Gruschenka , Schwartzbauer Gary , Hersh David S. 
Published: March 2017

Abstract
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion. Given the prevalence of traumatic subdural processes in the forensic setting and the importance of proper assessment of timing, etiology, risk factors, and clinicopathological correlation, we studied 47 patients presenting to the University of Maryland Shock Trauma Center, all of whom underwent craniotomy with resection of the outer membrane due to symptomatic ACSDH. The surgically resected tissue was examined for histopathologic features in all cases. Our findings highlight that ACSDH is a condition precipitated by trauma that affects middle-aged and older adults, is relatively indolent, is unilateral or asymmetric, and has a low in-hospital mortality rate. Pathological analysis demonstrates a substantial outer membrane in all cases with varying degrees of inflammation and organization that cannot be precisely dated as a function of clinical presentation. The extrapolation of adult ACSDH to mixed acute and chronic subdural hemorrhage in the pediatric setting is problematic due to substantial differences in clinical presentation, severity of underlying brain injury, gross and microscopic findings, and outcome.
Effects of Medical Interventions on Gender Dysphoria and Body Image: A Follow-Up Study
Authors: van de Grift Tim C. , Elaut Els , Cerwenka Susanne C. , Cohen-Kettenis Peggy T. , De Cuypere Griet , Richter-Appelt Hertha , Kreukels Baudewijntje P.C. 
Published: March 2017

ABSTRACT

Objective
The aim of this study from the European Network for the Investigation of Gender Incongruence is to investigate the status of all individuals who had applied for gender confirming interventions from 2007 to 2009, irrespective of whether they received treatment. The current article describes the study protocol, the effect of medical treatment on gender dysphoria and body image, and the predictive value of (pre)treatment factors on posttreatment outcomes.

Methods
Data were collected on medical interventions, transition status, gender dysphoria (Utrecht Gender Dysphoria Scale), and body image (Body Image Scale for transsexuals). In total, 201 people participated in the study (37% of the original cohort).

Results
At follow-up, 29 participants (14%) did not receive medical interventions, 36 hormones only (18%), and 136 hormones and surgery (68%). Most transwomen had undergone genital surgery, and most transmen chest surgery. Overall, the levels of gender dysphoria and body dissatisfaction were significantly lower at follow-up compared with clinical entry. Satisfaction with therapy responsive and unresponsive body characteristics both improved. High dissatisfaction at admission and lower psychological functioning at follow-up were associated with persistent body dissatisfaction.

Conclusions
Hormone-based interventions and surgery were followed by improvements in body satisfaction. The level of psychological symptoms and the degree of body satisfaction at baseline were significantly associated with body satisfaction at follow-up.