bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the management of multimorbidity in general practice: protocol of a cluster randomised controlled trial (The 3D Study)
Authors: Man Mei-See , Chaplin Katherine , Mann Cindy , Bower Peter , Brookes Sara , Fitzpatrick Bridie , Guthrie Bruce , Shaw Alison , Hollinghurst Sandra , Mercer Stewart , Rafi Imran , Thorn Joanna , Salisbury Chris 
Published: April 2016

IntroductionAn increasing number of people are living with multimorbidity. The evidence base for how best to manage these patients is weak. Current clinical guidelines generally focus on single conditions, which may not reflect the needs of patients with multimorbidity. The aim of the 3D study is to develop, implement and evaluate an intervention to improve the management of patients with multimorbidity in general practice.Methods and analysisThis is a pragmatic two-arm cluster randomised controlled trial. 32 general practices around Bristol, Greater Manchester and Glasgow will be randomised to receive either the ‘3D intervention’ or usual care. 3D is a complex intervention including components affecting practice organisation, the conduct of patient reviews, integration with secondary care and measures to promote change in practice organisation. Changes include improving continuity of care and replacing reviews of each disease with patient-centred reviews with a focus on patients' quality of life, mental health and polypharmacy. We aim to recruit 1383 patients who have 3 or more chronic conditions. This provides 90% power at 5% significance level to detect an effect size of 0.27 SDs in the primary outcome, which is health-related quality of life at 15 months using the EQ-5D-5L. Secondary outcome measures assess patient centredness, illness burden and treatment burden. The primary analysis will be a multilevel regression model adjusted for baseline, stratification/minimisation, clustering and important co-variables. Nested process evaluation will assess implementation, mechanisms of effectiveness and interaction of the intervention with local context. Economic analysis of cost-consequences and cost-effectiveness will be based on quality-adjusted life years.Ethics and disseminationThis study has approval from South-West (Frenchay) National Health Service (NHS) Research Ethics Committee (14/SW/0011). Findings will be disseminated via final report, peer-reviewed publications and guidance to healthcare professionals, commissioners and policymakers.Trial registration numberISRCTN06180958; Pre-results.
Perfect metamaterial absorbers with polarization angle independency in X-band waveguide
Authors: Sabah Cumali 
Published: April 2016

The design and characterization of perfect metamaterial absorbers (MAs) based on simple configurations including square- and triangle-shapes, which operate in X-band frequency region are numerically and experimentally investigated. The proposed MAs provide perfect absorption with the polarization angle independency. In X-band waveguide, the absorption rates are 99.69% and 99.97% at the resonance frequencies of 10.57 GHz and 10.93 GHz for the square- and triangle-shaped MAs, respectively. In addition, the same configurations are numerically tested under free space boundary conditions to compare and discuss the obtained results. The suggested MAs enable myriad potential application areas for security and stealth technologies in X-band including wireless communication.
Semiclassical limits, Lagrangian states and coboundary equations
Authors: Lopes Artur O. , Mohr Joana 
Published: April 2016

Assume that [Formula: see text] is a continuous transformation [Formula: see text]. We consider here the cases where [Formula: see text] is either the transformation [Formula: see text] or [Formula: see text] is a smooth diffeomorphism of the circle [Formula: see text]. Consider a fixed continuous potential [Formula: see text], [Formula: see text] and [Formula: see text] (a quantum state). The transformation [Formula: see text] acting on [Formula: see text], [Formula: see text], defined by [Formula: see text] describes a discrete time dynamical evolution of the quantum state [Formula: see text]. Given [Formula: see text] we define the Lagrangian state [Formula: see text] In this case [Formula: see text]. Under suitable conditions on [Formula: see text] the micro-support of [Formula: see text], when [Formula: see text], is [Formula: see text]. One of the meanings of the semiclassical limit in Quantum Mechanics is to take [Formula: see text] and [Formula: see text]. We address the question of finding [Formula: see text] such that [Formula: see text] satisfies the property: [Formula: see text], we have that [Formula: see text] has micro-support on the graph of [Formula: see text] (which is the micro-support of [Formula: see text]). In other words: which [Formula: see text] is such that [Formula: see text] leaves the micro-support of [Formula: see text] invariant? This is related to a coboundary equation for [Formula: see text], twist conditions and the boundary of the fat attractor.
Molecular Insights of Pathways Resulting from Two Common PIK3CA Mutations in Breast Cancer
Authors: Bhat-Nakshatri Poornima , Goswami Chirayu P. , Badve Sunil , Magnani Luca , Lupien Mathieu , Nakshatri Harikrishna 
Published: April 2016

Abstract
The PI3K pathway is activated in approximately 70% of breast cancers. PIK3CA gene mutations or amplifications that affect the PI3K p110α subunit account for activation of this pathway in 20% to 40% of cases, particularly in estrogen receptor alpha (ERα)-positive breast cancers. AKT family of kinases, AKT1–3, are the downstream targets of PI3K and these kinases activate ERα. Although several inhibitors of PI3K have been developed, none has proven effective in the clinic, partly due to an incomplete understanding of the selective routing of PI3K signaling to specific AKT isoforms. Accordingly, we investigated in this study the contribution of specific AKT isoforms in connecting PI3K activation to ERα signaling, and we also assessed the utility of using the components of PI3K–AKT isoform–ERα signaling axis as predictive biomarkers of response to PI3K inhibitors. Using a variety of physiologically relevant model systems with defined natural or knock-in PIK3CA mutations and/or PI3K hyperactivation, we show that PIK3CA-E545K mutations (found in ∼20% of PIK3CA-mutant breast cancers), but not PIK3CA-H1047R mutations (found in 55% of PIK3CA-mutant breast cancers), preferentially activate AKT1. Our findings argue that AKT1 signaling is needed to respond to estrogen and PI3K inhibitors in breast cancer cells with PIK3CA-E545K mutation, but not in breast cancer cells with other PIK3CA mutations. This study offers evidence that personalizing treatment of ER-positive breast cancers to PI3K inhibitor therapy may benefit from an analysis of PIK3CA–E545K–AKT1–estrogen signaling pathways. Cancer Res; 76(13); 3989–4001. ©2016 AACR.
Development of a quantification method with real-time PCR for three Pratylenchus species causing damage to chrysanthemum in Japan
Authors: Koyama Yuki , Toyota Koki , Miyamaru Naoko , Yoshida Koichi , Uesugi Kenta 
Published: April 2016

ThreePratylenchusspecies,P. penetrans,P. pseudocoffeaeandP. kumamotoensis, are major threats to chrysanthemum production in Japan. To develop a quantification method for these threePratylenchusspecies in soil using real-time PCR, we designed two new specific primer sets forP. pseudocoffeaeandP. kumamotoensisand applied the primer set NEG, developed previously, forP. penetrans. Relationships between the threshold cycle (Ct:y) values and number of nematodes inoculated (log2(no. (20 g soil)−1):x) were forP. penetrans,P. pseudocoffeaeandP. kumamotoensis. The quantification of thesePratylenchusspp. was conducted using 16 soil samples.Pratylenchus penetransandP. kumamotoensiswere detected from seven and one soil samples, respectively, while noP. pseudocoffeaewas detected. These results demonstrated that the presently designed primers are useful to quantify the densities of threePratylenchusspp. in chrysanthemum fields in Japan.
Liposomal Bupivacaine for Pain Control After Anterior Cruciate Ligament Reconstruction
Authors: Premkumar Ajay , Samady Heather , Slone Harris , Hash Regina , Karas Spero , Xerogeanes John 
Published: April 2016

Background: Local anesthetics are commonly administered into surgical sites as a part of multimodal pain control regimens. Liposomal bupivacaine is a novel formulation of bupivacaine designed for slow diffusion of a single dose of local anesthetic over a 72-hour period. While early results are promising in various settings, no studies have compared pain management regimens containing liposomal bupivacaine to traditional regimens in patients undergoing anterior cruciate ligament (ACL) reconstruction. Purpose: To evaluate liposomal bupivacaine in comparison with 0.25% bupivacaine hydrochloride (HCl) for pain control after ACL reconstruction. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 32 adult patients undergoing primary ACL reconstruction with a soft tissue quadriceps tendon autograft between July 2014 and March 2015 were enrolled. All patients received a femoral nerve block immediately before surgery. Patients then received either a 40-mL suspension of 20 mL Exparel (1 vial of bupivacaine liposome injectable suspension) and 20 mL 0.9% injectable saline or 20 mL 0.5% bupivacaine HCl and 20 mL 0.9% injectable saline, which was administered into the graft harvest site and portal sites during surgery. Patients were given either a postoperative smartphone application or paper-based journal to record data for 1 week after ACL reconstruction. Results: Of the 32 patients recruited, 29 patients were analyzed (90.6%). Two patients were lost to follow-up, and 1 was excluded because of a postoperative hematoma. There were no statistically significant differences in postoperative pain, medication use, pain location, recovery room time, or mobility between the 2 study groups. Conclusion: There were comparable outcomes with 0.25% bupivacaine HCl at a 200-fold lower cost than liposomal bupivacaine. This study does not support the widespread use of liposomal bupivacaine for pain control after ACL reconstruction in the setting of a femoral nerve block. Registration: ClinicalTrials.gov NCT02189317
Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures
Authors: Nosewicz Tomasz L. , Beerekamp M. Suzan H. , De Muinck Keizer Robert-Jan O. , Schepers Tim , Maas Mario , Niek van Dijk C. , Goslings J. Carel 
Published: April 2016

Background: Osteochondral lesions (OCLs) associated with ankle fracture correlate with unfavorable outcome. The goals of this study were to detect OCLs following ankle fracture, to associate fracture type to OCLs and to investigate whether OCLs affect clinical outcome. Methods: 100 ankle fractures requiring operative treatment were prospectively included (46 men, 54 women; mean age 44 ± 14 years, range 20-77). All ankle fractures (conventional radiography; 71 Weber B, 22 Weber C, 1 Weber A, 4 isolated medial malleolus and 2 isolated posterior malleolus fractures) were treated by open reduction and internal fixation. Multidetector computed tomography (CT) was performed postoperatively. For each OCL, the location, size, and Loomer OCL classification (CT modified Berndt and Harty classification) were determined. The subjective Foot and Ankle Outcome Scoring (FAOS) was used for clinical outcome at 1 year. Results: OCLs were found in 10/100 ankle fractures (10.0%). All OCLs were solitary talar lesions. Four OCLs were located posteromedial, 4 posterolateral, 1 anterolateral, and 1 anteromedial. There were 2 type I OCLs (subchondral compression), 6 type II OCLs (partial, nondisplaced fracture) and 2 type IV OCLs (displaced fracture). Mean OCL size (largest diameter) was 4.4 ± 1.7 mm (range, 1.7 mm to 6.2 mm). Chi-square analysis showed no significant association between ankle fracture type and occurrence of OCLs. OCLs did occur only in Lauge-Hansen stage III/IV ankle fractures. There were no significant differences in FAOS outcome between patients with or without OCLs. Conclusions: Ten percent of investigated ankle fractures had associated OCLs on CT. Although no significant association between fracture type and OCL was found, OCLs only occurred in Lauge-Hansen stage III/IV ankle fractures. With the numbers available, OCLs did not significantly affect clinical outcome at 1 year according to FAOS. Level of Evidence: Level IV, observational study.
Validated Method for Measuring Functional Range of Motion in Patients With Ankle Arthritis
Authors: Thornton James , Sabah Shiraz , Segaren Neil , Cullen Nicholas , Singh Dishan , Goldberg Andrew 
Published: April 2016

Background: Total range of motion between the tibia and the floor is an important outcome measure following ankle surgery. However, there is wide variation in its measurement: from clinical evaluation, to radiographic metrics, and gait analysis. The purpose of this study was to present and validate a simple, standardized technique for measurement of functional total range of motion between the tibia and the floor using a digital goniometer. Methods: Institutional review board approval was obtained. Forty-six ankles from 33 participants were recruited into 2 groups: Group 1 (healthy controls) comprised 20 ankles from 10 participants. None had any musculoskeletal or neurologic pathology. Group 2 (ankle osteoarthritis) comprised 25 ankles from 23 patients. Ankle pathology had been treated with ankle arthrodesis (n = 5), total ankle replacement (n = 6), and nonoperative treatment (n = 14). Measurement was performed by 2 testers according to a standardized protocol developed for the Total Ankle Replacement Versus Arthrodesis (TARVA) randomized controlled trial. Intra- and interrater reliability was calculated using intraclass correlation coefficients (ICCs). Results: Group 1 (healthy controls): the median difference for all measurements within an observer was 1.5 (interquartile range [IQR] 0.7-2.5) degrees, and the intraclass coefficients (ICCs) for inter- and intrarater total ankle range of motion were excellent: 0.95 (95% confidence interval [CI] 0.91-0.97, P < .001) and 0.942 (95% CI 0.859-0.977, P < .001), respectively. Group 2 (ankle osteoarthritis): the median difference for all measurements within an observer was 0.6 (IQR 0.2-1.3) degrees, and the ICCs for inter- and intrarater total ankle range of motion were excellent: 0.99 (95% CI 0.97-1.0), P < .001) and 0.99 (95% CI 0.96-1.0), P < .001), respectively. Conclusion: This technique provided a reliable, standardized method for measurement of total functional range of motion between the tibia and the floor. The technique required no special equipment or training. It provided a valid functional assessment for patients with or without ankle osteoarthritis, including those who had undergone operative treatment. Level of Evidence: Level II, prospective comparative study.
Variable Volumes of Resected Bone Resulting From Different Total Ankle Arthroplasty Systems
Authors: Goetz Jessica E. , Rungprai Chamnanni , Tennant Joshua N. , Huber Emmalei , Uribe Bastian , Femino John , Phisitkul Phinit , Amendola Annunziato 
Published: April 2016

Background: The increased popularity and success of total ankle arthroplasty (TAA) has resulted in the development of varying TAA hardware designs, many of which include specific bone-sparing or bone-sacrificing features. The goal of this work was to determine differences in the volume of bone removed for implantation of different total ankle arthroplasty hardware systems. Methods: Sixteen cadaveric specimens were computed tomography–scanned preoperatively and after total ankle arthroplasty using either an INBONE II, Salto Talaris, STAR, or Zimmer TMTA implant. Geometries of the talus and the distal tibia were manually segmented and converted to 3D bony surface models. The volume of bone removed for each implant was calculated as the difference in volume between the preoperative and postoperative bone models. To account for differences in specimen size, volume was expressed as a percentage of the intact bone. Results: There was a significant difference ( P = .049) in the average percent of talar bone removed, with the STAR and INBONE II systems requiring removal of greater volumes of bone. The INBONE II system required significantly ( P < .004) more tibial bone resection than the other 3 implants when evaluating a long span of the distal tibia. However, most of this increased bone resection was medullary bone. Close to the articular surface, bone volumes removed for the various tibial components were not significantly different ( P = .056). Conclusion: Volume and location of bone removed for different implant systems varied with implant design. Clinical Relevance: Primary bone resection associated with different implant hardware systems varied more on the talar side of the articulation, and the stemmed prosthesis did not result in dramatic increases in periarticular bone resection. Clinicians should weigh the effects of greater or lesser bone resection associated with various implant designs against other factors used for hardware selection.
Prophylactic Placement of an Inferior Vena Cava Filter During Aspiration Thrombectomy for Acute Deep Venous Thrombosis of the Lower Extremity
Authors: Kwon Se Hwan , Park So Hyun , Oh Joo Hyeong , Song Myung Gyu , Seo Tae-Seok 
Published: April 2016

Purpose: To evaluate the effect of an inferior vena cava (IVC) filter during aspiration thrombectomy for acute deep vein thrombosis (DVT) in the lower extremity. Materials and Methods: From July 2004 to December 2013, a retrospective analysis of 106 patients with acute DVT was performed. All patients received an IVC filter and were treated initially with aspiration thrombectomy. Among the 106 patients, DVT extension into the IVC was noted in 27 but was not evident in 79. We evaluated the presence of trapped thrombi in the filters after the procedure. The sizes of the trapped thrombi were classified into 2 grades based on the ratio of the maximum transverse length of the trapped thrombus to the diameter of the IVC (Grades I [≤ 50%] and II [> 50%]). Results: A trapped thrombus in the filter was detected in 46 (43%) of 106 patients on final venograms. The sizes of the trapped thrombi were grade I in 12 (26.1%) patients and grade II in 34 (73.9%). Among the 27 patients with DVT extension into the IVC, 20 (74.1%) showed a trapped thrombus in the filter, 75% (15 of 20) of which were grade II. Among the 79 patients without DVT extension into the IVC, 26 (32.9%) showed a trapped thrombus in the IVC filter, 73% (19 of 26) of which were grade II. Conclusions: Thrombus migration occurred frequently during aspiration thrombectomy of patients with acute DVT in the lower extremity. However, further studies are needed to establish a standard protocol for the prophylactic placement of an IVC filter during aspiration thrombectomy.
Acromegaly in a non-diabetic cat
Authors: Fracassi Federico , Salsi Margherita , Sammartano Federica , Bo Stefano , Kooistra Hans S 
Published: April 2016

Case summary A 14-year-old, neutered male European shorthair cat was evaluated for a routine health check. The owner did not report any clinical signs except for respiratory stridor. On physical examination the main findings were broad facial features and increased interdental spaces. On haematology, a mild, non-regenerative anaemia was detected, whereas the serum biochemistry profile and urinalysis were unremarkable. The serum glucose concentration was within the reference interval. Serum insulin-like growth factor-1 concentration was markedly elevated (>1600 ng/ml). The basal serum growth hormone concentration was elevated and decreased only mildly after somatostatin administration. Basal serum insulin concentration was high, and the insulin concentration increased considerably after glucose loading, consistent with insulin resistance. CT scanning of the skull showed an enlarged pituitary gland and increased skull bone thickness. The final diagnosis was acromegaly. Relevance and novel information These findings demonstrate that acromegaly should be pursued and suspected in cats other than those with diabetes mellitus.
CompNet: a GUI based tool for comparison of multiple biological interaction networks
Authors: Kuntal Bhusan K. , Dutta Anirban , Mande Sharmila S. 
Published: April 2016

Abstract
Background
Network visualization and analysis tools aid in better understanding of complex biological systems. Furthermore, to understand the differences in behaviour of system(s) under various environmental conditions (e.g. stress, infection), comparing multiple networks becomes necessary. Such comparisons between multiple networks may help in asserting causation and in identifying key components of the studied biological system(s). Although many available network comparison methods exist, which employ techniques like network alignment and querying to compute pair-wise similarity between selected networks, most of them have limited features with respect to interactive visual comparison of multiple networks.

Results
In this paper, we present CompNet - a graphical user interface based network comparison tool, which allows visual comparison of multiple networks based on various network metrics. CompNet allows interactive visualization of the union, intersection and/or complement regions of a selected set of networks. Different visualization features (e.g. pie-nodes, edge-pie matrix, etc.) aid in easy identification of the key nodes/interactions and their significance across the compared networks. The tool also allows one to perform network comparisons on the basis of neighbourhood architecture of constituent nodes and community compositions, a feature particularly useful while analyzing biological networks. To demonstrate the utility of CompNet, we have compared a (time-series) human gene-expression dataset, post-infection by two strains of Mycobacterium tuberculosis, overlaid on the human protein-protein interaction network. Using various functionalities of CompNet not only allowed us to comprehend changes in interaction patterns over the course of infection, but also helped in inferring the probable fates of the host cells upon infection by the two strains.

Conclusions
CompNet is expected to be a valuable visual data mining tool and is freely available for academic use from http://metagenomics.atc.tcs.com/compnet/ or http://121.241.184.233/compnet/