bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expandable vs Static Cages in Transforaminal Lumbar Interbody Fusion: Radiographic Comparison of Segmental and Lumbar Sagittal Angles
Authors: Yee Timothy J. , Joseph Jacob R. , Terman Samuel W. , Park Paul 
Published: March 2017

Abstract

BACKGROUND: One criticism of transforaminal lumbar interbody fusion (TLIF) is the inability to increase segmental lordosis (SL). Expandable interbody cages are a relatively new innovation theorized to allow improvement in SL.

OBJECTIVE: To compare changes in SL and lumbar lordosis (LL) after TLIF with nonexpandable vs expandable cages.

METHODS: We performed a retrospective cohort study of patients who were ≥18 years old and underwent single-level TLIF between 2011 and 2014. Patients were categorized by cage type (static vs expandable). Primary outcome of interest was change in SL and LL from preoperative values to those at 1 month and 1 year postoperatively.

RESULTS: A total of 89 patients were studied (48 nonexpandable group, 41 expandable group). Groups had similar baseline characteristics. For SL, median (interquartile range) improvement was 3° for nonexpandable and 2° for expandable (unadjusted, P = .09; adjusted, P = .68) at 1 month postoperatively, and 3° for nonexpandable and 1° for expandable (unadjusted, P = .41; adjusted, P = .28) at 1 year postoperatively. For LL, median improvement was 1° for nonexpandable and 2° for expandable (unadjusted, P = .20; adjusted, P = .21), and 2° for nonexpandable and 5° for expandable (unadjusted, P = .15; adjusted, P = .51) at 1 year postoperatively. After excluding parallel expandable cages, there was still no difference in SL or LL improvement at 1 month or 1 year postoperatively between static and expandable cages (both unadjusted and adjusted, P > .05).

CONCLUSION: Patients undergoing single-level TLIF experienced similar improvements in SL and LL regardless of whether nonexpandable or expandable cages were placed.
Infections in Hematopoietic Cell Transplant Recipients: Results From the Organ Transplant Infection Project, a Multicenter, Prospective, Cohort Study
Authors: Schuster Mindy G. , Cleveland Angela A. , Dubberke Erik R. , Kauffman Carol A. , Avery Robin K. , Husain Shahid , Paterson David L. , Silveira Fernanda P. , Chiller Tom M. , Benedict Kaitlin , Murphy Kathleen , Pappas Peter G. 
Published: March 2017

Abstract

Background
Infection is a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Our object was to better define the epidemiology and outcomes of infections after HCT.

Methods
This was a prospective, multicenter cohort study of HCT recipients and conducted from 2006 to 2011.
The study included 4 US transplant centers and 444 HCT recipients. Data were prospectively collected for up to 30 months after HCT using a standardized data collection tool.

Results
The median age was 53 years, and median follow up was 413 (range, 5–980) days. The most common reason for HCT was hematologic malignancy (87%). The overall crude mortality was 52%. Death was due to underlying disease in 44% cases and infection in 21%. Bacteremia occurred in 231 (52%) cases and occurred early posttransplant (median day 48). Gram-negative bloodstream infections were less frequent than Gram-positive, but it was associated with higher mortality (45% vs 13%, P = .02). Clostridium difficile infection developed in 148 patients (33%) at a median of 27 days post-HCT. There were 53 invasive fungal infections (IFIs) among 48 patients (11%). The median time to IFI was 142 days. Of 155 patients with cytomegalovirus (CMV) infection, 4% had CMV organ involvement. Varicella zoster infection (VZV) occurred in 13 (4%) cases and was disseminated in 2. Infection with respiratory viruses was seen in 49 patients. Pneumocystis jirovecii pneumonia was rare (1%), and there were no documented cases of nocardiosis, toxoplasmosis, endemic mycoses, or mycobacterial infection. This study lacked standardized antifungal and antiviral prophylactic strategies.

Conclusions
Infection remains a significant cause of morbidity and mortality after HCT. Bacteremias and C difficile infection are frequent, particularly in the early posttransplant period. The rate of IFI is approximately 10%. Organ involvement with CMV is infrequent, as are serious infections with VZV and herpes simplex virus, likely reflecting improved prevention strategies.
Functional Outcomes Post Lisfranc Injury—Transarticular Screws, Dorsal Bridge Plating or Combination Treatment?
Authors: Lau Simon , Guest Catherine , Hall Marcus , Tacey Mark , Joseph Samuel , Oppy Andrew 
Published: March 2017

Objective:
To identify whether transarticular screws, dorsal bridging plates or a combination of the 2 result in the best functional outcome after Lisfranc injury.

Design:
Case series.

Setting:
Level one trauma center.

Patients:
Fifty patients who underwent surgical fixation of Lisfranc injuries over a 6-year period were retrospectively reviewed.

Intervention:
One of 3 treatment arms: transarticular screw fixation alone, dorsal bridge plating alone or a combination of dorsal bridge and transarticular screw fixation.

Main Outcome Measures:
The primary outcome measures were 1 of 2 midfoot scores—the American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score and the Foot Function Index (FFI) Score. Secondary results included postoperative complications.

Results:
Quality anatomical reduction is the best predictor of functional outcomes (FFI—P = 0.008, AOFAS—P = 0.02). Functional outcomes with both FFI and AOFAS scores were not significantly associated with any of the fixation groups (FFI—P = 0.495, AOFAS—P = 0.654) on univariate analysis. Injury type by Myerson classification systems or open versus closed status was also not significantly associated with any fixation group. Open exposures were more likely to result in soft-tissue complications, but there was no significant difference in metalware failure or need for removal.

Conclusion:
Functional outcomes after Lisfranc fractures are most dependant on the quality of anatomical reduction and not the choice of fixation implant used.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Clinical Use and Optimal Cutoff Value of Ca15-3 in Evaluation of Adnexal Mass
Authors: Sagi-Dain Lena , Lavie Ofer , Auslander Ron , Sagi Shlomi 
Published: March 2017

Objective:
To estimate the diagnostic performance and reference values of serum cancer antigen (Ca)15-3 levels in the triage of adnexal masses.

Materials and Methods:
This retrospective cohort study was carried out in 481 patients referred to the Gynecology Department at Carmel Medical Center due to adnexal mass between years 2005 and 2012. All patients underwent surgery with histopathologically confirmed diagnosis and routine preoperative measurements of serum Ca125 and Ca15-3.

Results:
Combination of Ca125 with Ca15-3 elevated the sensitivity of Ca125 alone (from 86.9% to 93.2%; P=0.029), along with reduction of its specificity (from 80.5% to 69.5%; P=0.005) in differentiation between malignant and benign cases. According to receiver operating characteristic curve, Ca15-3 level of 21 U/mL was shown to be the optimal reference value for malignancy detection. All cases with Ca15-3 levels above 44.5 U/mL were malignant, mostly of primary ovarian source.

Conclusions:
As Ca15-3 assessment allowed detection of significantly more malignancy cases, we believe that measurement of this marker in combination with Ca125 is worthwhile in patients presenting with adnexal masses. The cutoff of 21 U/mL seems to be the optimal value in this specific population. High Ca15-3 levels (above 44.5 U/mL) strongly direct to a diagnosis of malignancy, mostly of primary ovarian tumors rather than breast malignancy.
Ethnicity, lipids and cardiovascular disease
Authors: Gazzola Katia , Reeskamp Laurens , van den Born Bert-Jan 
Published: March 2017

Purpose of review
The prevalence of cardiovascular disease differs among ethnic groups and along geographic boundaries. At present, most of the projected increase in mortality from cardiovascular disease occurs in sub-Saharan African, Chinese and Southeast Asian populations. Ethnic disparities in the prevalence of cardiovascular disease coincide with quantitative and qualitative differences in risk factors for cardiovascular disease. High plasma cholesterol is one of the most important preventable causes of ischemic heart disease.

Recent findings
The current review summarizes recent evidence on ethnic differences in ischemic heart disease and its correlates with genetic and acquired differences in plasma lipid and lipoprotein levels. The nature of ethnic differences in plasma lipid levels, apolipoprotein L1 en lipoprotein(a) [Lp(a)] is outlined, and the effects of lipid-lowering therapy and future efforts and challenges regarding implementation are discussed.

Summary
Ethnic differences in HDL-cholesterol (HDL-C), triglyceride levels and Lp(a) may impact ethnic differences in cardiovascular disease and result in higher residual risk during lipid-lowering therapy. Further efforts should be made to stimulate the use of statins in both high-income and low-income countries and study their effects in individuals with different ethnic backgrounds.
Developments in intestinal cholesterol transport and triglyceride absorption
Authors: Paalvast Yared , de Boer Jan Freark , Groen Albert K. 
Published: March 2017

Purpose of review
To discuss recent advances in research focused on intestinal lipid handling.

Recent findings
An important strategy in reducing atherosclerosis and risk of cardiovascular events is to increase the rate of reverse cholesterol transport, including its final step; cholesterol excretion from the body. The rate of removal is determined by a complex interplay between the factors involved in regulation of intestinal cholesterol absorption. One of these factors is a process known as transintestinal cholesterol excretion. This pathway comprises transport of cholesterol directly from the blood, through the enterocyte, into the intestinal lumen. In humans, this pathway accounts for 35% of cholesterol excretion in the feces. Mechanistic studies in mice revealed that, activation of the bile acid receptor farnesoid X receptor increases cholesterol removal via the transintestinal cholesterol excretion pathway as well as decreases plasma cholesterol and triglyceride providing an interesting target for treatment of dyslipidemia in humans. The physical chemical properties of bile acids are under control of farnesoid X receptor and determine intestinal cholesterol and triglyceride solubilization as well as absorption, providing a direct link between these two important factors in the pathogenesis of cardiovascular disease. Besides bile acids, intestinal phospholipids are important for luminal lipid solubilization. Interestingly, phospholipid remodeling through LPCAT3 was shown to be pivotal for uptake of fatty acids by enterocytes, which may provide a mechanistic handle for therapeutic intervention.

Summary
The importance of the intestine in control of cholesterol and triglyceride homeostasis is increasingly recognized. Recently, novel factors involved in regulation of cholesterol excretion and intestinal triglyceride and fatty acid uptake have been reported and are discussed in this short review.
Nursing Interruptions in a Trauma Intensive Care Unit
Authors: Craker Nicole C. , Myers Robert A. , Eid Jessy , Parikh Priti , McCarthy Mary C. , Zink Kathy , Parikh Pratik J. 
Published: March 2017

OBJECTIVE
The aims of this study were to identify and analyze elements that affect duration of an interruption and likelihood of activity switch as experienced by nurses in an ICU.

BACKGROUND
Although interruptions in the ICU impact patient safety, little is known regarding the complex situations that drive them.

METHODS
RNs were observed in a 23-bed surgical ICU. We observed 206 interruptions, and analyzed for duration and activity switch.

RESULTS
RNs were interrupted on the average every 21.8 minutes. Attending physicians/residents caused fewer, but longer, interruptions to the RN. Longer interruptions were more likely to result in an activity switch. During complex situations such as when an RN is documenting, interruptions by a physician led to longer durations. Interruptions by a device led to higher switches.

CONCLUSIONS
A deeper understanding of individual factors and their complex interactions related to interruptions experienced by ICU RNs are vital to understanding the clinical significance of these interruptions and intervention design.
Characteristics of Nurse Directors That Contribute to Registered Nurse Satisfaction
Authors: Burke Debra , Flanagan Jane , Ditomassi Marianne , Hickey Patricia A. 
Published: March 2017

OBJECTIVE
The aim of this study was to explore RNs and nurse directors' (NDs') perceptions of leadership on units with high RN satisfaction scores.

BACKGROUND
Identifying the characteristics of NDs that contribute to RN satisfaction is important in the recruitment and retention of RNs and in the selection and role development of NDs.

METHODS
This study used a qualitative design using appreciative inquiry–guided data collection.

RESULTS
Nine RNs and 9 NDs met the inclusion criteria. Each group identified 4 themes.

CONCLUSIONS
Registered nurse and ND participants identified similar themes representative of leadership attributes and behaviors that contribute to RN satisfaction.
Congenital cytomegalovirus infection: management update
Authors: Khalil Asma , Jones Chrissie , Ville Yves 
Published: March 2017

Purpose of review
Until recently, management options in congenital cytomegalovirus (cCMV) infection have been either conservative or termination of pregnancy. However, medical therapies aimed at reducing the risk of infection and/or its severity have recently been investigated.

Recent findings
In a phase 2 open label, nonrandomized trial, valaciclovir (ValACV) was given to women carrying a CMV-infected fetus. ValACV was associated with a greater proportion of asymptomatic neonates when compared with a historical cohort (82 vs. 43%). However, the study design and the small number of treated women limit its applicability. Even though initial observational data suggested that hyperimmune globulin (HIG) therapy in pregnancy was associated with a significantly lower risk of cCMV, its efficacy has not been borne out in a subsequent phase 2 randomized, placebo controlled, double-blind study [cCMV 30% in the HIG group, 44% in the placebo group (P = 0.13)]. Furthermore, 11% of fetuses in the HIG group had transient or permanent abnormalities, compared with 16% in the placebo group.

Summary
ValACV might have a promising role in the antenatal treatment of cCMV infection, but definitive recommendations require further research. The use of HIG should currently be limited to the research setting.
Video abstract http://links.lww.com/COID/A18.
Dual-energy Computed Tomography for the Evaluation of Enhancement of Pulmonary Nodules≤3 cm in Size
Authors: Reiter Michael J. , Winkler Weston T. , Kagy Kenton E. , Schwope Ryan B. , Lisanti Christopher J. 
Published: March 2017

Purpose:
The aim of the study was to compare the accuracies of 4 different methods of assessing pulmonary nodule enhancement to distinguish benign from malignant solid pulmonary nodules using nondynamic contrast-enhanced dual-energy computed tomography.

Materials and Methods:
Seventy-two patients (mean age, 62 y) underwent dual-energy chest computed tomography 3 minutes after intravenous contrast administration. Each of 118 pulmonary nodules (9±5.9 mm) were evaluated for enhancement by 4 methods: visual assessment, 3-dimensional automated postprocessing measurement tool, manually drawn region of interest with calculated iodine-related attenuation, and measurement of iodine concentration. The optimal cutoff for enhancement was defined as having the largest specificity among all cutoffs while maintaining 100% sensitivity. Accuracy of the methods was assessed with receiver operating characteristic curves.

Results:
Ninety-three of 118 pulmonary nodules were benign (79%). Visual assessment of enhancement had sensitivity and specificity of 100% and 44%, respectively. For the automated 3-dimensional measurement tool, 20 HU was found to be the optimal threshold for defining enhancement, resulting in a specificity of 71% and a sensitivity of 100%, as well as an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.82-0.92). The AUC was 0.79 (95% CI, 0.73-0.85) for the measured enhancement using a manually drawn region of interest. When a threshold of 21 HU was used for defining enhancement, maximum specificity was obtained (56%) while maintaining 100% sensitivity. The AUC for measured iodine concentration was 0.79 (95% CI, 0.77-0.85). At a cutoff iodine concentration of 0.6 mg/mL, the sensitivity was 100% with a specificity of 57%.

Conclusions:
Although use of automated postprocessing had the highest specificity while maintaining 100% sensitivity, there were only minor clinically relevant differences between measurement techniques given that no single technique misclassified a malignant nodule as nonenhancing.
Laparoscopic Anatomic Segment 6 Liver Resection Using the Glissonian Approach
Authors: Choi Hanlim , Han Ho-Seong , Yoon Yoo-Seok , Cho Jai Young , Choi YoungRok , Jang Jae Yool 
Published: March 2017

Introduction:
Laparoscopic liver resection has become important procedure for malignant liver disease. In this report, we describe the relevant technical maneuvers and perioperative outcomes in laparoscopic anatomic segment 6 liver resection using the Glissonian approach.

Patients and Methods:
From March 2003 and October 2015, 7 patients who diagnosed hepatocellular carcinoma had undergone laparoscopic anatomic segment 6 liver resection at the single institution. We performed retrospective analysis of the clinical and perioperative outcomes of these patients.

Results:
All patients were men with mean age of 62.3 years (range, 49 to 73 y). The mean operation time was 352.8 minutes (range, 180 to 435 min) and there was no case of open conversion. The mean estimated blood loss was 521.4 mL (range, 200 to 800 mL) and intraoperative transfusion needed in 1 patient. There was no postoperative morbidity and mortality. The mean postoperative hospital stay was 7.5 days (range, 5 to 12 d). All patients obtained negative resection margins. There was no patient had developed tumor recurrence during a median follow-up period of 43 months (range, 7 to 60.7 mo).

Conclusions:
Laparoscopic anatomic segment 6 liver resection is a feasible operative procedure, being possible even in patients with limited liver function.
A fully automated computer-based ‘Skinner Box’ for testing learning and memory in zebrafish
Authors: Brock Alistair J. , Sudwarts Ari , Daggett Jenny , Parker Matthew O. , Brennan Caroline H. 
Published: March 2017

AbstractZebrafish are an important model species with unparalleled potential to advance understanding of the genetics and neurobiology of behaviour through genetic and pharmacological screening and mutant analysis. However, advances using this species have been limited by the lack of robust, standardised methodology and equipment suitable for assessing adult behaviour. Here we describe a simple, fully automated, computer based, operant system for measuring behaviour in juvenile and adult zebrafish and provide detailed protocols for appetitive and aversive assays to assess cognitive function in adult zebrafish. Applications include the study of cognition in zebrafish (and other similar sized fish species) and in zebrafish models of psychiatric and neurodegenerative diseases (e.g., Alzheimer’s disease, schizophrenia, Huntington’s disease, frontotemporal dementia), and characterisation of the role of select brain regions, neurotransmitter systems and genes in zebrafish. Further, the scalable nature of the system makes the protocols suitable for use in pharmacological and genetic screening programmes.
Neurodesign: Optimal Experimental Designs for Task fMRI
Authors: Durnez Joke , Blair Ross , Poldrack Russell A. 
Published: March 2017

1AbstractA recent stream of alarmist publications has questioned the validity of published neuroimaging findings. As a consequence, fMRI teams worldwide have been encouraged to increase their sample sizes to reach higher power and thus increase the positive predictive value of their findings. However, an often-overlooked factor influencing power is the experimental design: by choosing the appropriate experimental design, the statistical power of a study can be increased within subjects. By optimizing the order and timing of the stimuli, power can be gained at no extra cost. To facilitate design optimization, we created apythonpackage and web-based tool called Neurodesign to maximize the detection power or estimation efficiency within subjects, while controlling for psychological factors such as the predictability of the design. We implemented both a simulation-based optimisation, as well as an optimisation using the genetic algorithm, introduced by Wager and Nichols (2003) and further improved by Kao et al. (2009), to optimize the experimental design. The toolboxNeurodesignallows more complex experimental setups than existing toolboxes, while the GUI provides a more user-friendly experience. The toolbox is accessible online atwww.neuropowertools.org.
On the mechanism of long-range orientational order of fibroblasts
Authors: Li Xuefei , Balagam Rajesh , He Ting-Fang , Lee Peter P. , Igoshin Oleg A. , Levine Herbert 
Published: March 2017

Long-range alignment ordering of fibroblasts have been observed in the vicinity of cancerous tumors and can be recapitulated within vitroexperiments. However, the mechanisms driving their ordering are not understood. Here we show that local collision-driven nematic alignment interactions among fibroblasts are insufficient to explain observed long-range alignment. One possibility is that there exists another orientation field co-evolving with the cells and reinforcing their alignment. We propose that this field reflects the mechanical cross-talk between the fibroblasts and the underlying fibrous material on which they move. We demonstrate that this new long-range interaction can give rise to high nematic order and to the observed patterning of the cancer microenvironment.Significance StatementLong-range alignment patterns of fibroblasts have been observed bothin vivoandin vitro. However, there has not been much understanding of the underlying mechanism. In this work, we demonstrate that these patterns cannot be simply explained by their steric interaction with one another during collisions. Instead, we propose that fibroblasts may collectively align through non-local interactions arising from their modification of an underlying extracellular matrix. The proposed mechanism explains the observed co-alignment between fibroblasts and collagen fibers around tumors and can be be tested in future experiments that can image the dynamics of this pattern formationin vivoorin vitro