bluuebunny/crossref_metadata_2025_split huggingface dataset:
Melanoma Pathology
Authors: Prieto-Granada Carlos , Howe Nicole , McCardle Timothy 
Published: February 2016

Abstract
Melanocytes are neural-crest-derived cells that are vital in the skin homeostasis, being responsible for the protection of the keratinocytes from harmful solar UV radiation via production and transfer of melanin. Normally, melanocytes are located in the basilar layer of the epidermis following a melanocyte-to-keratinocyte ratio of approximately 1:10 with considerable variation, depending on anatomical site and degree of sun exposure. Melanocytic lesions characteristically demonstrate quite protean clinical and pathological presentations and represent a wide spectrum that encompasses an immense variety of patterns, from low-cellularity benign lesions such as lentigo simplex and benign melanocytic nevi, to atypical (dysplastic) melanocytic nevi, and finally to the malignant counterpart: melanoma.
Follow-up Guidelines for Resected Melanoma
Authors: Farma Jeffrey M. , Abdulla Alia 
Published: February 2016

Abstract
Dermatological surveillance can detect potentially curable recurrence, especially resectable locoregional recurrences. Surveillance laboratory tests and chest X-rays can have limited value while producing a relatively high false-positive rate. Lymph node ultrasonography is a valuable imaging modality in patients with equivocal lymphatic nodal basin physical examinations. In early stages of melanoma, the benefit of routine surveillance imaging studies is questionable; however, close surveillance with detailed medical history and physical examination is necessary, with special attention to regional recurrences every three to 12 months, depending on the AJCC stage category and the risk of recurrence. In Stage III or greater, more frequent surveillance in the form of more frequent physical examination, laboratory tests based on symptomatology, and cross-sectional imaging may be indicated because of the higher risk of recurrence in this population. CT, MRI, and/or PET/CT are often components of the overall follow-up for these high-risk patients.
Metastatic Melanoma
Authors: Baksh Kathryn , Kudchadkar Ragini R. 
Published: February 2016

Abstract
Transformation into melanoma is thought to occur due to the accumulation of mutations in growth-regulating genes, the loss of adhesion receptors, and the increase in autocrine and paracrine growth factors; all of which contribute to uncontrolled proliferation promoting the survival of these abnormal cells. In addition, chemotherapy alone has not been able to proven to improve overall survival for patients with this disease. These circumstances set the stage for the exploration into the melanoma genome and the development of novel targeted agents to manipulate the respective molecular pathways. Further understanding of resistance mechanisms will lead to more combination trials, both with other signal transduction inhibitors and with immune therapies.
Management of Mucosal and Ocular Melanoma
Authors: Shoushtari Alexander N. , Carvajal Richard D. 
Published: February 2016

Abstract
Malignant melanomas account for 1–2% of all malignancies, with the vast majority of cases representing cutaneous primary tumors. In 5–10% of cases, however, melanoma arises from mucosal areas, the uveal tract of the eye, or an unknown primary site. Recently, advances in targeted kinase inhibitors and immune therapy have revolutionized the treatment of melanoma. These trials were largely conducted in cutaneous melanoma, however, and there are fewer published data regarding therapy in mucosal and ocular melanomas. Given the increasing knowledge of the distinct molecular changes underlying these various melanoma subtypes, it is increasingly important to understand the distinct epidemiology, presentation, prognosis, and treatment options for these subtypes.
The “Umbrella Sign”: A Useful Clue in the Diagnosis of Melanocytic Lesions in Sun Damaged Skin
Authors: Wood Benjamin A. , Harvey Nathan T. 
Published: February 2016

Abstract:
As ultraviolet radiation is an important aetiological agent in melanoma development, the presence of solar elastosis is an important factor in the assessment of any melanocytic lesion. However, melanocytic naevi are also seen in chronically sun damaged skin, particularly in regions with high levels of ultraviolet exposure and fair skinned populations. It has previously been noted that the relationship of a melanocytic proliferation to elastic fibers in the dermis can be of discriminatory value in the separation of melanoma from melanocytic naevus, in particular, it has been proposed that naevi act as a “sunscreen,” which may result in a histological clue that the authors colloquially refer to in practice as “the umbrella sign.” The aim of this study was to evaluate the patterns of solar elastosis within and beneath melanocytic proliferations developing in sun damaged skin and to determine the utility of the “umbrella sign” in diagnostic practice. We assessed 81 melanocytic proliferations in sun damaged skin for the presence of an umbrella sign, that was present in 49/53 melanocytic naevi (92%) compared with only 2/28 melanomas (7%, P < 0.05). In addition, entrapped elastotic fibers displaying distinct purple discolouration were identified in 16 melanocytic naevi. This finding was not identified in any of the melanomas. The umbrella sign appears to be a useful clue in the distinction of melanoma from melanocytic naevus in sun damaged skin, although as with all histological features in melanocytic pathology, it requires interpretation within a multifactorial assessment cognizant of potential diagnostic pitfalls.
Relationship Between Subfoveal Choroidal Thickness, Ocular Pulse Amplitude, and Intraocular Pressure in Healthy Subjects
Authors: Pekel Gökhan , Acer Semra , Yağci Ramazan , Özdemir Seyfullah , Kaya Hüseyin , Hiraali Mehmet C. , Çetin Ebru N. 
Published: February 2016

Purpose:
To investigate the correlation between subfoveal choroidal thickness (SFCT), ocular pulse amplitude (OPA), and intraocular pressure (IOP) in healthy individuals.

Methods:
In total, 106 eyes of 106 healthy adult participants were included in this cross-sectional study. Spectral-domain optical coherence tomography was used to measure the SFCT. OPA and IOP were measured with the Pascal dynamic contour tonometer. The Pearson correlation test was performed to examine the relationship between SFCT, OPA, and IOP.

Results:
When age, sex, and body mass index (BMI) were controlled separately, a weak correlation occurred between SFCT and OPA (age controlled, r=0.20; sex controlled, r=0.19; BMI controlled, r=0.13). SFCT and OPA were fairly correlated in older age (r=0.33, P=0.02) and low BMI (r=0.33, P=0.02). SFCT and IOP were not correlated statistically significantly (r=0.05, P=0.59).

Conclusion:
There is a weak correlation between SFCT and OPA in healthy individuals when age is controlled. The association becomes stronger in participants with low BMI. There is no relation between SFCT and IOP.
Reduced Incidence of Thromboembolic Events after Surgical Closure of Left Atrial Appendage in Patients with Atrial Fibrillation
Authors: Wilbring Manuel , Jung Friedrich , Weber Christoph , Matschke Klaus , Knaut Michael 
Published: February 2016

Objective Most of the detected thrombi in patients with atrial fibrillation (AF) can be found in the left atrial appendage (LAA). Interventional LAA closure recently proved to be noninferior to warfarin therapy. Whether these results can be fully translated into surgical LAA closure remains unclear. Corresponding data are still lacking. The present observational study evaluated the impact of surgical LAA closure in patients with AF undergoing cardiac surgery on postoperative thromboembolic events. Methods A prospective registry enrolled 398 patients with permanent AF undergoing cardiac surgery. Concomitant procedures were isolated surgical ablation (group I, n = 71), isolated LAA closure (group II, n = 44), and combined surgical ablation and LAA closure (group III, n = 196). The control group consisted of 87 patients without concomitant surgical ablation or LAA closure. One-year follow-up was completed in all patients. End points were thromboembolic events and death from any cause. Results Clinical baseline characteristics were comparable among the groups. General hospital mortality was 5.5% and likewise differed not significantly. Postoperatively, mean (SD) CHAD2S2-VASc score of 3.5 (1.3) differed not significantly among the groups, indicating comparable thromboembolic risk. Follow-up referred to all hospital survivors (n = 376). Herein, overall incidence of thromboembolic events was 9.8% (n = 37), with an associated mortality of 41.0%. Patients with LAA closure alone or in combination with surgical ablation had a significantly reduced incidence of thromboembolic events (6.6% vs 20.5%, P < 0.01) and consecutively improved survival after 1 year of follow-up (7.0% vs 17.1%, P < 0.01). Conclusions Left atrial appendage closure alone or in combination with surgical ablation was associated with a significantly reduced rate of thromboembolic events and consecutively improved survival after 1 year of follow-up.
Human Metapneumovirus
Authors: Koppisetty Shalini , Skrzynski Adam K. , Lauter Carl B. , Sims Matthew D. 
Published: February 2016

Abstract
Human metapneumovirus (hMPV) is an emerging pathogen well known to cause respiratory tract infections in children and adults. It is responsible for approximately 5% to 10% of all hospitalizations of children due to acute respiratory tract infections. The hMPV can cause severe illness in children, immunocompromised persons, and the elderly, which can progress to severe respiratory failure requiring hospitalization and mechanical ventilation. Transmission occurs via contact with contaminated respiratory secretions (droplet, aerosol). The hMPV is rarely known to cause central nervous system complications. Descriptions of this syndrome are limited to case reports, most of which have been in children. Reports suggest that this virus has been linked to diseases of the central nervous system including acute encephalopathy, encephalitis, and febrile seizures. Review of the literature revealed only one confirmed case of hMPV isolated from the cerebrospinal fluid of a patient with concurrent encephalitis. We describe an adult patient with acute meningoencephalitis associated with hMPV, in whom a respiratory virus panel with polymerase chain reaction was positive for hMPV on nasopharyngeal swab, but was negative on the cerebrospinal fluid specimen.
Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations
Authors: Spatz Erica S. , Lipska Kasia J. , Dai Ying , Bao Haikun , Lin Zhenqiu , Parzynski Craig S. , Altaf Faseeha K. , Joyce Erin K. , Montague Julia A. , Ross Joseph S. , Bernheim Susannah M. , Krumholz Harlan M. , Drye Elizabeth E. 
Published: February 2016

Background:
Population-based measures of admissions among patients with chronic conditions are important quality indicators of Accountable Care Organizations (ACOs), yet there are challenges in developing measures that enable fair comparisons among providers.

Methods:
On the basis of consensus standards for outcome measure development and with expert and stakeholder input on methods decisions, we developed and tested 2 models of risk-standardized acute admission rates (RSAARs) for patients with diabetes and heart failure using 2010–2012 Medicare claims data. Model performance was assessed with deviance R
2; score reliability was tested with intraclass correlation coefficient. We estimated RSAARs for 114 Shared Savings Program ACOs in 2012 and we assigned ACOs to 3 performance categories: no different, worse than, and better than the national rate.

Results:
The diabetes and heart failure cohorts included 6.5 and 2.6 million Medicare Fee-For-Service beneficiaries aged 65 years and above, respectively. Risk-adjustment variables were age, comorbidities, and condition-specific severity variables, but not socioeconomic status or other contextual factors. We selected hierarchical negative binomial models with the outcome of acute, unplanned hospital admissions per 100 person-years. For the diabetes and heart failure measures, respectively, the models accounted for 22% and 12% of the deviance in outcomes and score reliability was 0.89 and 0.81. For the diabetes measure, 51 (44.7%) ACOs were no different, 45 (39.5%) were better, and 18 (15.8%) were worse than the national rate. The distribution of performance for the heart failure measure was 61 (53.5%), 37 (32.5%), and 16 (14.0%), respectively.

Conclusion:
Measures of RSAARs for patients with diabetes and heart failure meet criteria for scientific soundness and reveal important variation in quality across ACOs.
Replacing Windows Reduces Childhood Lead Exposure: Results From a State-Funded Program
Authors: Jacobs David E. , Tobin Matthew , Targos Loreen , Clarkson Dale , Dixon Sherry L. , Breysse Jill , Pratap Preethi , Cali Salvatore 
Published: February 2016

Context:
Despite considerable evidence that window replacement reduces childhood lead exposure and improves energy conservation and market value, federal policies in childhood lead poisoning, home improvement, and weatherization programs all tend to discourage it.

Objective and Intervention:
To evaluate a state bond-financed pilot program that replaced old lead-contaminated windows with new lead-free energy efficient ones.

Design and Setting:
Pre-/post evaluation in 1 urban and 1 rural jurisdiction.

Participants:
Low-income households (n = 96).

Main Outcome Measures:
Dust wipe sampling, visual assessment, and physical and mental self-reported health at baseline and 1 year.

Results:
Geometric mean lead dust (PbD) from baseline to 1 year for interior floors, interior sills, and exterior troughs declined by 44%, 88%, and 98%, respectively (P < .001); 1 year later, levels remained well below baseline but rose slightly compared with clearance sampling just after intervention. PbD declined significantly on both sills and troughs in both the urban and rural jurisdictions from baseline to 1 year. On interior floors, PbD significantly declined by 58% (P = .003) in the rural area and 25% (P = .38) in the urban area, where the decline did not reach statistical significance. Households reported improvements in uncomfortable indoor temperatures (P < .001) and certain health outcomes. Economic benefits were estimated at $5 912 219 compared with a cost of $3 451 841, resulting in a net monetary benefit of $2 460 378. Residents reported that they were “very satisfied” with the window replacement work (87%).

Conclusion:
Local and state governments should fund and operate window replacement programs to eliminate a major source of childhood lead exposure, improve energy bills, increase home market value, and create local construction and industrial jobs. Federal agencies should encourage (not discourage) replacement of old windows contaminated with lead. In budget climates such as Illinois with reduced public expenditures, making wise investments such as lead-safe window replacement is more important than ever.
Multisector Health Policy Networks in 15 Large US Cities
Authors: Harris Jenine K. , Leider J. P. , Carothers Bobbi J. , Castrucci Brian C. , Hearne Shelley 
Published: February 2016

Context:
Local health departments (LHDs) have historically not prioritized policy development, although it is one of the 3 core areas they address. One strategy that may influence policy in LHD jurisdictions is the formation of partnerships across sectors to work together on local public health policy.

Design:
We used a network approach to examine LHD local health policy partnerships across 15 large cities from the Big Cities Health Coalition.

Setting/Participants:
We surveyed the health departments and their partners about their working relationships in 5 policy areas: core local funding, tobacco control, obesity and chronic disease, violence and injury prevention, and infant mortality.

Outcome Measures:
Drawing on prior literature linking network structures with performance, we examined network density, transitivity, centralization and centrality, member diversity, and assortativity of ties.

Results:
Networks included an average of 21.8 organizations. Nonprofits and government agencies made up the largest proportions of the networks, with 28.8% and 21.7% of network members, whereas for-profits and foundations made up the smallest proportions in all of the networks, with just 1.2% and 2.4% on average. Mean values of density, transitivity, diversity, assortativity, centralization, and centrality showed similarity across policy areas and most LHDs. The tobacco control and obesity/chronic disease networks were densest and most diverse, whereas the infant mortality policy networks were the most centralized and had the highest assortativity. Core local funding policy networks had lower scores than other policy area networks by most network measures.

Conclusion:
Urban LHDs partner with organizations from diverse sectors to conduct local public health policy work. Network structures are similar across policy areas jurisdictions. Obesity and chronic disease, tobacco control, and infant mortality networks had structures consistent with higher performing networks, whereas core local funding networks had structures consistent with lower performing networks.
Empiric TB Treatment of Severely Ill Patients With HIV and Presumed Pulmonary TB Improves Survival
Authors: Katagira Winceslaus , Walter Nicholas D. , Den Boon Saskia , Kalema Nelson , Ayakaka Irene , Vittinghoff Eric , Worodria William , Cattamanchi Adithya , Huang Laurence , Davis John Lucian 
Published: February 2016

Rationale:
In 2007, World Health Organization (WHO) issued emergency recommendations on empiric treatment of sputum acid-fast bacillus smear-negative patients with possible tuberculosis (TB) in HIV-prevalent areas, and called for operational research to evaluate their effectiveness. We sought to determine if early, empiric TB treatment of possible TB patients with abnormal chest radiography or severe illness as suggested by the 2007 WHO guidelines, is associated with improved survival.

Methods:
We prospectively enrolled consecutive HIV-seropositive inpatients at Mulago Hospital in Kampala, Uganda, from 2007 to 2011 with cough for ≥2 weeks. We retrospectively examined the effect of empiric TB treatment before discharge on 8-week survival among those with and without a WHO-defined “danger sign,” including fever >39°C, tachycardia >120 beats per minute, or tachypnea >30 breaths per minute. We modeled the interaction between empiric TB treatment and danger signs, and their combined effect on 8-week survival, and adjusted for relevant covariates.

Results:
Among 631 sputum smear-negative patients, 322 (51%) had danger signs. Cumulative 8-week survival of patients with danger signs was significantly higher with empiric TB treatment (80%) than without treatment (64%, P < 0.001). After adjusting for duration of cough and concurrent hypoxemia, patients with danger signs who received empiric TB treatment had a 44% reduction in 8-week mortality (risk ratio 0.56, 95% confidence interval: 0.34–0.91, P = 0.020).

Conclusions:
Empiric TB treatment of HIV-seropositive, smear-negative, presumed pulmonary TB patients with 1 or more danger signs is associated with improved 8-week survival. Enhanced implementation of the 2007 WHO empiric treatment recommendations should be encouraged whenever and wherever rapid and highly sensitive diagnostic tests for TB are unavailable.
Cognitive Effects of Bifrontal Versus Right Unilateral Electroconvulsive Therapy in the Treatment of Major Depression in Elderly Patients
Authors: Dybedal Gro Strømnes , Bjølseth Tor Magne , Benth Jūratė Šaltytė , Tanum Lars 
Published: February 2016

Objectives
Bifrontal (BF) electrode placement has been explored to refine the electroconvulsive therapy (ECT) technique. No previous study has compared the cognitive effects of BF versus right unilateral (RUL) ECT by only including the subgroup that is most likely to receive it: elderly patients with major depression.

Methods
Nondemented patients (n = 65) with major depression, aged 60 to 85 years, were randomly allocated to BF ECT and RUL formula-based ECT. Cognitive function was assessed at baseline (T1), within 1 week after a course of ECT (T2), and 3 months after T2 (T3). Six neuropsychological test measures of memory, 5 of executive function, and 3 of information-processing speed were administered.

Results
According to linear mixed models, there were no significant differences between the BF and RUL groups at any time. The retrograde memory score for public facts declined more for the RUL group (P < 0.001) than the BF group (P = 0.005) from baseline to the first retest and remained stable for both groups from T2 to T3. A rapid improvement in selective attention was observed in the RUL group from T1 to T2, but the scores remained stable from T2 to T3 (P < 0.001). This measure remained stable in the BF group from T1 to T3.

Conclusions
Our findings indicate that there were negligible differences in the cognitive effects of formula-based BF or RUL ECT. The overall cognitive effects of ECT were equally favorable for each of the groups.
Factors driving sustainable choice: the case of wine
Authors: Sogari Giovanni , Mora Cristina , Menozzi Davide 
Published: February 2016

Purpose
– The purpose of this paper is twofold: first, to explore the concept of consumers’ perception of sustainable wine and second, to investigate different clusters based on three factors identified (belief about environmental protection, beliefs about sustainable wine certification and attitude towards sustainable-labelled wine) and willingness to pay (WTP). Then, socio-demographic characteristics have been considered to assess whether group’s composition differ considerably.

Design/methodology/approach
– After preliminary literature review and qualitative analysis through focus groups, data were collected with a web-based questionnaire from 495 Italian wine drinkers. Factor analysis and cluster analysis were carried out using SPSS (21.0) statistical software packages.

Findings
– The cluster analysis based on the three factors identified confirms the presence of different segments of consumers. Four groups were identified and named: Well-disposed; Not interested; Skeptical; Adverse. Cluster analysis confirms that consumers with positive attitude towards sustainable wine and higher beliefs of environmental protection (Cluster 1 and 3) have higher WTP for sustainable wine.

Research limitations/implications
– One important limitation in the authors study occurred, considering that consumer’s answers in a hypothetical environment might not actually reflect the purchase behaviour of consumers in a real situation.

Practical implications
– These findings suggest that companies, which are implementing sustainability programmes, should understand what type of consumers value positively the presence of a sustainable claim on the label of a bottle.

Originality/value
– The work adds to the literature on wine marketing by evaluating how belief about environmental protection and sustainable wine certification, and attitude towards sustainable wine segment consumers in different groups. Eliciting WTP via hypothetical situation give us a better understanding of these clusters.