bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Human Papillomavirus Infection and Cervical Cancer Screening among Riverside Women of the Brazilian Amazon
Authors: Duarte Daniel Valim , Vieira Rodrigo Covre , Brito Elza Baía de , Pinheiro Maria da Conceição Nascimento , Monteiro Jeniffer do Socorro Valente , Valente Mário Diego Rocha , Ishikawa Edna Aoba Yassui , Fuzii Hellen Thais , Sousa Maísa Silva de 
Published: June 2017

Purpose The aim of this study was to evaluate the overall and type-specific prevalence of human papillomavirus (HPV) infection among females living in riverside communities in the state of Pará, in the Eastern Brazilian Amazon. These communities are inhabited by low-income people, and are accessible only by small boats. Cervical cytology and risk factors for HPV infection were also assessed.
Methods Cervical samples from 353 women of selected communities were collected both for Papanicolau (Pap) test and HPV detection. Conventional polymerase chain reaction (PCR) and real-time PCR were used to assess the overall and type-specific prevalence of HPV-16 and HPV-18, the main oncogenic types worldwide. Epidemiological questionnaires were used for the assessment of the risk factors for HPV infection.
Results The mean age of the participants was 37 years (standard deviation [SD] ± 13.7). Most were married or with a fixed sexual partner (79%), and had a low educational level (80%) and family monthly income (< U$ 250; 53%). Overall, HPV prevalence was 16.4% (n = 58), with 8 cases of HPV-16 (2.3%) and 5 of HPV-18 (1.4%). Almost 70% of the women surveyed had never undergone the Pap test. Abnormal cytology results were found in 27.5% (n = 97) of the samples, with higher rates of HPV infection according to the severity of the lesions (p = 0.026).
Conclusions The infections by HPV-16 and HPV-18 were not predominant in our study, despite the high prevalence of overall HPV infection. Nevertheless, the oncogenic potential of these types and the low coverage of the Pap test among women from riverside communities demonstrate a potential risk for the development of cervical lesions and their progression to cervical cancer, since the access to these communities is difficult and, in most cases, these women do not have access to primary care and public health services.
Distinct Pattern of Metastases in Patients with Invasive Lobular Carcinoma of the Breast
Authors: Mathew Aju , Rajagopal Padma , Villgran Vipin , Sandhu Gurprataap , Jankowitz Rachel , Jacob Mini , Rosenzweig Margaret , Oesterreich Steffi , Brufsky Adam 
Published: June 2017

Abstract
Background Invasive lobular carcinoma (ILC) comprises around 10 – 15% of invasive breast cancers. Few prior studies have demonstrated a unique pattern of metastases between ILC and the more common invasive ductal carcinoma (IDC). To our knowledge, such data is limited to first sites of distant recurrence. We aimed to perform a comparison of the metastatic pattern of ILC and IDC at first distant recurrence as well as over the entire course of metastatic disease.
Methods We used a prospectively collated database of patients with metastatic breast cancer. Breast cancer recurrence or metastases were classified into various sites and a descriptive analysis was performed.
Results Among 761 patients, 88 (11.6%) were diagnosed with ILC and 673 (88.4%) with IDC. Patients with ILC showed more frequent metastases to the bone (56.8 vs. 37.7%, p = 0.001) and gastrointestinal (GI) tract (5.7 vs. 0.3%, p < 0.001) as first site of distant recurrence, and less to organs such as lung (5.7 vs. 24.2%, p < 0.001) and liver (4.6 vs. 11.4%, p = 0.049). Over the entire course of metastatic disease, more patients with ILC had ovarian (5.7 vs. 2.1%, p = 0.042) and GI tract metastases (8.0 vs. 0.6%, p < 0.001), also demonstrating reduced tendency to metastasize to the liver (20.5 vs. 49.0%, p < 0.001) and lung (23.9 vs. 51.9%, p < 0.001). All associations but bone held after sensitivity analysis on hormonal status. Although patients presenting with ILC were noted to have more advanced stage at presentation, recurrence-free survival in these patients was increased (4.8 years vs. 3.2 years, p = 0.017). However, overall survival was not (2.5 vs. 2.0 years, p = 0.75).
Conclusion After accounting for hormone receptor status, patients with IDC had greater lung/pleura and liver involvement, while patients with ILC had a greater propensity to develop ovarian and GI metastases both at first site and overall. Clinicians can use this information to provide more directed screening for metastases; it also adds to the argument that these two variants of breast cancer should be managed as unique diseases.
Röntgenkriterien - Der mechanische Dünndarm-Ileus
Authors: Klein Sandra , Amort Kerstin , Tellhelm Bernd , Kramer Martin 
Published: June 2017

In dieser Serie werden Ihnen spezifische Details zur Röntgenanatomie präsentiert und/oder Röntgenbefunde, die als wesentliche differenzialdiagnostische Kriterien bei der Diagnose einer spezifischen Erkrankung herangezogen werden können. In dieser Folge geht es um Ileus-Kriterien.Der Ileus wird im Folgenden anhand ausgewählter Röntgenbilder besprochen. Die Röntgenzeichen können vielfältige weitere Ursachen haben.
Tributary Use by Imperiled Flannelmouth and Bluehead Suckers in the Upper Colorado River Basin
Authors: Fraser Gregory S. , Winkelman Dana L. , Bestgen Kevin R. , Thompson Kevin G. 
Published: June 2017

AbstractHabitat alterations and establishment of nonnative fishes have reduced the distributions of Flannelmouth Sucker Catostomus latipinnis and Bluehead Sucker C. discobolus to less than 50% of their historical ranges in the Colorado River basin. Tributaries are sometimes less altered than main‐stem habitat in the basin and may be important to support various life history processes, but their role in the maintenance of Flannelmouth Sucker and Bluehead Sucker populations is poorly understood. Using mark–recapture techniques, we show tributaries are important habitat for native suckers in the upper Colorado River basin and report three main findings. First, both Flannelmouth and Bluehead suckers likely respond to a thermal cue that initiates spawning movement patterns. Suckers moved into Coal Creek from the White River beginning in mid‐May of 2012 and 2013 to spawn. The majority of sucker spawning movements occurred when water temperatures in White River exceeded 11–14°C and those in Coal Creek were 2.5–4°C warmer, while flows varied between years. Second, based on PIT tag detection arrays, 13–45% of suckers showed spawning site fidelity. Sampling only with fyke nets would have resulted in the conclusion that site fidelity by native suckers was only 1–17%, because nets were less efficient at detecting marked fish. Third, most suckers of both species emigrated from Coal Creek within 48 h after being captured while suckers that were detected only via arrays remained resident for 10–12 d. The posthandling flight response we observed was not anticipated and to our knowledge has not been previously reported for these species. Remote PIT tag antenna arrays allowed for a stronger inference regarding movement and tributary use by these species than what could be achieved using just fyke nets. Tributaries are an important part of Flannelmouth Sucker and Bluehead Sucker life history and thus important to conservation strategies for these species.Received October 7, 2016; accepted March 20, 2017 Published online June 28, 2017
Loss and Lived Memory at the Moore’s Ford Lynching Reenactment
Authors: Eatman Megan 
Published: June 2017

ABSTRACT
Each year, members of the Moore’s Ford Movement conduct a memorial rally for and reenactment of a lynching that took place in 1946 near Monroe, Georgia. While a lynching memorial that includes a reenactment may sound suspect, particularly because lynching reenactments play a role in white supremacist activities, the Moore’s Ford Memorial’s unusual form offers affordances that other lynching memorials do not. This article argues that the memorial’s simultaneous attachment to and critique of necessarily inadequate traces of the past raise questions about what it means to remember violence in situ. Most lynching memorial rhetoric revolves around the narrow archive of lynching photographs produced, for the most part, by lynchers themselves. Through its combination of archival and lived memory, the Moore’s Ford Memorial both tells a broader story and draws attention to the archive’s inability to capture all that was lost. In dwelling in the gap between past and present, the memorial creates a generative space for community action.
Remembering Emmett Till: Reflections on Geography, Race, and Memory
Authors: Tell Dave 
Published: June 2017

ABSTRACTThis essay uses the commemoration of Emmett Till in the Mississippi Delta to explore the connections among race, geography, and memory. I provide four examples of how race and memory have conspired to fundamentally alter the geography of the Delta. I suggest that these four examples challenge the historic articulation of memory and site. While site is traditionally figured as a stable ground for commemorative work, I suggest that practices of commemoration can transform sites of memory. I conclude by previewing a collaborative, digital, public humanities initiative called the Emmett Till Memory Project. The project seeks to commemorate Till’s murder even as it alters the meaning and practice of commemoration.
Optimization of therapy against Pseudomonas aeruginosa with ceftazidime and meropenem using chemostats as model for infections
Authors: Feng Yanfang , Bakker Roosmarijn T , van Hest Reinier M , Hodiamont Caspar J , Brul Stanley , Schultsz Constance , ter Kuile Benno H 
Published: June 2017

Abstract
Pseudomonas aeruginosa is an opportunistic pathogen that can cause life-threatening infections in patients admitted to intensive care units. Resistance rapidly develops against two drugs of choice: ceftazidime and meropenem. Several therapeutic protocols were compared for reduction in viable cells and limiting development of resistance. Chemostat cultures were exposed to antibiotic concentrations measured in the blood of patients at low (5th percentile), medium (50th percentile) or high (95th percentile) levels in several therapy protocols to simulate therapy. Cultures exposed to ceftazidime recovered after 1 day at low, 2 days at medium and 3 days at high concentrations and developed corresponding levels of resistance. Patterns were very similar for meropenem except that recovery was delayed. Fluctuating levels and intermittent treatment achieved similar reduction of cell numbers at lower resistance costs. Treatment alternating ceftazidime and meropenem reduced cell numbers more than monotherapy, while strongly limiting resistance. Combination therapy was even more effective in both respects. Therapeutic goals are best reached with least risk of resistance when ceftazidime and meropenem are used in combination or alternating, at the highest concentrations the patient can endure. Monotherapy should also apply the highest concentration that is safe for the shortest time that achieves treatment objectives.
GAVCA Study: Randomized, Multicenter Trial to Evaluate the Quality of Ventricular Catheter Placement with a Mobile Health Assisted Guidance Technique
Authors: Thomale Ulrich-Wilhelm , Schaumann Andreas , Stockhammer Florian , Giese Henrik , Schuster Dhani , Kästner Stefanie , Ahmadi Alexander Sebastian , Polemikos Manolis , Bock Hans-Christoph , Gölz Leonie , Lemcke Johannes , Hermann Elvis , Schuhmann Martin U , Beez Thomas , Fritsch Michael , Orakcioglu Berk , Vajkoczy Peter , Rohde Veit , Bohner Georg 
Published: June 2017

Abstract

BACKGROUND
Freehand ventricular catheter placement may represent limited accuracy for the surgeon's intent to achieve primary optimal catheter position.

OBJECTIVE
To investigate the accuracy of a ventricular catheter guide assisted by a simple mobile health application (mhealth app) in a multicenter, randomized, controlled, simple blinded study (GAVCA study).

METHODS
In total, 139 eligible patients were enrolled in 9 centers. Catheter placement was evaluated by 3 different components: number of ventricular cannulation attempts, a grading scale, and the anatomical position of the catheter tip. The primary endpoint was the rate of primary cannulation of grade I catheter position in the ipsilateral ventricle. The secondary endpoints were rate of intraventricular position of the catheter's perforations, early ventricular catheter failure, and complications.

RESULTS
The primary endpoint was reached in 70% of the guided group vs 56.5% (freehand group; odds ratio 1.79, 95% confidence interval 0.89-3.61). The primary successful puncture rate was 100% vs 91.3% (P = .012). Catheter perforations were located completely inside the ventricle in 81.4% (guided group) and 65.2% (freehand group; odds ratio 2.34, 95% confidence interval 1.07-5.1). No differences occurred in early ventricular catheter failure, complication rate, duration of surgery, or hospital stay.

CONCLUSION
The guided ventricular catheter application proved to be a safe and simple method. The primary endpoint revealed a nonsignificant improvement of optimal catheter placement among the groups. Long-term follow-up is necessary in order to evaluate differences in catheter survival among shunted patients.
A Free-Market Approach to the Match: A Proposal Whose Time Has Not Yet Come
Authors: Arnold Louise , Sullivan Christine , Okah Felix A. 
Published: June 2017

The authors respond to a proposal in this issue of Academic Medicine by Ray, Bishop, and Dow, who recommend adopting a free-market approach to the Match in which applicants and programs negotiate directly with each other to find and fill residency positions year-round. This Invited Commentary examines and responds to the reasons Ray and colleagues give for changing the Match and explores their proposal’s implications and likelihood of success.
The authors question Ray and colleagues’ argument that assumptions underlying the National Resident Matching Program algorithm have been violated. The authors suggest there is insufficient evidence for the “July effect” and that the possibility for improvement in physician supply due to the year-round entry of graduates into the workforce ultimately faces the rate-limiting step of caps on residency positions allocated to programs. Most important, competency-based medical education, on which the free-market proposal depends, is not yet sufficiently developed.
Nonetheless, the imbalanced ratio of applicants to positions in the Match is contributing to a rise in the numbers of student applications and program interviews. Although the proposed free-market approach might, as Ray and colleagues envision, curtail applications as well as reduce time and financial resources currently expended on the process, it would require significant changes on the part of applicants, residency programs, medical schools, and other stakeholders.
Because the proposed free-market approach could reduce some negative effects of the imbalance of applicants and positions, it merits ongoing discussion along with other more immediate practical solutions to issues with the Match.
Musculoskeletal manifestations of systemic lupus erythmatosus
Authors: Mahmoud Khaled , Zayat Ahmed , Vital Edward M. 
Published: June 2017

Purpose of review
Imaging studies suggest potential changes to the classification and assessment of inflammatory musculoskeletal lupus. This is important because of the burden of disease but the potential for new targeted therapies.

Recent findings
Using our current classification and treatment, musculoskeletal symptoms continue to impact significantly on quality of life and work disability. Ultrasound and MRI studies suggested that new approaches to the diagnosis, classification, and evaluation of these symptoms are needed. Many patients with pain but no synovitis have ultrasound-proven joint and tendon inflammation but would not qualify for clinical trials or score highly on disease activity instruments. MRI studies show that erosions are more common than previously thought and may have a different pathogenesis than RA. Immunology studies suggest differences from other autoimmune synovitis, with a complex role for type I interferons. A wide range of biologic therapies appear more consistently effective for arthritis than some other manifestations.

Summary
Changes to the selection of patients for therapy and stratification using musculoskeletal imaging may offer new approaches to clinical trials and the routine care of systemic lupus erythematosus patients with inflammatory musculoskeletal symptoms. Outcomes may thereby be improved using existing therapies. There are significant knowledge gaps that must be addressed to achieve these potential improved outcomes.
Do Occupational Risks for Low Back Pain Differ From Risks for Specific Lumbar Disc Diseases?
Authors: Bergmann Annekatrin , Bolm-Audorff Ulrich , Ditchen Dirk , Ellegast Rolf , Grifka Joachim , Haerting Johannes , Hofmann Friedrich , Jäger Matthias , Linhardt Oliver , Luttmann Alwin , Meisel Hans Jörg , Michaelis Martina , Petereit-Haack Gabriela , Schumann Barbara , Seidler Andreas 
Published: June 2017

Study Design.
A multicenter, population based, case-control study.

Objective.
The aim of the present analysis is to clarify potential differences in the “occupational risk profiles” of structural lumbar disc diseases on the one hand, and low back pain (LBP) on the other hand.

Summary of Background Data.
Physical workplace factors seem to play an important etiological role.

Methods.
We recruited 901 patients with structural lumbar disc diseases (disc herniation or severe disc space narrowing) and 233 control subjects with “low-back-pain.” Both groups were compared with 422 “low-back pain free” control subjects. Case history, pain data, neurological deficits, and movement restrictions were documented. LBP was recorded by the Nordic questionnaire on musculoskeletal symptoms. All magnetic resonance imaging, computed tomography, and X-rays were inspected by an independent study radiologist. The calculation of cumulative physical workload was based on a computer-assisted interview and a biomechanical analysis by 3-D-dynamic simulation tool. Occupational exposures were documented for the whole working life.

Results.
We found a positive dose-response relationship between cumulative lumbar load and LBP among men, but not among women. Physical occupational risks for structural lumbar disc diseases [odds ratio (OR) 3.7; 95% confidence interval (95% CI) 2.3–6.0] are higher than for LBP (OR 1.9; 95% CI 1.0–3.5).

Conclusion.
Our finding points to potentially different etiological pathways in the heterogeneous disease group of LBP. Results suggest that not all of the structural disc damage arising from physical workload leads to LBP.

Level of Evidence: 4
Radiographic Analysis of Psoas Morphology and its Association With Neurovascular Structures at L4-5 With Reference to Lateral Approaches
Authors: Louie Philip K. , Narain Ankur S. , Hijji Fady Y. , Yacob Alem , Yom Kelly H. , Phillips Frank M. , Singh Kern 
Published: June 2017

Study Design.
Retrospective imaging review.

Objective.
Utilize magnetic resonance imaging (MRI) to expand the anatomical description of psoas morphology and its association with neurovascular structures at L4-5.

Summary of Background Data.
Anatomical psoas muscle variants may present a greater risk of neurovascular injury at the L4-5 level during lateral transpsoas approaches.

Methods.
Axial L4-5 sections of consecutive patients who obtained lumbar MRIs were analyzed. Teardrop psoas morphology was assessed qualitatively. MRI described psoas morphology and proximity of neurovascular structures, whereas plain radiographs were evaluated for lumbosacral transitional vertebrae (LSTV). Teardrop morphology was tested for associations with radiographic measurements using t tests and χ

2
analysis.

Results.
Fifty teardrop and 476 nonteardrop psoas muscles were identified. Teardrop morphology was associated with greater longitudinal length (53.1 vs. 49.3 mm, P = 0.012), and shorter transverse length (34.9 vs. 44.8 mm, P < 0.001) compared with nonteardrop. Teardrop morphology was associated with anterior and lateral migration of the psoas with greater distance between the anterior borders of the psoas and disc (13.5 vs. 6.3 mm, P < 0.001), and greater distance between the medial border of the psoas to the lateral disc border (1.6 vs. 0.5 mm, P < 0.001). Teardrop morphology was associated with a higher incidence of the lumbar plexus migrating anteriorly adjacent to the middle-third of the disc (43.4% vs. 17.6%, P < 0.001) and the iliac vasculature being more laterally and posteriorly located, adjacent to the anterior-third of the disc (43.4% vs. 30.0%, P = 0.047). Teardrop morphology was not associated with presence of LSTV (3.8% vs. 7.6%, P = 0.306).

Conclusion.
The current study provides detailed metrics of teardrop psoas muscles and surrounding structures. The study confirms that the presence of teardrop anatomy on L4-5 axial imaging is associated with anterior migration of the lumbar plexus and posterolateral migration of the iliac vasculature which may increase the risk of neurovascular injury during direct and oblique-lateral lumbar spine procedures.

Level of Evidence: 3
The Impact of Mortality on Total Costs Within the ICU
Authors: Kramer Andrew A. , Dasta Joseph F. , Kane-Gill Sandra L. 
Published: June 2017

Objectives:
The high cost of critical care has engendered research into identifying influential factors. However, existing studies have not considered patient vital status at ICU discharge. This study sought to determine the effect of mortality upon the total cost of an ICU stay.

Design:
Retrospective cohort study.

Setting:
Twenty-six ICUs at 13 hospitals in the United States.

Patients:
58,344 admissions from January 1, 2012, to June 30, 2016, obtained from a commercial ICU database.

Interventions:
None.

Measurements and Main Results:
The median observed cost of a unit stay was $9,619 (mean = $16,353). A multivariable regression model was developed on the log of total costs for a unit stay, using severity of illness, unit admitting diagnosis, mortality in the unit, daily unit occupancy (occupying a bed at midnight), and length of mechanical ventilation. This model had an r
2 of 0.67 and a median difference between observed and expected costs of $437. The first few days of care and the first day receiving mechanical ventilation had the largest effect on total costs. Patients dying before unit discharge had 12.4% greater costs than survivors (p < 0.01; 99% CI = 9.3–15.5%) after multivariable adjustment. This effect was most pronounced for patients with an extended ICU stay who were receiving mechanical ventilation.

Conclusions:
While the largest drivers of ICU costs at the patient level are day 1 room occupancy and day 1 mechanical ventilation, mortality before unit discharge is associated with substantially higher costs. The increase was most evident for patients with an extended ICU stay who were receiving mechanical ventilation. Studies evaluating costs among ICUs need to take mortality into account.