bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recruiting Faculty Leaders at U.S. Medical Schools: A Process Without Improvement?
Authors: Marsh James D. , Chod Ronald 
Published: May 2017

Recruiting faculty leaders to work in colleges of medicine is a ubiquitous, time-consuming, costly activity. Little quantitative information is available about contemporary leadership recruiting processes and outcomes. In this article, the authors examine current recruiting methods and outcomes in colleges of medicine and compare academic search approaches with the approaches often employed in intellectual-capital-rich industries.
In 2015, the authors surveyed chairs of internal medicine at U.S. medical schools regarding their recruiting practices and outcomes—specifically their selection methods, the duration of searches, the recruitment of women and minorities underrepresented in medicine (URM), and their satisfaction with search outcomes.
The authors found that department chairs were extensively engaged in numerous searches for leaders. The recruitment process most commonly required 7 to 12 months from initiation to signed contract. Interestingly, longer searches (19+ months) were much more frequently associated with a recruitment outcome that chairs viewed as unsatisfactory or very unsatisfactory. Most leadership searches produced very few women and URM finalists. The biggest perceived hurdles to successful recruitment were the need to relocate the candidate and family and the shortage of good candidates.
The process of recruiting leaders in academic medicine has changed little in more than 25 years. Process improvement is important and should entail carefully structured search processes, including both an overhaul of search committees and further emphasis on leadership development within the college of medicine. The authors propose specific steps to enhance recruitment of members of URM groups and women to leadership positions in academic medicine.
Radial Neck Dilatory Remodeling After Radial Head Arthroplasty With an Uncemented, Press Fit, Fully Chemically Etched Stem Design
Authors: Sullivan Matthew P. , Firoozabadi Reza , Kennedy Stephen A. , Agel Julie , Magnusson Eric , Schiffman Brett , Folchert Matthew , Beingessner Daphne 
Published: May 2017

Objectives:
To compare the radiographic outcomes of 2 widely used side loading, press fit, RHA implants used to reconstruct complex elbow trauma.

Design:
Retrospective cohort study.

Setting:
Level-1 Academic trauma center.

Participants:
Patients undergoing RHA.

Intervention:
Cohort 1 received Synthes Radial Head Prosthesis. Cohort 2 received Biomet ExploR Radial Head Replacement.

Main Outcome Measurements:
Radial neck dilatory remodeling.

Results:
Eighty-two subjects were included in final analysis, 63 from the Biomet Cohort, and 19 from Synthes cohort. Demographic and injury characteristics were similar among cohorts. Radial neck dilatory remodeling as well as periprosthetic radiographic lucency were seen significantly more frequently and to a significantly greater degree in the Synthes cohort. The average percentage of dilatory remodeling of the Synthes cohort was 34.9% and that of the Biomet cohort was 2.7%. There were no differences in rates of revision surgery.

Conclusions:
Our study demonstrates significant radiographic differences between 2 frequently used RHA implants. Radial neck dilatory remodeling is a common, rapidly progressive, and dramatic finding frequently seen with the Synthes Radial Head Prosthesis.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Incidence of Delayed Diagnosis of Orthopaedic Injury in Pediatric Trauma Patients
Authors: Podolnick Jeremy D. , Donovan Daniel S. , Atanda Alfred W. 
Published: May 2017

Objective:
Determine the incidence of the delayed diagnosis of orthopaedic injuries in pediatric trauma patients.

Design:
Cross-sectional retrospective analysis.

Setting:
Level I pediatric trauma center.

Patients/Participants:
All patients with an orthopaedic consultation after a trauma activation with a diagnosis of fracture, dislocation, traumatic arthrotomy, neurovascular injury, amputation, and tendon or ligament injury requiring intervention. A total of 1009 trauma codes and alerts occurred during the study period, of which 196 patients were diagnosed with an orthopaedic injury.

Intervention:
Charts were reviewed to obtain demographic information, time of presentation, Glasgow Coma Score (GCS) on presentation, injury severity score (ISS), mechanism of injury, intubation status, length of intensive care unit and hospital stay, primary and secondary survey diagnoses, discharge diagnoses, time of additional diagnoses, and reason for delayed diagnosis.

Main Outcome Measures:
Incidence of delayed diagnosis of injury (DDI).

Results:
There were 196 patients with a confirmed orthopaedic injury, of which, 18 were classified as a delayed diagnosis (9.18%). The mean time to detection of injury was 77.46 hours and the mean patient age was 132.22 months. One of the 18 patients required surgical intervention while the rest were treated conservatively. The mean GCS score of patients with a DDI were significantly lower than patients without a missed injury, 12 versus 14.19 (P = 0.0009). The median ISS, 21 versus 9 (P = 0.0021), and median hospital length of stay, 4 days versus 3 days (P = 0.0369) were significantly higher for patients with a missed injury compared with those without a missed injury. The intensive care unit length of stay approached significance with a median of 2 days for patients with a missed injury versus 1 day for patients without a missed injury (P = 0.057).

Conclusions:
In our study, factors that were associated with a DDI included lower GCS, higher ISS, and greater hospital length of stay. There was only 1 missed injury that required surgical intervention, and the remainder were treated conservatively. The initial evaluation of the trauma patient is able to detect life-threatening injuries, but the tertiary survey remains an important part of patient care to detect missed injuries.

Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Sepsis-Associated 30-Day Risk-Standardized Readmissions: Analysis of a Nationwide Medicare Sample*
Authors: Norman Brett C. , Cooke Colin R. , Ely E. Wes , Graves John A. 
Published: May 2017

Objectives:
To determine national readmission rates among sepsis survivors, variations in rates between hospitals, and determine whether measures of quality correlate with performance on sepsis readmissions.

Design:
Cross-sectional study of sepsis readmissions between 2008 and 2011 in the Medicare fee-for-service database.

Setting:
Acute care, Medicare participating hospitals from 2008 to 2011.

Patients:
Septic patients as identified by International Classification of Diseases, Ninth Revision codes using the Angus method.

Interventions:
None.

Measurements and Main Results:
We generated hospital-level, risk-standardized, 30-day readmission rates among survivors of sepsis and compared rates across region, ownership, teaching status, sepsis volume, hospital size, and proportion of underserved patients. We examined the relationship between risk-standardized readmission rates and hospital-level composite measures of quality and mortality. From 633,407 hospitalizations among 3,315 hospitals from 2008 to 2011, median risk-standardized readmission rates was 28.7% (interquartile range, 26.1–31.9). There were differences in risk-standardized readmission rates by region (Northeast, 30.4%; South, 29.6%; Midwest, 28.8%; and West, 27.7%; p < 0.001), teaching versus nonteaching status (31.1% vs 29.0%; p < 0.001), and hospitals serving the highest proportion of underserved patients (30.6% vs 28.7%; p < 0.001). The best performing hospitals on a composite quality measure had highest risk-standardized readmission rates compared with the lowest (32.0% vs 27.5%; p < 0.001). Risk-standardized readmission rates was lower in the highest mortality hospitals compared with those in the lowest (28.7% vs 30.7%; p < 0.001).

Conclusions:
One third of sepsis survivors were readmitted and wide variation exists between hospitals. Several demographic and structural factors are associated with this variation. Measures of higher quality in-hospital care were correlated with higher readmission rates. Several potential explanations are possible including poor risk standardization, more research is needed.
A Literature Review of Psychosocial Comorbidities Related to Working Capacity After Aneurysmal Subarachnoid Hemorrhage
Authors: Turi Eleanor , Conley Yvette , Stanfill Ansley Grimes 
Published: May 2017

ABSTRACT

Objective: The aim of this study was to describe literature regarding the impact of psychosocial comorbidities on working capacity after aneurysmal subarachnoid hemorrhage (aSAH). Design/Methods: This study is a review of the literature using PubMed, CINAHL, PyschINFO, and Google Scholar. Results: Patients with aSAH affected by depression, anxiety, cognitive impairment, or posttraumatic stress disorder are less likely to return to work, although there are mixed results. These may be due to inconsistent inclusion, adjustment of demographic and clinical variables shown to be associated with return to work, and differences in instrumentation and sample size. Conclusions: Working capacity after aSAH is likely affected by poor psychosocial outcomes, but future research should consider the standardization of demographic and clinical data, use standardized measurement tools, and consider the interrelatedness between psychosocial comorbidities.
Which Combination Treatment Is Better for Spinal Metastasis: Percutaneous Vertebroplasty With Radiofrequency Ablation, 125I Seed, Zoledronic Acid, or Radiotherapy?
Authors: Lu Chun-Wen , Shao Jie , Wu Yu-Gang , Wang Chao , Wu Jin-Hui , Lv Run-Xiao , Ding Mu-Chen , Shi Zhi-Cai , Mao Ning-Fang 
Published: May 2017

Background:
Percutaneous vertebroplasty (PVP) can not only alleviate pain but also restore mechanical stability with injection of bone cement, whereas it exhibits a poor effect on antitumor activity. But through combinations with other therapies, it may be possible to achieve the maximum effect in clinical treatment. Thus, this study is designed to assess the clinical efficacy of PVP separately combined with 4 ways for spinal metastasis (SM) treatment.

Study Question:
Which combination treatment is better for spinal metastasis, percutaneous vertebroplasty with radiofrequency ablation, 125I seed, zoledronic acid or radiotherapy?

Study Design:
A total of 169 patients with SM were retrospectively recruited and randomly assigned to 4 groups to receive 4 different ways separately: 49 patients (group A) received PVP plus 125I seed, 51 (group B) received PVP plus radiofrequency ablation (RFA), 38 (group C) underwent PVP plus zoledronic acid (ZA), and 31 (group D) underwent PVP plus radiotherapy (RT).

Measures and Outcomes:
All of them underwent routine examinations before operation. Visual analog scale (VAS), World Health Organization (WHO) Pain Relief, and ODI were applied to evaluate pain relief and motor function.

Results:
PVP plus RT achieved the best efficacy in relieving pains, with the highest WHO Pain Relief (P < 0.05). The PVP plus RFA exhibited lowest ODI, suggesting the best outcome after treatment (P < 0.05). The PVP plus 125I showed the lowest VAS score, but it was the worst to improve the routine exercise ability and relieve pains from patients. The PVP plus ZA presented higher VAS and ODI (P < 0.05).

Conclusions:
PVP combined with 125I seed exhibited the best clinical efficacy in terms of VAS, PVP combined with RT was the best choice in terms of WHO Pain Relief, and PVP combined with RFA showed the best effect in terms of ODI for the treatment of SM.
Systematic Review and Meta-Analysis of Perioperative Outcomes of Peroral Endoscopic Myotomy (POEM) and Laparoscopic Heller Myotomy (LHM) for Achalasia
Authors: Awaiz Aiman , Yunus Rossita M. , Khan Shahjahan , Memon Breda , Memon Muhammed A. 
Published: May 2017

Aims and Objectives:
Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM.

Materials and Methods:
A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed. Variables analyzed included prior endoscopic treatment, prior medical treatment, prior Heller myotomy, operative time, overall complications rate, postoperative gastroesophageal reflux disease (GERD), length of hospital stay, postoperative pain score, and long-term GERD.

Results:
Seven trials consisting of 483 (LHM=250, POEM=233) patients were analyzed. Preoperative variables, for example, prior endoscopic treatment [odds ratio (OR), 1.32; 95% confidence interval (CI), 0.23-4.61; P=0.96], prior medical treatment [weighted mean difference (WMD), 1.22; 95% CI, 0.52-2.88; P=0.65], and prior Heller myotomy (WMD, 0.47; 95% CI, 0.13-1.67; P=0.25) were comparable. Operative time was 26.28 minutes, nonsignificantly longer for LHM (WMD, 26.28; 95% CI, −11.20 to 63.70; P=0.17). There was a comparable overall complication rate (OR, 1.25; 95% CI, 0.56-2.77; P=0.59), postoperative GERD rate (OR, 1.27; 95% CI, 0.70-2.30; P=0.44), length of hospital stay (WMD, 0.30; 95% CI, −0.24 to 0.85; P=0.28), postoperative pain score (WMD, −0.26; 95% CI, −1.58 to 1.06; P=0.70), and long-term GERD (WMD, 1.06; 95% CI, 0.27-4.1; P=0.08) for both procedures. There was a significantly higher short-term clinical treatment failure rate for LHM (OR, 9.82; 95% CI, 2.06-46.80; P<0.01).

Conclusions:
POEM compares favorably to LHM for achalasia treatment in short-term perioperative outcomes. However, there was a significantly higher clinical treatment failure rate for LHM on short-term postoperative follow-up. Presently long-term postoperative follow-up data for POEM beyond 1 year are unavailable and eagerly awaited.
Laparoscopic Appendectomy in Children With Perforated Appendicitis: A Meta-Analysis
Authors: Zhang Shun , Du Tao , Jiang Xiaohua , Song Chun 
Published: May 2017

Background:
The purpose of this meta-analysis was to compare the influence of different surgical procedures on perforated appendicitis in pediatric population.

Materials and Methods:
Studies were identified through a computerized literature search of Pubmed, Embase, Ovid, the Cochrane Colorectal Cancer Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials, the Cochrane Library database, and Web of Science. Two reviewers independently assessed the quality of each study and abstracted outcome data. Data were extracted comparing laparoscopic appendectomy (LA) and open appendectomy (OA) in pediatric population with regard to several postoperative variables. We synthesized published data using fixed-effect models, expressing results as relative risk (RR).

Results:
Nine eligible studies were included which came from various medical centers all over the world. Statistically significant differences between “LA” and “OA” groups were found for wound infection (RR=0.88), intra-abdominal abscess (RR=1.38), and bowel obstruction (RR=0.79).

Conclusions:
Our meta-analysis found that LA is associated with lower incidence of wound infections and bowel obstruction, but the rate of intra-abdominal abscess was higher than OA.
Reexamining the Role of Electroconvulsive Therapy in Anorexia Nervosa in Adolescents
Authors: Andersen Laura , LaRosa Christina , Gih Daniel E. 
Published: May 2017

Abstract
Electroconvulsive therapy (ECT) is rarely, if ever, considered for the treatment of severe anorexia nervosa (AN) or other eating disorders comorbid with an affective illness. Mood disorders are common in these patients, and psychotropic medications, although frequently used, have limited evidence of benefit in AN or copresenting depressive symptoms. Even when the illness is life threatening, ECT as a treatment may be overlooked. We present a case of an adolescent girl with severe AN and comorbid major depressive disorder with suicidality. This patient failed multiple medication trials but went on to experience complete remission from both the symptoms of her AN and major depressive disorder after undergoing a course of bilateral ECT. Electroconvulsive therapy may prove to be a fast and effective treatment strategy for mood disorders and suicidality in the setting of comorbid AN in adolescents.
A supervised statistical learning approach for accurateLegionella pneumophilasource attribution during outbreaks
Authors: Buultjens Andrew H. , Chua Kyra Y. L. , Baines Sarah L. , Kwong Jason , Gao Wei , Cutcher Zoe , Adcock Stuart , Ballard Susan , Schultz Mark B. , Tomita Takehiro , Subasinghe Nela , Carter Glen P. , Pidot Sacha J. , Franklin Lucinda , Seemann Torsten , Da Silva Anders Gonçalves , Howden Benjamin P. , Stinear Timothy P. 
Published: May 2017

AbstractPublic health agencies are increasingly relying on genomics during Legionnaires’ disease investigations. However, the causative bacterium (Legionella pneumophila) has an unusual population structure with extreme temporal and spatial genome sequence conservation. Furthermore, Legionnaires’ disease outbreaks can be caused by multipleL. pneumophilagenotypes in a single source. These factors can confound cluster identification using standard phylogenomic methods. Here, we show that a statistical learning approach based onL. pneumophilacore genome single nucleotide polymorphism (SNP) comparisons eliminates ambiguity for defining outbreak clusters and accurately predicts exposure sources for clinical cases. We illustrate the performance of our method by genome comparisons of 234L. pneumophilaisolates obtained from patients and cooling towers in Melbourne, Australia between 1994 and 2014. This collection included one of the largest reported Legionnaires’ disease outbreaks, involving 125 cases at an aquarium. Using only sequence data fromL. pneumophilacooling tower isolates and including all core genome variation, we built a multivariate model using discriminant analysis of principal components (DAPC) to find cooling tower-specific genomic signatures, and then used it to predict the origin of clinical isolates. Model assignments were 93% congruent with epidemiological data, including the aquarium Legionnaires’ outbreak and three other unrelated outbreak investigations. We applied the same approach to a recently described investigation of Legionnaires’ disease within a UK hospital and observed model predictive ability of 86%. We have developed a promising means to breachL. pneumophilagenetic diversity extremes and provide objective source attribution data for outbreak investigations.
Glioma grade map: a machine-learning based imaging biomarker for tumor characterization
Authors: Jakab András , Molnár Péter , Emri Miklós , Berényi Ervin 
Published: May 2017

ABSTRACTPurposeTo use T1-, T2-weighted and diffusion tensor MR images to portray glioma grade by employing a voxel-wise supervised machine learning approach, and to assess the feasibility of this tool in preoperative tumor characterization.Materials and MethodsConventional MRI, DTI datasets and histopathological evaluations of 40 patients with WHO grade II-IV gliomas were retrospectively analyzed. Databases were construed incorporating preoperative images, tumor delineation and grades. This data was used to train a multilayer perceptron based artificial neural network that performed voxel-by-voxel correlation of tumor grade and the feature vector. Results were mapped to grayscale images, whereas grade map was defined as a composite image that depicts grade assignments for intra-tumoral regions. The voxel-wise probability for high grade tumor classification was calculated for the entire tumor volumes, defined as the grade index.ResultsThe color hue on glioma grade maps allowed the discrimination of low and high grade cases. This method revealed connection between the heterogeneous appearance of tumors and the histopathological findings. Classification by the grade index had 92.31% specificity, 85.71% sensitivity.ConclusionGlioma grade maps are advantageous in the visualization of the heterogeneous nature of intra-tumoral diffusion and relaxivity and can further enhance the characterization of tumors by providing a preoperative modality that expands information available for clinicians.ABBREVIATIONSADCapparent diffusion coefficient;ANNartificial neural networks;DWIdiffusion weighted imaging;DTIdiffusion tensor imaging;FAfractional anisotropy;HGPMhigh grade probability map;LGPMlow grade probability map;TPMtumor probability map;WHOWorld Health Organization
The Largest Subunit of Human RNA Polymerase III Is Closely Related to the Largest Subunit of Yeast and Trypanosome RNA Polymerase III
Authors: Sepehri Setareh , Hernandez Nouria 
Published: May 2017

In both yeast and mammalian systems, considerable progress has been made toward the characterization of the transcription factors required for transcription by RNA polymerase III. However, whereas in yeast all of the RNA polymerase III subunits have been cloned, relatively little is known about the enzyme itself in higher eukaryotes. For example, no higher eukaryotic sequence corresponding to the largest RNA polymerase III subunit is available. Here we describe the isolation of cDNAs that encode the largest subunit of human RNA polymerase III, as suggested by the observations that (1) antibodies directed against the cloned protein immunoprecipitate an active enzyme whose sensitivity to different concentrations of α-amanitin is that expected for human RNA polymerase III; and (2) depletion of transcription extracts with the same antibodies results in inhibition of transcription from an RNA polymerase III, but not from an RNA polymerase II, promoter. Sequence comparisons reveal that regions conserved in the RNA polymerase I, II, and III largest subunits characterized so far are also conserved in the human RNA polymerase III sequence, and thus probably perform similar functions for the human RNA polymerase III enzyme.[The sequence data described in this paper have been submitted to the GenBank data library under accession no. AF021351.]
Evolutionary Features of the 4-Mb Xq21.3 XY Homology Region Revealed by a Map at 60-kb Resolution
Authors: Mumm Steven , Molini Barbara , Terrell Jennifer , Srivastava Anand , Schlessinger David 
Published: May 2017

Forty-three yeast artificial chromosomes (YACs) from the X chromosome have been overlapped across the 4-Mb Xq21.3 region, which is homologous to a segment in Yp11.1. The region is formatted to 60-kb resolution with 57 STSs and is merged at its edges with contigs specific for X. This allows a direct comparison of marker orders and distances on X and Y. In addition to some sequence variation and possible differences in marker order, two larger evolutionary divergencies between the X and Y homologs were revealed: (1) The X homolog is interrupted by a small X-specific region detected by a 3-kb plasmid probe for locus DXS214. An STS was developed from one end of the probe, but the sequence at the other end was highly homologous to an L1 repetitive element. This suggests that the interpolation of the X-specific segment may have involved an L1-mediated event. (2) A 250-kb portion containing DXYS1 is several megabases away from the rest of the homologous DNA on the Y but is contiguous with the remainder of the homologous region on X. Marker orders are consistent with the origin of the Y-specific 250-kb region in a paracentric inversion after the initial transfer of X DNA to the Y chromosome.[All sequence data for the STSs are in the Genome Database and on the Washington University web site at http://genome.wustl.edu/cgm/cgm.html.]