bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thalamic Glioblastoma: Clinical Presentation, Management Strategies, and Outcomes
Authors: Esquenazi Yoshua , Moussazadeh Nelson , Link Thomas W , Hovinga Koos E , Reiner Anne S , DiStefano Natalie M , Brennan Cameron , Gutin Philip , Tabar Viviane 
Published: May 2017

Abstract

BACKGROUND
Thalamic glioblastomas (GBMs) represent a significant neurosurgical challenge. In view of the low incidence of these tumors, outcome data and management strategies are not well defined.

OBJECTIVE
To identify the natural history and factors associated with survival in patients with thalamic glioblastoma.

METHODS
A retrospective review of all patients with thalamic glioblastoma over a 10-yr period was performed. Presenting clinical, radiological, and outcome data were collected. Chi-squared and Fisher's exact tests were used to compare clinical characteristics across tumor groups. Cox proportional hazard models were utilized to investigate variables of interest with regard to overall survival.

RESULTS
Fifty-seven patients met inclusion criteria, with a median age of 53 and median Karnofsky Performance Scale (KPS) score of 80. The most common presenting symptoms were weakness, confusion, and headache. Hydrocephalus was present in 47% of patients preoperatively. Stereotactic biopsy was performed in 47 cases, and 10 patients underwent craniotomy. The median overall survival was 12.2 mo. Higher KPS, younger age, and cerebrospinal fluid (CSF) diversion were correlated with better overall survival univariately, respectively, while the presence of language deficits at initial presentation was associated with poorer survival. In multivariate analysis, the only significant predictor of survival was presenting KPS.

CONCLUSION
The overall survival of patients with thalamic glioblastoma is comparable to unresectable lobar supratentorial GBMs. Younger patients and those with good presenting functional status had improved survival. Midbrain involvement by the tumor is not a negative prognostic factor. Improved therapies are needed, and patients should be considered for early trial involvement and aggressive upfront therapy.
Fei-Fei Li: Artificial Intelligence is on its way to reshape the world
Authors: Zeng Yi , Wang Ling 
Published: May 2017

Abstract
Fei-Fei Li, a well-known scientist focusing on computer vision and Artificial Intelligence (AI), did not expect such zeal in China about AI. During her last visit to Beijing, the professor of Stanford University drew much attention from both academy and industry here; NSR took the opportunity to interview Professor Li. She points out that, although the neural network has made marvelous advances in the past 15–20 years, there are still enormous challenges ahead. On the one hand, computational models for AI, such as many current deep neural networks, have theoretical bottlenecks to resolve, such as interpretability and explainability; on the other hand, AI should offer more in solving societal problems and in accelerating innovation in industries such as healthcare, traffic control and agriculture. This would be a more practical way to realize the potential and speed up the advancement of AI. Moreover, Prof. Li is interested but cautious about Artificial General Intelligence (AGI).
Galen
Authors: Boudon-Millot Véronique 
Published: May 2017

After remaining for a long time in Hippocrates’ shadow, the Galenic corpus has attracted considerable scholarly attention since the 1970s. Born in Pergamum, Roman Asia Minor, in 129 ce, Galen was the most influential physician in antiquity after Hippocrates of Cos (flourished c. 425 bce) and considered himself to be the latter’s legitimate heir. His tremendous impact on the medical world and the wide circulation of his works until the modern era contrast with the way he then faded into a relative obscurity. Galen spent his career mainly in Rome during the reigns of Emperor Marcus Aurelius, Commodus, and Septimius Severus and described himself as both a physician and a philosopher. He was the author of nearly 150 treatises (one-eighth of the entire preserved Greek literature) covering all fields of medicine (anatomy, physiology, pathology, pharmacology, and therapeutics) without neglecting hygiene, gymnastics, or cosmetics, and other treatises on philosophy, logic, ethics, and the vocabulary of comedy. An important part of his work consisted of commentaries on the main Hippocratic treatises. After the Galenic corpus became a standard in medical education in late Byzantine Alexandria, interest in Galen’s works slowly ebbed, so that by the French Revolution in 1789 Galen had taken a lesser place in medical education than Hippocrates, although some medical schools still taught Galen in translation, most often in Latin. Thus it was not until the 1970s that a full resurgence took hold among medical historians, students of Greek and Roman history, and classical philologists: numerous studies are now available on Galen and Galenic medicine, and this renewed interest has led to fresh discoveries of basically unknown tracts in manuscript holdings. Since the 1980s, thanks to philologists’ constant curiosity about his works, numerous studies were produced and they led to important discoveries as well as to significant renewal of our knowledge of the Galenic corpus. Although a large part of this huge corpus still remains to be translated into a modern language, Galen’s work is finally beginning to receive the attention it deserves from medical doctors, philosophers, historians of medicine, and archeologists.
Jean Renoir
Authors: Faulkner Chris 
Published: May 2017

Few filmmakers are more world renowned than Jean Renoir (b. 1894–d. 1979), who directed thirty-seven films in five countries and on three continents between 1924 and 1979. There are more than one hundred books and many hundreds of articles in numerous languages about Renoir’s life and career. His career can be divided into four stages: a silent period from 1924 to 1929, when he made nine films (one of which is lost), including Nana 1926; his most prolific years in France between 1931 and 1939 when he made fifteen films, among which are his most celebrated, La Chienne (1931), Toni (1936), Le Crime de M. Lange (1936), Partie de campagne/Day in the Country (1946) (1936, released 1946), La Grande Illusion/Grand Illusion (1937), La Bête humaine/The Human Beast (1938), and La Règle du jeu/The Rules of the Game (1939); an American period from 1941 to 1948 comprising five features and a short informational film, during which his best known work was The Southerner (1945); and, an international period from 1951 to 1969 of eight films made in India, Italy, Austria, and France, which saw the production of The River (1951), The Golden Coach (1953), and French Cancan (1955). The critical literature on Renoir’s life and career is vast. There are three biographies, scores of Interviews in various languages, and dozens of critical studies, including single-authored works and Edited Collections of essays, with more than twenty books to date on La Règle du jeu alone. In addition to the Screenplays for his films, most of which he wrote or co-wrote, Renoir was a prolific writer, with more than two hundred articles to his credit; an autobiography; a biography of his father, the Impressionist painter Pierre-Auguste Renoir (b. 1841–d. 1919); four novels, and two plays. There are also two collections of his letters. Renoir was championed by Cahiers du cinéma from January 1952, and, under the influence of André Bazin, its young critics—among whom were François Truffaut, Jean-Luc Godard, Eric Rohmer, and Jacques Rivette—became staunch defenders and promoters of his films and career. Bazin and the Cahiers critics considered Renoir an exemplary auteur. However, they neglected the social dimension of Renoir’s work and skirted entirely his left-wing political activism during the 1930s. Major archival resources for students of Renoir are to be found at the Cinémathèque française in Paris and at the Special Collections Library at the University of California, Los Angeles. High-quality DVDs, many with informed commentaries and essays, exist for the major films.
The Dose-Dependent Efficacy of Cefepime in the Empiric Management of Febrile Neutropenia: A Systematic Review and Meta-Analysis
Authors: Andreatos Nikolaos , Flokas Myrto Eleni , Apostolopoulou Anna , Alevizakos Michail , Mylonakis Eleftherios 
Published: May 2017

Abstract

Background
Despite reports questioning its efficacy, cefepime remains a first-line option in febrile neutropenia. We aimed to re-evaluate the role of cefepime in this setting.

Methods
We searched the PubMed and EMBASE databases to identify randomized comparisons of (1) cefepime vs alternative monotherapy or (2) cefepime plus aminoglycoside vs alternative monotherapy plus aminoglycoside, published until November 28, 2016.

Results
Thirty-two trials, reporting on 5724 patients, were included. Clinical efficacy was similar between study arms (P = .698), but overall mortality was greater among cefepime-treated patients (risk ratio [RR] = 1.321; 95% confidence interval [CI], 1.035–1.686; P = .025). Also of note, this effect seemed to stem from trials using low-dose (2 grams/12 hours, 100 mg/kg per day) cefepime monotherapy (RR = 1.682; 95% CI, 1.038–2.727; P = .035). Cefepime was also associated with increased mortality compared with carbapenems (RR = 1.668; 95% CI, 1.089–2.555; P = .019), a finding possibly influenced by cefepime dose, because carbapenems were compared with low-dose cefepime monotherapy in 5 of 9 trials. Treatment failure in clinically documented infections was also more frequent with cefepime (RR = 1.143; 95% CI, 1.004–1.300; P = .043). Toxicity-related treatment discontinuation was more common among patients that received high-dose cefepime (P = .026), whereas low-dose cefepime monotherapy resulted in fewer adverse events, compared with alternative monotherapy (P = .009).

Conclusions
Cefepime demonstrated increased mortality compared with carbapenems, reduced efficacy in clinically documented infections, and higher rates of toxicity-related treatment discontinuation. The impact of cefepime dosing on these outcomes is important, because low-dose regimens were associated with lower toxicity at the expense of higher mortality.
Tailored Extended Bifrontal Craniotomy for Anterior Skull Base Tumors: Anatomic Description of a Modified Surgical Technique and Case Series
Authors: Safaee Michael M , McDermott Michael W , Benet Arnau , Theodosopoulos Philip V 
Published: May 2017

Abstract

BACKGROUND
Open transcranial approaches to the anterior skull base remain an integral component of current skull base practice. Evolution of these and other techniques has resulted in revisions of standard, tried-and-true methods in attempts to improve patient outcomes and cosmesis, while still providing the best combination of surgical exposure and ergonomics.

OBJECTIVE
To describe a modified approach for midline tumors of the anterior skull base.

METHODS
We describe the anatomy and techniques of a modified extended bifrontal craniotomy for anterior skull base tumors. Case examples and a postoperative 3-dimensional computed tomographic reconstruction of the craniotomy are provided.

RESULTS
The technique has been employed with success in 3 tuberculum sellae meningiomas where the anterior limit of the tumor is several centimeters back from the inner table of the frontal bone. The mean distance from the tumor to inner table was 2.8 cm (range 1.3-3.8 cm). Mean tumor dimensions were 3.0 cm (transverse), 3.5 cm (anterior-posterior), and 2.2 cm (craniocaudal). Average operative time was 557 min. No cases had new T2/fluid-attenuated inversion recovery magnetic resonance imaging signal of the inferior frontal lobe to indicate retraction injury.

CONCLUSION
The tailored extended bifrontal craniotomy for anterior skull base tumors provides adequate access to the anterior cranial fossa and has replaced our standard extended bifrontal approach. Keeping the osteotomy cut lines outside of the orbit reduces orbital swelling and mechanical disruption of conjugate eye movements in the early postoperative period, while allowing for minimal frontal lobe retraction and providing sufficient surgical exposure along the anterior skull base.
How electronic health records can unmask the hidden value of PAs
Authors: Ogunfiditimi Folusho , Sherry Scott P. , Foote Monica , Christie Sarah L. , Shock Lisa P. , Cawley James , Browne Aaron ,   American Academy of PAs Fee for Value Task Force
Published: May 2017

ABSTRACT
The Fee for Value (FFV) Task Force, a subgroup of the American Academy of PAs' Research and Strategic Initiatives Commission, has examined tools and mechanisms aimed at better clarifying the volume and value of PA work and how that work contributes to improving access to high-quality care. Establishing the value of PAs has been a challenging task for many healthcare providers. Often, PA value has been defined by their clinical productivity, without any clear direction as to what constitutes value versus productivity. The objective of this article is to unmask the value of PAs through the role of electronic health records and highlight PAs' ability to produce services that are value-oriented and quantifiably productive.
Factors Associated With Success of Clinician–Researchers Receiving Career Development Awards From the National Institutes of Health: A Longitudinal Cohort Study
Authors: Jagsi Reshma , Griffith Kent A. , Jones Rochelle D. , Stewart Abigail , Ubel Peter A. 
Published: May 2017

Purpose
Understanding the careers of recent career development awardees is essential to guide interventions to ensure gender equity and success in academic medicine.

Method
In 2010–2011 (T1) and 2014 (T2), 1,719 clinician–researchers who received new K08 and K23 awards in 2006–2009 were longitudinally surveyed. Multivariable analyses evaluated the influence of factors on success, including demographics, job characteristics, work environment, priorities, and domestic responsibilities.

Results
Of 1,275 respondents at T1, 1,066 (493 women; 573 men) responded at T2. Men and women differed in job characteristics, work environment, priorities, and domestic responsibilities. By T2, women had less funding (mean $780,000 vs. $1,120,000, P = .002) and published fewer papers (mean 33 vs. 45). Using a composite measure that considered funding, publications, or leadership to define success, 53.5% (264/493) of women and 67.0% (384/573) of men were successful. Gender differences in success persisted after accounting for other significant predictors—K award type, specialty, award year, work hours, funding institute tier, feeling responsible for participating in department/division administration, importance of publishing prolifically, feeling responsible for contributing to clinical care, importance of publishing high-quality research, collegiality of the mentoring relationship, adequacy of research equipment, and departmental climate. A significant interaction existed between K award type and gender; the gender difference in success was most pronounced among K23 researchers (among whom the odds ratio for females = 0.32).

Conclusions
Men and women continue to have different experiences and career outcomes, with important implications for the design of interventions to promote equity and success.
Obesity is Independently Associated With Increased Risk of Hepatocellular Cancer–related Mortality
Authors: Gupta Arjun , Das Avash , Majumder Kaustav , Arora Nivedita , Mayo Helen G. , Singh Preet P. , Beg Muhammad S. , Singh Siddharth 
Published: May 2017

Objective:Excess body weight is associated with increased risk of developing hepatocellular cancer (HCC), but its effect on HCC-related mortality remains unclear. We performed a systematic review and meta-analysis to assess the association between premorbid obesity and HCC-related mortality.Materials and Methods:Through a systematic literature search-up to March 2016, we identified 9 observational studies (1,599,453 individuals, 5705 HCC-related deaths) reporting the association between premorbid body mass index (BMI), and HCC-related mortality. We estimated summary adjusted hazard ratio (aHR) with 95% confidence intervals (CIs), comparing obese (BMI>30 kg/m2) and overweight (BMI, 25 to 29.9 kg/m2) individuals with normal BMI individuals using random-effects model.Results:On meta-analysis, compared with individuals with normal BMI, obese (aHR, 1.95; 95% CI, 1.46-2.46), but not overweight individuals (aHR, 1.08; 95% CI, 0.97-1.21), had higher HCC-related mortality, with moderate heterogeneity. On subgroup analysis, magnitude of increased mortality was higher in obese men (aHR, 2.50; 95% CI, 2.02-3.09; 3 studies) as compared with obese women (aHR, 1.45; 95% CI, 1.08-1.97; 2 studies). The impact of premorbid obesity on HCC-related mortality was observed only in western populations (aHR, 2.10; 95% CI, 1.77-2.48; 4 studies), but not Asian populations (aHR, 1.10; 95% CI, 0.63-1.92; 1 study). There was limited assessment of competing risk because of advanced liver disease.Conclusions:On the basis of this meta-analysis, premorbid obesity may be independently associated with a 2-fold risk of HCC-related mortality. This association was more pronounced in men and western populations. Strategies targeting obesity-associated metabolic abnormalities may provide novel pathways for HCC therapy.
Contralateral Augmentation with a Transmidline Scarless Technique During Unilateral Breast Reconstruction Using Implants
Authors: Ho Olivia A. , Lin Yi-Ling , Huang Jung-Ju , Cheng Ming-Huei 
Published: May 2017

Background:
Unilateral breast reconstruction can be a challenge when attempting to achieve an aesthetically pleasing and symmetrical breast mound on the contralateral side. This study investigates the outcomes of using a contralateral augmentation transmidline scarless (CATS) technique to simultaneously augment the contralateral breast using implants.

Methods:
Between January 2004 and July 2016, patients undergoing unilateral implant-based breast reconstruction and simultaneous contralateral implant augmentation using a transmidline access were studied. Characteristics and complications using this technique were assessed.

Results:
Sixty-five (91.5%) of 71 patients used the CATS technique for unilateral breast reconstruction using implants with contralateral breast implant augmentation. The remaining 6 cases used a preexisting chest scar. In the assessment of complication rates between the reconstructed and augmented sides, the reconstructed side had a statistically significant higher rate of implant exposure (P = 0.04) and total complications (P = 0.02). In comparing the revision rates between these 2 groups, the need for implant change (P = 0.04) and the total revision rates (P = 0.01) were higher in the reconstructive side. Use of saline implants had a higher rate of chest wall and breast skin necrosis (P = 0.03) in comparison with silicone implants. There was not a statistically significant difference in complications when comparing timing of reconstructions (immediate versus delayed).

Conclusions:
The CATS technique can be performed safely, with a desirable aesthetic outcome, and also symmetry with minimal risk of symmastia during unilateral breast reconstruction using implant-based reconstruction.
Multiuse of Disposable Microsurgical Instruments as a Cost-Efficient Alternative for Training and Research
Authors: Aman Martin , Sporer Matthias E. , Riedl Otto , Wang Wei-Te , Kramer Anne , Aszmann Oskar C. , Bergmeister Konstantin D. 
Published: May 2017

Summary:
Microsurgery demands significant preclinical training, often hampered by the high costs of the required microsurgery instruments. We hypothesized that recently available disposable microsurgery instruments provide sufficient quality and significantly reduced costs. In a comparative analysis with standard reusable instruments, participants performed equally with both instrument sets and recommended the disposable instruments for microsurgery training and research applications.
Comparative Analysis of Perioperative and Mid-Term Results of TECAB and MIDCAB for Revascularization of Anterior Wall
Authors: Kofler Markus , Schachner Thomas , Sebastian J. Reinstadler , Stastny Lukas , Dumfarth Julia , Wiedemann Dominik , Feuchtner Gudrun , Friedrich Guy , Bonatti Johannes , Bonaros Nikolaos 
Published: May 2017

Objective Totally endoscopic coronary artery bypass (TECAB) and minimally invasive direct coronary artery bypass (MIDCAB) grafting through minithoracotomy are currently the two minimally invasive surgical techniques of left ventricular anterior wall revascularization. We aimed to compare both techniques in terms of perioperative and mid-term results. Methods Arrested heart TECAB was carried out in 204 patients with a median (range) age of 60 (53–76) years and a median (range) EuroSCORE I of 2 (0–3). Minimally invasive direct coronary artery bypass was performed in 60 patients with a median (range) age of 66 (54–75) years and a median (range) EuroSCORE I of 2 (1–5). Both techniques were used for single or sequential internal mammary artery grafts to the anterior wall. Operative times, conversion rates, and surgical complications as well as mid-term results were compared between the groups after a median follow-up of 36 months. Results No perioperative deaths were noted. Rates of myocardial infarction (TECAB: 1.5% vs MIDCAB: 0%, P = 0.463) and stroke (TECAB: 1.5% vs MIDCAB: 0%, P = 0.454) were not significantly different between the groups. Total operative times were longer in the TECAB compared with the MIDCAB group [292 (250–345) minutes in TECAB versus 201 (173–289) minutes in MIDCAB ( P < 0.001)]. Intensive care unit stay and total length of stay were similar between the groups. There was no difference in mid-term survival (TECAB: 1.5% vs MIDCAB: 1.7%, P = 0.298) and freedom from major adverse cardiac and cerebrovascular events (TECAB: 12.4% vs MIDCAB: 5.1%, P = 0.358). Conclusions Robotically assisted arrested heart TECAB and robotic MIDCAB perform equally in terms of perioperative results and mid-term follow-up in this single-center patient cohort.
Effects of Music Listening During Loop Electrosurgical Excision Procedure on Pain and Anxiety: A Randomized Trial
Authors: Chantawong Nopwaree , Charoenkwan Kittipat 
Published: May 2017

Objective
The aim of the study was to compare pain, anxiety, and satisfaction between women, who listened to music, and those who did not during loop electrosurgical excision procedure (LEEP).

Material and Methods
Participants were randomly assigned into two groups. In group 1 (music), the participants listened to relaxing instrumental music through the stereo headset from the time of arrival at the preoperative waiting room until the procedure completed. For group 2 (control), the participants underwent LEEP without music listening. The women rated pain, anxiety, and satisfaction according to 10-cm visual analog scales. Pain was assessed at the time of speculum insertion (baseline pain) and immediately after the LEEP completed (procedural pain). Anxiety and satisfaction were examined just before starting the LEEP and 10 minutes after the procedure completed.

Results
One hundred fifty patients (74 in music group and 76 in control group) participated. Mean baseline pain scores after speculum insertion were comparable between the groups (3.7 in the music group vs. 3.5 in the control group, p = .55). Mean procedural pain scores were not different between the groups (4.7 in the music group vs. 5.2 in the control group, p = .32). The differences of the procedural pain scores from baseline were statistically comparable between the study groups (0.9 in the music group vs. 1.7 in the control group, p = .15). There were no significant differences in anxiety and satisfaction scores at any time points assessed between the groups.

Conclusions
The effects of music listening on reducing pain and anxiety during LEEP could not be demonstrated in this study.