bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inferring HIV-1 Transmission Dynamics in Germany From Recently Transmitted Viruses
Authors: Pouran Yousef Kaveh , Meixenberger Karolin , Smith Maureen R. , Somogyi Sybille , Gromöller Silvana , Schmidt Daniel , Gunsenheimer-Bartmeyer Barbara , Hamouda Osamah , Kücherer Claudia , von Kleist Max 
Published: July 2016

Background:
Although HIV continues to spread globally, novel intervention strategies such as treatment as prevention (TasP) may bring the epidemic to a halt. However, their effective implementation requires a profound understanding of the underlying transmission dynamics.

Methods:
We analyzed parameters of the German HIV epidemic based on phylogenetic clustering of viral sequences from recently infected seroconverters with known infection dates. Viral baseline and follow-up pol sequences (n = 1943) from 1159 drug-naïve individuals were selected from a nationwide long-term observational study initiated in 1997. Putative transmission clusters were computed based on a maximum likelihood phylogeny. Using individual follow-up sequences, we optimized our clustering threshold to maximize the likelihood of co-clustering individuals connected by direct transmission.

Results:
The sizes of putative transmission clusters scaled inversely with their abundance and their distribution exhibited a heavy tail. Clusters based on the optimal clustering threshold were significantly more likely to contain members of the same or bordering German federal states. Interinfection times between co-clustered individuals were significantly shorter (26 weeks; interquartile range: 13–83) than in a null model.

Conclusions:
Viral intraindividual evolution may be used to select criteria that maximize co-clustering of transmission pairs in the absence of strong adaptive selection pressure. Interinfection times of co-clustered individuals may then be an indicator of the typical time to onward transmission. Our analysis suggests that onward transmission may have occurred early after infection, when individuals are typically unaware of their serological status. The latter argues that TasP should be combined with HIV testing campaigns to reduce the possibility of transmission before TasP initiation.
Improving CT-Based PET Attenuation Correction in the Vicinity of Metal Implants by an Iterative Metal Artifact Reduction Algorithm of CT Data and Its Comparison to Dual-Energy–Based Strategies
Authors: Schabel Christoph , Gatidis Sergios , Bongers Malte , Hüttig Fabian , Bier Georg , Kupferschlaeger Juergen , Bamberg Fabian , la Fougère Christian , Nikolaou Konstantin , Pfannenberg Christina 
Published: July 2016

Objective
The aim of this study was to evaluate the potential of iterative metal artifact reduction (IMAR) for the improvement of computed tomography (CT)–based position emission tomography (PET) attenuation correction in the vicinity of metal implants and compare it with dual-energy–based metal artifact reduction strategies.

Methods
A dedicated dental phantom was constructed consisting of a cylindrical tube filled with [18-F]FDG solution (5300 mL and 50.9 MBq) containing 2 artificial jaws with 1 nonprecious alloy fixed dental prosthesis and 3 single tooth crowns in the lower jaw.
Computed tomography measurements of the phantom were acquired on a stand-alone dual-energy CT scanner equipped with IMAR capabilities. A series of 24 CT data sets were obtained using different scan parameters and monoenergetic extrapolation of dual-energy CT acquisitions with and without IMAR reconstruction.
Position emission tomography measurements of the phantom were performed on a state-of-art PET/CT scanner. Position emission tomography data were reconstructed using all 24 previously acquired CT data sets.
Relative errors in the quantification of activity concentrations using the different CT scanning and reconstruction parameters were quantified by placement of regions of interest within the phantom.

Results
Metal artifacts of different extent were observed in all CT data sets. A marked reduction in CT metal artifacts was observed using IMAR. In general, activity concentrations were overestimated/underestimated in areas of high/low-density metal artifacts, respectively.
Relative errors in PET quantification ranged between −71% and +70% without IMAR. Using IMAR, these errors were reduced to a range between −40% and +12%. Averaged absolute values of relative PET quantification errors were 27% and 7% without and with the use of IMAR (P < 0.001), respectively. Iterative metal artifact reduction was superior compared with dual-energy–based metal artifact reduction strategies, and the combination of both strategies did not result in further significant improvement of PET quantification.

Conclusions
The use of IMAR in PET/CT is a promising approach for markedly improving image quality and PET quantification in the vicinity of metal implants. Further clinical studies are necessary to assess the clinical performance of this algorithm in patients.
Risk Stratification For Axillary Lymph Node Metastases in Breast Cancer Patients
Authors: Yun Seong Jong , Sohn Yu-Mee , Seo Mirinae 
Published: July 2016

Abstract
This study was to investigate clinicopathological features including immunohistochemical subtype and radiological factors of primary breast cancer to predict axillary lymph node metastasis (ALNM) and preoperative risk stratification.
From June 2004 to May 2014, 369 breast cancer patients (mean age, 54.7 years; range, 29–82 years) who underwent surgical axillary node sampling were included. Two radiologists retrospectively reviewed clinicopathological features, initial mammography, and initial breast ultrasonography (US). Univariate and multivariate logistic regression analyses were used to evaluate associations between ALNM and variables. Odds ratio with 95% confidence interval and risk of ALNM were calculated.
Among 369 patients, 117 (31.7%) had ALNM and 252 (68.3%) had no ALNM revealed surgically. On multivariate analysis, four factors showed positive association with ALNM: the presence of symptoms (P < 0.001), triple-negative breast cancer subtype (P = 0.001), mass size on US (>10 mm, P < 0.001), and Breast Imaging Reporting and Data System category on US (≥4c, P < 0.001). The significant risk of ALNM was particularly seen in patients with two or more factors (2, P = 0.013; 3, P < 0.001; 4, P < 0.001).The estimated risks of ALNM increased in patients with two, three, and four factors with odds ratios of 5.5, 14.3, and 60.0, respectively.
The presence of symptoms, triple-negative breast cancer subtype, larger size mass on US (>10 mm), and higher Breast Imaging Reporting and Data System category on US (≥4c) were positively associated with ALNM. Radiologically, US findings are significant factors that can affect the decision making process regarding ALNM. Based on risk stratification, the possibility of ALNM can be better predicted if 2 or more associated factors existed preoperatively.
Post-Bariatric Body Contouring Surgery After Weight Loss
Authors: Wong Michael S. 
Published: July 2016

Abstract
With the rise in obesity in the United States, there has been a similar increase in bariatric surgery. This has resulted in numerous patients losing significant weight with accompanying circumferential body contouring issues. This has led to an amazing increase in the number of body contouring procedures performed, both traditional excisional techniques as well as new emerging techniques emphasizing tissue preservation, rearrangement, and dermal reshaping. Although China's rates of obesity lag behind the United States, there is a recipe for obesity that will eventually surpass the United States. Thus, China has the opportunity to learn from the United States experience with regards to obesity treatment and contouring procedures after significant weight loss. Time will tell whether China will choose to use similar tissue preservation techniques to address issues of soft tissue ptosis and volume deficiency seen after significant weight loss, make refinements of these techniques, or develop new uniquely Chinese solutions.
Workforce Analysis of Female Pelvic Medicine and Reconstructive Surgery, 2015 to 2045
Authors: Brueseke Taylor , Muffly Tyler , Rayburn William , Connolly AnnaMarie , Nieto Maria , De La Cruz Jacquia , Wu Jennifer 
Published: July 2016

Objectives
The aim of this study was to assess how the projected increase in prevalence of pelvic floor disorders (PFDs) will impact the number of patients per female pelvic medicine and reconstructive surgery (FPMRS) subspecialist between 2015 and 2045.

Methods
We performed a workforce analysis of FPMRS subspecialists in the United States by developing a model to predict the number of FPMRS subspecialists in 5-year increments from 2015 to 2045. Our model allowed for selection of the number of current FPMRS subspecialists, the number and sex of new FPMRS subspecialists added per year, and retirement age of FPMRS subspecialists. The number of women with PFDs from 2015 to 2045 was then predicted by applying published, age-specific prevalence rates to the 2012 US Census Projections for women aged 20 years or older. For our primary outcome, we divided the projected number of patients by the projected number of FPMRS subspecialists every 5 years from 2015 to 2045.

Results
The model predicts the number of FPMRS subspecialists will increase from 1133 to 1514 with a sex shift from 46% female to 81% female between 2015 and 2045. The number of women with ≥1 PFD is predicted to increase from 31.4 million in 2015 to 41.9 million in 2045. For our primary outcome, the number of patients per FPMRS subspecialist is projected to range from 27,870 in 2015 to 27,650 in 2045.

Conclusions
The current ratio of patients per FPMRS subspecialist appears high and is predicted to remain near current levels over the next 30 years. These projections support the need for continued training of physicians skilled in treating PFDs.
Therapeutic Index Estimation of Antiepileptic Drugs: A Systematic Literature Review Approach
Authors: Greenberg Rachel G. , Melloni Chiara , Wu Huali , Gonzalez Daniel , Ku Lawrence , Hill Kevin D. , Hornik Christoph P. , Cohen-Wolkowiez Michael , Guptill Jeffrey T. 
Published: July 2016

Objectives
Our study aimed to determine whether data obtained from the medical literature can be used to estimate the therapeutic index of 5 antiepileptic drugs (AEDs): carbamazepine, lamotrigine, phenobarbital, phenytoin, and valproate.

Methods
We performed a literature search using PubMed and EMBASE to collect published safety, efficacy, and therapeutic monitoring data for 5 AEDs and extracted all relevant information into a drug- and study-specific drug database. For each AED, we summarized (1) type, severity, and incidence of toxicity-related adverse events and toxicity-associated range of drug doses or concentrations; (2) effective versus toxic concentration and dose (therapeutic range); and (3) therapeutic drug monitoring practices. We defined therapeutic index as the ratio of the minimum toxic concentration to the minimum effective concentration.

Results
We reviewed a total of 810 full-text articles and extracted data from 163. The literature suggests that the therapeutic index of phenytoin is 2. The therapeutic indices of phenobarbital and valproate exceed 2. There were insufficient data to precisely quantify the therapeutic indices of carbamazepine and lamotrigine.

Conclusions
For some drugs, this approach offers a low-cost method of therapeutic index estimation. Our results can serve as preliminary data for future trials and as guidance for US Food and Drug Administration decision making regarding narrow therapeutic index classification.
Ancient coexistence of norepinephrine, tyramine, and octopamine signaling in bilaterians
Authors: Bauknecht Philipp , Jékely Gáspár 
Published: July 2016

AbstractNorepinephrine/noradrenaline is a neurotransmitter implicated in arousal and other aspects of vertebrate behavior and physiology. In invertebrates, adrenergic signaling is considered absent and analogous functions are performed by the biogenic amines octopamine and its precursor tyramine. These chemically similar transmitters signal by related families of GPCR in vertebrates and invertebrates, suggesting that octopamine/tyramine are the invertebrate equivalents of vertebrate norepinephrine. However, the evolutionary relationships and origin of these transmitter systems remain unclear. Using phylogenetic analysis and receptor pharmacology, here we establish that norepinephrine, octopamine, and tyramine receptors coexist in some marine invertebrates. In the protostomesPlatynereis dumerilii(an annelid) andPriapulus caudatus(a priapulid) we identified and pharmacologically characterized adrenergic α1 and α2 receptors that coexist with octopamine α, octopamine β, tyramine type 1, and tyramine 2 receptors. These receptors represent the first examples of adrenergic receptors in protostomes. In the deuterostomeSaccoglossus kowalewskii(a hemichordate), we identified and characterized octopamine α, octopamine β, tyramine type 1, and tyramine 2 receptors, representing the first example of these receptors in deuterostomes.S. kowalewskiialso has adrenergic α1 and α2 receptors, indicating that all three signaling systems coexist in this animal. In phylogenetic analysis, we also identified adrenergic and tyramine receptor orthologs in xenacoelomorphs. Our results clarify the history of monoamine signaling in bilaterians. Since all six receptor families (two each for octopamine and tyramine and three for norepinephrine) can be found in representatives of the two major clades of Bilateria, the protostomes and the deuterostomes, all six receptors coexisted in the protostome-deuterostome last common ancestor. Adrenergic receptors were lost from most insects and nematodes and tyramine and octopamine receptors were lost from most deuterostomes. This complex scenario of differential losses cautions that octopamine signaling in protostomes is not a good model for adrenergic signaling in deuterostomes, and that the studies of marine animals where all three transmitter systems coexist will be needed for a better understanding of the origin and ancestral functions of these transmitters.
The EFQM Model as a framework for total quality management in healthcare
Authors: van Schoten Steffie , de Blok Carolien , Spreeuwenberg Peter , Groenewegen Peter , Wagner Cordula 
Published: July 2016

Purpose
– To guide organizations toward total quality management (TQM), various models have been developed such as the European Foundation for Quality Management Excellence Model (EFQM Model). The purpose of this paper is to conduct a longitudinal investigation of whether the EFQM Model can serve as a framework for TQM in healthcare.

Design/methodology/approach
– Data on a national representative survey about quality management (QM) in the hospital population in the Netherlands were used to conduct this study. The survey had five measurement points between 1995 and 2011.

Findings
– The results of the study show that applying the EFQM Model in hospitals is related to improvement in organizational performance over time, a feedback loop in which hospitals use their results to further improve their organizational processes is established, and improvement is stronger when all the model’s elements are considered simultaneously.

Practical implications
– The results of the study can be applied by quality managers of healthcare institutions to achieve higher quality of care.

Originality/value
– Previous research on the relationship between the EFQM excellence model and TQM neglects two essential characteristics of the TQM philosophy, namely, the holistic perspective on QM and the presumed feedback loop of organizational performance that feeds a cycle of continuous quality improvement. The study provides new insights into the long-term benefits of applying the EFQM Model as a framework for TQM in healthcare.
Operational antecedents of integrated patient planning in hospitals
Authors: Drupsteen Justin , van der Vaart Taco , Van Donk Dirk Pieter 
Published: July 2016

Purpose
– Hospitals struggle to integrate the planning from different departments; resulting in unacceptable waiting times for patients. The literature mainly addresses general, organizational factors inhibiting or enabling integration and omits important factors stemming from the care delivery process. Therefore, the purpose of this paper is to uncover operational antecedents and to assess their effect on the integration of hospital planning.

Design/methodology/approach
– The study is based on a three-hospital multi-case study. The main findings stem from over 40 in-depth interviews with specialists, nurses, planners, and managers of four specialties that are all involved in the orthopedic internal supply chain.

Findings
– This study identifies five critical operational antecedents: performance management, shared resources, information technology, process visibility, and uncertainty/variability. The latter two are of specific importance in a healthcare context. Three distinctive roles are identified; initiating (performance management and process visibility), facilitating (information technology), and inhibiting (shared resources and uncertainty/variability).

Practical implications
– The authors address how integration can be achieved, rather than merely prescribing integration as a means to improve performance. The identification of specific operational antecedents and their role help managers to find tangible ways to effectively integrate hospital planning which increases hospital performance.

Originality/value
– First, the identified operational antecedents are essential supplementary factors to more common organizational and behavioral antecedents. Second, in contrast to earlier contributions the authors show the effects of antecedents on three different stages of integration, rather than on integration in general.
Recycling as a result of “cultural greening”?
Authors: Flagg Julia A. , Bates Diane C. 
Published: July 2016

Purpose
This study aims to test whether faculty and students who have developed the most pro-environmental values and concerns are also the most likely to reduce the on-campus waste stream. It does so by using the theory of ecological modernization.

Design/methodology/approach
Questionnaires were created and disseminated to a representative sample of 590 undergraduate students and faculty on one college campus. This research took place after widespread efforts were made to increase faculty and student knowledge of the college’s recycling guidelines.

Findings
Among the measures of environmental orientation (values, concern about pollution and green consumption), only environmental values were associated with claiming to know guidelines and self-reporting higher levels of recycling effort. None was associated with knowledge about local recycling guidelines.

Research limitations/implications
Research on recycling programs at other campuses would help move beyond this specific case. The use of longitudinal surveys would help establish time-order.

Originality/value
This research makes an important contribution by measuring the impact well-intentioned people have on the waste stream. Without thorough knowledge of local recycling guidelines, even the most environmentally oriented people with the best of intentions may contribute to the waste stream by throwing away things that can be recycled and contaminating recycling bins with non-recyclable materials. The authors conclude that activist interventions are necessary to teach about campus recycling guidelines to reduce the waste produced on campus.
Beneficial Effect of Endovascular Therapy and Low‐Density Lipoprotein Apheresis Combined Treatment in Hemodialysis Patients With Critical Limb Ischemia due to Below‐Knee Arterial Lesions
Authors: Ohtake Takayasu , Mochida Yasuhiro , Matsumi Junya , Tobita Kazuki , Ishioka Kunihiro , Oka Machiko , Maesato Kyoko , Moriya Hidekazu , Hidaka Sumi , Saito Shigeru , Kobayashi Shuzo 
Published: July 2016

AbstractTo assess the clinical benefit of combined treatment of below‐knee endovascular therapy (BK‐EVT) plus low‐density lipoprotein apheresis (LDLA) compared with BK‐EVT monotherapy, we retrospectively evaluated the clinical outcome of hemodialysis (HD) patients with critical limb ischemia (CLI) due to isolated BK arterial lesions who underwent BK‐EVT or BK‐EVT plus short‐term LDLA. Between October 2011 and September 2014, 62 HD patients underwent isolated BK‐EVT monotherapy (BK‐EVT group), and 25 HD patients underwent BK‐EVT plus LDLA (BK‐EVT + LDLA group). LDLA was started within 1 week after BK‐EVT and performed four times in total within next 2 weeks. Major adverse limb events (MALE) including major amputation and re‐intervention, and all‐cause mortality were examined by Kaplan–Meier method and the log‐rank test. Baseline characteristics were not different other than low ABI and low dorsal SPP in BK‐EVT + LDLA group. Cumulative MALE‐free rate was significantly improved in BK‐EVT + LDLA group over the BK‐EVT group (72.0% and 45.1% respectively at 30 months after treatment, P = 0.04). All‐cause mortality did not differ between the two groups. Major causes of death were heart failure and sepsis in both groups. Short‐term LDLA hybrid treatment immediately after BK‐EVT might improve the outcome of ischemic limbs after re‐vascularization therapy.
Cold hardiness in the pre‐imaginal stages of the great web‐spinning pine‐sawfly Acantholyda posticalis
Authors: Voolma Kaljo , Hiiesaar Külli , Williams Ingrid H. , Ploomi Angela , Jõgar Katrin 
Published: July 2016

Abstract

The great web‐spinning pine‐sawfly Acantholyda posticalis Mats. (Hymenoptera: Pamphiliidae) is one of the major defoliating insects of pine forests. Mass outbreaks of this species have occurred in Scots pine (Pinus sylvestris L.) stands in Central Europe and in the southern parts of Eastern Europe and Siberia. Recently, the outbreak range has shifted northward and new outbreaks have been recorded in Estonia and Finland.
The dynamics of the supercooling capability of pre‐imaginal stages of A. posticalis (eonymphs, pronymphs, pupae) collected from the soil in a pine forest on the Island of Saaremaa, Estonia, were determined.
The supercooling points (SCP) of overwintering eonymphs and pronymphs changed during the winter, although there were no significant differences between the mean SCPs of either larval stage on any measuring date. The mean SCPs decreased from October (−8 to −10 °C) to January and March (−15 to −17 °C) and increased once again in May (−9 to −11 °C). The average SCP of pupae was considerably higher (−5.3 °C).
Overwintering larvae in the soil are potentially covered by an insulating layer of forest litter, moss and snow, thus avoiding direct exposure to low temperatures. Cold‐hardiness in both overwintering larval stages of A. posticalis is sufficient for successful survival during winter in the northern Baltic region.
At present, outbreaks of A. posticalis in higher latitudes are concentrated in milder maritime regions near the coast of the Baltic Sea, although these may expand in the future as a result of climate warming, with the sawfly possibly becoming a serious pest of pine forests of northern Europe.
Pricing a rural development program: uncertainty, indifference, and protest behaviors
Authors: Domínguez‐Torreiro Marcos , Soliño Mario 
Published: July 2016

AbstractThis article presents an econometric approach to modeling uncertainty, unwillingness to pay, and protest behavior in contingent valuation studies. For that purpose, a mixture model with sample selection is developed for a multiple‐bounded uncertainty elicitation format. The proposed theoretical framework is applied to evaluate the social welfare impact of implementing a sustainable rural development program. Results show that a “naive” analytical approach that excludes protesters from the analysis would result in significantly higher willingness to pay estimates for those individuals who favor the implementation of the program and agree to reveal their true reservation prices.