bluuebunny/crossref_metadata_2025_split huggingface dataset:
Controls of Mantle Potential Temperature and Lithospheric Thickness on Magmatism in the North Atlantic Igneous Province
Authors: Hole M. J. , Millett J. M. 
Published: April 2016

Abstract
Modelled primary magma compositions of Palaeogene basalts from the North Atlantic Igneous Province (NAIP) require melting at mantle potential temperatures (TP) in the range 1480–1550°C. Modern lavas from Icelandic rift zones require TP ∼ 1500°C and those from the rift flanks TP ∼ 1450°C. Secular cooling of the NAIP thermal anomaly was therefore of the order of ∼50°C over the past 61 Myr. There were systematic variations in TP of 50–100°C from the centre of the thermal anomaly to its margins at any one time, although limits on the stratigraphical distribution of TP determinations do not rule out thermal pulsing on a timescale of millions of years. Variation in extent of melting at similar TP was controlled by local variability in lithospheric thickness. In the west of the NAIP, lithosphere thickness varied from ∼90 km at Disko Island to ∼65 km at Baffin Island, with similar thickness variations being evident for magmatism in the Faroe Islands, Faroe–Shetland Basin and the British Palaeogene Igneous Province (BPIP). Mean pressure of melting was greater than or equal to the final pressure of melting; the two values converge for melting columns with a melting interval of &lt;1·5 GPa, regardless of TP. The majority of the BPIP magmas were generated in the garnet–spinel transition in the upper mantle. Calculated and observed rare earth element distributions in NAIP lavas are entirely consistent with the melting regimes derived from major element melting models. This allows a calibration of rare earth element fractionation and melting conditions that can be applied to other flood basalt provinces.
Efficacy of vaginally applied estrogen, testosterone, or polyacrylic acid on vaginal atrophy: a randomized controlled trial
Authors: Fernandes Tatiane , Costa-Paiva Lucia Helena , Pedro Adriana Orcesi , Baccaro Luiz Francisco Cintra , Pinto-Neto Aarão Mendes 
Published: April 2016

Abstract

Objective:
Vaginal atrophy is a common chronic condition among postmenopausal women that can affect their quality of life. Recent studies have evaluated new treatment alternatives for vaginal atrophy; however, few therapeutic options have been thoroughly evaluated. This study aimed to compare the effectiveness and adverse effects of estrogen, testosterone, polyacrylic acid, and placebo lubricant for the treatment of postmenopausal women with vaginal atrophy.

Methods:
We conducted a randomized clinical trial with 80 postmenopausal women aged between 40 and 70 years who were being followed up at the Menopause Clinic of CAISM UNICAMP between November 2011 and January 2013. Women were randomly assigned to topical vaginal treatment with estrogen, testosterone, polyacrylic acid, and placebo lubricant, three times a week for 12 weeks. We used the vaginal maturation index, pH, vaginal health score, vaginal flora, laboratory tests, and ultrasound to evaluate changes of vaginal atrophy at baseline and after 6 and 12 weeks of treatment.

Results:
After a 12-week treatment with topical estrogen and testosterone compared with the lubricant, an increased percentage of participants had vaginal pH less than 5, increased vaginal score, and an increase in the number of lactobacilli. Treatment with topical estrogen improved the vaginal maturation index and showed increased levels of estradiol in three women. No changes were observed in the endometrial evaluation of all treatment groups.

Conclusions:
After a 12-week treatment with testosterone and estrogen compared with placebo lubrication, there was a significant improvement in vaginal trophism in postmenopausal women with vaginal atrophy.
Our Experience with 131 Cases of Simultaneous Breast Implant Exhange with Fat (SIEF)
Authors: Ohashi Masanori , Yamakawa Masayuki , Chiba Akihiko , Nagano Hiroshi , Nakai Hirokazu 
Published: April 2016

Background:
Breast augmentation with fat injection is a growing trend in Japan. Many Japanese patients experiencing breast implant complications are requesting to have their breast implants removed and simultaneously exchanged with autologous fat injection. The keys of our simultaneous implant exchange with fat (SIEF) process are to embrace the “Coleman technique” and to carefully detach implant capsules when removing breast implants. Furthermore, we carefully inject fat to avoid necrosis.

Methods:
Between January 2010 and January 2015, we investigated consecutively 131 Japanese patients whom we could follow up for over 6 months postsurgery. We ascertained the usefulness of SIEF by assessing changes in breast size, complications, and a satisfaction survey.

Results:
There were no serious complications. We had experienced mild complications in 9.2% of patients (12/131). Partial fat necrosis with inflammation occurred in 2.3% of patients (3/131), seroma in the capsule in 3.1% (4/131), complaints of nodules (cysts, lumps) in 3.1% (4/131), and 1 hematoma patient (0.8%). At 6 months after surgery (n = 131), breast cup size (by Japanese Industrial Standards) had decreased by less than 1 cup size, despite SIEF. At 6 months, we performed a postsurgery satisfaction survey, and only 4% of the patients (5/131) were not satisfied with their surgery results.

Conclusions:
SIEF is a very safe and effective procedure. Breast implants removed with a low invasive traumatic approach and centrifuged fat injected with the “Coleman technique” are important principles in our practice. Furthermore, avoiding fat necrosis is one of the most important considerations, and our SIEF approach allows us to better control this potential complication during the surgical process.
Reconstruction of Extensive Volar Finger Defects with Double Cross-Finger Flaps
Authors: Buehrer Gregor , Arkudas Andreas , Ludolph Ingo , Horch Raymund E. , Taeger Christian Dirk 
Published: April 2016

Summary:
Cross-finger flaps still represent a viable option to reconstruct small- to medium-sized full-thickness finger defects but they are not commonly used if larger areas have to be covered. We present 2 cases showing a simple and pragmatic approach with homodigital double cross-finger flaps to reconstruct extensive volar finger soft-tissue defects. We observed very low donor-site morbidity and excellent functional and aesthetic outcomes. Furthermore, there is no need for microsurgical techniques or equipment when using this method. Although this case report only addresses volar defects, one might also think of applying this concept to dorsal defects using reversed double cross-finger flaps.
Factors Associated With Utilization of Cardiac Rehabilitation Among Patients With Ischemic Heart Disease in the Veterans Health Administration
Authors: Schopfer David W. , Priano Susan , Allsup Kelly , Helfrich Christian D. , Ho P. Michael , Rumsfeld John S. , Forman Daniel E. , Whooley Mary A. 
Published: April 2016

BACKGROUND:
Cardiac rehabilitation (CR) programs reduce morbidity and mortality in patients with ischemic heart disease but are vastly underutilized in the United States, including the Veterans Health Administration (VA) Healthcare System. Numerous barriers affecting utilization have been identified in other health care systems, but the specific factors affecting Veterans are unknown. We sought to identify barriers and facilitators associated with utilization of CR in VA facilities.

METHODS:
We performed a qualitative study of 56 VA patients, providers, and CR program managers at 30 VA facilities across the United States. We conducted semistructured interviews with key informants to explore their attitudes and knowledge toward CR. Interviews were conducted until thematic saturation occurred. Analyses using grounded theory to identify key themes were conducted using the qualitative data analysis package ATLAS.ti.

RESULTS:
We identified 6 themes as barriers and 5 as facilitators. The most common barriers to participation in CR were patient transportation issues (68%), lack of patient willingness to participate (41%), and no access to a nearby VA hospital with a CR program (30%). The most common facilitators were involvement of a dedicated provider or “clinical champion” (50%), provider knowledge of or experience with CR (48%), and patient desire for additional medical support (32%).

CONCLUSIONS:
Our findings suggest that addressing access issues and educating and activating providers on CR may increase utilization of CR programs. Targeting these specific factors may improve utilization of CR programs.
Prescribing Cycle Exercise Intensity Using Moderate Symptom Levels in Chronic Obstructive Pulmonary Disease
Authors: Zainuldin Rahizan , Mackey Martin G. , Alison Jennifer A. 
Published: April 2016

PURPOSE:
Laboratory-based cardiopulmonary exercise testing from which to prescribe cycle training intensity in pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD) is not readily available in clinical practice. Alternative methods of prescribing cycle exercise intensity, such as patient symptoms of dyspnea or rating of perceived exertion (RPE), have been used, but it is unknown whether cycle intensity based on such symptoms elicits an exercise intensity appropriate for achieving physiological training responses. The aim of the study was to determine the exercise intensity elicited when continuous cycle exercise was prescribed at symptoms of moderate dyspnea or RPE in people with COPD.

METHODS:
Participants with diagnosed COPD performed lung function tests and an incremental cycle test to peak work capacity. On a subsequent day, participants performed 10 minutes of cycle exercise based on moderate symptoms (CycleSYMP) of either dyspnea or RPE, depending on which symptom limited the incremental cycle test. Oxygen uptake (

JOURNAL/jcprh/04.03/01273116-201605000-00007/7FSM1/v/2023-09-11T074048Z/r/image-gif

o
2) was measured during all exercise using a portable metabolic system (Cosmed K4b2).

RESULTS:
Thirty participants, mean age of 70 ± 9 years and FEV1 60 ± 12% predicted, completed the study. The mean intensity achieved during CycleSYMP was 78 ± 12%

JOURNAL/jcprh/04.03/01273116-201605000-00007/7FSM1/v/2023-09-11T074048Z/r/image-gif

o
2
peak and 71 ± 18 %

JOURNAL/jcprh/04.03/01273116-201605000-00007/7FSM1/v/2023-09-11T074048Z/r/image-gif

o
2
Reserve. Steady-state

JOURNAL/jcprh/04.03/01273116-201605000-00007/7FSM1/v/2023-09-11T074048Z/r/image-gif

o
2 was achieved by the sixth minute of CycleSYMP.

CONCLUSIONS:
Using symptoms of moderate dyspnea or RPE as a method of prescribing cycle exercise elicited a high training intensity at which steady-state was achieved in people with mild to moderate COPD.
Transaortic Aortic Valve Implantation in 100 Patients: Follow-up to 3 Years
Authors: Cocchieri Riccardo , Koh Ezra Y. , Wollersheim Laurens W. , Meregalli Paola G. , Bardai Abdenasser , Bouma Berto J. , De Mol Bas A. 
Published: April 2016

Objective Transaortic aortic valve implantation (TAo-AVI) through the ascending aorta is a novel technique and is used as an alternative in patients with poor femoral access. Although early results have been promising, no midterm data have been published yet. To determine whether this approach is an acceptable treatment option, we analyzed the first 100 cases performed at our institution with a follow-up to 3 years. Methods Between July 2011 and January 2015, a total of 100 patients with high-risk or inoperable aortic valve stenosis were treated with TAo-AVI. Preoperative patient data were collected and analyzed retrospectively. All surviving patients were seen for clinical and echocardiographic examination for follow-up. Results Median follow-up was 15 months. Device success was accomplished in 94 patients (94%). There were no access site complications. The 30-day mortality rate was 9%. Stroke occurred in a total of six patients (6%). Survival at 1-, 2-, and 3 years was 75%, 62%, and 58%, respectively. Conclusions Our results show that TAo-AVI is a promising alternative to transapical implantation for treating severe inoperable aortic valve stenosis.
Laboratory Investigations for Diagnosis of Autoimmune and Inflammatory Periocular Disease: Part II
Authors: Srinivasan Archana , Kleinberg Teri T. , Murchison Ann P. , Bilyk Jurij R. 
Published: April 2016

Purpose:
To review the important laboratory serological investigations routinely performed for the diagnosis of autoimmune and inflammatory diseases of the orbit and ocular adnexa.

Methods:
Review of the literature as well as personal clinical experience of the authors. Due to the extensive nature of the topic, the review has been split into 2 parts. Part I covers thyroid eye disease, IgG4-related disease, and myasthenia gravis. In part II of the review, sarcoidosis, vasculitis, Sjögren syndrome, and giant cell arteritis will be discussed.

Results:
Several relatively specific serologic tests are available for the diagnosis of a variety of inflammatory and serologic diseases of the orbit.

Conclusion:
In cases of limited orbital or sino-orbital disease, serologic testing may be negative in a significant number of patients. Specifically, the clinician should be wary of ruling out limited orbital sarcoid or sinoorbital granulomatosis with polyangiitis based on serologic testing alone. Part I of this review has covered serologic testing for thyroid eye disease, IgG4-related disease, and myasthenia gravis. In part II, the authors discuss serologic testing for sarcoidosis, vasculitis, Sjögren syndrome (SS), and giant cell arteritis (GCA).
Who Were the Early Adopters of Dabigatran?
Authors: Lo-Ciganic Wei-Hsuan , Gellad Walid F. , Huskamp Haiden A. , Choudhry Niteesh K. , Chang Chung-Chou H. , Zhang Ruoxin , Jones Bobby L. , Guclu Hasan , Richards-Shubik Seth , Donohue Julie M. 
Published: April 2016

Background:
Variation in physician adoption of new medications is poorly understood. Traditional approaches (eg, measuring time to first prescription) may mask substantial heterogeneity in technology adoption.

Objective:
Apply group-based trajectory models to examine the physician adoption of dabigratran, a novel anticoagulant.

Methods:
A retrospective cohort study using prescribing data from IMS Xponent™ on all Pennsylvania physicians regularly prescribing anticoagulants (n=3911) and data on their characteristics from the American Medical Association Masterfile. We examined time to first dabigatran prescription and group-based trajectory models to identify adoption trajectories in the first 15 months. Factors associated with rapid adoption were examined using multivariate logistic regressions.

Outcomes:
Trajectories of monthly share of oral anticoagulant prescriptions for dabigatran.

Results:
We identified 5 distinct adoption trajectories: 3.7% rapidly and extensively adopted dabigatran (adopting in ≤3 mo with 45% of prescriptions) and 13.4% were rapid and moderate adopters (≤3 mo with 20% share). Two groups accounting for 21.6% and 16.1% of physicians, respectively, were slower to adopt (6–10 mo post-introduction) and dabigatran accounted for <10% share. Nearly half (45.2%) of anticoagulant prescribers did not adopt dabigatran. Cardiologists were much more likely than primary care physicians to rapidly adopt [odds ratio (OR)=12.2; 95% confidence interval (CI), 9.27–16.1] as were younger prescribers (age 36–45 y: OR=1.49, 95% CI, 1.13–1.95; age 46–55: OR=1.34, 95% CI, 1.07–1.69 vs. >55 y).

Conclusions:
Trajectories of physician adoption of dabigatran were highly variable with significant differences across specialties. Heterogeneity in physician adoption has potential implications for the cost and effectiveness of treatment.
Racial/Ethnic Disparities in Medicare Beneficiaries’ Care Coordination Experiences
Authors: Martino Steven C. , Elliott Marc N. , Hambarsoomian Katrin , Weech-Maldonado Robert , Gaillot Sarah , Haffer Samuel C. , Hays Ron D. 
Published: April 2016

Background:
Little is known about racial/ethnic differences in the experience of care coordination. To the extent that they exist, such differences may exacerbate health disparities given the higher prevalence of some chronic conditions among minorities.

Objective:
To investigate the extent to which racial/ethnic disparities exist in the receipt of coordinated care by Medicare beneficiaries.

Subjects:
A total of 260,974 beneficiaries who responded to the 2013 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

Methods:
We fit a series of linear, case-mix adjusted models predicting Medicare CAHPS measures of care coordination from race/ethnicity.

Results:
Hispanic, black, and Asian/Pacific Islander (API) beneficiaries reported that their personal doctor had medical records and other relevant information about their care significantly less often than did non-Hispanic white beneficiaries (−2 points for Hispanics, −1 point for blacks, and −4 points for APIs on a 100-point scale). These 3 groups also reported significantly greater difficulty getting timely follow-up on test results than non-Hispanic white beneficiaries (−9 points for Hispanics, −1 point for blacks, −5 points for APIs). Hispanic and black beneficiaries reported that help was provided in managing their care significantly less often than did non-Hispanic white beneficiaries (−2 points for Hispanics, −3 points for blacks). API beneficiaries reported that their personal doctor discussed their medications and had up-to-date information on care from specialists significantly less often than did non-Hispanic white beneficiaries (−2 and −4 points, respectively).

Discussion:
These results suggest a need for efforts to address racial/ethnic disparities in care coordination to help ensure high-quality care for all patients. Public reporting of plan-level performance data by race/ethnicity may also be helpful to Medicare beneficiaries and their advocates.
‘Waterloo’: when normal blood cells meet leukemia
Authors: Cheng Hui , Cheng Tao 
Published: April 2016

Purpose of review
Mortality and morbidity associated with leukemia are largely due to frequently occurring cytopenias or the dysfunction of normal blood cells in patients. Our knowledge of how normal blood cells degenerate in response to leukemic cell infiltration has been quite limited. This review summarizes recent findings and discusses both extrinsic and intrinsic mechanisms underlying the suppression of normal hematopoiesis in leukemia.

Recent findings
Recent studies have shown that leukemic cells are able to remodel the bone marrow niche by secreting specific cytokines or dampening its hematopoietic-supporting functions. In turn, a suitable microenvironment for leukemic cell proliferation but not for normal hematopoietic cell growth is created. Intrinsically, the leukemic condition impairs the normalcy of hematopoietic stem and progenitor cells and alters their signaling networks; consequently, it exhausts hematopoietic progenitor cells and forces stem cells into a more quiescent state, which would allow a reversible suppression of hematopoietic regeneration. The deepened quiescence of hematopoietic stem cells in leukemic marrow was achieved in part via transcription factor Egr3.

Summary
These findings provide new insights into the mechanisms underlying hematopoietic suppression in response to leukemic cell outgrowth and offer new strategies to further improve current therapies for leukemias, placing more emphasis on the augmentation of normal hematopoietic regeneration when targeting leukemic cells.
Methylphenidate Overdose Causing Secondary Polydipsia and Severe Hyponatremia in an 8-Year-Old Boy
Authors: Patel Vanisha , Krishna Ashwin Subramani , Lefevre Cassandra , Kaagaza Mildred , Wittkamp Michael 
Published: April 2016

Objective
Attention deficit hyperactivity disorder (ADHD) is an increasingly common diagnosis of childhood that manifests with symptoms that affect cognitive, academic, behavioral, emotional, and social functioning. There are a multitude of pharmaceutical therapies to choose from when managing this condition, and though many studies on the safety and efficacy of these medications have been published, adverse effects still occur.

Case
This case discusses a previously healthy 8-year-old boy who had been prescribed 20-mg lisdexamfetamine dimesylate for ADHD however mistakenly took his brother's 36-mg methylphenidate extended-release tablets, resulting in hyperhidrosis, excessive thirst, polydipsia, and combative behavior that began within 3 hours of ingestion. He was evaluated at a community hospital emergency department and given lorazepam due to agitation and combativeness before discharge. However, he returned with hypothermia, hyponatremia, and status epilepticus resulting in intubation. Patient was transferred to our facility where a computer tomography of his head was negative and hyponatremia was corrected with 3% NaCl saline solution. A lumbar puncture was performed due to temperature instability before starting broad-spectrum antibiotics. Cerebrospinal fluid findings were normal, and he was extubated at 18 hours postingestion. Patient was discharged home after 3 days with no residual symptoms.

Discussion/Conclusions
Though both lisdexamfetamine dimesylate and methylphenidate are widely used among pediatricians today for treatment of ADHD, reports of life-threatening water intoxication as a result of overdose is rare. Studies have reported that severe 3,4-methylenedioxymethamphtamine toxicity in adults is associated with syndrome of inappropriate diuretic hormone (SIADH) secretion, hyponatremia, and seizures, along with serotonin-induced transient elevation in antidiuretic hormone. Adult schizophrenics who receive psychostimulants have also been shown to develop polydipsia with hyponatremia. Although the use of psychostimulants in adult schizophrenic patients has been studied, literature on toxicity and effects in the pediatric psychiatric population is scarce. We would suggest that this patient's polydipsia and hyponatremia are most likely a result of his ingestion of a toxic dose of a long-acting agent known to cause secondary psychosis.