bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of an Integrated Hip Fracture Inpatient Program on Length of Stay and Costs
Authors: Soong Christine , Cram Peter , Chezar Ksenia , Tajammal Faiqa , Exconde Kathleen , Matelski John , Sinha Samir K. , Abrams Howard B. , Fan-Lun Christopher , Fabbruzzo-Cota Christina , Backstein David , Bell Chaim M. 
Published: September 2016

Background:
Hip fractures are associated with significant morbidity and mortality. Co-management models pairing orthopaedic surgeons with hospitalists or geriatricians may be effective at improving processes of care and outcomes such as length of stay (LOS) and cost. We set out to determine the effect of an integrated hip fracture co-management model on LOS, cost, and process measures.

Methods:
We conducted a single-center pre–post study of 571 patients admitted to an academic medical center with hip fractures between January 2009 and December 2013. The group receiving an integrated medical-surgical co-management incorporating continuous improvement methodology was compared with a control population. Primary outcome was LOS. Secondary outcomes included cost per case, time to surgery, osteoporosis (OP) treatment, preoperative echocardiogram utilization, mortality, and readmission.

Results:
LOS decreased from 18.2 (1.1) to 11.9 (1.5) days, a reduction of 6.3 days (P < 0.001). Mean cost decreased by $4953 (P < 0.001) per case. Mean time to surgery decreased from 45.8 (66.8) to 29.7 (17.9) hours (P < 0.001). Initiation of OP treatment increased from 55.8% to 96.4% (P < 0.001). Preoperative echocardiogram use decreased from 15.8% to 9.1% (P < 0.05). There was a nonsignificant difference in mortality rate (5.0% vs. 2.1%, P = 0.06). Readmission rate remained unchanged (4.6% vs. 6.0%, P = 0.56).

Conclusions:
An integrated medical-surgical co-management model incorporating continuous improvement methodology was associated with reduced LOS, costs, time to surgery, and increased initiation of appropriate OP treatment.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Clinical and Histologic Effects of Fractional Microneedling Radiofrequency Treatment on Rosacea
Authors: Park Seon Yong , Kwon Hyuck Hoon , Yoon Ji Young , Min Seonguk , Suh Dae Hun 
Published: September 2016

BACKGROUND
Fractional microneedling radiofrequency (FMR) is an emerging treatment modality, but its effect on rosacea has not been studied yet.

OBJECTIVE
To investigate the potential impact of FMR treatment on clinical improvement and histologic changes in rosacea patients.

MATERIALS AND METHODS
A 12-week, prospective, randomized, split-face clinical trial was conducted. Two sessions of FMR were performed on one side of the cheeks with 4-week interval and the other side remained untreated. Erythema index from DermaSpectrometer and a* value from Spectrophotometer CM-2002 were measured at each visit for the objective measurement of erythema. Histologic analysis of skin samples was also carried out.

RESULTS
Clinical evaluation and photometric measurement revealed the reduction of redness in the treated side compared with untreated side and baseline. Erythema index decreased 13.6% and a* value decreased 6.8% at Week 12 compared with baseline. Reduced expression of markers related to inflammation, innate immunity, and angiogenesis was observed in immunohistochemical staining of tissue obtained after FMR treatment.

CONCLUSION
Fractional microneedling radiofrequency treatment showed modest clinical and histologic improvement of rosacea, and it might be used as an alternative or in combination with other treatment methods.
Effect of Atherosclerosis on the Lateral Circumflex Femoral Artery and Its Descending Branch: Comparative Study to Nonatherosclerotic Risk
Authors: Burusapat Chairat , Nanasilp Tirapat , Kunaphensaeng Paiboon , Ruamthanthong Anuchit 
Published: September 2016

Background:
The anterolateral thigh (ALT) flap has been widely used for reconstructions. Nevertheless, the atherosclerotic risk factors that affect the lateral circumflex femoral artery (LCFA) are still inconclusive. The aim was to study the effect of atherosclerosis on the LCFA and descending branch (dLCFA) visualized by computer tomographic angiography (CTA) between nonatherosclerosis and atherosclerosis.

Methods:
Retrospective studies of CTA of lower extremity were reviewed. The patients were divided into 2 groups: nonatherosclerotic and atherosclerotic risk factors. The angiographic study of LCFA and dLCFA was analyzed, and atherosclerotic and nonatherosclerotic risk factors were compared.

Results:
Ninety-seven patients with 194 lower extremities were enrolled. Atherosclerotic risks comprised 76 patients. A total of 14, 16, and 46 patients had 1, 2, and 3 risk factors, respectively. Musculocutaneous perforator was 79.38%. The LCFA originated from deep femoral, common femoral, and superficial femoral artery was 97.42%, 2.06%, and 0.52%, respectively. The dLCFA was classified into 5 types depending on its origin. Diameters of LCFA in nonatherosclerotic and atherosclerotic patients were 4.03 ± 0.71 and 4.07 ± 0.97 mm, respectively. No statistical significance was found between both groups in diameters of LCFA. Diameters of dLCFA in nonatherosclerotic patients were 2.28 ± 0.28 mm and in atherosclerotic patients were 2.11 ± 0.28 mm. Statistical significance of diameters of dLCFA was found in patients having 3 risk factors and smoker groups (p < 0.05).

Conclusions:
LCFA is not atherosclerosis resistant. Stenosis of the LCFA and dLCFA occurred in varying degrees in atherosclerosis-risk patients. Preoperative CTA should be considered to evaluate the patency in multiple risk factors patients.
The Transareolar–Periareolar Approach
Authors: Zelken Jonathan , Huang Jung-Ju , Wu Chih-Wei , Lin Yi-Ling , Cheng Ming-Huei 
Published: September 2016

Summary:
The periareolar approach is limited by areolar diameter. Asian women typically have smaller areolae than Western women. Voluminous and form-stable silicone implants demand larger incisions. Zigzag transareolar approaches closely approximate the nipple and improve exposure, but scar appearance remains problematic, and there is a risk of ductal injury and capsular contracture. We prefer a zigzag incision that straddles the areolar border. Between 2013 and 2015, 11 augmentation mammoplasties (20 incisions) were performed through a transareolar–periareolar (TAPA) incision. The TAPA incision resembles 3 inverted V’s that traverse the inferior areolar border. Outcomes were evaluated on the basis of photographs, clinical charts, and surveys. Women were 36 years old (range, 25–50). Silicone implants were used in 10 patients and saline in 1 patient. Implants were 270 cm3, placed in subpectoral position in 6 patients and subglandular position in 5. Follow-up was 12.5 months (range, 5–20 mo); there were no hematomas or infections. There was 1 case each of seroma (9.1%) and unilateral capsular contracture (9.1%) after secondary mammoplasty. There was no implant malposition or contour deformity. There were no keloids or hypertrophic scars. Every patient was satisfied. Nipple sensation was maintained or heightened in 100% of patients surveyed. The incisions were 139% longer than 180-degree periareolar scars. TAPA scars were well tolerated in this series of Asian women. We did not observe malposition, infection, or sensory disturbances. Despite its peripheral position on the nipple–areola complex, there are not enough data to determine whether TAPA incisions reduce risks compared with traditional approaches.
Descemet Membrane Endothelial Keratoplasty for Epithelial Downgrowth After Clear Corneal Cataract Surgery
Authors: Kim Young Shin , Jin So-Young , Chung Jin Kwon 
Published: September 2016

Objectives:
To describe the first case of Descemet membrane endothelial keratoplasty (DMEK) combined with argon laser photocoagulation and intracameral 5-fluorouracil (5-FU) injection in a patient with epithelial downgrowth after cataract surgery.

Methods:
Case report and review of the literature.

Results:
A 77-year-old female underwent uneventful cataract surgery using a clear corneal incision in her left eye. Six months after surgery, an epithelial cell sheet began to cover the posterior cornea and then spread to the anterior chamber structures, leading to anterior synechia and corectopia at 2 years. Argon laser photocoagulation was used to remove epithelial downgrowth on the iris surface. However, retrocorneal epithelial downgrowth gradually progressed, resulting in bullous keratopathy. DMEK with intracameral 5-FU injection was performed to remove epithelial tissue and replace the diseased endothelium with healthy endothelium. One year after surgery, her vision improved to 20/50 and the endothelial cell count was 1,643 cells/mm2 in her left eye. There were no further complications or recurrence of epithelial downgrowth.

Conclusions:
DMEK with preoperative argon laser and intraoperative 5-FU is a useful option for the treatment of diffuse epithelial downgrowths.
Clinical, histological, and molecular risk factors for cancer recurrence in patients with stage II colon cancer
Authors: Touchefeu Yann , Provost-Dewitte Marie , Lecomte Thierry , Morel Alain , Valo Isabelle , Mosnier Jean-François , Bossard Céline , Eugène Juliette , Duchalais Emilie , Chetritt Jérôme , Guyetant Serge , Bézieau Stéphane , Senellart Hélène , Caulet Morgane , Cauchin Estelle , Matysiak-Budnik Tamara 
Published: September 2016

Introduction
The assessment of risk factors of cancer recurrence in patients with stage II colon cancer (CC) is crucial. Our aim was to study the clinical, histological, and molecular features associated with 3-year disease-free survival in a series of consecutive patients with stage II CC treated in three regional digestive oncology centers.

Methods
Clinical and histological data of all patients after curative surgery for stage II CC, treated from 2001 until 2009, were collected retrospectively. Histological samples were obtained and tested prospectively for microsatellite instability using fluorescent PCR amplification. Cox proportional hazards regression models were used to calculate P values, hazard ratios (HRs), and 95% confidence intervals (CIs).

Results
Among 195 patients studied, 22 (11%) had disease recurrence during the 3-year period following diagnosis. On multivariate analysis, only low number of lymph nodes (HR=3.81, 95% CI: 1.19–12.19, P=0.02) and T4 status (HR=5.49, 95% CI: 1.06–28.43, P=0.04) were associated significantly with an increased risk of relapse.

Conclusion
In this series of stage II CC patients, only T4 status and low number of lymph nodes were independent risk factors for poor 3-year disease-free survival, suggesting that patients with these features should be considered for adjuvant chemotherapy.
Distinct Mitochondrial Disturbance in CD4+T and CD8+T Cells From HIV-Infected Patients
Authors: Yu Fengting , Hao Yu , Zhao Hongxin , Xiao Jiang , Han Ning , Zhang Yu , Dai Guorui , Chong Xuejing , Zeng Hui , Zhang Fujie 
Published: September 2016

Background:
Mitochondrial dysfunction has frequently been found in HIV-infected patients regardless of whether they received antiretroviral therapy (ART). Accumulating evidence suggests that HIV-infected patients exhibit marked changes in mitochondrial membrane potential (MMP), reactive oxygen species (ROS) accumulation, adenosine triphosphate generation, mitochondrial mass (MM), mitochondrial DNA, etc. However, mitochondrial toxicity in CD4+T and CD8+T cells caused by different levels of HIV progression and ART is poorly understood.

Methods:
Blood samples were obtained from 97 ART-naïve HIV-infected patients with different CD4+T cell counts, 97 nucleoside-reverse transcriptase inhibitors-exposed HIV-infected patients, and 25 HIV-negative subjects. MMP, ROS, and MM in CD4+T and CD8+T cells were assessed by flow cytometry.

Results:
In healthy subjects, the levels of MMP and MM in CD4+T cells were higher than those in CD8+T cells. HIV infection led to an increase in MM in CD4+T and CD8+T cells, but mainly influenced MMP in CD8+T cells and ROS accumulation in CD4+T cells. MM in CD4+T and CD8+T cells gradually increased after the loss of CD4+T cells. Although the dynamic changes in MMP in CD4+T cells were different from those in CD8+T cells during highly active ART, MM in both CD4+T and CD8+T cells was significantly decreased after 2 years of therapy, but increased again after 3 years.

Conclusions:
HIV infection and antiretroviral therapy both led to mitochondrial disturbances in CD4+T cells and CD8+T cells; however, the abnormal changes in mitochondrial parameters in CD4+T cells were different from those in CD8+T cells caused by HIV infection and antiretroviral therapy.
Affective capitalism of knowing and the society of search engine
Authors: Huvila Isto 
Published: September 2016

PurposeThe purpose of this paper is to discuss the affective premises and economics of the influence of search engines on knowing and informing in the contemporary society.Design/methodology/approachA conceptual discussion of the affective premises and framings of the capitalist economics of knowing is presented.FindingsThe main proposition of this text is that the exploitation of affects is entwined in the competing market and emancipatory discourses and counter-discourses both as intentional interventions, and perhaps even more significantly, as unintentional influences that shape the ways of knowing in the peripheries of the regime that shape cultural constellations of their own. Affective capitalism bounds and frames our ways of knowing in ways that are difficult to anticipate and read even from the context of the regime itself.Originality/valueIn the relatively extensive discussion on the role of affects in the contemporary capitalism, influence of affects on knowing and their relation to search engine use has received little explicit attention so far.
Collaborative information seeking in student group projects
Authors: Leeder Chris , Shah Chirag 
Published: September 2016

PurposeThe purpose of this paper is to gain a better understanding of the collaborative information seeking (CIS) behaviors of students conducting authentic group work projects, and the features of a collaborative search system that are most useful to these students.Design/methodology/approachAn exploratory study was conducted with 41 participants in ten groups working on an in class, for-credit group project assignment utilizing a collaborative search system. Quantitative and qualitative data were gathered on the everyday search practices of students over the course of the group project, along with quality scores for the sources found.FindingsResults showed that student behavior during their CIS related to the quality of their search outcomes, as the effective and efficient searchers found better quality sources. Students’ pre-task attitudes and experiences toward group work also relate to the quality of their search outcomes. Student feedback demonstrated the importance of making collaborative search tools convenient, lightweight, and easy to use.Practical implicationsThese findings may be useful to researchers designing and studying the effectiveness of collaborative search tools, and to instructors planning to incorporate group projects into their classes.Originality/valueIn this paper, the authors document the authentic behaviors and attitudes of students conducting group projects in an classroom setting, and offer specific recommendations for developers of collaborative search systems. These findings provide greater context for CIS research into the collaborative search behaviors of students conducting group work projects.
Developing a standard for youth modified therapeutic communities
Authors: Northam Jaimie Chloe , Magor-Blatch Lynne 
Published: September 2016

Purpose
The purpose of this paper is to explore the applicability of the Australasian Therapeutic Communities Association (ATCA) Standard to Australian youth-specific modified therapeutic communities (MTCs). An Interpretive Guide for Youth MTCs and Residential Rehabilitation (RR) Services was developed and a pilot trial conducted with three Australian youth MTC services.

Design/methodology/approach
Using a mixed-methods design, this study included three components: a consultation process with residential youth MTCs (N=15), which informed the development of the ATCA Standard Interpretive Guide for Youth MTCs and RR Services; a pilot trial of the materials with three Australian youth MTCs (N=53); and an evaluation of the interpretive guide and assessment of applicability of the ATCA standard to youth MTCs through pre- (N=32) and post- (N=19) pilot trial administrations of the Survey of Essential Elements Questionnaires (SEEQ), and post-pilot trial focus groups (N=21).

Findings
Results indicate that the ATCA Standard is applicable to youth MTC settings when applied with the Interpretive Guide, although no significant differences were found between the pre- and post-pilot trial administrations of the SEEQ.

Practical implications
Future research is recommended to explore active mechanisms of youth-specific MTCs, differences between adults and youth MTCs, and the development of TC-specific training.

Originality/value
To date, no standard for youth residential substance use services in Australia has been developed, and this is the first study of its kind internationally to explore the efficacy of standards in a youth MTC.
Length of stay as a predictor of reliable change in psychological recovery and well being following residential substance abuse treatment
Authors: Turner Brie , Deane Frank Patrick 
Published: September 2016

Purpose
Longer length of stay (LOS) in residential alcohol and other drug treatment has been associated with more favourable outcomes, but the optimal duration has yet to be determined for reliable change indices. Optimal durations are likely to be a function of participant and problem characteristics. The purpose of this paper is to determine whether LOS in a residential therapeutic community for alcohol and other drug treatment community independently predicts reliable change across a range of psychological recovery and well-being measures.

Design/methodology/approach
In total, 380 clients from Australian Salvation Army residential alcohol and other drug treatment facilities were assessed at intake and three months post-discharge using the Addiction Severity Index 5th ed., The Depression, Anxiety and Stress Scale, The Recovery Assessment Scale, the Mental Health Continuum-Short Form and The Life Engagement Test.

Findings
The findings confirm LOS as an independent predictor of reliable change on measures of well-being and client perceived assessment of recovery. The mean LOS that differentiated reliable change from no improvement was 37.37 days.

Originality/value
The finding of LOS as a predictor of reliable change and the identification of an estimated time requirement may be useful for residential drug treatment providers in modifying treatment durations.
Hidradenitis suppurativa is not associated with the metabolic syndrome based on body type: A cross‐sectional study
Authors: Vossen Allard R. J. V. , van der Zee Hessel H. , Onderdijk Armanda J. , Boer Jurr , Prens Errol P. 
Published: September 2016

AbstractA body type with a high waist circumference or elevated waist‐to‐hip ratio (WHR), known as the “apple” body type, represents central/visceral obesity and is associated with the metabolic syndrome. The aim of this study was to simultaneously investigate the body mass index (BMI) and WHR in order to classify body types in individuals with hidradenitis suppurativa (HS) compared with a general dermatological population. A hospital‐based cross‐sectional study was performed in the Netherlands. One hundred and six HS patients and 212 controls were included. The BMI was significantly higher in the HS group in comparison with the control group, at 27.8 ± 5.4 and 25.6 ± 4.8, respectively (P < 0.001). The WHR did not significantly differ between HS patients and the control dermatological population (P > 0.05). A more peripheral pattern of bodyweight distribution was seen in 43% of the 37 obese HS individuals, in contrast to 19% of 31 obese patients in the control group (P = 0.036). In conclusion, the body type in obese HS patients, based on the WHR, shows a more peripheral pattern and differs from the WHR in the BMI‐matched general dermatological population.
Compound heterozygosity for novel splice site mutations of ITGA6 in lethal junctional epidermolysis bullosa with pyloric atresia
Authors: Masunaga Takuji , Ogawa Junki , Akiyama Masashi , Nishikawa Takeji , Shimizu Hiroshi , Ishiko Akira 
Published: September 2016

AbstractJunctional epidermolysis bullosa with pyloric atresia (PA‐JEB) is a rare congenital bullous disease with gastrointestinal disturbance that has been associated with mutations in ITGA6 or ITGB4 encoding the α6 or β4 subunit of integrin, respectively. Only six ITGA6 mutations in PA‐JEB have been reported while many ITGB4 mutations have been identified, and all the ITGA6 mutations were homozygous. Here, we report a case of lethal type PA‐JEB, in which immunofluorescence showed the lack of both α6 and β4 integrins resulting from compound heterozygous splice site mutation in ITGA6, c.387G>T and c.2506‐1G>C. Maternal c.387G>T induced the skipping of the entire exon 3 and both exons 3 and 4, resulting in premature termination codon and in‐frame deletion, respectively. Paternal c.2506‐1G>C caused the skipping of the exon 20 and resulted in in‐frame deletion. As a reason why the present case showed lethal phenotype despite the in‐frame deletion mutation, rapid degradation of neo‐synthesized α6 protein and/or impaired transport of integrin were suggested from previous reports, and the lack of localization of integrin α6β4 to the epidermal basement membrane resulted in skin fragility. Our case expands the variety of integrin α6 mutations in PA‐JEB.
Usefulness of real‐time tissue elastography for detecting the border of basal cell carcinomas
Authors: Tanaka Takamitsu , Tada Yayoi , Ohnishi Takamitsu , Watanabe Shinichi 
Published: September 2016

AbstractPreoperative evaluation of tumor thickness and silhouette in basal cell carcinoma (BCC) is one of the important assessments to be done. However, evaluation is not always sufficient even utilizing sonography and magnetic resonance imaging. Recently, a new technique called real‐time tissue elastography (RTE) was developed that can display the hardness of tissue as a color overlay of a sonographic image. Therefore, RTE could be used as a tool for detecting the tumor border according to differences in tissue rigidity. In the present study, the correlation between histopathological and RTE tumor thickness measurements was evaluated for BCC. Eleven BCC (six nodular, three superficial, and two adenoid or cystic) from individual patients were evaluated. Tumor silhouette and thickness were detected using conventional B‐mode sonography and RTE. All lesions were surgically excised and tumor thickness was also examined histologically. In the six nodular BCC, the tumor silhouette determined by RTE showed a close correlation with the results of histopathology. Particularly, for four out of the six cases, the correlation was excellent. In addition, the mean difference in tumor thickness measurements between histology and RTE (−0.368 mm) was lower than that between histology and B‐mode sonography (−0.835 mm). As for the superficial BCC, tumor thickness was too thin to evaluate. Tumor thickness measured by B‐mode sonography and RTE was identical for two cases of adenoid or cystic BCC. In conclusion, RTE is useful in the preoperative assessment of tumor thickness, especially with the nodular type of BCC, and allows us to determine adequate surgical margins.