bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Anchored Hearing Implant Surgery: 1 Year Follow-Up Data Shows No Effect of Hydroxyapatite Coating on Soft Tissue Reaction After Loading at 1 Week
Authors: Høgsbro Morten , Agger Andreas , Johansen Lars Vendelbo 
Published: May 2017

Objective:
To assess postoperative skin complications around a bone anchored hearing implant (BAHI) abutment coated with hydroxyapatite and loaded after 1 week.

Design:
Single center, prospective cohort study of 25 adults with expected normal skin and bone quality.

Intervention:
Implantation of the Baha BA400 hydroxyapatite coated implant system using a linear incision technique without soft tissue reduction. Abutments with lengths of 8 mm (n = 9), 10 mm (n = 11), and 12 mm (n = 5) were used. The implants were loaded after 7 days (n = 23), 8 days (n = 1), and 12 days (n = 1).

Main Outcome Measures:
: Soft tissue evaluation (Holger's score, skin overgrowth, pain, numbness) at 7 (±2), 14 (±3), and 30 (±7) days and 3 months (±14 days), 6 months (±14 days), and 12 months (±30 days). The results were compared with a historic control group.

Results:
Twenty five patients were included, 23 could be followed up for 1 year. In 93.8% of the visits, patients had a Holger's score less than or equal to 1. One patient needed revision surgery due to skin overgrowth. 18.8% of the patients experienced mild pain during follow-up, primarily during the first month. Sensibility loss was very limited. Compared with similar patients having the smooth titanium abutment (loaded at 2 wk), there was a slightly increased level of short-term soft tissue reaction.

Conclusion:
The study shows a small, non-detrimental, negative effect on short-term soft tissue status after loading of the implant at 7 days. No positive effect from the hydroxyapatite coating could be demonstrated for the long-term soft tissue status.
Patients in prehospital transport to the emergency department: a cohort study of risk factors for 7-day mortality
Authors: Noergaard Bech Camilla L. , Brabrand Mikkel , Mikkelsen Søren , Lassen Annmarie 
Published: May 2017

Background
Ambulance transfer is the first contact with the healthcare system for many patients in emergency conditions.
We aimed to identify prognostic risk factors accessible in the prehospital phase that indicate an increased risk of 7-day mortality.

Patients and methods
We included patients aged 18 years or older, transferred by ambulance to the emergency department at Odense University Hospital, from 1 April 2012 to 30 September 2014. We carried out multivariate logistic regressions, adjusted for age and sex, to describe the relationship between vital sign values recorded in the prehospital setting and 7-day mortality.

Results
A total of 32 076 ambulance transfers were recorded. Of these, 20 328 were first-time transfers, including 2692 that received assistance from a physician-staffed mobile emergency care unit (MECU). The 7-day mortality was 5.3% [95% confidence interval (CI): 5.0–5.6]. The risk of death increased with age. The odds ratios (ORs) were 2.0 (95% CI: 1.1–3.5) for ages 30–44 years and 7.3 (95% CI: 4.5–11) for ages 45–69 years compared with the 18–29-year-olds. All abnormal vital sign values were associated with increased 7-day mortality. Glasgow Coma Score of less than 14 had the strongest association (OR: 17, 95% CI: 14.7–19.7). MECU assistance showed an adjusted OR of 5.3 (95% CI: 4.6–6.1).

Conclusion
The overall 7-day mortality was 5.3%, but differed in the two subgroups, with 15.4% in the MECU-assisted ambulance transfers and 3.8% in non-MECU-assisted transfers. Older age and Glasgow Coma Scores below 14 were the strongest of factors associated significantly with 7-day mortality.
Elapsed Time Between the First Symptoms of Breast Cancer and Medical Help-Seeking Behavior and the Affecting Factors
Authors: Gözüm Sebahat , Tuzcu Ayla 
Published: May 2017

Background:
Many studies have determined that the time between women’s realization of first symptoms and seeking help from a healthcare professional is more than 1 month. The situation is defined as delay in medical help-seeking behavior (MHSB).

Objective:
The purpose of this study was to determine the time elapsed between the first symptoms of breast cancer and MHSB, as well as the factors contributing to the delay.

Methods:
In this descriptive study, the data were collected from 132 patients who received a diagnosis of breast cancer and are receiving treatment in the Oncology Clinic of Akdeniz University Hospital. The questionnaire used in the study was structured in 3 parts: sociodemographic characteristics, breast cancer history/screening behaviors, and psychological factors affecting MHSB. The elapsed time between patients’ first symptoms and MHSB was classified into “normal” when it was less than 1 month, “delay” when it was between 1 and 3 months, “long-term delay” when it was more than 3 months, and “very serious delay” when it was more than 6 months.

Results:
A total of 59.8% were classified as normal, 16.7% as delayed, 5.3% as a long-term delay, and 18.2% as a very serious delay after first symptoms. The delay in MHSB time was affected 18.55 times by “not caring/minding,” 10.73 times by “fear,” 7.13 times by “having more important problems,” and 4.23 times by “realization of first symptoms” by themselves.

Conclusion:
Psychological factors were the most important determinants in delay. The MHSB time was less if those first realizing the symptoms were healthcare professionals.

Implications for Practice:
Healthcare professionals should direct women to screenings and train them to interpret symptoms correctly.
The 3-Phase Process in the Cancer Experience of Adolescents and Young Adults
Authors: Belpame Nathalie , Kars Marijke C. , Beeckman Dimitri , Decoene Elsie , Quaghebeur Marijke , Van Hecke Ann , Verhaeghe Sofie 
Published: May 2017

Background:
When confronted with cancer, adolescents and young adults (AYAs) enter a psychosocial trajectory. Previous research has acknowledged the importance of care adjusted to the specific needs of AYAs. To develop AYA-focused care, in-depth knowledge about the experiences of AYAs with cancer is necessary.

Objective:
The purposes of this study were to discover the psychosocial experiences of and their meanings for AYAs enduring cancer, as well as its treatment and follow-up, and to capture the basic social psychological process that shaped these experiences.

Methods:
This was a qualitative study in which individual semistructured interviews were conducted with 23 participants aged 15 to 25 years.

Results:
A 3-phase process was identified, which demonstrated alterations in the AYAs’ experiences and their underlying meanings: (1) maintaining normal life was essential, (2) normal life was slipping away, and (3) evolving toward a new normal life after treatment. Certain core dynamics were present in these 3 phases. Throughout the cancer trajectory, the AYAs attempted to maintain control, redefine the self, and incorporate their cancer experience to the long-term course of life and had varying expectations of their social networks.

Conclusions:
Understanding the process that AYAs with cancer go through and taking into account their experiences can facilitate better psychosocial care for this emotionally vulnerable population.

Implications for Practice:
Healthcare professionals need to take a patient-centered approach, with a focus on communication, to meet the needs of AYAs throughout the cancer trajectory.
Analysis of Interventions Required in 12,021 Children With Acute Intoxications Admitted to PICUs*
Authors: Patel Meral M. , Travers Curtis D. , Stockwell Jana A. , Geller Robert J. , Kamat Pradip P. , Grunwell Jocelyn R. 
Published: May 2017

Objectives:
Acute intoxications in children account for 4.6% of annual admissions to the PICU. We aimed to describe the interventions and monitoring required for children admitted to the PICU following intoxications with the ultimate goal of determining patient and intoxication characteristics associated with the need for PICU interventions.

Design:
Retrospective review of prospectively collected data from Virtual Pediatric Systems, LLC.

Setting:
United States PICUs participating in the Virtual Pediatric Systems database from 2011 to 2014.

Patients:
Less than or equal to 18 years old admitted to a PICU with a diagnostic code for poisoning, ingestion, intoxication, or overdose.

Interventions:
None.

Measurements and Main Results:
In total, 12,021 patients were included with a median PICU length of stay of 0.97 days (interquartile range, 0.67–1.60). Seventy-eight percent of the intoxications were intentional. The top five classes of medications ingested were unknown substances (21.6%), antidepressants (11.5%), other chemicals (10.7%), analgesics (7.3%), and antihypertensives (6.2%). Seventy-six (0.61%) patients died. Any of the interventions reported in the Virtual Pediatric Systems database were performed in only 29.1% of the total cases.

Conclusions:
The majority of cases (70.9%) admitted to the PICU following an intoxication did not undergo any significant intervention. Future studies should focus on distinguishing patient and intoxication characteristics associated with need for PICU intervention to optimize patient safety and minimize resource burden.
Brief Report: CYP2B6 516G>T Minor Allele Protective of Late Virologic Failure in Efavirenz-Treated HIV-Infected Patients in Botswana
Authors: Vujkovic Marijana , Bellamy Scarlett L. , Zuppa Athena F. , Gastonguay Marc , Moorthy Ganesh S. , Ratshaa Bakgaki R. , Han Xiaoyan , Steenhoff Andrew P. , Mosepele Mosepele , Strom Brian L. , Aplenc Richard , Bisson Gregory P. , Gross Robert 
Published: May 2017

Background:

CYP2B6 polymorphisms that affect efavirenz (EFV) concentrations are common, but the effect of this polymorphism on HIV virologic failure in clinical practice settings has not fully been elucidated. Our objective was to investigate the relationship between the CYP2B6 516G>T genotype and late virologic failure in patients treated with EFV in Gaborone, Botswana.

Setting:
We performed a case–control study that included 1338 HIV-infected black Batswana on EFV-based antiretroviral therapy (ART). Patients were approached for enrollment during regular visits at one of the outpatient HIV clinics between July 2013 and April 2014.

Methods:
Cases experienced late HIV failure, defined as plasma HIV RNA >1000 copies/mL after maintaining viral suppression (<400 copies/mL) for at least 6 months. For each case, a total of 4 control patients were randomly sampled from the same population. Controls had plasma HIV RNA <400 copies/mL on ART for at least 6 months. Logistic regression was used to determine the adjusted odds of late HIV failure by 516G>T genotype.

Results:
After adjustment for the confounding variables age and CD4 count, the CYP2B6 516 T-allele was protective against late HIV virologic breakthrough, adjusted OR 0.70; 95% CI: 0.50 to 0.97.

Conclusion:
The CYP2B6 516 T-allele was protective against late virologic breakthrough in patients with initial (6 month) HIV RNA suppression on EFV-based ART. Future studies are needed to assess long-term viral benefits of identifying and offering EFV containing ART to black African HIV-infected patients with CYP2B6 T-alleles, especially given the wider availability of a single pill EFV in this setting.
Intraluminal Uterine Hypodensity in CT Scans of Postmenopausal Women: Recommendations for Interpretation
Authors: Amitai Michal Marianne , Yassin Mohamad , Kanana Nayrouz , Apter Sara , Rozendorn Noa , Konen Eli , Klang Eyal 
Published: May 2017

Objective
This study aims to investigate the association between intraluminal uterine hypodensity and uterine malignancy and establish thresholds that would minimize routine gynecological evaluation.

Methods
Two groups were recruited retrospectively: cancer group, which comprised 32 sequential endometrial cancer patients, and postmenopausal group, which comprised 63 women, with no known gynecologic malignancy.
Two radiologists independently measured hypodensity, transversely in the axial plane and anterioposteriorly in the sagittal plane.
The association between cancer and hypodensity was evaluated. Receiver operating characteristic curves were evaluated diameters predictive of cancer.

Results
Hypodensity was associated with cancer (cancer group, 93.8% vs. postmenopausal group, 38.1%; P < 0.0001). Hypodensity diameters correlated highly with prediction of cancer (transverse area under the curve, 0.899; anteroposterior area under the curve, 0.892). Diameters of 19.5 mm transverse and 6.0 mm anteroposterior yielded a sensitivity of 87% and 83% and specificity of 91% and 83%, respectively.

Conclusions
Intrauterine hypodensity is a common finding in computed tomography scans of postmenopausal women. A transverse diameter of 19.5 mm and an anteroposterior diameter of 6.0 mm are suggested as thresholds for further gynecological sonographic evaluation.
Intraoperative Use of Vasopressors Does Not Increase the Risk of Free Flap Compromise and Failure in Cancer Patients
Authors: Fang Lin , Liu Jun , Yu Cuicui , Hanasono Matthew M. , Zheng Gang , Yu Peirong 
Published: May 2017

Objective:
To examine the effects of vasopressors on free flap outcomes.

Background:
Most micro-surgeons avoid the use of vasopressors during free flap surgery due to concerns of vasoconstriction, which could potentially lead to vascular thrombosis and flap failure. Previous studies lack the statistical power to draw meaningful conclusions.

Methods:
All free flaps between 2004 and 2014 from a single institution were reviewed retrospectively. Vasopressors were given intraoperatively as an intravenous bolus when blood pressure dropped >20% from baseline. The timing of intraoperative vasopressor administration was divided into 3 phases: from anesthesia induction to 30 minutes before the start of flap ischemia (P1); end of P1 to 30 minutes after revascularization (P2); end of P2 to end of surgery (P3). Agents included phenylephrine, ephedrine and calcium chloride.

Results:
A total of 5671 free flap cases in 4888 patients undergoing head and neck, breast, trunk, or extremity reconstruction were identified. Vasopressors were used intraoperatively in 85% of cases. The overall incidence of pedicle compromise was 3.6%, with a flap loss rate of 1.7%. A propensity score matching analysis showed that intraoperative use of any agents at any time of surgery was not associated with increased overall pedicle compromise [51/1584 (3.2%) vs 37/792 (4.7%); P = 0.074] or flap failure rates [26/1584 (1.6%) vs 19/792 (2.4%); P = 0.209]. Rather, there was less risk of venous congestion [33/1584 (2.1%) vs 31/792 (3.9%); P = 0.010].

Conclusions:
Intraoperative use of phenylephrine, ephedrine, or calcium chloride as an intravenous bolus does not increase flap compromise and failure rates in cancer patients.
Organization of theDrosophilalarval visual circuit
Authors: Larderet Ivan , Fritsch Pauline M. J. , Gendre Nanaë , Neagu-Maier Larisa , Fetter Rick D. , Schneider-Mizell Casey , Truman James W. , Zlatic Marta , Cardona Albert , Sprecher Simon G. 
Published: May 2017

AbstractVisual systems transduce, process and transmit light-dependent environmental cues. Computation of visual features depends on the types of photoreceptor neurons (PR) present, the organization of the eye and the wiring of the underlying neural circuit. Here, we describe the circuit architecture of the visual system ofDrosophilalarvae by mapping the synaptic wiring diagram and neurotransmitters. By contacting different targets, the two larval PR-subtypes create parallel circuits potentially underlying the computation of absolute light intensity and temporal light changes already within this first visual processing center. Locally processed visual information then signals via dedicated projection interneurons to higher brain areas including the lateral horn and mushroom body. The stratified structure of the LON suggests common organizational principles with the adult fly and vertebrate visual systems. The complete synaptic wiring diagram of the LON paves the way to understanding how circuits with reduced numerical complexity control wide ranges of behaviors.
Naturally-segregating Variation atUgt86DdContributes to Nicotine Resistance inDrosophila melanogaster
Authors: Highfill Chad A. , Tran Jonathan H. , Nguyen Samantha K. T. , Moldenhauer Taylor R. , Wang Xiaofei , Macdonald Stuart J. 
Published: May 2017

ABSTRACTIdentifying the causative sequence polymorphisms underlying complex trait variation is a key goal of evolutionary and biomedical genetics. By knowing the precise molecular events that confer phenotypic changes we can gain insight into the pathways underlying complex traits and the evolutionary forces acting on variation. Genetic analysis of complex traits in model systems regularly starts by constructing QTL maps, but generally fails to identify causative nucleotide-level polymorphisms. Previously we mapped a series of QTL contributing to resistance to nicotine in aDrosophila melanogastermultiparental mapping resource, and here use a battery of functional tests to resolve QTL to the molecular level. One large-effect QTL resided over a cluster of UDP-glucuronosyltransferases, and quantitative complementation tests using deficiencies eliminating subsets of these detoxification genes revealed allelic variation impacting resistance. RNAseq showed thatUgt86Ddhad significantly higher expression in genotypes that are more resistant to nicotine, and anterior midgut-specific RNAi of this gene reduced resistance. We discovered a naturally-segregating 22-bp frameshift deletion inUgt86Dd, and overexpression of the insertion-containing allele in a range of tissues enhanced resistance. Accounting for the InDel event during mapping largely eliminates the QTL, implying the InDel explains the bulk of the effect associated with the mapped locus. Finally, we edited a relatively resistant genetic background to generate lesions inUgt86Ddthat recapitulate the naturally-occurring putative loss-of-function allele, and succeeded in radically reducing resistance. The putatively causative coding InDel inUgt86Ddcan be a launchpad for future mechanistic exploration of xenobiotic detoxification.ARTICLE SUMMARYResolving the mutations that contribute to among-individual trait variation is a major goal of biomedical and evolutionary genetics. In general however, genetic mapping experiments do not allow immediate resolution of the underlying causative variants. Previous mapping work revealed several loci contributing to nicotine resistance inDrosophila melanogaster. We employed a battery of functional tests to demonstrate that the detoxification geneUgt86Ddhas a major phenotypic effect, and that a segregating frameshift mutation is likely causative. Editing the gene to introduce a premature stop codon led to a significant reduction in resistance, validating its role in xenobiotic detoxification.
Differential proportionality - a normalization-free approach to differential gene expression
Authors: Erb Ionas , Quinn Thomas , Lovell David , Notredame Cedric 
Published: May 2017

AbstractGene expression data, such as those generated by next generation sequencing technologies (RNA-seq), are of an inherently relative nature: the total number of sequenced reads has no biological meaning. This issue is most often addressed with various normalization techniques which all face the same problem: once information about the total mRNA content of the origin cells is lost, it cannot be recovered by mere technical means. Additional knowledge, in the form of an unchanged reference, is necessary; however, this reference can usually only be estimated. Here we propose a novel method where sample normalization is unnecessary, but important insights can be obtained nevertheless. Instead of trying to recover absolute abundances, our method is entirely based on ratios, so normalization factors cancel by default. Although the differential expression of individual genes cannot be recovered this way, the ratios themselves can be differentially expressed (even when their constituents are not). Yet, most current analyses are blind to these cases, while our approach reveals them directly. Specifically, we show how the differential expression of gene ratios can be formalized by decomposing log-ratio variance (LRV) and deriving intuitive statistics from it. Although small LRVs have been used to detect proportional genes in gene expression data before, we focus here on the change in proportionality factors between groups of samples (e.g. tissue-specific proportionality). For this, we propose a statistic that is equivalent to the squaredt-statistic of one-way ANOVA, but for gene ratios. In doing so, we show how precision weights can be incorporated to account for the peculiarities of count data, and, moreover, how a moderated statistic can be derived in the same way as the one following from a hierarchical model for individual genes. We also discuss approaches to deal with zero counts, deriving an expression of our statistic that is able to incorporate them. In providing a detailed analysis of the connections between the differential expression of genes and the differential proportionality of pairs, we facilitate a clear interpretation of new concepts. The proposed framework is applied to a data set from GTEx consisting of 98 samples from the cerebellum and cortex, with selected examples shown. A computationally efficient implementation of the approach in R has been released as an addendum to the propr package.1