bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimated Organ Doses to Patients from Diagnostic Nuclear Medicine Examinations over Five Decades
Authors: Villoing Daphnée , Drozdovitch Vladimir , Simon Steven L. , Kitahara Cari M. , Linet Martha S. , Melo Dunstana R. 
Published: September 2017

Abstract
Ionizing radiation exposure to the general U.S. population nearly doubled between 1980 and 2006, due almost entirely to the significant increase in the number of radiologic and nuclear medicine procedures performed. Significant changes in the types of procedures and radionuclides used in nuclear medicine, as well as in detection technology, have led to notable changes over time in absorbed doses to specific organs. This study is the first to estimate per-procedure organ doses to nuclear medicine patients and trends in doses over five decades. Weighted average organ doses per examination to 14 organs of interest were calculated for 17 examination types over 10 5‐y time periods (1960–2010) as the product of the percentage of use of each radiopharmaceutical in those diagnostic procedures based on comprehensive literature review, the administered activity, and ICRP dose coefficients; doses per radiopharmaceutical were also provided for each organ, procedure, and time period. The weighted doses to adult nuclear medicine patients from cardiac procedures increased to all organs of interest between 1960 and 2010 except for the urinary bladder wall. From high radiation doses for most other procedures in the 1960s, with up to 0.7 Gy in the specific case of radioiodinated thyroid scans, organ-absorbed doses generally decreased from 1960 to 1990. In contrast, during the 1990s and 2000s, the weighted doses were gradually increased for some procedures, such as brain and skeleton scans. The increasing number of nuclear medicine procedures, specifically cardiac scans and changes in weighted doses, underscore the need to monitor exposure levels and radiation-related disease risks in nuclear medicine patients.
Contact Lens Compliance With Ophthalmologists and Other Health Professionals
Authors: Taslipinar Uzel Ayse Guzin , Uzel Mehmet Murat , Yuksel Nilay , Akcay Emine Kalkan 
Published: September 2017

Purpose:
To assess the compliance with contact lens (CL) use among ophthalmologists and other health professionals, and to identify the main noncompliant behaviors.

Methods:
A cross-sectional, comparative study was designed for soft CL wearers. Twenty-five ophthalmologists, 24 medical doctors other than ophthalmologists, 20 nurses (health professionals), and 52 lay people (members of the public) subjects were included in the interview. The compliance rate for each behavior were determined and compared. Users were asked to rate their subjective use to calculate self-evaluation scores.

Results:
The compliance rate was found to be the highest among ophthalmologists; however, the difference was not significant (P=0.083). Although the level of compliance was not associated with the subjects' age, duration of lens wear, or wearing days per week (P>0.05), an association was found with the number of wearing hours per day (P=0.010). Increased wearing hours per day was found to increase the rate of poor compliance (P=0.010). Significant differences were found between the groups in storing lenses in fresh solution, lens wearing time according to the ophthalmologist recommendation, and follow-up visits according to ophthalmologist recommendation (P<0.001, P=0.036, P=0.001, respectively). Self-evaluation scores among ophthalmologists, health professionals, and the lay people were 7.56±0.86, 7.59±1.29, and 7.67±1.60, respectively, and no significant differences existed between the groups (P=0.930).

Conclusion:
No differences were evident between the groups in terms of good compliance with CL wear and care practices. As this result shows that compliance with CL wear and care practices is not only related to the level of knowledge, different methods should be developed to increase compliance.
Reconstruction of Peripelvic Oncologic Defects
Authors: Weichman Katie E. , Matros Evan , Disa Joseph J. 
Published: September 2017

Learning Objectives:
After studying this article, the participant should be able to: 1. Understand the anatomy of the peripelvic area. 2. Understand the advantages and disadvantages of performing peripelvic reconstruction in patients undergoing oncologic resection. 3. Select the appropriate local, pedicled, or free-flap reconstruction based on the location of the defect and donor-site characteristics.

Summary:
Peripelvic reconstruction most commonly occurs in the setting of oncologic ablative surgery. The peripelvic area contains several distinct reconstructive regions, including vagina, vulva, penis, and scrotum. Each area provides unique reconstructive considerations. In addition, prior or future radiation therapy or chemotherapy along with cancer cachexia can increase the complexity of reconstruction.
Five-Year Safety Data for More than 55,000 Subjects following Breast Implantation: Comparison of Rare Adverse Event Rates with Silicone Implants versus National Norms and Saline Implants
Authors: Singh Navin , Picha George J. , Hardas Bhushan , Schumacher Andrew , Murphy Diane K. 
Published: September 2017

Background:
The U.S. Food and Drug Administration has required postapproval studies of silicone breast implants to evaluate the incidence of rare adverse events over 10 years after implantation.

Methods:
The Breast Implant Follow-Up Study is a large 10-year study (>1000 U.S. sites) evaluating long-term safety following primary augmentation, revision-augmentation, primary reconstruction, or revision-reconstruction with Natrelle round silicone breast implants compared with national norms and outcomes with saline implants. Targeted adverse events in subjects followed for 5 to 8 years included connective tissue diseases, neurologic diseases, cancer, and suicide.

Results:
The safety population comprised 55,279 women (primary augmentation, n = 42,873; revision-augmentation, n = 6837; primary reconstruction, n = 4828; and revision-reconstruction, n = 741). No targeted adverse events occurred at significantly greater rates in silicone implant groups versus national norms across all indications. The standardized incidence rate (observed/national norm) for all indications combined was 1.4 for cervical/vulvar cancer, 0.8 for brain cancer, 0.3 for multiple sclerosis, and 0.1 for lupus/lupus-like syndrome. Silicone implants did not significantly increase the risk for any targeted adverse events compared with saline implants. The risk of death was similar with silicone versus saline implants across all indications. The suicide rate (10.6 events per 100,000 person-years) was not significantly higher than the national norm. No implant-related deaths occurred.

Conclusions:
Results from 5 to 8 years of follow-up for a large number of subjects confirmed the safety of Natrelle round silicone implants, with no increased risk of systemic disease or suicide versus national norms or saline implants.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Extended Alar Contour Grafts: An Evolution of the Lateral Crural Strut Graft Technique in Rhinoplasty
Authors: Cochran C. Spencer , Sieber David A. 
Published: September 2017

Summary:
Modification of the lower lateral cartilage complex is the sine qua non of modern rhinoplasty, and the open approach to rhinoplasty has expanded the number of techniques available to help achieve an aesthetically pleasing tip. The ideal tip has been described as having a diamond-shaped configuration, with the lateral points formed by the tip-defining points, the superior point by the supratip, and the inferior point by the columellar break point. Over the years, various techniques have been described to minimize isolation of the tip and to help achieve the ideal tip configuration: lateral crural strut grafts, alar contour grafts (i.e., rim grafts), alar strut grafts, subdomal grafts, and suturing techniques such as alar flaring sutures. The authors present their technique of the extended alar contour graft, which represents an evolution of the lateral crural strut graft and its marriage with the alar contour graft. Lateral crural abnormalities do not usually occur singularly, but rather are the result of an interplay of several factors. Nevertheless, the recurring theme of orientation and alar support to prevent isolation of the tip by extended alar grooves remains. Extended alar contour grafts are a versatile technique to optimize tip shape and orientation by combining the many positive attributes of lateral crural strut grafts and alar contour grafts.
What Is the Best Lens Angle for Rigid Diagnostic Cystoscopy? A Comparison of 30-Degree and 70-Degree Lenses
Authors: Ragsdale Cassandra , Hreha Holly , Hardesty Jeffrey S. , Yune Junchan J. , Chan Philip J. , Siddighi Sam 
Published: September 2017

Objectives
The optimal degree of cystoscope to perform diagnostic cystoscopy is dependent on the surgeon’s discretion because there are no studies addressing the superiority of one degree of cystoscope over another. The objective was to determine which lens, 70-degree versus 30-degree lens, was better in identifying lesions scattered throughout the bladder.

Methods
A simulation was created using 3 different artificial bladder models complete with sutures representing lesions placed at different locations in each bladder. Gynecologists and urologists performed cystoscopy using both the 30- and 70-degree lenses on the bladder models in a randomized and single-blinded fashion. The physicians performed routine diagnostic cystoscopy and noted the number of lesions throughout the bladder. The number of lesions each physician identified and the time to complete cystoscopy were noted. A total of 16 physicians participated, and there were a total of 18 lesions among the 3 different bladder models.

Results
A total of 86 cystoscopy trials were obtained from all physicians and bladder models attempted. The odds of detecting a lesion with the 70-degree lens cystoscope was 1.77 times greater than the 30-degree lens cystoscope (95% confidence interval, 1.24–2.53; P = 0.002). There was also difference in the average number of lesions found between the 30- and 70-degree cystoscopes with 2.6 ± 2.7 more lesions identified using the 70-degree cystoscope compared with the 30-degree cystoscope. In terms of specific location, 2.6 ± 1.7 more lesions were found at the bladder neck using the 70-degree lens scope versus the 30-degree lens scope (95% confidence interval, 1.37–3.83; P = 0.013).

Conclusions
The results suggested that the 70-degree lens was the better choice for the identification of bladder lesions when compared with the 30-degree lens in rigid diagnostic cystoscopy.
Is There a Relationship Between Patient-Reported Satisfaction and Persistence on Overactive Bladder Syndrome Pharmacotherapy?
Authors: Tran Alexis M. , Reis Renata , Iyer Shilpa , Botros Carolyn , Goldberg Roger P. , Sand Peter K. , Botros Sylvia M. 
Published: September 2017

Objectives
This study aimed to determine the relationship between patient satisfaction with overactive bladder syndrome (OAB) pharmacotherapy and persistence rates. We compared persistence rates between satisfied and dissatisfied patients at designated study intervals.

Methods
This was a retrospective cohort study of new patients who initiated OAB medication. Patients were classified as either satisfied or dissatisfied on the basis of a single-item treatment satisfaction question. Persistence was defined as continuous days on therapy. The measured rate of persistence was determined as the ratio of patients who persisted on medication at 4, 12, and 24 weeks. Data collection included demographic and prescription information; urinary symptom parameters, symptom and quality-of-life scales, and patient-reported outcomes. Two-sample t test or Wilcoxon rank sum test was used to compare continuous outcomes between both groups (satisfied vs not satisfied). χ2 Test or Fisher exact test was used to compare categorical outcomes between groups.

Results
We analyzed the first 116 charts that met our inclusion criteria. Satisfied and dissatisfied patients did not differ in demographic variables. Satisfied patients had a median of 461 vs 254 persistent days (P = 0.0001). Satisfied patients (12.5% vs 40%) were less likely to discontinue medication (P = 0.0068). The discontinuation-free distribution was significantly different between satisfied and dissatisfied cohorts, favoring those who reported satisfaction with OAB medication at all time points (P < 0.0001). Patients who totally discontinued pharmacotherapy were 7 times more likely to be dissatisfied (odds ratio, 7.0; P = 0.002).

Conclusions
Our study helps clarify the relationship between persistence on OAB medication and treatment satisfaction. We found that persistence could serve as a surrogate marker for patient satisfaction because those who reported being satisfied were more likely to persist on therapy at all study intervals.
Age-related decline in behavioral discrimination of amplitude modulation frequencies compared to envelope-following responses
Authors: Lai Jesyin , Bartlett Edward L. 
Published: September 2017

AbstractThe ability to discriminate modulation frequencies is important for speech intelligibility because speech has amplitude and frequency modulations. Neurophysiological responses assessed by envelope following responses (EFRs) significantly decline at faster amplitude modulation frequencies (AMF) in older subjects. A typical assumption is that a decline in EFRs will necessarily result in corresponding perceptual deficits. To test this assumption, we investigated young and aged Fischer-344 rats’ behavioral AMF discrimination abilities and compared to their EFRs. A modified version of prepulse inhibition (PPI) of acoustic startle reflex (ASR) was used to obtain behavioral performance. A PPI trial contains pulses of sinusoidal AM (SAM) at 128 Hz presented sequentially, a SAM prepulse with different AMF and a startle-eliciting-stimulus. To account for hearing threshold shift or age-related synaptopathy, stimulus levels were presented at 10-dB lower or match to the aged peripheral neural activation (using auditory brainstem response wave I amplitude). When AMF differences and modulation depths were large, young and aged animals’ behavioral performances were comparable. Aged animals’ AMF discrimination abilities declined as the AMF difference or the modulation depth reduced, even compared to the young with peripheral matching. Young animals showed smaller relative decreases in EFRs with reduced modulation depths. The correlation of EFRs and AM perception was identified to be more consistent in young animals. The overall results revealed larger age-related deficits in behavioral perception compared to EFRs, suggesting additional factors that affect perception despite smaller degradation in neural responses. Hence, behavioral and physiological measurements are critical in unveiling a more complete picture on the auditory function.
Quantifying ethical tradeoffs for vaccine efficacy trials during severe epidemics
Authors: Bellan Steven E. , Pulliam Juliet R.C. , van der Graaf Rieke , Fox Spencer J. , Dushoff Jonathan , Meyers Lauren Ancel 
Published: September 2017

AbstractBackgroundDuring emerging epidemics of highly fatal diseases, rapid development and testing of new vaccines may be critical to curbing transmission and saving lives. However, the design of vaccine efficacy trials in such contexts may face considerable logistical, epidemiological, or ethical impediments. Three different vaccine efficacy trials were conducted during the 2014-2016 Ebola virus epidemic in West Africa, each with different designs. At the time, there was vigorous debate on the tradeoff between a trial’s ability to yield information of scientific and societal value versus the perceived ethical dilemma of withholding potentially life-saving vaccines from control participants. Whereas the scientific value of a trial is often estimated in terms of statistical power, speed, and rigor, we lack similar metrics for the ethical costs of withholding interventions.Methods and FindingsHere, we introduce a conceptual framework that fills this gap and allows quantitative assessment of both the scientific value of a study and the risks incurred by trial participants. We show that even untested vaccines against severe diseases may be probabilistically beneficial—i.e. after accounting for realistic uncertainty in their safety and efficacy, trial participants are expected to be better off vaccinated than not. While accounting for this uncertainty, we estimate trial participant risk under a hypothetical, idealized vaccine rollout scenario and compare it to risk under various candidate trial designs, in order to elucidate specific quantitative tradeoffs between cumulative risk to trial participants and information gained. Through an illustrative simulation example, we highlight specific trial-design modifications that allow for conscientious balance between minimizing participant risk and acquiring information of societal value. These include modifications that affect the speed with which a trial would detect an efficacious vaccine (greater sample size or enrollment rate, interim analyses, or risk-prioritized vaccine rollout), which leads to earlier vaccination of control participants should the vaccine be efficacious, and those that systematically limit the risk “spent” by unvaccinated individuals (e.g., providing vaccination to controls after a delay, or presumptive vaccination of subjects above a risk threshold).ConclusionWe advocate this conceptual approach as a means of clarifying the tensions between opposing viewpoints and facilitating transparent discussion to aid ethical and efficient responses to future emerging epidemics.
The GENIUS Approach to Robust Mendelian Randomization Inference
Authors: Tchetgen Eric J. Tchetgen , Sun BaoLuo , Walter Stefan 
Published: September 2017

AbstractMendelian randomization (MR) is a popular instrumental variable (IV) approach, in which one or several genetic markers serve as IVs that can be leveraged to recover under certain conditions, valid inferences about a given exposure-outcome causal association subject to unmeasured confounding. A key IV identification condition known as the exclusion restriction states that the IV has no direct effect on the outcome that is not mediated by the exposure in view. In MR studies, such an assumption requires an unrealistic level of knowledge and understanding of the mechanism by which the genetic markers causally affect the outcome, particularly when a large number of genetic variants are considered as IVs. As a result, possible violation of the exclusion restriction can seldom be ruled out in such MR studies, and if present, such violation can invalidate IVbased inferences even if unbeknownst to the analyst, confounding is either negligible or absent. To address this concern, we introduce a new class of IV estimators which are robust to violation of the exclusion restriction under a large collection of data generating mechanisms consistent with parametric models commonly assumed in the MR literature. Our approach which we have named “MR G-Estimation under No Interaction with Unmeasured Selection” (MR GENIUS) may in fact be viewed as a modification to Robins’ G-estimation approach that is robust to both additive unmeasured confounding and violation of the exclusion restriction assumption. We also establish that estimation with MR GENIUS may also be viewed as a robust generalization of the well-known Lewbel estimator for a triangular system of structural equations with endogeneity. Specifically, we show that unlike Lewbel estimation, MR GENIUS is under fairly weak conditions also robust to unmeasured confounding of the effects of the genetic IVs on both the exposure and the outcome, another possible violation of a key IV Identification condition. Furthermore, while Lewbel estimation involves specification of linear models both for the outcome and the exposure, MR GENIUS generally does not require specification of a structural model for the direct effect of invalid IVs on the outcome, therefore allowing the latter model to be unrestricted. Finally, unlike Lewbel estimation, MR GENIUS is shown to equally apply for binary, discrete or continuous exposure and outcome variables and can be used under prospective sampling, or retrospective sampling such as in a case-control study, as well as for right censored time-to-event outcomes under an additive hazards model.
Neonatal Zika virus infection causes epileptic seizures, viral persistence and long-term behavioral impairment
Authors: Souza Isis N. O. , Frost Paula S. , França Julia V. , Nascimento-Viana Jéssica , Neris Rômulo L. S. , Freitas Leandro , Pinheiro Daniel J. L. L. , Neves Gilda , Chimelli Leila , De Felice Fernanda G. , Cavalheiro Ésper A. , Ferreira Sergio T. , Da Poian Andrea T. , Assunção-Miranda Iranaia , Figueiredo Claudia P. , Clarke Julia R. 
Published: September 2017

AbstractA causal relationship between congenital Zika virus (ZIKV) exposure and microcephaly and other neurological disorders have been established, but long-term consequences of infection are still unknown. We evaluated acute and late neuropathological and behavioral consequences of ZIKV infection in a neonatal immunocompetent mouse model. ZIKV showed brain tropism, causing post-natal microcephaly and several behavioral dysfunctions. During the acute phase of infection, mice developed very frequent epileptic seizures, which are consistently reduced by TNF-α neutralization. Although adult animals recover from seizures, they become more susceptible to chemically-induced crises. Intriguingly, the virus remained actively replicating in adult animals, which show persistent necrosis and calcifications in the mice brain. Altogether the results reveal late consequences of neonatal ZIKV exposure and suggest the early inhibition of neuroinflammation as a potential treatment.
Integrative pipeline for profiling DNA copy number and inferring tumor phylogeny
Authors: Urrutia Eugene , Chen Hao , Zhou Zilu , Zhang Nancy R , Jiang Yuchao 
Published: September 2017

AbstractSummaryCopy number variation is an important and abundant source of variation in the human genome, which has been associated with a number of diseases, especially cancer. Massively parallel next-generation sequencing allows copy number profiling with fine resolution. Such efforts, however, have met with mixed successes, with setbacks arising partly from the lack of reliable analytical methods to meet the diverse and unique challenges arising from the myriad experimental designs and study goals in genetic studies. In cancer genomics, detection of somatic copy number changes and profiling of allele-specific copy number (ASCN) are complicated by experimental biases and artifacts as well as normal cell contamination and cancer subclone admixture. Furthermore, careful statistical modeling is warranted to reconstruct tumor phylogeny by both somatic ASCN changes and single nucleotide variants. Here we describe a flexible computational pipeline, MARATHON, which integrates multiple related statistical software for copy number profiling and downstream analyses in disease genetic studies.Availability and implementationMARATHON is publicly available athttps://github.com/yuchaojiang/MARATHON.Contactyuchaoj@email.unc.eduSupplementary informationSupplementary data are available atBioinformaticsonline.