bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Metabolic Parameters as Prognostic Factors During Concomitant Chemoradiotherapy for Locally Advanced Cervical Cancer
Authors: Krhili Samar , Muratet Jean-Pierre , Roche Sophie , Pointreau Yoann , Yossi Sena , Septans Anne-Lise , Denis Fabrice 
Published: March 2016

Objectives:
To investigate the use of metabolic parameters as early prognostic factors during concomitant chemoradiotherapy for locally advanced cervix carcinoma (LACC).

Materials and Methods:
Between February 2008 and January 2012, 34 consecutive patients treated for LACC (International Federation of Gynecology and Obstetrics Staging System stage IB2-IVA) were included in a retrospective study. Treatment was standard of care: total dose of 45 Gy in 1.8 Gy per fraction with concurrent cisplatin followed by brachytherapy. 18F-FDG PET-CT modalities were performed before treatment and per-treatment (at 40 Gy). The analyzed parameters were: maximum standardized uptake value (SUVmax), SUVmax variations of the primary tumor between the 2 investigations (DSUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Survival was assessed according to early metabolic changes during chemoradiotherapy.

Results:
Median follow-up was 16 months (range, 5.3 to 32.4 mo). Median SUVmax before treatment was 13.15 (5.9 to 31) and was 5.05 (0 to 12) per-treatment. Median DSUVmax was 63.97% (0% to 100%). Median MTV before treatment was 44.16 mL (3.392 to 252.768 mL) and was 5.44 mL (0 to 69.88 mL) per-treatment. Median TLG before treatment was 249.82 mL (13.40 to 1931.10 mL) and was 20.14 mL (0 to 349.99 mL) per-treatment. At 40 Gy, SUVmax≥6, DSUVmax≤40%, MTV≥5.6 mL, and TLG≥21.6 mL were significantly associated with overall survival and progression-free survival reduction. MTV predicted progression with a sensitivity of 80% and a specificity of 87.5% and TLG with a sensitivity of 80% and a specificity of 83.3%.

Conclusions:
PET-CT imaging could be useful as an early prognostic factor during treatment for LACC. MTV and TLG seem to provide better prognostic information than SUVmax and DSUVmax.
Preenlistment and Early Service Risk Factors for Traumatic Brain Injury in the Army and Marine Corps: FY 2002-2010
Authors: Elmasry Hoda , Boivin Michael R. , Feng Xiaoshu , Packnett Elizabeth R. , Cowan David N. 
Published: March 2016

Objective:
To determine the preenlistment and early service risk factors for traumatic brain injury (TBI)-related disability in Army and Marine Corps service members.

Design:
Matched case-control design.

Main Outcome:
TBI disability discharges.

Subjects:
Army and Marine Corps service members with an enlistment record and disability discharge for TBI were included as cases. Controls were selected from the enlisted population with no disability evaluation record and were matched on fiscal year of enlistment, sex, and service at a ratio of 5:1.

Results:
Older age at enlistment resulted in a significantly increased risk for TBI disability in the crude and adjusted models (adjusted odds ratio [aOR] = 1.49; 95% confidence interval [CI], 1.16-1.91). An enlistment military occupational specialty (MOS) with a combat arms designation resulted in an almost 3-fold increased odds of TBI disability compared with other MOS categories (aOR = 2.75; 95% CI, 2.46-3.09). This remained a significant risk factor for TBI disability in the multivariate model (aOR = 2.74; 95% CI, 2.45-3.08).

Conclusion:
Results from this study help inform the existing body of military TBI research by highlighting the preenlistment demographic and early service risk factors for TBI disability. Further research into the role of age on TBI disability in the military is merited.
Secondary Neck Lift and the Importance of Midline Platysmaplasty: Review of 101 Cases
Authors: Narasimhan Kailash , Ramanadham Smita , O’Reilly Eamon , Rohrich Rod J. 
Published: March 2016

Background:
The authors believe that open access to the submental region, platysmaplasty, and wide skin undermining provide the most long-lasting results in neck rejuvenation, and sought to evaluate this hypothesis by reviewing their neck-lift patients.

Methods:
The authors performed a retrospective chart review of their experience with neck-lift procedures and patients who underwent a secondary procedure. Patient age, sex, initial technique, visible neck deformities, and reasons for revision were assessed. Photographs were used to assess the features of persistent or recurrent neck-lift deformity and techniques to correct them.

Results:
Of 1089 neck lifts reviewed, 101 patients underwent secondary or revision procedures (approximately 10 percent of total). The average patient age was 57.4 years, 95 percent were women, and secondary procedures were performed 10.3 years after the first procedure. Seventy percent of the revisions were of the authors’ own primary neck lifts, and all of these after 10 years. The most common aesthetic deformities—recurrent platysmal bands (87 percent), persistent/recurrent jowling (48 percent), fat malposition/irregularities (10 percent), and vertical band deformity (8 percent)—were most often corrected with open platysmaplasty and medial or lateral plication and skin redraping. All patients had their submental region opened in the secondary procedure. All secondary operations were performed at least 10 years after primary surgery.

Conclusions:
The authors believe their technique of open submental neck access and platysmal approximation in patients with medial bands provides long-lasting results. The authors use precise preoperative evaluation, recontouring of neck fat irregularities, opening of the submental region with platysmaplasty, drains, and strict hemostasis.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Principles for Management of Orbital Fractures in the Pediatric Population: A Cohort Study of 150 Patients
Authors: Coon Devin , Kosztowski Martin , Mahoney Nicholas R. , Mundinger Gerhard S. , Grant Michael P. , Redett Richard J. 
Published: March 2016

Background:
Pediatric orbital fractures represent a challenging and sometimes controversial clinical problem. Patients may present with clear indications for surgery, but most require balancing benefits against intraoperative and late complications. The authors assessed these fractures at a state-designated ophthalmology referral center to develop criteria for surgery.

Methods:
Institutional review board approval was obtained to retrospectively analyze pediatric trauma registry patients with orbital fracture diagnoses at the Wilmer Eye Institute over 10 years. Patients were excluded if they did not undergo a full ophthalmologic examination, never followed up after their injury, or had significant facial fractures outside of the orbit.

Results:
One hundred fifty patients met selection criteria; 116 patients (77 percent) completed all follow-up (average, 309 days). Two patients had 20/40 vision or worse at the end of follow-up. One hundred ten patients (71 percent) underwent surgery; 96 underwent acute repair (<3 weeks) and 11 underwent delayed repair (median, 49 days). Three patients required reoperation, two for plate infection and one for hyperglobus, with an overall complication rate of 4.7 percent.

Conclusions:
The authors analyzed the largest series of operative pediatric orbital fractures to propose criteria for surgical intervention. There are four potential indications: (1) rectus muscle entrapment; (2) early enophthalmos; (3) central-gaze diplopia or extraocular movement restriction after the resolution of swelling; and (4) loss of orbital support likely to produce secondary changes in globe position and/or binocular stereo vision. In our series, application of these principles offered excellent long-term aesthetic and ophthalmic outcomes with an acceptably low complication profile.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Arterialization of the Venous System for Treatment of Chronic Ischemia in the Hand
Authors: Zeng Wenjing , Hammert Warren C. 
Published: March 2016

Summary:
Symptomatic chronic ischemia of the upper extremity is a difficult condition to treat. At a critical level of ischemia, patients suffer from intractable pain and nonhealing ulcerations and potentially necrosis. When no distal vessels are available for vascular reconstruction, arterialization of the venous system is a salvage procedure that may be considered. This article describes a surgical technique for venous arterialization to improve the vascular supply to the ischemic hand, which can result in decreased pain, wound healing, improved patient function, and limb salvage.
Adipose Tissue and Extracellular Matrix Development by Injectable Decellularized Adipose Matrix Loaded with Basic Fibroblast Growth Factor
Authors: Zhang Shipin , Lu Qiqi , Cao Tong , Toh Wei Seong 
Published: March 2016

Background:
There is a significant need for soft-tissue replacements in the field of reconstructive surgery. Decellularized adipose tissues were heparin crosslinked and loaded with basic fibroblast growth factor (bFGF). This injectable system was evaluated for its adipogenic and angiogenic capabilities for in vivo adipose tissue regeneration.

Methods:
Decellularized adipose tissues were harvested from the inguinal fat pads of C57BL/6J mice, minced, and heparinized before being loaded with bFGF. Decellularized adipose tissues without bFGF served as a control. In vivo adipose neotissue formation, neovascularization, and volume stability were evaluated over a period of 12 weeks. After 6 or 12 weeks, mice were killed and the newly formed adipose tissues, together with the contralateral endogenous adipose tissues, were harvested for gross, volumetric, histologic, and immunohistochemical analysis.

Results:
Decellularized adipose tissues that were heparinized and loaded with bFGF induced significant de novo adipose neotissue formation, with progressive tissue growth and neovascularization from 6 to 12 weeks. The adipose neotissues exhibited mature adipose morphology and extracellular matrix that closely resembled that of the endogenous adipose tissue. In contrast, decellularized adipose tissues without bFGF induced limited adipose neotissue formation and were completely resorbed by the end of 12 weeks.

Conclusion:
This study demonstrates the high efficiency of heparinized decellularized adipose tissue matrix loaded with bFGF in promoting adipose neotissue formation and neovascularization with long-term volume stability.
The Role of Military Plastic Surgeons in the Management of Modern Combat Trauma: An Analysis of 645 Cases
Authors: Maitland Laura , Lawton Graham , Baden James , Cubison Tania , Rickard Rory , Kay Alan , Hettiaratchy Shehan 
Published: March 2016

Background:
Plastic surgery has historically been linked to war. Between 2008 and the end of combat operations in Afghanistan in 2014, British military plastic surgeons formed part of the multinational military surgical team at the Role 3 Medical Treatment Facility, Camp Bastion, Helmand Province. The present study aimed to analyze the activity of these surgeons objectively and to determine the utility of their deployment.

Methods:
Data were gathered prospectively from four periods (2009 to 2012). This coincided with different surgeons, types of combat activity, wounding patterns, and mission emphases for the hospital. Various metrics were employed.

Results:
Plastic surgeons were involved in 40 percent of surgical cases (645 of 1654). This was consistent, despite changes in the predominant wounding mechanism and casualty population. One-third of cases involved the plastic surgeon as the lead or sole surgeon and two-thirds involved working with surgeons from other disciplines. Caseload by anatomical region was as follows: hand and upper limb, 64 percent; head and neck, 46 percent; lower limb, 40 percent; and trunk, 25 percent. A median of 1.75 body areas were operated on per patient. Involvement did not differ between patients wearing combat body armor when injured and those who were not.

Conclusions:
Plastic surgeons played a significant role in the management of modern military trauma. This reflects the types of injuries sustained and the expertise of military plastic surgeons complementing the skill set of the other surgical team members. The level of activity was independent of wounding patterns, suggesting that the specialty may be useful, irrespective of the nature of the conflict.
Low Rates of Blood Transfusion in Elective Resections of Neurofibromas in a Cohort Study: Neurofibroma Length as a Predictor of Transfusion Requirement
Authors: Hivelin Mikael , Plaud Benoit , Hemery Francois , Boulat Claire , Ortonne Nicolas , Valleyrie-Allanore Laurence , Wolkenstein Pierre , Lantieri Laurent 
Published: March 2016

Background:
Neurofibromas in neurofibromatosis type 1 induce aesthetic and functional morbidity. Perioperative bleeding has been reported as an obstacle to neurofibroma resections. The authors studied the requirement for blood transfusion during surgical treatment of neurofibromatosis type 1.

Methods:
Six hundred twenty-two procedures performed on 390 neurofibromatosis type 1 patients at the national referral center from 1995 to 2011 were analyzed in two chronologic sets of patients: set 1 (February of 1995 to September of 2007), in which only one surgeon operated; and set 2 (October of 2007 to January of 2011), in which two additional surgeons were involved. Malignant peripheral nerve sheath tumors, reconstructive procedures, and spontaneous hemorrhages were excluded from the analysis. Age, sex, preoperative hemoglobin concentration, location, length, estimated volume and histologic features of the largest neurofibroma (cumulative values for multiple neurofibromas), and procedure duration were studied as potential predictors of blood transfusion that were measured in terms of units of packed red blood cells.

Results:
Seventy reconstructive procedures, two cases of spontaneous hemorrhage, and 32 malignant peripheral nerve sheath tumor resections were excluded. Among 516 procedures (318 and 198 in sets 1 and 2, respectively), 17 (2.7 percent) required blood transfusions. The requirement for transfusion was associated with neurofibroma length in both sets, with an optimal cutoff value of 13 cm in both sets.

Conclusions:
Contrary to the literature, the requirement for blood transfusion was found to be low (2.7 percent of the cases) during elective resection of neurofibromas in neurofibromatosis type 1. Elective resections of benign neurofibromas less than 13 cm in length were not associated with a requirement for blood transfusion.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Association Analysis of Polymorphisms in TOMM40, CR1, PVRL2, SORL1, PICALM, and 14q32.13 Regions in Colombian Alzheimer Disease Patients
Authors: Ortega-Rojas Jenny , Morales Luis , Guerrero Esneyder , Arboleda-Bustos Carlos E. , Mejia Adriana , Forero Diego , Lopez Luis , Pardo Rodrigo , Arboleda Gonzalo , Yunis Juan , Arboleda Humberto 
Published: March 2016

Objective:
We evaluated the association of several single-nucleotide polymorphisms in different genes including APOE, TOMM40, CR1, PVRL2, SORL1, PICALM, and GWA_14q32.13 in a Colombian sample of Late-Onset Alzheimer disease (LOAD) patients.

Methods:
A case-control study was conducted in 362 individuals (181 LOADs and 181 controls) to determine the association of single-nucleotide polymorphisms in APOE (e2, e3, and e4), TOMM40 (rs2075650), CR1 (rs665640), PVRL2 (rs6859), SORL1 (rs11218304), PICALM (rs3851179), and GWA_14q32.13 (rs11622883) with LOAD in a sample from Colombia.

Results:
We were able to confirm the previously reported association of the APOE4 allele with AD. In addition, we report a new significant association with rs2075650 of TOMM40 for LOAD in our sample. We did not detect any significant interaction between TOMM40 and APOE4 carriers (heterozygous or homozygous) for disease risk development. However, Kaplan-Meier survival analyses suggest that AD patients with TOMM40 allele rs2075650-G have an average age of disease onset of 6 years earlier compared with carriers of the A allele. In addition, the age of disease onset is earlier if APOE4/4 is present.

Conclusion:
Our findings suggest that rs2075650 of TOMM40 could be involved in earlier presentation of LOAD in the Colombian population.
Optic Nerve Fenestration in a Patient With the Syndrome of Acquired Hyperopia and Choroidal Folds
Authors: Adesina Ore-ofe O. , Warner Judith E.A. , Patel Bhupendra C.K. 
Published: March 2016

Abstract:
We performed bilateral optic nerve sheath fenestrations on a patient with the syndrome of acquired hyperopia and choroidal folds. We are unaware of previous reports of this procedure being performed in this clinical setting. Despite the incomplete resolution of his posterior segment findings postoperatively, the results of the procedure, along with an understanding of the relevant anatomy, may help to shed light on the pathogenesis of this rare entity.
Evidence for alternate stable States in Collapsing Ecological Networks
Authors: Babu Suresh , Yadav Gitanjali 
Published: March 2016

ABSTRACTBackgroundThere has been considerable interest and progress in our perception of organized complexity in recent years. Recurrent debates on the dynamics and stability of complex systems have enriched our understanding of these systems, but generalities in the relationship between structure and dynamics are hard to come by. Although traditionally an arena for theoreticians, much of this research has been invigorated by demonstration of the existence of alternate stable equilibria in real world ecosystems such as lakes, coral reefs, forests and grasslands.ResultsLinking up systems thinking with recent advances in our understanding of ecological networks opens up exciting possibilities. In an attempt to obtain general patterns of behaviour of complex systems, we have analyzed the response of eighty-six real world ecological networks to targeted extinctions, and the findings suggest that most networks are robust to loss of specialists until specific thresholds are reached in terms of geodesics. If the extinctions persist, a state change or ‘flip’ occurs and the structural properties are altered drastically, although the network does not collapse. Further, we find that as opposed to simpler networks, larger networks have several such alternate states that ensure their long-term persistence and that indeed complexity does endow resilience to such networks.ConclusionsThis is the first report of critical transitions in ecological networks and the implications of these findings for complex systems characterized by networks are likely to be profound with immediate significance in conservation biology, invasion biology and restoration ecology.
Using interpretive structure modeling to analyze the interactions between environmental sustainability boundary enablers
Authors: Dev Navin K. , Shankar Ravi 
Published: March 2016

Purpose
– The modern business community understands the importance of long-term satisfaction of consumer. Enabling the consumer to return products is a significant part of the equation. The purpose of this paper is to analyze the sustainable boundaries in terms of their relationship toward greening a supply chain.

Design/methodology/approach
– Using interpretive structural modeling the research presents a hierarchy-based model to realize the driving power and dependence of sustainable boundary enablers.

Findings
– The research shows that there exists a group of enablers having a high driving power and low dependence requiring maximum attention and of strategic importance while another group consists of those variables which have high dependence and are the resultant actions.

Practical implications
– This classification provides a useful tool to supply chain managers to differentiate between independent and dependent variables and their mutual relationships which would help them to focus while making strategic, tactical or operational decisions as and when required while designing a green supply chain.

Originality/value
– This research assumes importance in context of greening a supply chain when globally enterprises are getting a lot of pressure from consumers as well as the regulatory measures from the government. Sustainability demands that the resources be used in lean manner through information coordination with all partners in a supply chain. The findings of this study would help delineate those variables that should to be necessarily considered to design a sustainable supply chain.
Benchmarking hospitals through a web based platform
Authors: Portela Maria Conceição A. Silva , Camanho Ana Santos , Almeida Diogo Queiroz , Lopes Luiz , Silva Sofia Nogueira , Castro Ricardo 
Published: March 2016

Purpose– In a context of international economic crisis the improvement in the efficiency and productivity of public services is seen as a way to maintain high-quality levels at lower costs. Increased productivity can be promoted through benchmarking exercises, where key performance indicators (KPIs), individually or aggregated, are used to compare health units. The purpose of this paper is to describe a benchmarking platform, called Hospital Benchmarking (HOBE), where hospital’s services are used as the unit of analysis.Design/methodology/approach– HOBE platform includes a set of managerial indicators through which hospital services’ are compared. The platform also benchmarks services through aggregate service indicators, and provides an aggregate measure of hospital’s performance based on a composite indicator of the service’s performances. These aggregate indicators were obtained through data envelopment analysis (DEA).Findings– Some results are presented for Portuguese hospitals for the trial years of 2008 and 2009, for which data is publicly available. Details for the service-level analysis are provided for a sample hospital, as well as details on the aggregate performance resulting from services performances.Practical implications– HOBE’s features and outcomes show that the platform can be used to guide management actions and to support the design of health policies by administrative authorities, provided that good quality and timely data are available, and that hospitals are involved in the design of the KPIs.Originality/value– The platform is innovative in the sense that it bases its analysis on hospital’s services, which are in general more comparable among hospitals than indicators of hospital overall performance. In addition, it makes use of DEA to aggregate performance indicators, allowing for user choice in the inputs and outputs to be aggregated, and it proposes a novel model to aggregate service’s efficiencies into a single measure of hospital performance.