bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anasarca as the Initial Manifestation of Tuberculous Pericarditis in a Child
Authors: Pilania Rakesh , Mahajan Sachin , Das Ashim , Vaishnavi Kalthi , Kumar Rakesh , Bhatia Anmol , Dayal Devi 
Published: May 2017

AbstractPericarditis is a rare manifestation of tuberculosis in children. The usual clinical features include fever, cough, tachypnea, chest pain, and pedal edema. Very rarely, generalized edema may occur as a presenting feature. We describe a 10-year-old boy, who presented with anasarca and had received treatment with corticosteroids for a mistaken diagnosis of nephrotic syndrome and was subsequently diagnosed with tuberculous pericardial effusion. The rarity of manifestations and the difficulties encountered to diagnose tuberculous pericarditis prompted us to report this case. The report may serve to sensitize pediatricians to consider systematic investigations to reach the diagnosis in children presenting with anasarca and avoid the empiric use of steroids in anasarca.
Tests as boundary signifiers: level 6 tests and the primary secondary divide
Authors: Coldwell Mike , Willis Ben 
Published: May 2017

ABSTRACTThis paper addresses the question: How do teachers and school leaders respond to high stakes testing of pupils transitioning from primary to secondary school? It explores how a new test, the Level 6 test, operated with regard to primary/secondary school relationships in England. It draws on an analysis of qualitative interviews with teachers and school leaders in 20 primary schools that took part in the test, 40 school leaders that chose not to and 20 secondary‐school leaders. Theoretical work on social boundaries is utilised to develop an argument that this test and its results acted as a boundary signifier, crystallising many of the tensions between primary and secondary schools. These tensions included the role of accountability regimes in requiring schools to demonstrate progress; narrowing of the curriculum and teaching to the test; and the extent to which test results can provide a true representation of pupil attainment. We conclude by suggesting the potential of the boundary signifier concept in relation to other tests at the primary/secondary boundary and other key transition points in education, and consider whether such tests can act as an ideal boundary object, serving to help overcome, rather than cement, barriers between schools.
CWDPRNP: a tool for cervid prion sequence analysis in program R
Authors: Miller William L , Walter W David 
Published: May 2017

AbstractSummaryChronic wasting disease is a fatal, neurological disease caused by an infectious prion protein, which affects economically and ecologically important members of the family Cervidae. Single nucleotide polymorphisms within the prion protein gene have been linked to differential susceptibility to the disease in many species. Wildlife managers are seeking to determine the frequencies of disease-associated alleles and genotypes and delineate spatial genetic patterns. The CWDPRNP package, implemented in program R, provides a unified framework for analyzing prion protein gene variability and spatial structure.Availability and implementationThe CWDPRNP package, manual and example data files are available at http://ecosystems.psu.edu/research/labs/walter-lab/additional-labs/population-genetics-lab. This package is available for all commonly used platforms.
Preeclampsia mediates the association between shorter height and increased risk of preterm delivery
Authors: Morisaki Naho , Ogawa Kohei , Urayama Kevin Y , Sago Haruhiko , Sato Shoji , Saito Shigeru 
Published: May 2017

Abstract

Background
Maternal short stature has been observed to increase the risk of preterm birth; however, the aetiology behind this phenomenon is unknown. We investigated whether preeclampsia, an obstetric complication that often leads to preterm delivery and is reported to have an inverse association with women’s height, mediates this association.

Methods
We studied 218 412 women with no underlying diseases before pregnancy, who delivered singletons from 2005 to 2011 and were included in the Japan Society of Obstetrics and Gynecology perinatal database, which is a national multi-centre-based delivery database among tertiary hospitals. We assessed the risk of preterm delivery in relation to height using multivariate analysis, and how the association was mediated by risk of preeclampsia using mediation analysis.

Results
Each 5-cm decrement in height was associated with significantly higher risk of preterm delivery [relative risk 1.20; 95% confidence interval (CI): 1.13, 1.27] and shorter gestational age (−0.30; 95% CI: −0.44, −0.16 weeks). Mediation analysis showed that the effect of shorter height on increased risk of preterm delivery, due to an indirect effect mediated through increased risk of preeclampsia, was substantial for shorter gestational age (48%), as well as risk of preterm delivery (28%). When examining the three subtypes of preterm delivery separately, mediated effect was largest for provider-initiated preterm delivery without premature rupture of membranes (PROM) (34%), compared with spontaneous preterm delivery without PROM (17%) or preterm delivery with PROM (0%).

Conclusions
Preeclampsia partially mediates the association between maternal short stature and preterm delivery.
18F-FDOPA PET/MRI for monitoring early response to bevacizumab in children with recurrent brain tumors
Authors: Gauvain Karen , Ponisio Maria Rosana , Barone Amy , Grimaldi Michael , Parent Ephraim , Leeds Hayden , Goyal Manu , Rubin Joshua , McConathy Jonathan 
Published: May 2017

Abstract

Background
Noninvasively predicting early response to therapy in recurrent pediatric brain tumors provides a challenge. 3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine (18F-FDOPA) PET/MRI has not been previously studied as a tool to evaluate early response to antiangiogenic therapy in children. The purpose of this study was to evaluate the safety and feasibility of using 18F-FDOPA PET/MRI to assess response to bevacizumab in children with relapsed brain tumors.

Materials and Methods
Six patients with recurrent gliomas (5 low-grade, 1 high-grade) planned to undergo treatment with bevacizumab were enrolled. 18F-FDOPA PET/MRI scans were obtained prior to and 4 weeks following the start of treatment, and these were compared with the clinical response determined at the 3-month MRI. The primary PET measure was metabolic tumor volume (MTV) at 10 to 15 min after 18F-FDOPA injection. For each tumor, the MTV was determined by manually defining initial tumor volumes of interest (VOI) and then applying a 1.5-fold threshold relative to the mean standardized uptake value (SUV) of a VOI in the frontal lobe contralateral to the tumor.

Results
18F-FDOPA PET/MRI was well tolerated by all patients. All tumors were well visualized with 18F-FDOPA on the initial study, with peak tumor uptake occurring approximately 10 min after injection. Maximum and mean SUVs as well as tumor-to-brain ratios were not predictors of response at 3 months. Changes in MTVs after therapy ranged from 23% to 98% (n = 5). There is a trend towards the percent MTV change seen on the 4-week scan correlating with progression-free survival.

Conclusion
18F-FDOPA PET/MRI was well tolerated in pediatric patients and merits further investigation as an early predictor of response to therapy.
Acetabular Labral Tears
Authors: Lewis Cara L , Sahrmann Shirley A 
Published: May 2017

AbstractAnterior hip or groin pain is a common complaint for which people are referred for physical therapy, with the hip region being involved in approximately 5% to 9% of injuries in high school athletes.1 Although anterior hip pain is known to result from a number of musculoskeletal and systemic pathologies, a tear of the acetabular labrum is a recent addition to the list that is of particular interest to physical therapists. This mechanically induced pathology is thought to result from excessive forces at the hip joint2,3 and has been proposed as part of a continuum of hip joint disease that may result in articular cartilage degeneration.2 Although the number of recent articles in the orthopedic literature identifying acetabular labral tears as a source of hip pain is increasing, labral tears often evade detection, resulting in a long duration of symptoms, greater than 2 years on average, before diagnosis.4–8 Studies have shown that 22% of athletes with groin pain9 and 55% of patients with mechanical hip pain of unknown etiology2 were found to have a labral tear upon further evaluation. In order to provide the most appropriate intervention for patients with anterior hip or groin pain, physical therapists should be knowledgeable about all of the possible sources and causes of this pain, including a tear of the acetabular labrum and the possible factors contributing to these tears. Therefore, the purpose of this article is to review the anatomy and function of the acetabular labrum and present current concepts on the etiology, clinical characteristics, diagnosis, and treatment of labral tears.
CORRELATION OF STRUCTURAL AND FUNCTIONAL OUTCOME MEASURES IN A PHASE ONE TRIAL OF CILIARY NEUROTROPHIC FACTOR IN TYPE 2 IDIOPATHIC MACULAR TELANGIECTASIA
Authors: Sallo Ferenc B. , Leung Irene , Clemons Traci E. , Peto Tunde , Chew Emily Y. , Pauleikhoff Daniel , Bird Alan C. ,   for the MacTel CNTF Research Group
Published: May 2017

Purpose:
Macular telangiectasia Type 2 is a bilateral, progressive, potentially blinding retinal disease characterized by both vascular and neurodegenerative signs. Both the area of the break in the ellipsoid zone seen in “en face” optical coherence tomographic (OCT) images and microperimetric focal retinal sensitivity loss have been proposed as potential measures of progression in macular telangiectasia. The authors aimed to assess the characteristics and interrelationship of these structural and functional disease markers from the data collected in a phase one clinical trial of ciliary neurotrophic factor in macular telangiectasia.

Methods:
Orthogonal topographic (en face) maps of the ellipsoid zone were generated from Heidelberg Spectralis OCT volume scans (15 × 10° area, 30-μm B-scan intervals) or Zeiss Cirrus HD-OCT 4000 512 × 128 cube scans. Mesopic microperimetry was performed on CenterVue MAIA perimeters, using a Goldmann III stimulus in a custom test grid. Structural and functional data were analyzed by two methods: by calculating aggregate loss and by simple thresholding. The alignment quality of structural and functional data was also evaluated.

Results:
Overall, the break area showed a good correlation with aggregate sensitivity loss (ρ = 0.834, P < 0.0001, 95% confidence interval 0.716–0.906) but also with the number of test points below a threshold value (e.g., <20 dB: ρ = 0.843, P < 0.0001, 95% confidence interval 0.755–0.902). Significant misalignment of the MAIA test grid was apparent in 13/48 visits of 7/14 eyes.

Conclusion:
The authors found a good correlation between ellipsoid zone break area and function loss. En face OCT mapping of the ellipsoid zone appears to demonstrate structural change before mesopic microperimetry can detect a focal loss of retinal sensitivity. Thresholding offers a quick alternative to calculating aggregate sensitivity loss.
Corneal Endothelial Cells Have an Absolute Requirement for Cysteine for Survival
Authors: Okumura Naoki , Inoue Ryota , Kakutani Kazuya , Nakahara Makiko , Kinoshita Shigeru , Hamuro Junji , Koizumi Noriko 
Published: May 2017

Purpose:
The aim of this study was to evaluate which amino acid(s) among the 20 standard protein amino acids is indispensable for the survival of cultured human corneal endothelial cells (HCECs).

Methods:
HCECs were cultured in amino acid screening media that were missing 1 specific amino acid, and cell growth was evaluated. After this first selection, we conducted a further evaluation of cell growth in response to the addition of 4 amino acids (cysteine, methionine, valine, and arginine) to amino acid-free culture media. We then evaluated the antioxidant effect of cysteine compared with other antioxidants in terms of apoptosis of HCECs, rabbit corneal endothelial cell (CECs), monkey CECs, and ex vivo human donor corneas.

Results:
Culture in an amino acid-free Dulbecco Modified Eagle Medium (DMEM) decreased the cell numbers to 11.0% when compared with culture in normal DMEM. Removal of cysteine, methionine, valine, or arginine from DMEM significantly suppressed cell numbers (27.7%, 61.4%, 75.5%, and 60.6%, respectively) (P < 0.01), whereas removal of other amino acids did not significantly decrease cell numbers. A lack of cysteine induced apoptosis, but addition of antioxidants reversed this. Removal of cysteine induced in vitro apoptosis in HCECs, rabbit CECs, monkey CECs, and ex vivo human donor corneas, whereas the presence of cysteine almost completely suppressed this apoptosis.

Conclusions:
Cysteine seems to be an indispensable amino acid for HCEC growth and survival. Its necessity might reflect a high requirement for antioxidants to protect HCECs from oxidative stress, as HCECs have high aerobic metabolic activity.
Drivers Motivating Community Health Improvement Plan Completion by Local Public Health Agencies and Community Partners in the Rocky Mountain Region and Western Plains
Authors: Hill Anne , Wolf Holly J. , Scallan Elaine , Case Jenny , Kellar-Guenther Yvonne 
Published: May 2017

Context:
There are numerous drivers that motivate completion of community health improvement plans (CHIPs). Some are more obvious and include voluntary public health accreditation, state requirements, federal and state funding, and nonprofit hospital requirements through IRS regulations. Less is known about other drivers, including involvement of diverse partners and belief in best practices, that may motivate CHIP completion.

Objective:
This research investigated the drivers that motivated CHIP completion based on experiences of 51 local public health agencies (LPHAs).

Design:
An explanatory mixed-methods design, including closed- and open-ended survey questions and key informant interviews, was used to understand the drivers that motivated CHIP completion. Analysis of survey data involved descriptive statistics. Classical content analysis was used for qualitative data to clarify survey findings.

Setting:
The surveys and key informant interviews were conducted in the Rocky Mountain Region and Western Plains among 51 medium and large LPHAs in Colorado, Kansas, Montana, Nebraska, North Dakota, South Dakota, Utah, and Wyoming.

Participants:
More than 50% of respondents were public health directors; the balance of the respondents were division/program directors, accreditation coordinators, and public health planners.

Main Outcome Measures:
CHIP completion.

Results:
Most LPHAs in the Rocky Mountains and Western Plains have embraced developing and publishing a CHIP, with 80% having completed their plan and another 13% working on it. CHIP completion is motivated by a belief in best practices, with LPHAs and partners seeing the benefit of quality improvement activities linked to the CHIP and the investment of nonprofit hospitals in the process. Completing a CHIP is strengthened through engagement of diverse partners and a well-functioning partnership.

Conclusion:
The future of CHIP creation depends on LPHAs and partners investing in the CHIP as a best practice, dedicating personnel to CHIP activities, and enhancing leadership skills to contribute to a synergistic partnership by effectively working and communicating with diverse partners and developing and achieving common goals.
Comparing Health Care Resource Use between Implant and Autologous Reconstruction of the Irradiated Breast: A National Claims-Based Assessment
Authors: Aliu Oluseyi , Zhong Lin , Chetta Matthew D. , Sears Erika D. , Ballard Tiffany , Waljee Jennifer F. , Chung Kevin C. , Momoh Adeyiza O. 
Published: May 2017

Background:
In the debate on reconstruction of the irradiated breast, there is little information on associated health care resource use. Nationwide data were used to examine health care resource use associated with implant and autologous reconstruction. It was hypothesized that failure rates would contribute the most to higher average cumulative cost with either reconstruction method.

Methods:
From the 2009 to 2013 MarketScan Commercial Claims and Encounters database, irradiated breast cancer patients who underwent implant or autologous reconstruction were selected. In a 24-month follow-up period, the cumulative costs of health care services used were tallied and described. Regression models stratified by reconstruction method were then used to estimate the influence of failure on cumulative cost of reconstruction.

Results:
There were 2964 study patients. Most (78 percent) underwent implant reconstruction. The unadjusted mean costs for implant and autologous reconstructions were $22,868 and $30,527, respectively. Thirty-two percent of implant reconstructions failed, compared with 5 percent of autologous cases. Twelve percent of the implant reconstructions had two or more failures and required subsequent autologous reconstruction. The cost of implant reconstruction failure requiring a flap was $47,214, and the cost for autologous failures was $48,344. In aggregate, failures constituted more than 20 percent of the cumulative costs of implant reconstruction compared with less than 5 percent for autologous reconstruction.

Conclusions:
More than one in 10 patients who had implant reconstruction in the setting of radiation therapy to the breast eventually required a flap for failure. These findings make a case for autologous reconstruction being primarily considered in irradiated patients who have this option available.
Comparison of Outcomes with Tissue Expander, Immediate Implant, and Autologous Breast Reconstruction in Greater Than 1000 Nipple-Sparing Mastectomies
Authors: Frey Jordan D. , Choi Mihye , Salibian Ara A. , Karp Nolan S. 
Published: May 2017

Background:
Nipple-sparing mastectomy permits complete preservation of the nipple-areola complex with excellent aesthetic results and with oncologic safety similar to that associated with traditional mastectomy techniques. However, outcomes have not been directly compared for tissue expander–, immediate implant–, and autologous tissue–based breast reconstruction after nipple-sparing mastectomy.

Methods:
All patients undergoing nipple-sparing mastectomy from 2006 to June of 2016 were identified at a single institution. Demographics and outcomes were analyzed and compared among different types of breast reconstruction.

Results:
A total of 1028 nipple-sparing mastectomies were performed. Of these, 533 (51.8 percent) were tissue expander–based, 263 (25.6 percent) were autologous tissue–based, and 232 (22.6 percent) were immediate implant–based reconstructions. Tissue expander–based reconstructions had significantly more minor cellulitis (p = 0.0002) but less complete nipple necrosis (p = 0.0126) and major mastectomy flap necrosis (p < 0.0001) compared with autologous tissue–based reconstructions. Compared to immediate implant–based reconstruction, tissue expander–based reconstructions had significantly more minor cellulitis (p = 0.0006) but less complete nipple necrosis (p = 0.0005) and major (p < 0.0001) and minor (p = 0.0028) mastectomy flap necrosis (p = 0.0059). Immediate implant–based reconstructions had significantly more minor cellulitis (p = 0.0051), minor mastectomy flap necrosis (p = 0.0425), and partial nipple necrosis (p = 0.0437) compared with autologous tissue–based reconstructions. Outcomes were otherwise equivalent among the three groups.

Conclusions:
Tissue expander, immediate implant, and autologous tissue breast reconstruction techniques may all be safely offered with nipple-sparing mastectomy. However, reconstructive complications appear to be greater with immediate implant– and autologous tissue–based techniques compared with tissue expander–based reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Urinary Excretion of MicroRNA-126 Is a Biomarker for Hemangioma Proliferation
Authors: Biswas Ayan , Pan Xueliang , Meyer Melissa , Khanna Savita , Roy Sashwati , Pearson Gregory , Kirschner Richard , Witman Patricia , Faith Esteban Fernandez , Sen Chandan K. , Gordillo Gayle M. 
Published: May 2017

Background:
Hemangiomas are unique endothelial cell tumors that involute spontaneously, which makes interpreting their response to therapies difficult. The objective of this work was to identify a potential biomarker in the urine of children with infantile hemangiomas that would facilitate testing new therapies.

Methods:
A prospective longitudinal study in children with hemangiomas and age-matched healthy controls was performed to determine whether microRNA-126, which is highly abundant in fetal endothelial cells, was more abundant in the urine of affected children. Prospective ultrasound measurements of hemangioma size and blood flow velocity were obtained as secondary endpoints to document longitudinal changes in untreated hemangiomas.

Results:
Urinary microRNA-126 levels were significantly elevated in children with proliferating hemangiomas, and relative levels of urinary microRNA abundance correlated with hemangioma size. Hemangiomas had elevated levels of microRNA abundance compared with healthy controls. Ultrasound data revealed that hemangioma proliferation typically stopped between 6 and 9 months of age. When hemangioma proliferation stopped, urinary microRNA-126 levels in children with hemangiomas dropped to levels observed in healthy age-matched controls.

Conclusions:
These are the first reported results to identify a potential microRNA biomarker in the urine of children with hemangiomas. Measurement of urinary levels of microRNA-126 could potentially be used to monitor hemangioma response to therapies.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, II.
A Randomized, Controlled, Multicenter Study of Juvéderm Voluma for Enhancement of Malar Volume in Chinese Subjects
Authors: Li Dong , Wang Xiaojun , Wu Yan , Sun Jiaming , Li Qin , Guo Shuzhong , Jia Yi , Murphy Diane K. 
Published: May 2017

Background:
Hyaluronic acid gels are used to restore volume to the midface, but there are few data published on this use in Asian subjects.

Methods:
This study evaluated the safety and effectiveness in Chinese subjects of Juvéderm Voluma, a 20-mg/ml hyaluronic acid gel formulated for midface volumizing. This prospective, multicenter study randomized 119 subjects aged 18 years or older to a treatment group and 27 subjects to a no-treatment control group. The primary effectiveness endpoint was the objectively measured magnitude of change from baseline in volume of the midface area (right and left combined) calculated by digital analysis at month 6 using three-dimensional images for all subjects in both groups. Effectiveness was protocol-defined as a mean change for the treatment group that was significantly greater than that for the control group at month 6 using a one-side two-group t test performed at the 5 percent level.

Results:
With a median volume of 2 ml of Voluma injected, the primary effectiveness endpoint was met, with the mean change from baseline to 6 months in malar volume for the treatment group (1.83 ml) being significantly greater than that for the control group (0.11 ml; p < 0.001). The secondary effectiveness endpoints of responder rate (malar volumization rated improved or much improved) using the Global Aesthetic Improvement Scale as assessed at month 6 by the investigator and by the subject were 98.2 and 93.8 percent, respectively. The most common treatment-related adverse events were mild injection-site swelling and bruising.

Conclusion:
Juvéderm Voluma is effective and well tolerated for midface augmentation in Chinese subjects.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.