bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asymmetric toroidal eddy currents (ATEC) to explain sideways forces at JET
Authors: Roccella R. , Roccella M. , Riccardo V. , Chiocchio S. 
Published: August 2016

Abstract
During some JET vertical displacement events (VDEs) plasma current and position are found to be toroidally asymmetric. When asymmetries lock, the vessel has been observed to move horizontally, consequently strong horizontal forces are expected following plasma asymmetries, whether locked or rotating. The cause of horizontal forces is, as already identified in previous works, the asymmetric circulation of current in the structures. The physics mechanism responsible for these asymmetric currents is instead an open issue and it is the object of the present analysis. In particular it will be shown that the asymmetry is not due to a direct exchange of current between plasma and structure (as in the case of halo currents) but to asymmetric conductive paths which arise, in the structures, when the plasma column asymmetrically wets the wall. Simulations of this phenomenon using finite element (FE) models have been conducted to reproduce the JET observation during locked and rotating asymmetric VDEs. Estimated sideways force, asymmetry (

I

p

asym

) and normalized asymmetry (

A

p

asym

) of plasma current, vertical position at different toroidal locations during the disruption and halo current asymmetry have been compared with measurements done at JET during upward AVDEs. The substantial match between experiments and simulations confirms the soundness of the assumptions. Furthermore, the same physical model applied to downward VDEs shows that divertor support and coils, together with the geometry of the limiting surfaces, considerably lessen asymmetric loads as experienced at JET after installing those components.
shinyGEO: a web-based application for analyzing gene expression omnibus datasets
Authors: Dumas Jasmine , Gargano Michael A. , Dancik Garrett M. 
Published: August 2016

Summary: The Gene Expression Omnibus (GEO) is a public repository of gene expression data. Although GEO has its own tool, GEO2R, for data analysis, evaluation of single genes is not straightforward and survival analysis in specific GEO datasets is not possible without bioinformatics expertise. We describe a web application, shinyGEO, that allows a user to download gene expression data sets directly from GEO in order to perform differential expression and survival analysis for a gene of interest. In addition, shinyGEO supports customized graphics, sample selection, data export and R code generation so that all analyses are reproducible. The availability of shinyGEO makes GEO datasets more accessible to non-bioinformaticians, promising to lead to better understanding of biological processes and genetic diseases such as cancer.
Availability and Implementation: Web application and source code are available from http://gdancik.github.io/shinyGEO/.
Contact: dancikg@easternct.edu
Supplementary information: Supplementary data are available at Bioinformatics online.
Radiogenomics to characterize regional genetic heterogeneity in glioblastoma
Authors: Hu Leland S. , Ning Shuluo , Eschbacher Jennifer M. , Baxter Leslie C. , Gaw Nathan , Ranjbar Sara , Plasencia Jonathan , Dueck Amylou C. , Peng Sen , Smith Kris A. , Nakaji Peter , Karis John P. , Quarles C. Chad , Wu Teresa , Loftus Joseph C. , Jenkins Robert B. , Sicotte Hugues , Kollmeyer Thomas M. , O'Neill Brian P. , Elmquist William , Hoxworth Joseph M. , Frakes David , Sarkaria Jann , Swanson Kristin R. , Tran Nhan L. , Li Jing , Mitchell J. Ross 
Published: August 2016

AbstractBackgroundGlioblastoma (GBM) exhibits profound intratumoral genetic heterogeneity. Each tumor comprises multiple genetically distinct clonal populations with different therapeutic sensitivities. This has implications for targeted therapy and genetically informed paradigms. Contrast-enhanced (CE)-MRI and conventional sampling techniques have failed to resolve this heterogeneity, particularly for nonenhancing tumor populations. This study explores the feasibility of using multiparametric MRI and texture analysis to characterize regional genetic heterogeneity throughout MRI-enhancing and nonenhancing tumor segments.MethodsWe collected multiple image-guided biopsies from primary GBM patients throughout regions of enhancement (ENH) and nonenhancing parenchyma (so called brain-around-tumor, [BAT]). For each biopsy, we analyzed DNA copy number variants for core GBM driver genes reported by The Cancer Genome Atlas. We co-registered biopsy locations with MRI and texture maps to correlate regional genetic status with spatially matched imaging measurements. We also built multivariate predictive decision-tree models for each GBM driver gene and validated accuracies using leave-one-out-cross-validation (LOOCV).ResultsWe collected 48 biopsies (13 tumors) and identified significant imaging correlations (univariate analysis) for 6 driver genes: EGFR, PDGFRA, PTEN, CDKN2A, RB1, and TP53. Predictive model accuracies (on LOOCV) varied by driver gene of interest. Highest accuracies were observed for PDGFRA (77.1%), EGFR (75%), CDKN2A (87.5%), and RB1 (87.5%), while lowest accuracy was observed in TP53 (37.5%). Models for 4 driver genes (EGFR, RB1, CDKN2A, and PTEN) showed higher accuracy in BAT samples (n = 16) compared with those from ENH segments (n = 32).ConclusionMRI and texture analysis can help characterize regional genetic heterogeneity, which offers potential diagnostic value under the paradigm of individualized oncology.
Pediatric temporal bone rhabdomyosarcoma
Authors: Goldberg Monica J. 
Published: August 2016

ABSTRACT
Rhabdomyosarcoma is one of the most common soft-tissue sarcomas in children. Prompt diagnosis and treatment significantly improve survival; however, misdiagnosis is common because of this aggressive temporal bone lesion's similarity to more common benign diseases. Clinicians should maintain a high index of suspicion for rhabdomyosarcoma in patients with a presumed otologic infection not responsive to medical therapy.
An update on ocular allergy
Authors: Shaker Marcus , Salcone Erin 
Published: August 2016

Purpose of review
The update reviews prevalence, classification, cause, and treatment options for allergic eye disease.

Recent findings
The incidence of allergic eye disease is underreported but may affect almost all patients with allergic rhinitis. Increased rates of oculonasal symptoms have been reported in the United States resulting in significant economic expenditures. The spectrum of allergic conjunctivitis and its differential considerations include seasonal and perennial conjunctivitis, vernal and atopic keratoconjunctivitis, and giant papillary conjunctivitis. Patients with allergic conjunctivitis have classic immunoglobulin E-mediated pathophysiology and treatments directed at allergen avoidance, traditional pharmacotherapy with oral antihistamines, topical dual-acting antihistamine/mast cell stabilizer agents, and treatment of tear film dysfunction are first-line management strategies. Immunotherapy is an effective treatment option and refractory cases may require ophthalmology comanagement for consideration of topical ester-based corticosteroid therapy and consideration of topical immunomodulators.

Summary
Ocular allergy involving specific modifiable and treatable environmental sensitizations is common and often underrecognized. It can impair quality of life to varying degrees. Some cases are quite refractory to management and may require multidisciplinary coordination of care between allergy and ophthalmology specialists. Understanding classification, triggers, and treatment options is important in designing the most appropriate patient-tailored management plans.
The Impact of Project ECHO on Participant and Patient Outcomes: A Systematic Review
Authors: Zhou Carrol , Crawford Allison , Serhal Eva , Kurdyak Paul , Sockalingam Sanjeev 
Published: August 2016

Purpose
Project Extension for Community Healthcare Outcomes (ECHO) uses tele-education to bridge knowledge gaps between specialists at academic health centers and primary care providers from remote areas. It has been implemented to address multiple medical conditions. The authors examined evidence of the impact of all Project ECHO programs on participant and patient outcomes.

Method
The authors searched PubMed, MEDLINE, EMBASE, PsycINFO, and ProQuest from January 2000 to August 2015 and the reference lists of identified reviews. Included studies were limited to those published in English, peer-reviewed articles or indexed abstracts, and those that primarily focused on Project ECHO. Editorials, commentaries, gray literature, and non-peer-reviewed articles were excluded. The authors used Moore’s evaluation framework to organize study outcomes for quality assessment.

Results
The authors identified 39 studies describing Project ECHO’s involvement in addressing 17 medical conditions. Evaluations of Project ECHO programs generally were limited to outcomes from Levels 1 (number of participants) to 4 (providers’ competence) of Moore’s framework (n = 22 studies, with some containing data from multiple levels). Studies also suggested that Project ECHO changed provider behavior (n = 1), changed patient outcomes (n = 6), and can be cost-effective (n = 2).

Conclusions
Project ECHO is an effective and potentially cost-saving model that increases participant knowledge and patient access to health care in remote locations, but further research examining its efficacy is needed. Identifying and addressing potential barriers to Project ECHO’s implementation will support the dissemination of this model as an education and practice improvement initiative.
Sedation with Dexmedetomidine or Propofol Impairs Hypoxic Control of Breathing in Healthy Male Volunteers
Authors: Lodenius Åse , Ebberyd Anette , Hårdemark Cedborg Anna , Hagel Eva , Mkrtchian Souren , Christensson Eva , Ullman Johan , Scheinin Mika , Eriksson Lars I. , Jonsson Fagerlund Malin 
Published: August 2016

Abstract

Background
In contrast to general anesthetics such as propofol, dexmedetomidine when used for sedation has been put forward as a drug with minimal effects on respiration. To obtain a more comprehensive understanding of the regulation of breathing during sedation with dexmedetomidine, the authors compared ventilatory responses to hypoxia and hypercapnia during sedation with dexmedetomidine and propofol.

Methods
Eleven healthy male volunteers entered this randomized crossover study. Sedation was administered as an intravenous bolus followed by an infusion and monitored by Observer’s Assessment of Alertness/Sedation (OAA/S) scale, Richmond Agitation Sedation Scale, and Bispectral Index Score. Hypoxic and hypercapnic ventilatory responses were measured at rest, during sedation (OAA/S 2 to 4), and after recovery. Drug exposure was verified with concentration analysis in plasma.

Results
Ten subjects completed the study. The OAA/S at the sedation goal was 3 (3 to 4) (median [minimum to maximum]) for both drugs. Bispectral Index Score was 82 ± 8 and 75 ± 3, and the drug concentrations in plasma at the sedation target were 0.66 ± 0.14 ng/ml and 1.26 ± 0.36 μg/ml for dexmedetomidine and propofol, respectively. Compared with baseline, sedation reduced hypoxic ventilation to 59 and 53% and the hypercapnic ventilation to 82 and 86% for dexmedetomidine and propofol, respectively. In addition, some volunteers displayed upper airway obstruction and episodes of apnea during sedation.

Conclusions
Dexmedetomidine-induced sedation reduces ventilatory responses to hypoxia and hypercapnia to a similar extent as sedation with propofol. This finding implies that sedation with dexmedetomidine interacts with both peripheral and central control of breathing.
Comparison of the Motor Performance and Vestibular Function in Infants with a Congenital Cytomegalovirus Infection or a Connexin 26 Mutation: A Preliminary Study
Authors: Maes Leen , De Kegel Alexandra , Van Waelvelde Hilde , De Leenheer Els , Van Hoecke Helen , Goderis Julie , Dhooge Ingeborg 
Published: August 2016

Objectives:
Hearing-impaired children are at risk for vestibular damage and delayed motor development. Two major causes of congenital hearing loss are cytomegalovirus (CMV) infection and connexin (Cx) 26 mutations. Comparison of the motor performance and vestibular function between these specific groups is still underexplored. The objective of this study was to investigate the impact of congenital (c)CMV and Cx26 on the motor performance and vestibular function in 6 months old infants.

Design:
Forty children (mean age 6.7 months; range 4.8 to 8.9 months) participated in this cross-sectional design and were recruited from the Flemish CMV registry. They were divided into five age-matched groups: normal-hearing control, asymptomatic cCMV, normal-hearing symptomatic cCMV, hearing-impaired symptomatic cCMV, and hearing-impaired Cx26. Children were examined with the Peabody Developmental Motor Scales-2 and cervical vestibular-evoked myogenic potential (cVEMP) test.

Results:
Symptomatic hearing-impaired cCMV children demonstrated a significantly lower gross motor performance compared with the control group (p = 0.005), the asymptomatic cCMV group (p = 0.034), and the Cx26 group (0.016). In this symptomatic hearing-impaired cCMV group, 4 out of 8 children had absent cVEMP responses that were related to the weakest gross motor performance. The Cx26 children showed no significant delay in motor development compared with the control children and none of these children had absent cVEMP responses.

Conclusions:
The weakest gross motor performance was found in symptomatic hearing-impaired cCMV-infected children with absent cVEMP responses. These results suggest that abnormal saccular responses are a major factor for this delayed motor development, although more work is needed including comprehensive vestibular function testing to verify this.
Risk of Subluxation or Dislocation After Operative Treatment of Terrible Triad Injuries
Authors: Zhang Dafang , Tarabochia Matthew , Janssen Stein , Ring David , Chen Neal 
Published: August 2016

Objective:
The management of terrible triad injuries has evolved over the last 2 decades to include routine radial head fixation or replacement, reattachment of the lateral collateral ligament, with or without coronoid fixation. Our objective was to determine the likelihood of and factors associated with subluxation or dislocation after operative treatment of terrible triad injuries among a large group of surgeons using current techniques.

Design:
Retrospective cohort study.

Setting:
Two level I trauma centers.

Patients/Participants:
A total of 107 patients with operatively treated terrible triad injuries from January 2000 to June 2015.

Intervention:
Review of patient- and surgery-related factors during the first postoperative month.

Main Outcome Measurement:
Radiographic subluxation of the ulnohumeral joint.

Results:
One hundred of the 107 patients (93%) treated with open fixation of terrible triad injuries had no radiographic subluxation or redislocation. Two patients (2%) had slight transient radiographic subluxation (“drop sign”) that corrected with active exercises within weeks of surgery. Five patients (5%) had persistent radiographic subluxation, 3 treated with a second surgery (3%). When treated within 2 weeks of injury, recurrent subluxation or dislocation after operative fixation of terrible triad injuries was rare (1%), provided that the radial head was replaced and the lateral collateral ligament reattached.

Conclusions:
Radiographic subluxation is very uncommon with current operative management of terrible triad injuries of the elbow within 2 weeks. Patients treated more than 2 weeks after injury might benefit from ancillary fixation to limit subluxation (ie, cross pinning, external fixation, or internal joint stabilizer).

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Gartland Type 3 Supracondylar Humeral Fractures in Children: Which Open Reduction Approach Should Be Used After Failed Closed Reduction?
Authors: Kızılay Yusuf Onur , Aktekin Cem Nuri , Özsoy Mehmet Hakan , Akşahin Ertuğrul , Sakaoğulları Abdurrahman , Pepe Murad , Kocadal Onur 
Published: August 2016

Objectives:
For displaced supracondylar humeral fractures in children, in the event of closed reduction failure, anatomic reduction is achieved via open reduction techniques; however, there are no confirmative reports among the published open reduction approaches that deliver the best functional and cosmetic results. Here, we compared long-term functional and cosmetic results of different surgical approaches.

Design:
Retrospective cohort study.

Setting:
Ankara Education and Research Hospital/Turkey. Secondary care hospital and trauma center.

Patients/participants:
We evaluated 70 surgically treated Gartland type 3 supracondylar humeral fractures. Patients, with detailed history record, were divided into 5 groups with respect to surgery methods.

Intervention:
All patients were treated surgically using closed reduction and percutaneous pinning or 4 different open reduction approaches and percutaneous pinning.

Main Outcome Measures:
Flynn cosmetic and functional score results were compared between surgical groups.

Results:
Posterior open reduction and triceps transection groups showed worst results, whereas medial and lateral open reduction groups showed good to excellent results similar to closed reduction group.

Conclusion:
Medial and lateral approaches demonstrated better functional results than posterior and triceps transection approaches. Posterior approaches lead to restrictions in extension and poor functional results. In the posterior approach, transecting triceps from olecranon does not benefit from fracture reduction but results in loss of triceps strength and should be avoided. In failed closed reduction, medial and lateral open reduction approaches lead to similar cosmetic outcomes and functional results that are only slightly worse compared with those in closed reduction.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Clinical and Radiological Study Focused on Relief of Low Back Pain After Decompression Surgery in Selected Patients With Lumbar Spinal Stenosis Associated With Grade I Degenerative Spondylolisthesis
Authors: Ikuta Ko , Masuda Keigo , Tominaga Fuyuki , Sakuragi Takahide , Kai Kazuhiro , Kitamura Takahiro , Senba Hideyuki , Shidahara Satoshi 
Published: August 2016

Study Design.
A retrospective study.

Objective.
The aim of the present study was to identify the clinical and radiological features of low back pain (LBP) that was relieved after decompression alone of lumbar spinal stenosis (LSS) associated with grade I lumbar degenerative spondylolisthesis (LDS).

Summary of Background Data.
Although decompression and fusion are generally the recommended surgical treatments of LDS, several authors have reported that some patients with LDS could obtain good clinical results including relief from LBP by decompression alone. The pathogenesis of relief from LBP after decompression is, however, not known.

Methods.
Forty patients with LSS associated with grade I LDS, who underwent a minimally invasive surgical-decompression were enrolled in the present study. All patients complained preoperatively of predominantly leg-related symptoms and LBP (≥ 4 points on Numeric Rating Scale). Clinical and radiological assessments were performed 1 year after surgery (a relief of LBP: Numeric Rating Scale reduction ≥3 points and valuation ≤3 points) and at the last follow-up. We conducted a comparative study between patient groups with and without the relief from LBP (groups R and N, respectively).

Results.
Twenty-nine patients were distributed to group R and the remaining 11 patients to group N. Preoperatively, there was a significant difference between the two groups for age and radiographic flexibility for lumbar extension. Postoperatively, there was a positive correlation between improvement in both LBP and leg symptoms. The clinical outcomes of group R were significantly better than those of group N throughout follow-up period (mean 37 mo). In group R, sagittal lumbopelvic radiographic parameters improved significantly after surgery.

Conclusion.
Although the causes of LBP are varied in each patients, our results show that concomitant LSS itself might cause LBP in some patients with grade I LDS, because it involves impingement of the neural tissue and discordant sagittal lumbopelvic alignment.

Level of Evidence: 3
Direct Repair of Lumbar Pars Interarticularis Defects by Utilizing Intraoperative O-Arm-Based Navigation and Microendoscopic Techniques
Authors: Jia Min , Wang Jian , Zhang Zhengfeng , Zheng Wenjie , Zhou Yue 
Published: August 2016

Study Design.
A retrospective analysis of the clinical outcomes of eight patients with the lumbar pars interarticulars defects treated by direct repair with the aid of intraoperative O-arm based navigation and microendoscopic techniques.

Objective.
The aim of this study was to investigate the efficacy and safety of direct screw repair by using minimally invasive surgery for the lumbar pars interarticulars defects in a pilot study.

Summary of Background Data.
Direct repair of pars interarticulars defects has been used to treat young adult patients. Reports concerning direct repair by minimally invasive techniques for pars interarticulars defects are quite rare.

Methods.
Review of medical records identified eight consecutive patients treated with intraoperative O-arm based navigation and microendoscopic techniques. Debridement and autograft of pars interarticularis defects was performed under microendoscopic procedure. Then, percutaneous bilateral intralaminar screws were inserted by utilizing intraoperative navigation. The clinical and radiological data were collected and analyzed retrospectively.

Results.
Eight patients had a mean age of 28.4 years, and five were 30 years or younger at the time of treatment. Symptoms included axial back pain in 100% of patients without concomitant radiculopathy. Autograft was used in all cases. The average follow-up duration was 27.4 months with a range of 20 to 33 months. Symptoms resolved completely or partially in all patients. Low back pain visual analog scores decrease from preoperative 6.8 to postoperative 1.4 of eight cases. Of 16 pars defects, healing was observed in 13 (81.3%) at last radiological follow-up. One patient with bilateral fusion failure refused revision surgery because of mild complaint. No complications such as dural tear, nerve root injury, and infection occurred.

Conclusion.
Minimally invasive direct repair of the pars interarticularis defects with intralaminar screws by using microendoscopic system and navigation procedure can provide safe and effective treatment of spondylolysis with satisfactory clinical and radiological outcomes, which need some special tools with steep learning curve.

Level of Evidence: 4