bluuebunny/crossref_metadata_2025_split huggingface dataset:
On the origin of jets from disc-accreting magnetized stars
Authors: Lovelace Richard VE , Romanova Marina M , Lii Patrick , Dyda Sergei 
Published: September 2014

AbstractA brief review of the origin of jets from disc-accreting rotating magnetized stars is given. In most models, the interior of the disc is characterized by a turbulent viscosity and magnetic diffusivity (‘alpha’ discs) whereas the coronal region outside the disc is treated using ideal magnetohydrodynamics (MHD). Extensive MHD simulations have established the occurrence of long-lasting outflows in the case of both slowly and rapidly rotating stars. (1) Slowly rotating stars exhibit a new type of outflow, conical winds. Conical winds are generated when stellar magnetic flux is bunched up by the inward motion of the accretion disc. Near their region of origin, the winds have a thin conical shell shape with half opening angle of ∼30∘. At large distances, their toroidal magnetic field collimates the outflow forming current carrying, matter dominated jets. These winds are predominantly magnetically and not centrifugally driven. About 10-30% of the disc matter from the inner disc is launched in the conical wind. Conical winds may be responsible for episodic as well as long lasting outflows in different types of stars. (2) Rapidly rotating stars in the ‘propeller regime’ exhibit twocomponent outflows. One component is similar to the matter dominated conical wind, where a large fraction of the disc matter may be ejected in this regime. The second component is a high-velocity, low-density magnetically dominated axial jet where matter flows along the open polar field lines of the star. The axial jet has a mass flux of about 10% that of the conical wind, but its energy flux, due to the Poynting flux, can be as large as for the conical wind. The jet’s magnetically dominated angular momentum flux causes the star to spin down rapidly. Propeller-driven outflows may be responsible for protostellar jets and their rapid spin-down.When the artificial requirement of symmetry about the equatorial plane is dropped, the conical winds are found to come alternately from one side of the disc and then the other, even for the case where the stellar magnetic field is a centered axisymmetric dipole.Recent MHD simulations of disc accretion to rotating stars in the propeller regime have been done with no turbulent viscosity and no diffusivity. The strong turbulence observed is due to the magneto-rotational instability. This turbulence drives accretion in the disc and leads to episodic conical winds and jets.
Comparison of Local Recurrence With Conventional and Intensity-Modulated Radiation Therapy for Primary Soft-Tissue Sarcomas of the Extremity
Authors: Folkert Michael R. , Singer Samuel , Brennan Murray F. , Kuk Deborah , Qin Li-Xuan , Kobayashi Wendy K. , Crago Aimee M. , Alektiar Kaled M. 
Published: September 2014

PurposeThe use of intensity-modulated radiation therapy (IMRT) in the treatment of soft tissue sarcoma (STS) of the extremity is increasing, but no large-scale direct comparison has been reported between conventional external-beam radiation therapy (EBRT) and IMRT.MethodsBetween January 1996 and December 2010, 319 consecutive adult patients with primary nonmetastatic extremity STS were treated with limb-sparing surgery and adjuvant radiotherapy (RT) at a single institution. Conventional EBRT was used in 154 patients and IMRT in 165 with similar dosing schedules. Median follow-up time for the cohort was 58 months.ResultsTreatment groups were comparable in terms of tumor location, histology, tumor size, depth, and use of chemotherapy. Patients treated with IMRT were older (P = .08), had more high-grade lesions (P = .05), close (< 1 mm) or positive margins (P = .04), preoperative radiation (P < .001), and nerve manipulation (P = .04). Median follow-up was 90 months for patients treated with conventional EBRT and 42 months for patients treated with IMRT. On multivariable analysis adjusting for patient age and tumor size, IMRT retained significance as an independent predictor of reduced LR (hazard ratio = 0.46; 95% CI, 0.24 to 0.89; P = .02).ConclusionDespite a preponderance of higher-risk features (especially close/positive margin) in the IMRT group, IMRT was associated with significantly reduced local recurrence compared with conventional EBRT for primary STS of the extremity.
Risk of Fracture After Radical Cystectomy and Urinary Diversion for Bladder Cancer
Authors: Gupta Amit , Atoria Coral L. , Ehdaie Behfar , Shariat Shahrokh F. , Rabbani Farhang , Herr Harry W. , Bochner Bernard H. , Elkin Elena B. 
Published: September 2014

Purpose Radical cystectomy and urinary diversion may cause chronic metabolic acidosis, leading to long-term bone loss in patients with bladder cancer. However, the risk of fractures after radical cystectomy has not been defined. We assessed whether radical cystectomy and intestinal urinary diversion are associated with increased risk of fracture. Patients and Methods Population-based study using SEER-Medicare–linked data from 2000 through 2007 for patients with stage 0-III bladder cancer. We evaluated the association between radical cystectomy and risk of fracture at any site, controlling for patient and disease characteristics. Results The cohort included 50,520 patients, of whom 4,878 had cystectomy and urinary diversion. The incidence of fracture in the cystectomy group was 6.55 fractures per 100 person-years, compared with 6.39 fractures per 100 person-years in those without cystectomy. Cystectomy was associated with a 21% greater risk of fracture (adjusted hazard ratio, 1.21; 95% CI, 1.10 to 1.32) compared with no cystectomy, controlling for patient and disease characteristics. There was no evidence of an interaction between radical cystectomy and age, sex, comorbidity score, or cancer stage. Conclusion Patients with bladder cancer who have radical cystectomy and urinary diversion are at increased risk of fracture.
Phase II Study of the Safety and Antitumor Activity of the Hypoxia-Activated Prodrug TH-302 in Combination With Doxorubicin in Patients With Advanced Soft Tissue Sarcoma
Authors: Chawla Sant P. , Cranmer Lee D. , Van Tine Brian A. , Reed Damon R. , Okuno Scott H. , Butrynski James E. , Adkins Douglas R. , Hendifar Andrew E. , Kroll Stew , Ganjoo Kristen N. 
Published: September 2014

Purpose TH-302, a prodrug of the cytotoxic alkylating agent bromo-isophosphoramide mustard, is preferentially activated in hypoxic conditions. This phase II study investigated TH-302 in combination with doxorubicin, followed by single-agent TH-302 maintenance therapy in patients with first-line advanced soft tissue sarcoma (STS) to assess progression-free survival (PFS), response rate, overall survival, safety, and tolerability. Patients and Methods In this open-label phase II study, TH-302 300 mg/m2 was administered intravenously on days 1 and 8 with doxorubicin 75 mg/m2 on day 1 of each 21-day cycle. After six cycles, patients with stable and/or responding disease could receive maintenance monotherapy with TH-302. Results Ninety-one patients initiated TH-302 plus doxorubicin induction treatment. The PFS rate at 6 months (primary efficacy measure) was 58% (95% CI, 46% to 68%). Median PFS was 6.5 months (95% CI, 5.8 to 7.7 months); median overall survival was 21.5 months (95% CI, 16.0 to 26.2 months). Best tumor responses were complete response (n = 2 [2%]) and partial response (n = 30 [34%]). During TH-302 maintenance (n = 48), five patients improved from stable disease to partial response, and one patient improved from partial to complete response. The most common adverse events during induction were fatigue, nausea, and skin and/or mucosal toxicities as well as anemia, thrombocytopenia, and neutropenia. These were less severe and less frequent during maintenance. There was no evidence of TH-302–related hepatic, renal, or cardiac toxicity. Conclusion PFS, overall survival, and tumor response compared favorably with historical outcomes achieved with other first-line chemotherapies for advanced STS. A phase III study of TH-302 is ongoing (NCT01440088).
Risk of Subsequent Malignant Neoplasms in Long-Term Hereditary Retinoblastoma Survivors After Chemotherapy and Radiotherapy
Authors: Wong Jeannette R. , Morton Lindsay M. , Tucker Margaret A. , Abramson David H. , Seddon Johanna M. , Sampson Joshua N. , Kleinerman Ruth A. 
Published: September 2014

Purpose Hereditary retinoblastoma (Rb) survivors have increased risk of subsequent malignant neoplasms (SMNs). Previous studies reported elevated radiotherapy (RT) -related SMN risks, but less is known about chemotherapy-related risks. Patients and Methods In a long-term follow-up study of 906 5-year hereditary Rb survivors diagnosed from 1914 to 1996 and observed through 2009, treatment-related SMN risks were quantified using cumulative incidence analyses and multivariable Cox proportional hazards regression models with age as the underlying time scale. Results Nearly 90% of Rb survivors were treated with RT, and almost 40% received alkylating agent (AA) –containing chemotherapy (predominantly triethylenemelamine). Median follow-up time to first SMN diagnosis was 26.3 years. Overall SMN risk was not significantly elevated among survivors receiving AA plus RT versus RT without chemotherapy (hazard ratio [HR], 1.27; 95% CI, 0.99 to 1.63). AA-related risks were significantly increased for subsequent bone tumors (HR, 1.60; 95% CI, 1.03 to 2.49) and leiomyosarcoma (HR, 2.67; 95% CI, 1.22 to 5.85) but not for melanoma (HR, 0.74; 95% CI, 0.36 to 1.55) or epithelial tumors (HR, 0.89; 95% CI, 0.48 to 1.64). Leiomyosarcoma risk was significantly increased for survivors who received AAs at age < 1 (HR, 5.17; 95% CI, 1.76 to 15.17) but not for those receiving AAs at age ≥ 1 year (HR, 1.75; 95% CI, 0.68 to 4.51). Development of leiomyosarcoma was significantly more common after AA plus RT versus RT (5.8% v 1.6% at age 40 years; P = .01). Conclusion This comprehensive quantification of SMN risk after chemotherapy and RT among hereditary Rb survivors also demonstrates an AA-related contribution to risk. Although triethylenemelamine is no longer prescribed, our findings warrant further follow-up to investigate potential SMN risks associated with current chemotherapies used for Rb.
Vicair Academy Mattress in the prevention of pressure damage
Authors: Collins Fiona 
Published: September 2014

There are many costs associated with the development of pressure ulcers, both in terms of the patient experience and those associated with healing. If patients who are deemed to be at risk are identified and suitable preventive equipment is provided, incidence of pressure ulcer development can be reduced significantly. Pressure-reducing mattresses are primarily used to prevent pressure ulcers from occurring, in conjunction with other preventive measures, such as repositioning. The Vicair Academy Mattress, manufactured by Vicair BV and distributed by Gerald Simonds, uses Vicair's ‘dry air’ flotation system to offer maximum pressure and shear protection to patients who are at high risk of developing pressure ulcers. There are many different types of pressure-reducing mattresses currently on the market, the majority of which are constructed from polyurethane or viscoelastic foam. However, more recently, mattresses such as the Vicair Academy Mattress have incorporated the use of air flotation as an alternative method of supporting the body surface. This method of construction is able to cradle and support the body without exerting upward pressures.
The DARTNet Institute: Seeking a Sustainable Support Mechanism for Electronic Data
Enabled Research Networks
Authors: Pace Wilson D. , Fox Chet , White Turner , Graham Deborah , Schilling Lisa M. , West David R. 
Published: September 2014

Context: Clinical data research networks require large investments in
infrastructure support to maintain their abilities to extract, transform, and load data
from varied data sources, expand electronic data sources and develop learning
communities.Case Description: This paper outlines a sustainable business model of
ongoing infrastructure support for clinical data research activities. The DARTNet
Institute is a not-for-profit 501(c)(3) organization that serves as a support entity for
multiple practice-based research networks. Several clinical data research networks
working closely with a professional society began collaborating to support shared goals
in 2008. This loose affiliation called itself the “DARTNet Collaborative.” In 2011, the
DARTNet Institute incorporated as an independent, not-for-profit entity. The business
structure allows DARTNet to advocate for all partners without operating its own
practice-based research network, serve as a legal voice for activities that overlap
multiple partners, share personnel resources through service contracts between partners,
and purchase low-cost (nonprofit rate) software.Major Themes: DARTNet’s business model
relies upon four diverse sources of revenue: (1) DARTNet licenses and provides access to
a propriety software system that extracts, transforms, and loads data from all major
electronic health records (EHRs) utilized in the United States, and which also provides
clinical decision support for research studies; (2) DARTNet operates a recognized,
national professional-society-quality improvement registry that enables organizations to
fulfill Meaningful Use 2 criteria; (3) DARTNet provides access to data for research
activities that are funded by direct research dollars, provided at prices that generate
excess revenue; and (4) DARTNet provides access to large primary care datasets for
observational studies and pregrant analyses such as for sample size development. The
ability of the system to support pragmatic trials will be described.Conclusion: The
DARTNet model facilitates the use of direct grant dollars to generate revenue to support
the overall enterprise through a purchased services arrangement. Other services provided
through subcontracting provide facilities and administration fees as well as direct
dollars to support the system. The flexibility of the business model overcomes the
complicated financial arrangements and governance requirements of many professional
associations and academic medical centers.
The effects and effectiveness of electromotive drug administration and chemohyperthermia for treating non-muscle invasive bladder cancer
Authors: Slater SE , Patel P , Viney R , Foster M , Porfiri E , James ND , Montgomery B , Bryan RT 
Published: September 2014

Introduction Preliminary studies show that device assisted intravesical therapies appear more effective than passive diffusion intravesical therapy for the treatment of non-muscle invasive bladder cancer (NMIBC) in specific settings, and phase III studies are now being conducted. Consequently, we have undertaken a non-systematic review with the objective of describing the scientific basis and mechanisms of action of electromotive drug administration (EMDA) and chemohyperthermia (CHT). Methods PubMed, ClinicalTrials.gov and the Cochrane Library were searched to source evidence for this non-systematic review. Randomised controlled trials, systematic reviews and meta-analyses were evaluated. Publications regarding the scientific basis and mechanisms of action of EMDA and CHT were identified, as well as clinical studies to date. Results EMDA takes advantage of three phenomena: iontophoresis, electro-osmosis and electroporation. It has been found to reduce recurrence rates in NMIBC patients and has been proposed as an addition or alternative to bacillus Calmette–Guérin (BCG) therapy in the treatment of high risk NMIBC. CHT improves the efficacy of mitomycin C by three mechanisms: tumour cell cytotoxicity, altered tumour blood flow and localised immune responses. Fewer studies have been conducted with CHT than with EMDA but they have demonstrated utility for increasing disease-free survival, especially in patients who have previously failed BCG therapy. Conclusions It is anticipated that EMDA and CHT will play important roles in the management of NMIBC in the future. Techniques of delivery should be standardised, and there is a need for more randomised controlled trials to evaluate the benefits of the treatments alongside quality of life and cost-effectiveness.
Hearing outcomes following primary malleostapedial rotation ossiculoplasty in patients undergoing modified radical mastoidectomy
Authors: Kanegaonkar RG , Whittaker M , Najuko-Mafemera A 
Published: September 2014

Introduction Treatment of cholesteatoma consists of either excision or exteriorisation of disease. Approaches have traditionally included a radical or modified radical mastoidectomy and combined approach tympanoplasty. Hearing thresholds following a modified radical mastoidectomy alone have been reported as poor. We assessed hearing outcomes in patients undergoing a primary malleostapedial reconstruction combined with their open cavity surgery. Methods All patients undergoing open cavity mastoidectomy with primary malleostapedial rotation ossiculoplasty between 2009 and 2013 were identified. Case notes were reviewed, and demographic data, recurrence rate and audiometry were recorded. Results Twenty-one patients were identified. The age range was 10–65 years. There was no evidence of recurrence of cholesteatoma. The mean postoperative air-bone gap was 20dBHL, 23dBHL, 10dBHL and 27dBHL at 0.5kHz, 1kHz, 2kHz and 4kHz respectively. Excluding cases consistent with a postoperative ossicular discontinuity (n=3), the mean postoperative air-bone gap was 15dBHL, 19dBHL, 8dBHL and 26dBHL at 0.5kHz, 1kHz, 2kHz and 4kHz respectively. Conclusions The improvement in hearing thresholds demonstrated in this cohort of patients supports the use of this form of ossiculoplasty in those undergoing open cavity procedures. This would also suggest that the subsequent use of hearing aids in these patients would require less amplification and therefore provide superior hearing outcomes. As hearing loss remains a significant concern following modified radical mastoidectomy, we suggest an open cavity with primary malleostapedial rotation ossiculoplasty as a viable alternative to modified radical mastoidectomy alone, in selected cases.
Association of ABO blood group with fracture pattern and mortality in hip fracture patients
Authors: Uzoigwe CE , Smith RP , Khan A , Aghedo D , Venkatesan M 
Published: September 2014

Introduction The mechanism of falling has been proposed as the exclusive explanation for hip fracture pattern. Evidence exists that other genetic factors also influence proximal femoral fracture configuration. The ABO blood group serotype has been associated with other pathologies but any role in hip fracture has yet to be definitively characterised. Methods Our National Hip Fracture Database was interrogated over a four-year period. All patients had their blood group retrieved, and this was compared with hip fracture pattern and mortality rates. Confounding factors were accounted for using logistic regression and the Cox proportional hazards model. Results A total of 2,987 consecutive patients presented to our institution. Those with blood group A were significantly more likely to sustain intracapsular fractures than ‘non-A’ individuals (p=0.009). The blood group distribution of patients with intracapsular fractures was identical to that of the national population of England. However, blood group A was less common in patients with intertrochanteric fractures than in the general population (p=0.0002). Even after correction for age and sex, blood group A was associated with a decrease in the odds of suffering an intertrochanteric fracture to 80% (p=0.002). Blood group A had inferior survivorship correcting for age, sex and hip fracture pattern (hazard ratio: 1.14, p=0.035). This may be due to associated increased prevalence of co-morbid disease in this cohort. Conclusions Blood group is an independent predictor of hip fracture pattern, with group A patients more likely to sustain an intracapsular fracture and non-A individuals more likely to sustain an intertrochanteric fracture. The determinants of fracture pattern are likely to be related to complex interactions at a molecular level based on genetic susceptibility. The mechanism of fall may not be the only aetiological determinant of proximal femoral fracture configuration.
Predictors and outcomes of treatment in hip hemiarthroplasty dislocation
Authors: Salem KMI , Shannak OA , Scammell BE , Moran CG 
Published: September 2014

Introduction Dislocation following hip hemiarthroplasty (HHA), its incidence, predictors, treatment outcomes and mortality were investigated in a single centre series. Methods The prospectively collected data on neck of femur fracture admissions compiled over 11 years were reviewed. Place of residence, place of fall, past medical history, intraoperative factors (grade of surgeon, delay in surgery, type of implant and operative time), postoperative complications and mortality were compared between patients who suffered a dislocation and those who did not. In the dislocation group, the mean number of dislocations, reduction method, type and fate of implant, and mortality were investigated. Results Prospective data on 8,631 admissions were collected; 41% of these were managed with a HHA. The dislocation rate was 0.76%. A delay in surgery of >24 hours was associated with a fourfold increase in the dislocation risk. The majority (81%) of dislocations occurred in the first six weeks and closed manipulation was the definitive treatment in only 23% of the cases. The mortality rate was not increased following HHA dislocation. Conclusions The delay in surgery was the most important predictor of HHA dislocation. Closed reduction was associated with a high failure rate. While an initial attempt at closed reduction for a first dislocation is recommended, for redislocators, we recommend early exploration/revision as an alternative to repeat manipulations.
Modification of Geometric Parameters in Outer Rotor Permanent Magnet Generators to Improve THD, Efficiency, and Cogging Torque
Authors: de la Cruz Javier , Ramirez Juan M. , Leyva Luis 
Published: September 2014

Abstract
The improvement of efficiency, total harmonic distortion (THD), and cogging torque in outer rotor permanent magnet synchronous generator (PMSG) is the main concern in this paper. The paper focuses on handling the parameters of design, i.e. the geometry of the stator, the polar arc percentage, the air gap, the skew angle in rotor poles, the pole length, and the core steel class. The modification of geometric parameters related to the stator’s inductance is analyzed. Seventy-six cases are simulated, and results provide useful information for designing this type of machines. The study is carried out in a 5 kW PMSG.
Novel methods for elasticity characterization using optical coherence tomography: Brief review and future prospects
Authors: Matveev Lev A. , Zaitsev Vladimir Y. , Matveev Aleksander L. , Gelikonov Grigory V. , Gelikonov Valentin M. , Vitkin Alex 
Published: September 2014

AbstractIn this paper, a brief overview of several recently proposed approaches to elastographic characterization of biological tissues using optical coherence tomography is presented. A common feature of these “unconventional” approaches is that unlike most others, they do not rely on a two-step process of first reconstructing the particle displacements and then performing its error-prone differentiation in order to determine the local strains. Further, several variants of these new approaches were proposed and demonstrated essentially independently and are based on significantly different principles. Despite the seeming differences, these techniques open up interesting prospects not only for independent usage, but also for combined implementation to provide a multifunctional investigation of elasticity of biological tissues and their rheological properties in a wider sense.