bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facilitating the transition from use case models to analysis models
Authors: Yue Tao , Briand Lionel C. , Labiche Yvan 
Published: March 2013

Use case modeling, including use case diagrams and use case specifications (UCSs), is commonly applied to structure and document requirements. UCSs are usually structured but unrestricted textual documents complying with a certain use case template. However, because Use Case Models (UCMods) remain essentially textual, ambiguity is inevitably introduced. In this article, we propose a use case modeling approach, called Restricted Use Case Modeling (RUCM), which is composed of a set of well-defined restriction rules and a modified use case template. The goal is two-fold: (1) restrict the way users can document UCSs in order to reduce ambiguity and (2) facilitate the manual derivation of initial analysis models which, when using the Unified Modeling Language (UML), are typically composed of class diagrams, sequence diagrams, and possibly other types of diagrams.
Though the proposed restriction rules and template are based on a clear rationale, two main questions need to be investigated. First, do users find them too restrictive or impractical in certain situations? In other words, can users express the same requirements with RUCM as with unrestricted use cases? Second, do the rules and template have a positive, significant impact on the quality of the constructed analysis models? To investigate these questions, we performed and report on two controlled experiments, which evaluate the restriction rules and use case template in terms of (1) whether they are easy to apply while developing UCMods and facilitate the understanding of UCSs, and (2) whether they help users manually derive higher quality analysis models than what can be generated when they are not used, in terms of correctness, completeness, and redundancy. This article reports on the first controlled experiments that evaluate the applicability of restriction rules on use case modeling and their impact on the quality of analysis models. The measures we have defined to characterize restriction rules and the quality of analysis class and sequence diagrams can be reused to perform similar experiments in the future, either with RUCM or other approaches.
Results show that the restriction rules are overall easy to apply and that RUCM results into significant improvements over traditional approaches (i.e., with standard templates, without restrictions) in terms of class correctness and class diagram completeness, message correctness and sequence diagram completeness, and understandability of UCSs.
Mild Renal Dysfunction and Metabolites Tied to Low HDL Cholesterol Are Associated With Monocytosis and Atherosclerosis
Authors: Ganda Anjali , Magnusson Martin , Yvan-Charvet Laurent , Hedblad Bo , Engström Gunnar , Ai Ding , Wang Thomas J. , Gerszten Robert E. , Melander Olle , Tall Alan R. 
Published: March 2013

Background—
The number of circulating blood monocytes impacts atherosclerotic lesion size, and in mouse models, elevated levels of high-density lipoprotein cholesterol suppress blood monocyte counts and atherosclerosis. We hypothesized that individuals with mild renal dysfunction at increased cardiovascular risk would have reduced high-density lipoprotein levels, high blood monocyte counts, and accelerated atherosclerosis.

Methods and Results—

To test whether mild renal dysfunction is associated with an increase in a leukocyte subpopulation rich in monocytes that has a known association with future coronary events, we divided individuals from the Malmö Diet and Cancer study (MDC) into baseline cystatin C quintiles (n=4757). Lower levels of renal function were accompanied by higher monocyte counts, and monocytes were independently associated with carotid bulb intima-media thickness cross-sectionally (
P
=0.02). Cystatin C levels were positively and plasma high-density lipoprotein cholesterol levels negatively associated with monocyte counts at baseline, after adjustment for traditional risk factors. Several amino acid metabolites tied to low levels of high-density lipoprotein cholesterol and insulin resistance measured in a subset of individuals (n=752) by use of liquid chromatography–mass spectrometry were independently associated with a 22% to 34% increased risk of being in the top quartile of monocytes (
P
<0.05).

Conclusions—
A low high-density lipoprotein cholesterol, insulin resistance phenotype occurs in subjects with mild renal dysfunction and is associated with elevated monocytes and atherosclerosis. High blood monocyte counts may represent a previously unrecognized mechanism underlying the strong relationship between cystatin C and cardiovascular risk.
Late Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease
Authors: David Tirone E. , Armstrong Susan , McCrindle Brian W. , Manlhiot Cedric 
Published: March 2013

Background—
The pathological spectrum of degenerative diseases of the mitral valve (MV) that causes mitral regurgitation (MR) is broad, and there is limited information on late outcomes of MV repair in various subgroups of patients and pathologies. This study examines this issue.

Methods and Results—
All 840 patients who had MV repair for MR due to degenerative diseases from 1985 to 2004 were prospectively followed with clinical and echocardiographic evaluations at biennial intervals up to 26 years, median of 10.4 years. Clinical, hemodynamic, and pathological variables were evaluated for their association with outcomes. Age, left ventricular ejection fraction, and functional class were predictors of late cardiac- and valve-related deaths by multivariable analysis. MV repair failed to restore life span to normal in patients with functional class IV. Thirty-eight patients had repeat MV surgery, and the probability of reoperation at 20 years was 5.9%. During the follow-up, recurrent severe MR developed in 37 patients, and moderate MR developed in 61. Age, isolated prolapse of the anterior leaflet, the degree of myxomatous changes in the MV, lack of mitral annuloplasty, and duration of cardiopulmonary bypass were associated with increased risk of recurrent MR. At 20 years, the freedom from recurrent severe MR was 90.7%, and the freedom from moderate or severe MR was 69.2%.

Conclusions—
MV repair for degenerative MR restored life span to normal except in patients with symptoms at rest and impaired left ventricular function. Advanced age and complex mitral valve pathologies increased the risk of late recurrent MR.
Observations of Near-Inertial Internal Gravity Waves Radiating from a Frontal Jet
Authors: Alford Matthew H. , Shcherbina Andrey Y. , Gregg Michael C. 
Published: March 2013

Abstract
Shipboard ADCP and towed CTD measurements are presented of a near-inertial internal gravity wave radiating away from a zonal jet associated with the Subtropical Front in the North Pacific. Three-dimensional spatial surveys indicate persistent alternating shear layers sloping downward and equatorward from the front. As a result, depth-integrated ageostrophic shear increases sharply equatorward of the front. The layers have a vertical wavelength of about 250 m and a slope consistent with a wave of frequency 1.01f. They extend at least 100 km south of the front. Time series confirm that the shear is associated with a downward-propagating near-inertial wave with frequency within 20% of f. A slab mixed layer model forced with shipboard and NCEP reanalysis winds suggests that wind forcing was too weak to generate the wave. Likewise, trapping of the near-inertial motions at the low-vorticity edge of the front can be ruled out because of the extension of the features well south of it. Instead, the authors suggest that the wave arises from an adjustment process of the frontal flow, which has a Rossby number about 0.2–0.3.
Castleman Disease in the Pediatric Neck: A Literature Review
Authors: Rabinowitz Mindy R. , Levi Jessica , Conard Katrina , Shah Udayan K. 
Published: March 2013

ObjectiveTo investigate the common features of cervical pediatric Castleman disease.Data SourcesLiterature review of pediatric patients with cervical Castleman disease.Review MethodsOnline medical journal databases were searched for patients aged 18 years or younger. Eighteen published studies were found, comprising 29 patients.ConclusionsAn asymptomatic or slowly enlarging neck mass was the most common presentation. No sex differences were noted. Magnetic resonance imaging demonstrates a homogeneous, isointense to slightly hyperintense T1‐weighted signal and high signal intensity on T2‐weighted imaging. Lymphoma was the most common differential diagnosis. All patients were treated with complete surgical excision and diagnosed as hyaline‐vascular type on histology, except for 1 patient for whom histologic type was not reported. No reports of multicentric disease, plasma cell, or mixed histology were found. No recurrences were reported.Implications for PracticeIn this article, we provide the largest known literature review of pediatric patients with cervical Castleman disease. Although Castleman disease is rare, it should be considered on the differential for a pediatric neck mass, particularly when presenting with an asymptomatic posterior neck mass and equivocal workup. Fortunately, our study suggests that if diagnosed as Castleman disease, the most likely diagnosis is hyaline‐vascular type, for which the long‐term prognosis is good. Surgical excision is both diagnostic and therapeutic.
Vertical Dome Division: A Quality‐of‐Life Outcome Study
Authors: Lavinsky‐Wolff Michelle , Dolci José Eduardo Lutaif , Camargo Humberto Lopes , Manzini Michelle , Petersen Sara , Romanczuk Sabrina , Pizzoni Rodrigo , Polanczyk Carisi Anne 
Published: March 2013

ObjectiveTo assess quality‐of‐life outcomes in patients undergoing nasal tip surgery with the vertical dome division technique using validated instruments (Rhinoplasty Outcome Evaluation [ROE] and Nasal Obstruction Symptom Evaluation [NOSE]).Study DesignCase series with planned data collection.SettingTertiary university center.Subject and MethodsPatients undergoing primary cosmetic and functional rhinoseptoplasty using vertical dome division were consecutively evaluated. The ROE, NOSE, and 100‐mm visual analog scale (VAS) were administered pre‐ and postoperatively.ResultsForty‐four patients were included and completed pre‐ and postoperative questionnaires. Their median age was 28 years, 27 (61%) were female, and the median duration of follow‐up was 5 months (range, 3‐9 months). Median postoperative ROE, NOSE, and VAS scores (79 [66; 87], 20 [15; 23], and 88 [61; 97], respectively) showed significant improvement compared with preoperative scores (29 [16; 41], 75 [60; 95], and 65 [46; 82], respectively; P <. 001). The change in median ROE score was significantly greater in normal‐ and thin‐skinned patients than in thick‐skinned patients (54 vs 33; P =. 033). Median changes in NOSE‐p (−48.5 vs −68.0; P =. 10) and VAS (69.0 vs 48.0; P =.083) scores did not differ between normal‐/thin‐ and thick‐skinned patients.ConclusionVertical dome division is a versatile technique for nasal tip refinement that resulted in significant improvement in quality‐of‐life outcomes related to rhinoplasty and nasal obstruction, as well as satisfaction with nasal appearance in a short‐term follow‐up period. The vertical dome division technique does not seem to be indicated only in patients with thick skin.
Reconstruction of a Bony Bankart Lesion
Authors: DeHaan Alexander , Munch Jacqueline , Durkan Michael , Yoo Jung , Crawford Dennis 
Published: March 2013

Background: The inferior coracoid process has traditionally been considered to be the gold standard for glenoid augmentation after anteroinferior bone loss. Other autograft sites, and more recently, osteochondral allograft sites, have been described as potential donor sources. Purpose: Potential autograft and osteochondral allograft sites were compared to identify the graft source that would provide the best fit for glenoid augmentation. Study Design: Controlled laboratory study. Methods: Mose circles, a geometric tool found on a standard goniometer, were used to make radius of curvature measurements of 10 anatomic locations in 17 cadaveric specimens. The bony surface of the glenoid, measured from superior to inferior (G-SI) and from anterior to posterior (G-AP), was used as the standard for comparison. Autograft sites were the inferior coracoid, lateral coracoid, and inner table of the iliac crest. Potential osteochondral allograft sites were the radial head, scaphoid fossa of the distal radius (S-DR), lunate fossa of the distal radius (L-DR), medial tibial plateau, and lateral distal tibia. An acceptable match for autograft sites was based on a paired analysis and defined as a radius of curvature within 5 mm of the G-SI or the G-AP of the same cadaveric specimen. Allograft sites were evaluated using an unpaired analysis in which an ideal fit was defined as a radius of curvature of 25 to 30 mm, based on the interquartile range of the G-SI and G-AP. Results: The median (interquartile range) radii of curvature for the G-SI and G-AP were 30 mm (range, 25-30 mm) and 25 mm (range, 25-25 mm), respectively. The inferior coracoid was within 5 mm of the G-SI 59% of the time and the G-AP 94% of the time; no measurements from the lateral coracoid or iliac crest were within the range of the glenoid radius of curvature. Analysis of the allograft sites demonstrated an acceptable fit for 94% of the distal tibia, 68% of the medial tibial plateau, 12% of the S-DR, and 0% of the L-DR and the radial head specimens. Conclusion: An autograft of the inferior coracoid or an osteochondral allograft of the lateral distal tibia provided the best match to re-establish the native radius of curvature of the glenoid. Clinical Relevance: To best re-create the native glenohumeral anatomy, surgeons should consider the use of an autograft of the inferior coracoid or an osteochondral allograft of the lateral distal tibia for the reconstruction of osseous glenoid defects.
How to Improve the Prediction of Quadrupled Semitendinosus and Gracilis Autograft Sizes With Magnetic Resonance Imaging and Ultrasonography
Authors: Erquicia Juan Ignacio , Gelber Pablo Eduardo , Doreste Jose Luis , Pelfort Xavier , Abat Ferran , Monllau Juan Carlos 
Published: March 2013

Background: Hamstring tendon grafts may have an unacceptable size for use in anterior cruciate ligament (ACL) reconstruction. Magnetic resonance imaging (MRI) has been proposed to predict the diameters of hamstring tendon grafts. Hypothesis: Preoperative ultrasonography (US) might reliably anticipate intraoperative 4-strand semitendinosus and gracilis tendon (4ST-GT) graft sizes similarly to MRI. An MRI evaluation of the hamstring tendons with a higher magnification may improve the accuracy of the method. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 33 patients undergoing ACL reconstruction with a 4ST-GT graft and MRI performed at our institution were included. The cross-sectional area (CSA) of each semitendinosus tendon (ST) and gracilis tendon (GT) was calculated preoperatively with US and with MRI under 2× and 4× magnification. Intraoperative measurement of the final diameter of the 4ST-GT using a closed-hole sizing block with 0.5-mm increments was made. Pearson correlation coefficients were calculated to determine the relationship between the final intraoperative graft diameter of the 4ST-GT and the CSA of the ST and GT measured with US and MRI with 2× and 4× magnification. Simple linear regression was also calculated to attempt to predict the graft diameter based on given measurements. Results: There were statistically significant correlations between the measured CSA with US and both MRI magnifications with the 4ST-GT diameter. However, MRI under 4× magnification showed a much higer correlation (0.86) than MRI under 2× magnification (0.54) or US (0.51). Final graft diameters ≥8 mm were observed in 80.8% of patients with a CSA >14 mm2, in 76.9% of patients with a CSA >25 mm2, and in 96.2% of patients with a CSA >17 mm2 measured with US, 2× magnification of MRI, and 4× magnification of MRI, respectively. Conclusion: Preoperative calculation of the CSA of the hamstring tendons with MRI and US can help to reliably estimate 4ST-GT grafts. In terms of correlation of the CSA with graft diameter, US was comparable to 2× MRI, but 4× MRI showed a much greater accuracy. Threshold values of the CSA of the ST and GT of 25 mm2, 17 mm2, and 14 mm2 with the 2× MRI, 4× MRI, and US methods, respectively, are needed to reliably predict a 4ST-GT graft with a minimum diameter of 8 mm.
Effect of Evidence and Changes in Reimbursement on the Rate of Arthroscopy for Osteoarthritis
Authors: Holmes Robert , Moschetti Wayne , Martin Brook , Tomek Ivan , Finlayson Samuel 
Published: March 2013

Background: The efficacy of arthroscopic debridement or lavage for knee osteoarthritis (OA) was cast into doubt after publication of several randomized controlled trials beginning in 2002. Purpose: The authors set out to determine whether evidence of ineffectiveness, along with subsequent changes in reimbursement, were followed by changes in utilization rates of arthroscopy for patients with OA. Study Design: Cohort study (prevalence); Level of evidence, 2. Methods: The Florida State Ambulatory Surgery Database was used to examine population-based rates of knee arthroscopy from 2000 to 2008 for patients with and without the diagnosis of OA; data were stratified between public and private payers. These trends were compared with patients who underwent arthroscopy for other diagnoses and were also compared with patients whose arthritis was not the primary indication for surgery. Results: A 39% decrease in the adjusted population-based rate of knee arthroscopy for OA was observed, from 12.2 per 100,000 adults in 2000 (95% CI, 9.9-14.4) to 7.7 per 100,000 adults in 2008 (95% CI, 6.7-8.6). The overall rate among individuals with a primary diagnosis of OA significantly decreased for both public ( P < .001) and private insurance ( P = .001) and the rate of this decrease was similar between the two insurance types ( P = .610). Although the unadjusted rates for all knee arthroscopy increased over the study period, the rate of increase was slowed in the years following the publication of several randomized controlled trials and subsequent changes in reimbursement. The average effect on arthroscopy rates attributed to these events was a reduction in 12 per 100,000 private arthroscopies (95% CI, –16.3 to 40.6; P = .404) and 35.7 per 100,000 publicly insured arthroscopies (95% CI, 15.0-56.4; P = .001). Conclusion: Evidence of the lack of efficacy of arthroscopy for knee OA, along with changes in reimbursement, preceded a significant decline in the population-based rates of this procedure in both publicly and privately insured patients in Florida.
Factors Influencing Worker Morale
Authors: Patterson-Silver Wolf David A. , Dulmus Catherine N. , Maguin Eugene , Cristalli Maria 
Published: March 2013

Objectives: Mental health organizations are strongly encouraged to implement empirically supported treatments (ESTs); however, little is known about their working environments. The present study investigated how provider demographics, workplace environment, and whether ESTs were used affected the worker morale. Method: Frontline workers ( N = 1,273) from 55 different programs in a single, large organization completed a measure of organizational culture and climate (OCC) and worker morale. A multilevel regression analysis used worker demographics to predict worker morale at Level 1 and EST use and OCC scales to predict program-level worker morale. Results: Worker morale was significantly negatively correlated with EST use and significantly correlated with OCC dimensions. Regression results showed that culture and climate but not EST use predicted morale. Conclusions: Although EST use by programs in this agency had negative effects on both morale and OCC, separately, the effect on morale was subsumed by the effect on OCC.
Alemtuzumab improves contrast sensitivity in patients with relapsing–remitting multiple sclerosis
Authors: Graves Jennifer , Galetta Steven L , Palmer Jeffrey , Margolin David H , Rizzo Marco , Bilbruck John , Balcer Laura J 
Published: March 2013

Background: Alemtuzumab is a monoclonal antibody directed against CD52 that depletes T and B lymphocytes. Objective: To evaluate the treatment effect of alemtuzumab on low-contrast vision in relapsing–remitting multiple sclerosis (RRMS) patients. Methods: This was a pre-defined exploratory analysis within a randomized, rater-blinded trial (CAMMS223) that was run at 49 academic medical centers in the US and in Europe. Patients with untreated, early, RRMS (McDonald, n = 334) were randomized 1:1:1 to subcutaneous interferon beta-1a (IFNB-1a), or alemtuzumab 12 mg or 24 mg. Visual contrast sensitivity was measured for each eye at baseline and quarterly, with Pelli-Robson charts. Results: The eyes of patients in the pooled alemtuzumab group (versus IFNB-1a) had a greater than 2-fold higher rate of both 3-month and 6-month sustained visual improvement, of at least 0.3 log units (2 triplets, 6 letters) (At 3 months the hazard ratio (HR) = 2.26; CI = 1.19 to 4.31; P = 0.013; and at 6 months the HR = 2.44; CI =1.16 to 5.15; P = 0.019), and they had a lower risk of 3- and 6-month sustained worsening of at least 0.15 log units (1 triplet, 3 letters) (At 3 months the HR = 0.58; CI = 0.38 to 0.89; P = 0.012; and at 6 months HR = 0.55; CI=0.35 to 0.87; P = 0.010). Over the 36-month study period, the eyes of patients in the pooled alemtuzumab group improved in mean contrast sensitivity to a greater extent than those in the IFNB-1a group (0.080 log units versus 0.038 log units; P = 0.0102). Conclusions: Alemtuzumab was associated with a greater chance of improved contrast sensitivity in patients with RRMS and may delay the worsening of visual function. Contrast sensitivity testing was sensitive to treatment effects, even within an active comparator study design. These results support the validity of low-contrast vision testing as a clinical outcome in MS trials.
Clinical significance of atrophy and white matter mean diffusivity within the thalamus of multiple sclerosis patients
Authors: Benedict Ralph HB , Hulst Hanneke E , Bergsland Niels , Schoonheim Menno M , Dwyer Michael G , Weinstock-Guttman Bianca , Geurts Jeroen JG , Zivadinov Robert 
Published: March 2013

Background: Gray-matter (GM) atrophy is strongly predictive of cognitive impairment in multiple sclerosis (MS) patients. The thalamus is the region where the atrophy/cognition correlation is most robust. However, few studies have assessed diffusion tensor imaging (DTI) metrics within the thalamus. Objective: This study was designed to determine if thalamus white matter DTI predicts cognitive impairment after accounting for the effects of volume loss. Methods: We enrolled 75 MS patients and 18 healthy controls undergoing 3T brain magnetic resonance imaging (MRI). Thalamus volumes were calculated on 3D T1 images. Voxelwise analyses of DTI metrics were performed within the thalamic white matter tracts. Neuropsychological (NP) testing, acquired using consensus standard methods, contributed measures of memory, cognitive processing speed and executive function. Results: All cognitive tests were significantly predicted ( R2 =0.31, p<0.001) by thalamus volume after accounting for influence of demographics. Mean diffusivity was retained in regression models predicting all cognitive tests, adding from 7–13% of additional explained variance ( p<0.02) after accounting for thalamus volume. Conclusions: We confirm the significant role of thalamus atrophy in MS-associated cognitive disorder, and further report that subtle thalamus pathology as detected by DTI adds incremental explained variance in predicting cognitive impairment.