bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding and Targeting Alkylator Resistance in Glioblastoma
Authors: Wick Wolfgang , Platten Michael 
Published: October 2014

Abstract
Summary: Alkylating chemotherapy is the mainstay in the treatment of pediatric and adult glioblastoma despite primary and acquired resistance and scientific efforts to precisely define therapies for individual patients. A focus on non–MGMT-mediated temozolomide resistance for pediatric glioblastoma suggests options for new drug combinations. Cancer Discov; 4(10); 1120–2. ©2014 AACR.
See related article by Agnihotri et al., p. 1198
Impact of Aortic Annulus Size on Valve Hemodynamics and Clinical Outcomes After Transcatheter and Surgical Aortic Valve Replacement
Authors: Rodés-Cabau Josep , Pibarot Philippe , Suri Rakesh M. , Kodali Susheel , Thourani Vinod H. , Szeto Wilson Y. , Svensson Lars G. , Dumont Eric , Xu Ke , Hahn Rebecca T. , Leon Martin B. 
Published: October 2014

Background—
The objective was to evaluate the effects of aortic annulus size on valve hemodynamics and clinical outcomes in those patients included in the Placement of Aortic Transcatheter Valves (PARTNER) randomized controlled trial cohort A and the nonrandomized continued access cohort.

Methods and Results—

Patients included the randomized controlled trial (n=574) and nonrandomized continued access (n=1358) cohorts were divided in tertiles according to aortic annulus diameter (small aortic annulus tertile, medium aortic annulus tertile, and large aortic annulus tertile [LAA], respectively) as measured by transthoracic echocardiography. Severe prosthesis–patient mismatch was defined as an effective aortic orifice area of <0.65 cm
2
/m
2
. In the randomized controlled trial cohort, patients in the small aortic annulus tertile who underwent transcatheter aortic valve replacement had a lower incidence of severe prosthesis–patient mismatch (19.7% versus 37.5%;
P
=0.03) and only a trend toward a higher incidence of moderate-to-severe paravalvular leaks compared with surgical aortic valve replacement (5.7% versus 0%;
P
=0.06). In the LAA tertile, there were no differences in the rate of prosthesis–patient mismatch between groups, and a significant increase in moderate-to-severe paravalvular leaks was associated with transcatheter aortic valve replacement (9% versus 0%;
P
=0.01). There were no differences in mortality between transcatheter aortic valve replacement and surgical aortic valve replacement. In the nonrandomized continued access cohort, there were no differences in prosthesis–patient mismatch between the small aortic annulus and LAA tertiles, but a higher rate of moderate-to-severe paravalvular leaks was observed in the LAA tertile (5.9% versus 11.5%;
P
=0.009). Patients in the LAA tertile had a higher mortality rate at 1-year follow-up (
P
=0.02), and differences persisted in multivariable analysis (
P
=0.048 for LAA versus medium aortic annulus tertile,
P
=0.035 for LAA versus small aortic annulus tertile).

Conclusions—
Aortic annulus size had a major impact on valve hemodynamics and clinical outcomes after transcatheter aortic valve replacement and surgical aortic valve replacement. This study highlights the importance of considering aortic annulus size in the evaluation of high-risk patients who are candidates for aortic valve replacement.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00530894.
β-Blockers and Cardiovascular Events in Patients With and Without Myocardial Infarction
Authors: Bangalore Sripal , Bhatt Deepak L. , Steg Ph. Gabriel , Weber Michael A. , Boden William E. , Hamm Christian W. , Montalescot Gilles , Hsu Amy , Fox Keith A.A. , Lincoff A. Michael 
Published: October 2014

Background—
The long-term efficacy of β-blockers in patients with and without myocardial infarction (MI) is controversial.

Methods and Results—

This is post hoc analysis from the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial of 4772 patients with prior MI, 7804 patients with known atherothrombosis, and 2101 patients with risk factors alone but without heart failure. Primary outcome was a composite of nonfatal MI, stroke, or cardiovascular mortality. The cohorts were divided into 2 groups based on baseline β-blocker use. In the propensity score–matched prior MI cohort, after 28 months of follow-up, β-blocker use was associated with a 31% lower risk of the primary outcome (70 [7.1%] versus 100 [10.2%]; hazards ratio, 0.69; 95% confidence interval, 0.50–0.94;
P
=0.021), driven by a lower risk of recurrent MI (33 [3.4%] versus 48 [4.9%]; hazards ratio, 0.62; 95% confidence interval, 0.39–1.00;
P
=0.049) with no difference in mortality (52 [5.3%] versus 66 [6.7%];
P
=0.20). In the known atherothrombotic disease and the risk factors alone cohorts, β-blocker use was not associated with lower ischemic outcomes, whereas a trend toward a higher risk of stroke (3.5% versus 1.5%; hazards ratio, 2.13; 95% confidence interval, 0.92–4.92;
P
=0.079) was observed in the risk factors alone cohort. This higher stroke risk was significant in the regression model adjusted to the propensity score (hazards ratio, 2.69; 95% confidence interval, 1.33–5.44;
P
=0.006) and in the multivariable models.

Conclusions—
β-blocker use in patients with prior MI but no heart failure was associated with a lower composite cardiovascular outcome driven by lower risk of recurrent MI with no difference in mortality. However, β-blocker use was not associated with lower cardiovascular events in those without MI, with a suggestion of inferior outcome with regard to stroke risk.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00050817.
Vortex Encounter Rates with Fixed Barometer Stations: Comparison with Visual Dust Devil Counts and Large-Eddy Simulations
Authors: Lorenz Ralph D. 
Published: October 2014

Abstract
A phenomenological model is developed wherein vortices are introduced at random into a virtual arena with specified distributions of diameter, core pressure drop, longevity, and translation speed, and the pressure history at a fixed station is generated using an analytic model of vortex structure. Only a subset of the vortices present are detected as temporary pressure drops, and the observed peak pressure-drop distribution has a shallower slope than the vortex-core pressure drops. Field studies indicate a detection rate of about two vortex events per day under favorable conditions for a threshold of 0.2 mb (1 mb = 1 hPa): this encounter rate and the observed falloff of events with increasing pressure drop can be reproduced in the model with approximately 300 vortices per square kilometer per day—rather more than the highest visual dust devil counts of approximately 100 devils per square kilometer per day. This difference can be reconciled if dust lifting typically only occurs in the field above a threshold core pressure drop of about 0.3 mb, consistent with observed laboratory pressure thresholds. The vortex population modeled to reproduce field results is concordant with recent high-resolution large-eddy simulations, which produce some thousands of 0.04–0.1-mb vortices per square kilometer per day, suggesting that these accurately reproduce the character of the strongly heated desert boundary layer. The amplitude and duration statistics of observed pressure drops suggest large dust devils may preferentially be associated with low winds.
Description of photochromic textile properties in selected color spaces
Authors: Viková Martina , Vik Michal 
Published: October 2014

Research in color science includes studies on the spectral properties of light and the perception of color by the human eye and the brain. Color spaces allow the description of the position of a color by using three basic attributes, namely lightness, chroma and hue. Photochromic pigments used as a component of ultraviolet sensors can help to define color changes in time through the measurement of color differences in exposition and decay phases. The change of color can be evaluated in terms of the light source employed, reversion and the kinetics of photochromic effects. Commercial spectrometers are not suitable for this type of measurement. These instruments cannot measure the kinetics of exposure and the decay phase of photochromic materials. A unique spectrophotometer and a methodology for measuring colorimetric and spectral data of photochromic pigments in selected color spaces are presented. This work is the first step towards standardization of the measurement of color-changing materials containing functional dyestuffs, such as photochromic pigments.
The Clinical Outcome of Dental Implants Placed through Skin Flaps
Authors: Li Bo‐Han , Byun Soo‐Hwan , Kim Soung‐Min , Lee Jong‐Ho 
Published: October 2014

Objective and Study DesignThe incidence of peri‐implantitis, marginal bone loss, implant success, and survival rates of 52 dental implants placed through the skin paddle and 23 implants through the neighboring gingiva were investigated. Mixed linear model was adopted to analyze the influence of radiation and skin paddle on marginal bone loss and peri‐implantitis.ResultsThe incidence of peri‐implantitis in implants placed through the skin flaps was higher (32.7%) than that of implants placed through the oral mucosa (8.7%). According to the mixed linear analysis, no significant difference in the amount of marginal bone loss was observed between the 2 groups: implants placed through the skin graft had marginal bone loss of 0.39 ± 0.14 mm at 1 year and 0.50 ± 0.23 mm at 5 years, and implants placed through the oral mucosa had marginal bone loss of 0.32 ± 0.12 mm and 0.52 ± 0.21 mm at the same time intervals. The 1‐year and 2‐ to 5‐year cumulative survival rates of the implants placed through the skin were 100% and 98%, respectively, and those of implants placed through the oral mucosa were both 95.65%. The 1‐year and 2‐ to 5‐year cumulative success rates of the implants placed through the skin were 92.30% and 79.38%, respectively, and those of implants placed through the oral mucosa were 91.30% and 82.59%, respectively.ConclusionImplants can be successfully placed and maintained in lining defects covered with a skin paddle; hence, this treatment modality may be considered reasonable and reliable for the functional and aesthetic rehabilitation of patients with oromaxillofacial reconstructions.
The effects of the CORE programme on pain at rest, movement-induced and secondary pain, active range of motion, and proprioception in female office workers with chronic low back pain: a randomized controlled trial
Authors: Kim Tae Hoon , Kim Eun-Hye , Cho Hwi-young 
Published: October 2014

Objective: To investigate the effects of the CORE programme on pain at rest, movement-induced pain, secondary pain, active range of motion, and proprioception deficits in female office workers with chronic low back pain. Design: Randomized controlled trial. Setting: Rehabilitation clinics. Subjects: A total of 53 participants with chronic low back pain were randomized into the CORE group and the control group. Intervention: CORE group participants underwent the 30-minute CORE programme, five times per week, for eight weeks, with additional use of hot-packs and transcutaneous electrical nerve stimulation, while the control group used only hot-packs and transcutaneous electrical nerve stimulation. Main measures: Participants were evaluated pretest, posttest, and two months after the intervention period to measure resting and movement-induced pain, pressure pain as secondary pain, active range of pain-free motion, and trunk proprioception. Results: Pain intensity at rest (35.6 ±5.9 mm) and during movement (39.4 ±9.1 mm) was significantly decreased in the CORE group following intervention compared with the control group. There were significant improvements in pressure pain thresholds (quadratus lumborum: 2.2 ±0.7 kg/cm2; sacroiliac joint: 2.0 ±0.7 kg/cm2), active range of motion (flexion: 30.8 ±14.3°; extension: 6.6 ±2.5°), and proprioception (20° flexion: 4.3 ±2.4°; 10° extension: 3.1 ±2.0°) in the CORE group following intervention (all p < 0.05). These improvements were maintained at the two-month follow-up. The control group did not show significant improvements in any measured parameter. Conclusion: The CORE programme is an effective intervention for reducing pain at rest and movement-induced pain, and for improving the active range of motion and trunk proprioception in female office workers with chronic low back pain.
Spatial distribution of malignant tissue in gliomas: correlations of 11C-L-methionine positron emission tomography and perfusion- and diffusion-weighted magnetic resonance imaging
Authors: Tietze Anna , Boldsen Jens K , Mouridsen Kim , Ribe Lars , Dyve Suzan , Cortnum Søren , Østergaard Leif , Borghammer Per 
Published: October 2014

Background The prognosis of glioma patients is contingent on precise target selection for stereotactic biopsies and the extent of tumor resection. 11C-L-methionine (MET) positron emission tomography (PET) demonstrates tumor heterogeneity and invasion with high diagnostic accuracy. Purpose To compare the spatial tumor distribution delineated by MET PET with that by perfusion- and diffusion-weighted magnetic resonance imaging (MRI), in order to understand the diagnostic value of these MRI methods, when PET is not available. Material and Methods Presurgical MET PET and MRI, including perfusion- and diffusion-weighted MRI, were acquired in 13 patients (7 high-grade gliomas, 6 low-grade gliomas). A quantitative volume of interest analysis was performed to compare the modalities objectively, supplemented by a qualitative evaluation that assessed the clinical applicability. Results The inaccuracy of conventional MRI was confirmed (area under the curve for predicting voxels with high MET uptake = 0.657), whereas cerebral blood volume (CBV) maps calculated from perfusion data improved accuracy (area under the curve = 0.760). We considered CBV maps diagnostically comparable to MET PET in 5/7 cases of high-grade gliomas, but insufficient in all cases of low-grade gliomas when evaluated subjectively. Cerebral blood flow and apparent diffusion coefficient maps did not contribute to further accuracy. Conclusion Adding perfusion-weighted MRI to the presurgical protocol can increase the diagnostic accuracy of conventional MRI and is a simple and well-established method compared to MET PET. However, the definition of low-grade gliomas with subtle or no alterations on cerebral blood volume maps remains a diagnostic challenge for stand-alone MRI.
Biomechanical Comparison of Krackow Locking Stitch Versus Nonlocking Loop Stitch With Varying Number of Throws
Authors: Hahn Joseph Minsoo , İnceoğlu Serkan , Wongworawat Montri Daniel 
Published: October 2014

Background: Common suture configuration techniques used for ligament and tendon grafts and repair are the Krackow locking stitch and a nonlocking loop stitch, such as a whipstitch. Clinically, the preferences of orthopaedic surgeons vary. Hypothesis: The Krackow locking stitch and the nonlocking whipstitch, with varying suture loops, produce different biomechanical and physical effects on the tendon end. Study Design: Controlled laboratory study. Methods: A total of 52 fresh-frozen porcine flexor digitorum tendons were used and assigned into 10 groups. Two stitch configurations (Krackow stitch [K] and whipstitch [W]) with varying number of loops (2 throws, n = 6; 4 throws, n = 5; 6 throws, n = 5; 8 throws, n = 5; 10 throws, n = 5) were tested. No. 2 FiberWire was used. Each sample was preloaded to 5 N and then cyclically loaded for 200 cycles to 200 N at 1 Hz, and then the tendon-suture construct was analyzed for gap formation, tendon elongation, and tendon end width. Next, each tendon was loaded to failure, and ultimate strength and mode of failure were recorded. Data were evaluated with 2-way analysis of variance. Results: For gap formation, the Krackow stitch produced less gap compared with the whipstitch (15.2 ± 4.0 mm [K] vs 18.9 ± 6.8 mm [W]; P = .012). Gap formation was larger when the number of loops increased from 2 to ≥6 ( P = .015). For elongation, the Krackow technique increased the tendon length after cyclic loading. In contrast, the whipstitch was noted to shorten the length of the tendon (1.17 ± 0.97 mm [K] vs −0.14 ± 1.13 mm [W]; P < .001). For tendon end width, the Krackow better preserved the transverse width (–0.64 ± 0.81 mm [K] vs −1.39 ± 0.64 mm [W]; P = .001). Both stitch types had similar ultimate strength (322.1 ± 20.3 N [K] vs 319.7 ± 20.4 N [W]; P = .676) and modes of failure (all by suture breakage; therefore, no statistical calculation was performed). There was no statistical difference in tendon elongation, width, failure load, or mode regardless of the number of throws. Conclusion/Clinical Relevance: Given the finding that the Krackow suture had less gap formation and better preservation of tendon architecture (length and width) compared with the whipstitch, coupled with the finding that ultimate strength is similar with both types of sutures, the Krackow stitch is recommended for tendon reconstruction when these parameters are important.
Modified Transtibial Versus Anteromedial Portal Technique in Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction
Authors: Youm Yoon-Seok , Cho Sung-Do , Lee Seon-Ho , Youn Chang-Hyun 
Published: October 2014

Background: Although several studies have compared a conventional transtibial technique with an anteromedial (AM) portal technique for single-bundle (SB) anterior cruciate ligament (ACL) reconstruction, no study to date has investigated whether the modified transtibial technique results in the femoral tunnel being in a similar anatomic position and produces similar clinical outcomes with those of the AM portal technique. Purpose: To compare the clinical outcomes and femoral tunnel position of SB ACL reconstruction using a modified transtibial technique (creating a femoral tunnel with varus and internal rotation of the tibia as well as modification of the tibial tunnel orientation) with those of SB ACL reconstruction using an AM portal technique. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 40 patients (40 knees) who underwent arthroscopic SB ACL reconstruction were included in this study. Patients were randomized using a computer-generated sequence into 2 groups: 20 patients by the modified transtibial technique (group 1) and 20 patients by the AM portal technique (group 2). Clinical evaluations included the 2000 International Knee Documentation Committee (IKDC) subjective knee score, Lysholm knee score, Tegner activity scale, Lachman test, pivot-shift test, 2000 IKDC knee examination, and KT-1000 arthrometer measurement. Three-dimensional computed tomography scans were analyzed according to the quadrant method, and the obliquity of the femoral tunnels in the coronal and sagittal planes and the size of the tunnel orifice were measured. Results: All clinical parameters improved significantly after SB ACL reconstruction, with no between-group differences. The mean distance of the femoral tunnel center location from the posterior condylar surface (0.8% difference; P = .167) and from the Blumensaat line (2.1% difference; P = .067) was similar in groups 1 and 2. The mean coronal obliquity of the femoral tunnel was significantly lower in group 1 than in group 2 (42.5° ± 6.1° vs 49.3° ± 7.2°, respectively; P = .001), but the mean sagittal obliquity was similar between the 2 groups (41.9° ± 6.1° vs 43.3° ± 5.4°, respectively; P = .303). The mean area of the tunnel orifice was significantly greater in group 1 than in group 2 (11.6 ± 1.4 × 9.2 ± 1.6 mm vs 10.3 ± 1.1 × 9.1 ± 1.4 mm, respectively; P = .013). Conclusion: The modified transtibial technique for SB ACL reconstruction showed good clinical results and anatomic placement of the femoral tunnel, similar with those of the AM portal technique.
Nurses’ autonomy in end-of-life situations in intensive care units
Authors: Paganini Maria Cristina , Bousso Regina Szylit 
Published: October 2014

Background: The intensive care unit environment focuses on interventions and support therapies that prolong life. The exercise by nurses of their autonomy impacts on perception of the role they assume in the multidisciplinary team and on their function in the intensive care unit context. There is much international research relating to nurses’ involvement in end-of-life situations; however, there is a paucity of research in this area in Brazil. In the Brazilian medical scenario, life support limitation generated a certain reluctance of a legal nature, which has now become unjustifiable with the publication of a resolution by the Federal Medical Council. In Brazil, the lack of medical commitments to end-of-life care is evident. Objective: To understand the process by which nurses exercise autonomy in making end-of-life decisions in intensive care units. Research design: Symbolic Interactionism and Corbin and Strauss theory methodology were used for this study. Participants and research context: Data were collected through single audio-recorded qualitative interviews with 14 critical care nurses. The comparative analysis of the data has permitted the understanding of the meaning of nurse’s experience in exercising autonomy relating to end-of-life decision-making. Ethical considerations: Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were anonymized. Findings: The results revealed that nurses experience the need to exercise autonomy in intensive care units on a daily basis. Their experience expressed by the process of increase opportunities to exercise autonomy is conditioned by the pressure of the intensive care unit environment, in which nurses can grow, feel empowered, and exercise their autonomy or else can continuously depend on the decisions made by other professionals. Conclusion: Nurses exercise their autonomy through care. They work to create new spaces at the same time that they acquire new knowledge and make decisions. Because of the complexity of the end-of-life situation, nurses must adopt a proactive attitude that inserts them into the decision-making process.
Differential Outcomes in Agency-Based Mental Health Care Between Minority and Majority Youth
Authors: Patterson David A. , Dulmus Catherine N. , Maguin Eugene , Perkins Jacob 
Published: October 2014

Background: Childhood mental health problems represent a significant public health concern globally. There is a converging discussion among researchers and practitioners alike that the research results of effectiveness studies are not fully generalizable and applicable to ethnoracial minority groups in real-world practice settings. Methods: Archival data on discharges from eight residential programs for children and youth aged 5–18 and operated by a large, child and family human services agency were analyzed to identify the relationship between client demographics and treatment outcomes. Results: Minority status was associated with lower odds of treatment success and higher odds of disengagement from treatment. Discussion: The results found that minority youth in residential programs had less favorable outcomes, in terms of both disengagement from treatment and a successful discharge, than White youth. This study calls into question whether current treatments are reaching and best serve ethnoracial minority groups in real-world practice settings.