bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings
Authors: Al-Amin Mona , Makarem Suzanne C. , Rosko Michael 
Published: June 2015

Background:
Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance.

Purposes:
As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients’ experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings.

Methodology:
We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness.

Findings:
Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings.

Practice Implications:
Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.
Design Concepts and Preclinical Results of a Miniaturized HeartWare Platform: The MVAD System
Authors: Cheung Anson , Chorpenning Katherine , Tamez Daniel , Shambaugh Charles , Dierlam Anne E. , Taskin M. Ertan , Ashenuga Michael , Reyes Carlos , LaRose Jeffrey A. 
Published: June 2015

Objective Ventricular assist device (VAD) miniaturization is one design trend that may result in less-invasive implantation techniques and more versatility with patient selection. The MVAD System is a miniature, continuous-flow device implanted in the ventricle. The pump is capable of delivering between 0 and 7 L/min of flow at a mean arterial pressure of 75 mm Hg. The impeller was optimized from its original design to improve hydraulic performance, minimize shear regions, and enhance the impeller's radial stiffness. These studies evaluated the MVAD System with modified impeller in the preclinical setting. Methods This modified pump design was tested through chronic studies (n = 6) in a healthy ovine model where 4 animals were implanted for a duration of 30 ± 5 days and 2 animals were implanted for a duration of 90 ± 5 days. The pump was placed in the left ventricular apex with the outflow graft anastomosed to the descending aorta. Postoperatively, no anticoagulant or antiplatelet therapies were administered throughout the study duration. Results All 6 animals reached their elective date of kill, demonstrating no evidence of organ compromise or device-related complications. Average pump parameters did not deviate significantly, and average rotational speed, pump flow, and power consumption were 14095 ± 139 RPM, 4.1 ± 0.4 L/min, and 4.3 ± 0.1 W, respectively. Examination of pump components postexplant demonstrated no mechanical wear or thrombus formation. Conclusions Hemocompatibility and biocompatibility of the modified MVAD System were demonstrated through pump parameters, blood chemistry panels, and histopathology analysis.
Managing One’s Symptoms
Authors: Yeager Katherine A. , Sterk Claire E. , Quest Tammie E. , DiIorio Colleen , Vena Catherine , Bauer-Wu Susan 
Published: June 2015

Background:
African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life.

Objective:
The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do.

Methods:
A purposive sample of 27 individuals participated in semistructured interviews conducted by 2 research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management.

Results:
Participants described 2 approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience.

Conclusions:
This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms.

Implications for Practice:
As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.
Effectiveness and Safety of Selective Neck Dissection in Lymph Node-Positive Squamous Cell Carcinoma of the Head and Neck
Authors: Polat Mustafa , Celenk Fatih , Baysal Elif , Durucu Cengiz , Kul Seval , Mumbuc Semih , Kanlikama Muzaffer 
Published: June 2015

Abstract
The aim of this study was to investigate the effectiveness and safety of selective neck dissection in patients with lymph node-positive head and neck squamous cell carcinoma to determine regional control and survival rates. Eighty patients with lymph node-positive head and neck squamous cell carcinoma who underwent selective dissection were included in the study. Regional control, survival rates, and factors affecting survival were analyzed. Regional control was 90%, disease-specific survival was 93.4%, and the overall survival rate was 87.25%. T stage, N stage, age, and extracapsular spread were included in hazard regression models. None of the factors were statistically significant. Selective neck dissection is an effective and oncologically safe treatment option in selected cases. T stage, N stage, and extracapsular spread had no significant impact on disease-specific survival.
Frontal Sinolith
Authors: Lee Dong Hoon , Yoon Tae Mi , Lee Joon Kyoo , Lim Sang Chul 
Published: June 2015

Abstract
Sinolith in the paranasal sinus is still a rare entity. A sinolith in the frontal sinus is extremely rare, and only 2 patients have been reported in the English literature. Herein, the authors present an additional patient of frontal sinolith in a 78-year-old woman. The patient was preoperatively diagnosed with fungus ball of the frontal sinus, based on radio-opaque densities on computed tomography. Endoscopic surgery was performed and surgical biopsy was interpreted as sinolith. Clinical manifestations of frontal sinolith, including imaging study findings, are discussed with a review of the literature pertaining to this condition. Despite its rarity, frontal sinolith should be considered in the differential diagnosis of radio-densities in the frontal sinus.
Giant Solitary Fibrous Tumor of Orbit
Authors: Tenekeci Goktekin , Sari Alper , Vayisoglu Yusuf , Serin Onur 
Published: June 2015

Abstract
Solitary fibrous tumors (SFTs) have been reported in various locations in the body. Solitary fibrous tumors are extremely rare tumors, especially when located in the orbit. Diagnosis of SFT cannot be made based on histopathology only because it exhibits a variable microscopic appearance, and necessitates immunohistochemistry to confirm the diagnosis.
A 51-year-old man was admitted to our clinic for the evaluation of a mass bulging in his left eye. Clinical examination revealed a painless mass extruding out of the orbital cavity with dimensions of 8 × 7 cm. Exenteration of the left eye including the upper and lower eyelid and reconstruction of the orbital cavity using a temporoparietal fascia flap and a temporal muscle flap was performed.
SFT of orbital region is known as a slow growing and painless tumor. Based on previous studies, increased mitotic rate of the tumor gives the impression that the tumor has a malignant nature. Until now a small number or orbital SFTs were reported and none of them presented with a giant mass protruding out of the orbital cavity. We present a unique case of orbital SFT filling the whole orbital cavity and protruding outward as a giant mass. This case has been reported to expand our knowledge in this debated entity.
Surgical Management of Giant Scalp Neurofibroma After Ultra-Selective Embolization of Nutrient Artery
Authors: Yuan Si-Ming , Guo Yao , Cui Lei , Wang Jun , Hu Xin-Bao , Zhou Ji-Hong , Jiang Hui-Qing , Hong Zhi-Jian 
Published: June 2015

Objectives:
Neurofibroma, a common benign tumor in soft tissue, continues to grow, so it often appears to be giant. Surgical management of giant neurofibroma is a challenge due to the risk of excessive bleeding. Embolization of tumor's nutrient artery may reduce the blood loss in operation. This study introduces the surgical management of giant scalp neurofibroma with preoperative ultra-selective embolization of nutrient artery.

Methods:
From January 2006 to December 2013, 9 patients with giant scalp neurofibroma were enrolled into the study. Digital subtraction angiography (DSA) showed tumor's nutrient artery. Ultra-catheter was inserted into the nutrient artery and its branches as close as possible to the tumor. Then ultra-selective embolization was performed with gelatin sponge particles. Surgical removal of tumor was performed in 3 days after embolization. The wound was repaired by skin graft.

Results:
All of the 9 patients underwent successful DSA and ultra-selective embolization. Among them, occipital artery was embolized in 3 patients (left side in 1 patient and right side in 2 patients). Both occipital artery and superficial temporal artery were embolized in 6 patients (left side in 2 patients, right side in 3 patients, and both side in 1 patient). No complications, such as ectopic embolism, occurred in the patients. All of the tumors were resected completely without blood transfusion. The skin graft survived very well on the wounds.

Conclusions:
Preoperative ultra-selective embolization of nutrient artery is a feasible, safe, and effective method to reduce the blood loss in operation and facilitate the surgical management of giant scalp neurofibroma.
The Risk of Blepharoptosis in Contact Lens Wearers
Authors: Hwang Kun , Kim Joo Ho 
Published: June 2015

Abstract
The aim of this systematic review was to summarize and evaluate the risk of blepharoptosis in contact lens wearers. In a PubMed search, 393 papers were found using the terms “lens and ptosis.” The abstracts were read and 16 full text articles were reviewed. Among them, 5 articles were analyzed. Five studies were subgrouped and a meta-analysis of these data suggested there is an increased risk of blepharoptosis in hard contact lens wearers over nonwearers (n = 7426, OR, 17.38, 95% CI = 3.71–81.29, P < 0.00001). One study was subgrouped and these data suggested there is also an increased risk of blepharoptosis in soft contact lens wearers over nonwearers (n = 90, OR, 8.12, 95% CI = 2.68–24.87, P < 0.0002). Patients wearing rigid contact lenses should be advised of the risk of ptosis, and a history of contact lens use should be sought in all patients who have acquired ptosis as the previous authors have recommended.
Aging as the Impact Factor on Septoplasty Success
Authors: Habesoglu Mehmet , Kilic Osman , Caypinar Basak , Onder Serap 
Published: June 2015

Objective:
The aim of the study was to discuss the impact of aging on septoplasty success.

Study Design and Setting:
This prospective case control study was conducted at the Umraniye Education and Research Hospital.

Methods:
Our study group consists of 23 patients older than 60-year-old who have septal deviation and have previously been postponed for this surgery due to various reasons. Twenty-six patients under 40-year-old are randomly chosen as the control group who were running to septoplasty. Postoperative Glasgow Benefit Inventory Index, preoperative and postoperative NOSE score, and nasal mucociliary clearance time (MCCt) were noted for both the groups. All collected data were compared between the groups.

Results:
In both the groups, postoperative NOSE scores decreased significantly compared to preoperative values (P < 0.01). This decrease was not significantly different between the groups. In both the groups, a significant decrease was noted in nasal MCCt with surgery (P = 0.004). However, this difference between two groups was not statistically significant. In addition, the Glasgow Benefit Inventory (GBI) index of control group was notably higher than the study group and this was statistically significant (P = 0.027). Also, the decrease of NOSE scores was conversely related to high GBI indexes and this is statistically significant (P = 0.005).

Conclusion:
For many surgical procedures, aging is considered as one of the important prognostic factors on success. To date no study in the literature discussed this relationship between aging and the success of septoplasty. At this point, our results showed that septoplasty is a successfully performed procedure in all ages. But, satisfaction of patients is statistically decreasing with aging.
Orthoptic Sequelae Following Conservative Management of Pure Blowout Orbital Fractures
Authors: Steinegger Ken , De Haller Raoul , Courvoisier Delphine , Scolozzi Paolo 
Published: June 2015

Abstract
The aim of this study was to prospectively assess the prevalence of orthoptic anomalies following conservative management of pure blowout orbital fractures and to evaluate their clinical relevance. Clinical and radiologic data of patients with unilateral conservatively managed pure blowout orbital fractures with a minimum follow-up of 6 months were reviewed. Eligible patients were contacted and invited to undergo an extended ophthalmologic examination as follows: distance and near visual acuities, Hertel exophthalmometry, corneal light reflex (Hirschberg test), ductions and versions in the 6 cardinal fields of gaze, eye deviation with prisms and alternate cover test in all of the 9-gaze directions with Maddox rod, degrees of incyclo/excyclotorsion with right and left eye fixation, horizontal and vertical deviation with Hess-Weiss coordimetry, degree of horizontal/vertical and incyclo/excyclotorsion deviation with Harms wall deviometry, and vertical deviation with Bielschowsky head-tilt test. Of the 69 patients contacted, 49 declined to participate given that they were asymptomatic. Twenty patients agreed to undergo the examination. One patient complained of minimal double vision limited to the extreme downgaze. Four patients had asymptomatic ocular motility disturbances limited to the extreme gaze. Seven patients had asymptomatic horizontal heterophoria. These disturbances did not interfere with daily or professional activities in any of the patients. The current study demonstrated that conservative management of pure orbital blowout fractures can result in orthoptic anomalies. These sequelae were restricted to a very limited portion of the binocular field of the vision and were not found to be clinically relevant.
New Screw Design for Securing Buried Distractors Usefulness and Ease of Removal
Authors: Fariña Rodrigo , Hinojosa Andrés , Sánchez Martín , Olate Sergio 
Published: June 2015

Abstract
There are 2 types of distraction devices for mandibular distraction: buried and external. The advantage of buried devices is the stability, but the difficulty in removing the screws is the greatest disadvantage. To resolve this problem, an osteosynthesis screw (Fariña Screw) has been designed, which greatly facilitates its removal when buried distractors are used.
Cryptococcus gattii genotype AFLP6/VGII meningoencephalitis in an immunocompetent Filipino male in Kuwait: activation of a dormant infection
Authors: Alfouzan Wadha , Al-Sheridah Saud , Alenzi Laila , Hagen Ferry , Meis Jacques F. , Khan Ziauddin 
Published: June 2015

Introduction
Cases of Cryptococcus gattii infections are being increasingly recognized in geographical regions that were traditionally regarded as non-endemic. Here, we describe a case of C. gattii meningoencephalitis in an immunocompetent Filipino male diagnosed in Kuwait.

Case presentation:
A 34-year-old healthy Filipino male presented with a history of progressive generalized headache, nausea and repeated episodes of vomiting. The patient had continuously lived and worked in Kuwait for three consecutive years before developing the disease. The diagnosis of meningoencephalitis was established by demonstrating capsulated budding yeast cells in cerebrospinal fluid, isolating C. gattii in culture and detecting cryptococcal polysaccharide antigen in serum and cerebrospinal fluid specimens. Molecular characterization of the isolate confirmed its identity as C. gattii, genotype AFLP6/VGII. The isolate showed reduced susceptibility to fluconazole and was treated suboptimally until flucytosine became available.

Conclusions:
A case of C. gattii meningoencephalitis in a healthy Filipino male, who apparently acquired the infection in his native country, is described. The infection remained dormant for several years before becoming clinically apparent. To the best of our knowledge, this is the first report of C. gattii meningitis diagnosed in Kuwait.
Scedosporium apiospermum: a fungal pathogen causing pneumonia in a patient with cystic fibrosis
Authors: Schwarz Carsten , Thronicke Anja , Staab Doris , Tintelnot Kathrin 
Published: June 2015

Introduction:

Scedosporium apiospermum is a slow-growing pathogenic fungus that can cause pneumonia. Diagnosis of this rare filamentous fungus is challenging. To the best of our knowledge, this is the first case describing an acute pulmonary infection caused by this fungal pathogen in a patient with cystic fibrosis (CF).

Case presentation:
A 35-year-old female with CF, with a 1-month history of irritating cough, increased sputum production and dyspnoea, was admitted to hospital. A chest computed tomography scan revealed new bilateral infiltrations, mediastinal lymphadenopathy and bronchiectasis. Pseudomonas aeruginosa and S. apiospermum were detected in the bronchoalveolar lavage. The patient's clinical status was not improved by standard antibiotic therapy. Antifungal systemic therapy consisting of systemic caspofungin and oral posaconazole against the highly suspected scedosporiosis was initiated, but the clinical outcome was not significantly improved. Antibodies against the S. apiospermum complex were present in the patient's serum. Only after the addition of 50 mg once a day of inhaled liposomal amphotericin B the patient was successfully treated.

Conclusion:
The patient was cured by a combined therapy of two systemic antimycotic drugs and one local antimycotic drug.
Myopericarditis and atrial fibrillation complicating meningococcal meningitis in a human immunodeficiency virus-infected man who has sex with men: a case report
Authors: Zhu Ziqiang , Shahzad Ali , Rozin Alexander 
Published: June 2015

Introduction:

Neisseria meningitidis is the leading cause of bacterial meningitis in children and young adults. Multiple complications have been reported previously, either at the time of presentation or later during the recovery phase of the illness. Cardiac arrhythmias and electrocardiogram (ECG) abnormalities have rarely been reported in N. meningitidis infection.

Case presentation:
We report a 48-year-old African-American man, with newly diagnosed human immunodeficiency virus infection, admitted with a diagnosis of meningococcal meningitis. An initial 12-lead ECG at admission showed a normal sinus rhythm with widespread concave ST elevation. The patient's troponin level was significantly elevated. A Transthoracic echocardiogram revealed left ventricle moderate anterior pericardial effusion. He was treated with antibiotics for meningitis and ibuprofen for myopericarditis. He subsequently developed atrial fibrillation, which was suppressed with metoprolol, diltiazem and amiodarone during hospitalization. To the best of our knowledge, this is the first reported case of atrial fibrillation complicating meningococcal meningitis.

Conclusion:
Myopericarditis complicates the course of meningococcal meningitis. Various forms of cardiac arrhythmias can occur during the course of meningococcal infection. Therefore, telemetry and serial ECG monitoring are recommended throughout the course of meningococcal infection.
Metacommunity in dynamic landscapes
Authors: de Santana Charles Novaes , Klecka Jan , Palamara Gian M. , Melián Carlos J. 
Published: June 2015

AbstractPredictions from theory, field data, and experiments have shown that high landscape connectivity promotes higher species richness than low connectivity. However, examples demonstrating high diversity in low connected landscapes also exist. Here we describe the many factors that drive landscape connectivity at different spatiotemporal scales by varying the amplitude and frequency of changes in the dispersal radius of spatial networks. We found that the fluctuations of landscape connectivity support metacommunities with higher species richness than static landscapes. Our results also show a dispersal radius threshold below which species richness drops dramatically in static landscapes. Such a threshold is not observed in dynamic landscapes for a broad range of amplitude and frequency values determining landscape connectivity. We conclude that merging amplitude and frequency as drivers of landscape connectivity together with patch dynamics into metacommunity theory can provide new testable predictions about species diversity in rapidly changing landscapes.
TESS: Bayesian inference of lineage diversification rates from (incompletely sampled) molecular phylogenies in R
Authors: Höhna Sebastian , May Michael R. , Moore Brian R. 
Published: June 2015

AbstractSummaryMany fundamental questions in evolutionary biology entail estimating rates of lineage diversification (speciation – extinction). We develop a flexible Bayesian framework for specifying an effectively infinite array of diversification models—where rates are constant, vary continuously, or change episodically through time—and implement numerical methods to estimate parameters of these models from molecular phylogenies, even when species sampling is incomplete. Additionally we provide robust methods for comparing the relative and absolute fit of competing branching-process models to a given tree, thereby providing rigorous tests of biological hypotheses regarding patterns and processes of lineage diversification.Availability and implementationthe source code for TESS is freely available athttp://cran.r-project.org/web/packages/TESS/.ContactSebastian.Hoehna@gmail.com