bluuebunny/crossref_metadata_2025 huggingface dataset:
A Method for Block Compression of Images Based on Data-hiding
Authors: Cui T , Zhou Q , Shen J , Li J , Hu Y L , Liang W
Published: October 2019

The existing image block compression method does not reduce the amount of data after the image block processing. For the image with large amount of raw data, such as high-resolution remote sensing images, the image compression will consume more hardware resources and cause great pressure on the compression performance. Aiming at this situation, a method for block compressed of images based on data-hiding is proposed. The reference image block and similar image blocks are judged by the similarity of image blocks. The number of similar image blocks is hidden in the reference image block by data-hiding, and only the reference image blocks are subjected to JPEG2000 compression. The experimental results show that the method reduces the amount of data before image compression by 1/3 and increase the compression ratio of image compression by 1.5 times.
Digital Modeling and Display of Ancient Architecture Based on Multi-Station Laser Scanning
Authors: Li Xiaoyan , Li Guo , Li Pengyi , Li Jun , Hu Tao , Li Meng , Yu Ya
Published: October 2019

In order to better display and protect ancient Chinese architecture, a three-dimensional model reconstruction method based on multi-station laser scanning is proposed. This method mainly includes several steps, such as point cloud data collection, preconditioning, multi-site cloud data fusion, point cloud data compression, 3D model reconstruction and texture mapping, environment rendering, video processing, and 3D roaming. According to the requirement of video rendering and virtual roaming, we focus on cloud processing, 3D modeling and 3D model display in this paper. Experimental results show that an famous building named Enshi Dong Drum Tower is well digitally reconstructed, so as to result in ethnic characteristics and cultural heritage protection in practical application.
Fast Detection of Hidden Dangers in Transmission Line Corridors Based on Region Partitioning and Feature Extraction
Authors: Zheng Wenjie , Li Chengqi , Bai Demeng , Qin Jiafeng
Published: October 2019

Hidden dangers like large-scale construction machinery are the main causes of line trips. In this paper, we propose a fast detection algorithm for hidden dangers in transmission line corridors based on region partitioning and feature extraction. Since the scenes in the sky are simple and stable compared with the scenes on the ground, we detect hidden dangers in the sky and those on the ground separately. For hidden dangers in the sky, we firstly designed an algorithm to calculate the mask image for sky area. After dividing the sky area, we extracted features including colors and shapes of the difference areas in order to eliminate the interference factors. The targets left are the hidden dangers we truly cared about. For hidden dangers on the ground, firstly we design a pre-processing algorithm to eliminate the influence of uneven illumination on subsequent matching. Secondly, we propose a multi-scale gray-weighted average method to fuse multiple channels of multiple color spaces, by which we can effectively suppress noise caused by camera shake and maximize the area that cannot be matched. Thirdly, we use the Haar feature density map to filter the photo to remove discrete pixel points caused by small disturbances. Finally, we extract multiple features and fuse those features on decision level to obtain the final matching result. When deployed on intelligent monitoring devices and tested with massive scene photos, our algorithm has achieved the expected running efficiency and detection accuracy.
IR Target Detection via Lateral Inhibition and Singular Value Decomposition
Authors: Zhao Yufei , Song Yong , Wu Yao , Teng Feifei , Li Yun , Zhao Shangnan
Published: October 2019

IR (infrared) target detection has been an important technology in the field of target search and tracking. Generally, due to the influence of IR detector noise, cloud interference and other factors, IR image is blurred, the contrast is low, and the background clutter is heavy. As a result, detecting IR targets from complex background has become a challenging task, especially when the target is small, dim and shapeless. Meanwhile, when detecting and tracking a moving IR target, the method should be able to detect both small target and area target. In this paper, an IR target detection method via LI (lateral inhibition) and SVD (singular value decomposition) is proposed. Firstly, a local structure descriptor based on SVD of gradient domain is constructed, which reflects the basic structures of the local regions of an IR image. Then, combining with the local structure descriptor, a modified LI network is established to enhance target and suppress background. Meanwhile, to calculate lateral inhibition coefficients adaptively, the direction parameters of LI network are determined according to the dominant orientations obtained from SVD. Experimental results show that compared with the typical methods, the proposed method not only can detect small and area target under complex backgrounds, but also has excellent abilities of background suppression and target enhancement.
Indonesian aquaculture futures—identifying interventions for reducing environmental impacts
Authors: Henriksson Patrik John Gustav , Banks Lauren K , Suri Sharon K , Pratiwi Trini Y , Fatan Nurulhuda Ahmad , Troell Max
Published: October 2019

Indonesia is the world’s second largest producer and third largest consumer of seafood. Fish is therefore essential to the nation, both financially and nutritionally. Overfishing and the effects of climate change will, however, limit future landings of capture fisheries, so any increases in future seafood production will need to come from aquaculture. The ecological effects of aquaculture are dependent upon the choice of species, management, and where it is sited. In the present study we use life cycle assessment (LCA) to evaluate how possible interventions and innovations can mitigate environmental impacts related to the aquaculture sector’s growth. The mitigation potential of six interventions were also quantified, namely (1) FCR reductions for whiteleg shrimp, carp, and tilapia; (2) sustainable intensification of milkfish and Asian tiger shrimp polyculture; (3) shifting groupers from whole fish diets to pellets; (4) favoring freshwater finfish over shrimp; (5) renewable electricity; and (6) reduced food waste and improved byproduct utilization. If all six interventions are implemented, we demonstrate that global warming, acidification, eutrophication, land occupation, freshwater use, and fossil energy use could be reduced by between 28% and 49% per unit of fish. The addition of many innovations that could not be quantified in the present study, including innovative feed ingredients, suggest that production could double within the current environmental footprint. This does not, however, satisfy the expected 3.25-fold increase under a business-as-usual scenario, neither does it satisfy the government’s growth targets. We therefore also explore possible geographical areas across Indonesia where aquaculture expansions and ecological hotspots may conflict. Conclusively, we advocate more conservative production targets and investment in more sustainable farming practices. To accelerate the implementation of these improvements, it will be central to identify the most cost-effective aquaculture interventions.
Identity and Bias: Insights from Driving Tests
Authors: Bar Revital , Zussman Asaf
Published: October 2019

How does one's identity affect the evaluation of others? To shed light on this question, we analyse the universe of driving tests conducted in Israel between 2006 and 2015, leveraging the effectively random assignment of students and testers to tests. We find strong and robust evidence of both ethnic (Arab/Jewish) in-group bias and gender out-group bias. While the first result is in line with the typical finding in the literature, the second is novel. Analyses of administrative and survey data suggest a utility-based interpretation for the observed patterns: testers seem to reward members of groups whose company they enjoy.
Experimental study of crack density influence on the accuracy of effective medium theory
Authors: Shuai Da , Wei Jianxin , Di Bangrang , Guo Junxin , Li Dongqing , Gong Fei , Stovas Alexey
Published: October 2019

Effective medium theory plays an important role in the characterization of fractured reservoirs. The main goal of this paper is to assess the accuracy of three classical effective medium theories (compliance-based non-interaction approximation, Hudson theory and anisotropic self-consistent approximation) and investigate their applicable frequency range. To evaluate the crack density limitation of these models, we construct a series of physical models with crack density varying from 0 to 12 per cent. To satisfy the long-wavelength approximation of effective medium theory, we consider a crack diameter and aperture of 3 and 0.12 mm, respectively. To study their appropriate high-frequency laboratory condition, we use the ultrasonic transmission method to measure the elastic wave velocities at frequencies of 500, 250 and 100 kHz. The experimental results are then compared with the effective medium theories to discuss their accuracy. We also highlight and compare the accuracy of these theories for the inversion procedure to quantify the crack density.
Activities of Select Enzymes Involved in Insecticide Resistance in Spinosad-Resistant and -Susceptible Strains of Musca domestica (Diptera: Muscidae)
Authors: Khan Hafiz Azhar Ali , Akram Waseem , Ali Sajid
Published: October 2019

A Musca domestica L. strain collected from Pakistan has recently been shown to be resistant to spinosad; however, there is scarce information about the mechanism of resistance. For this reason, we explored whether a metabolic-based mechanism was responsible by analyzing the activities of the metabolic detoxifying enzymes, carboxylesterases, glutathione S-transferases, and mixed-function oxidases, in both a spinosad-selected (Spin-SEL) strain of M. domestica and a susceptible counterpart (Lab-susceptible). The results revealed that both strains were statistically at par in terms of enzyme activities. The activity of carboxylesterases in the Lab-susceptible strain was 78.17 ± 3.06 in comparison to 79.16 ± 3.31 nmol min−1 mg−1 in the Spin-SEL strain. The activity of mixed-function oxidases was 51.58 ± 4.20 in the Lab-susceptible strain, whereas 54.33 ± 4.08 pmol min−1 mg−1 was recorded in the Spin-SEL strain. The activity of glutathione S-transferases was 86.50 ± 4.59 (Lab-susceptible) and 90.33 ± 2.81 nmol min−1 mg−1 (Spin-SEL). These results revealed that the studied enzymes might not be responsible for spinosad resistance in the studied strain of M. domestica. Therefore, studies should be extended to find out other possible mechanisms of spinosad resistance.
Congenital Leishmaniasis in a Newborn Infant Whose Mother was Coinfected With Leishmaniasis and HIV
Authors: Argy Nicolas , Lariven Sylvie , Rideau Aline , Lemoine Anais , Bourgeois Moine Agnès , Allal Lahcene , Choudat Laurence , Ravel Christophe , Michard Florence , Buffet Pierre , Faye Albert , Houze Sandrine , Yazdanpanah Yazdan
Published: October 2019

In utero transmission of Leishmania infantum is the putative mechanism of congenital leishmaniasis. However, this hypothesis is based on limited research. In addition, the consequences for infant newborn development remain to be clarified by additional data. We report here the occurrence, specific management, and monitoring of congenital leishmaniasis in a newborn infant whose mother was coinfected with leishmaniasis and human immunodeficiency virus; transplacental transmission, confirmed by overt clinical disease at birth, was documented, which provides, to our knowledge, the first evidence of hepatic and neurologic impairment in an infant with congenital visceral leishmaniasis.
Update From the Advisory Committee on Immunization Practices
Authors: O’leary Sean T , Maldonado Yvonne A , Kimberlin David W
Published: October 2019

The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts, meets 3 times per year to develop recommendations for vaccine use in the United States. There usually are 15 voting members, but at the June 2019 meeting, only 14 were present; each member’s term is 4 years. ACIP members and Centers for Disease Control and Prevention (CDC) staff discuss the epidemiology of vaccine-preventable diseases and vaccine research, effectiveness, safety data, and clinical trial results. Representatives from the American Academy of Pediatrics (AAP) (Y. A. M. and D. W. K.) and the Pediatric Infectious Diseases Society (S. T. O.) are present as liaisons to the ACIP. The ACIP met on June 26 to 27, 2019, to discuss the use of human papillomavirus (HPV) vaccine in adults, pneumococcal vaccines in adults, measles updates, zoster vaccine, influenza vaccines, hepatitis A virus (HAV) vaccines, meningococcal vaccines, and dengue vaccine.
When a Childhood Sexual Abuse History Influences Patient Trust
Authors: Carder Jami
Published: October 2019

It's time to acknowledge this safety issue and train nurses in compassionate care.
Anticholinergic Drug Use Associated with Risk of Dementia
Authors: Pfeifer Gail M. , Zolot Joan
Published: October 2019

Data suggest reducing or stopping anticholinergics for middle-aged and older adults.
Cannabis Use Increasingly Common in Pregnancy, Alcohol Still a Problem
Authors: Nelson Roxanne
Published: October 2019

Experts urge greater awareness.
New Drug for Hypoactive Sexual Desire Disorder in Premenopausal Women
Authors: Aschenbrenner Diane S.
Published: October 2019

Bremelanotide (Vyleesi) is now approved for the treatment of generalized hypoactive sexual desire disorder in premenopausal women.

The drug may transiently increase blood pressure, induce focal hyperpigmentation, and produce nausea.

Nurses and NPs should confirm that a patient's blood pressure is under control prior to starting bremelanotide.
Dupilumab Approved to Treat Chronic Rhinosinusitis with Nasal Polyposis
Authors: Aschenbrenner Diane S.
Published: October 2019

Dupilumab (Dupixent) is now approved to treat adults with chronic rhinosinusitis with nasal polyps.

Nurses should note that the dose for this indication is different than the dose for treating asthma or atopic dermatitis.
New Pediatric Indication for Dalteparin Sodium
Authors: Aschenbrenner Diane S.
Published: October 2019

Dalteparin sodium (Fragmin) is the first anticoagulant approved to treat children with symptomatic venous thromboembolism.

With infants, nurses should avoid using the formulation of the drug that comes in a multidose vial containing benzyl alcohol, which can potentially induce fatal “gasping syndrome” in these patients.
EBP 2.0: Implementing and Sustaining Change: The STAND Skin Bundle
Authors: Gallagher-Ford Lynn , Tucker Sharon J. , Labardee Ruth , Rodgers Julie
Published: October 2019

This is the fourth article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series—Evidence-Based Practice, Step by Step—published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes—one of the most challenging steps in the EBP process.
Autism Spectrum Disorder is Mostly Due to Genetic Factors
Authors: Rosenberg Karen
Published: October 2019

According to this study:

The variation in the occurrence of autism spectrum disorder in the population is mostly due to genetic influences, with little evidence of maternal effects.

The heritability of autism spectrum disorder was estimated to be approximately 80%.
Keeping Count of Women and Girls Killed by Men
Authors: McSpedon Corinne
Published: October 2019

School nurse Dawn Wilcox compiles a database of violence against women.
Diagnosis and management of impetigo
Authors: VanRavenstein Kathy , Durham Catherine O'Connor , Williams Tiffany H. , Smith Whitney
Published: October 2019

Impetigo, a bacterial skin infection that involves the superficial layers of the skin, is one of the most common skin infections in children ages 2 to 5 but can occur in individuals across the lifespan. This article discusses the diagnosis and management of impetigo in primary care.
Warm water hazard
Authors: Quail Myles Thomas
Published: October 2019

Nurses may see patients who have recently returned from tropical vacations complaining of a severe pruritic dermatitis known as seabather's eruption (SBE). Caused by exposure to jellyfish larvae, SBE is characterized by a pruritic rash, but some patients, particularly children, experience systemic signs and symptoms such as fever, chills, and nausea/vomiting. This article discusses SBE and reviews assessment tips, nursing care, and patient teaching.
Solving alarm fatigue with smartphone technology
Authors: Short Kathleen , Chung You “Jay”
Published: October 2019

Alarms were developed to improve patient safety, but alarm fatigue may put patients at higher risk for harm. This article recounts one acute care institution's search for a better alarm management solution using smartphone technology to replace its beeper-based system for telemetry alarm events.
The black veil
Authors: Love Gayla H.
Published: October 2019

Retinal detachments are a rare but serious event, and nurses have an important role in helping maintain optimal outcomes for these patients. This article addresses the causes and treatments for a detached retina.
Perioperative Nutrition Care of Orthopedic Surgery Patient
Authors: Williams David G.A. , Wischmeyer Paul E.
Published: October 2019

Despite evidence that malnutrition is associated with significant complications in orthopedic surgery, unrecognized malnutrition continues to be a “silent epidemic,” affecting up to 50% of hospitalized patients. Specifically, presurgical malnutrition is associated with increased risk for surgical site infections, increased length of hospital stay, and increased health care costs in patients following total joint arthroplasty. Serologic markers (ie, serum albumin and total lymphocyte count), anthropometric measurements (ie, calf muscle circumference and triceps skinfold), and assessment and screening tools (ie, The Rainey-MacDonald Nutritional Index, the Mini Nutrition Assessment Short Form, the Malnutrition Universal Screening Tool and the Nutrition Risk Screening 2002) have all been used to aid in the diagnosis of malnutrition in orthopedic patients, yet there is no universal gold standard for screening or assessing nutritional risk and no accepted guideline for perioperative nutritional optimization in this patient population. Recently, the Perioperative Nutrition Screen was introduced as an easy and efficient way to preoperatively identify and risk stratify patients for malnutrition in order to guide perioperative nutrition optimization. Given malnutrition is associated with increased risk of surgical site infections and increased length of hospital stay, adequate assessment of perioperative risk for malnutrition and preoperative nutrition optimization, including structured weight loss in the obese population, consumption of high protein oral nutritional supplements, immunonutrition oral supplements and adequate glucose control, may improve perioperative outcomes. The presence of a registered dietician should be a standard of care in all preoperative clinics to improve nutrition care and surgical outcomes.
Determining the Impact of a Cancer Diagnosis on Diabetes Management
Authors: Pinheiro Laura C. , Kaur Harveen , Nilo Daniela , Safford Monika M. , DeRosa Antonio P. , Kern Lisa M.
Published: October 2019

Objectives:

Cancer patients with comorbid diabetes have a 50% increased risk of all-cause mortality compared with cancer patients without diabetes. Less attention to diabetes management (glucose control, medication adherence, and diabetes self-management behaviors) during active cancer treatment is hypothesized as an explanation for worse outcomes among diabetic cancer patients. The objective of this systematic review is to determine and quantify how a cancer diagnosis impacts diabetes management.

Methods:

Quantitative and qualitative studies evaluating diabetes management among patients were identified by searching 4 databases: MEDLINE, EMBASE, The Cochrane Library, and Web of Science. Two independent reviewers extracted data and summarized results from eligible studies. Study quality was formally assessed.

Results:

Thirty-six studies met all inclusion criteria. We observed heterogeneity across studies in terms of study design, sample size, cancer site, type of diabetes management evaluated, and quality. Numerous articles discussed that overall, glucose control, medication adherence, and diabetes self-management behaviors declined following a cancer diagnosis. However, findings were inconsistent across studies.

Conclusions:

Although the effects of a cancer diagnosis on diabetes management are mixed, when results across studies were synthesized together, diabetes management appeared to generally decline after a cancer diagnosis. Declines in diabetes management seem to be primarily due to shifts in the priority of care from diabetes management to cancer. A next critical step in this line of work is to identify patient and provider level predictors of better or worse diabetes management to design and test interventions aimed at improving effective diabetes management for cancer patients.
Does Early Chemotherapy Improve Survival in Advanced Endometrial Cancer?
Authors: Boothe Dustin , Orton Andrew , Kim Jaewhan , Poppe Matthew M. , Werner Theresa L. , Gaffney David K.
Published: October 2019

Objectives:

In endometrial cancer, the appropriate sequence of adjuvant chemotherapy (aCT) and adjuvant radiation therapy (aRT) is unclear. We aim evaluated whether early chemotherapy is associated with improved overall survival (OS) and cancer-specific survival (CSS).

Methods:

Endometrial cancer patients that received aCT and aRT were selected from the SEER-Medicare database. Early chemotherapy was defined as receiving aCT before aRT, with or without additional aCT (“sandwich” regimens). All other patients received a full course of aRT before chemotherapy with or without concurrent chemotherapy. Univariate and multivariate Cox proportional hazards regression was utilized to assess the impact of clinical and demographic factors on OS.

Results:

We selected 597 patients for analysis. Median age and was 72 years; 85% of patients were white. Overall, 68% of women had FIGO (International Federation of Gynecology and Obstetrics) stage III disease and 77% received 4 to 6 cycles of chemotherapy. Five-year OS (66.6% vs. 62.4%, P=0.46) and 5-year CSS (71.1% vs. 71.2%, P=0.88) was not significantly improved among those receiving early chemotherapy. In addition, early chemotherapy did not improve OS (hazard ratio [HR]=0.87; 95% confidence interval [CI]: 0.56-1.34, P=0.53) or CSS (HR=1.21; 95% CI: 0.82-1.79, P=0.34) on multivariate analysis. Compared with 1 to 3 cycles, receiving 4 to 6 (HR=0.48, 95% CI: 0.26-0.87, P=0.02), and ≥7 cycles (HR=0.42, 95% CI: 0.20-0.89, P=0.02) of chemotherapy was associated with improved OS.

Conclusion:

No differences in OS or CSS were noted among endometrial patients receiving early chemotherapy. However, the number of chemotherapy cycles was associated with prolonged survival.
“Pleurex Desalination” in Malignancy-related Ascites
Authors: Gupta Shruti , McMahon Gearoid M. , Motwani Shveta S. , Mount David B. , Waikar Sushrut S.
Published: October 2019

Objective:

Pleurex catheters are a form of palliative therapy for patients, offering relief from symptomatic ascites while also affording greater independence and flexibility; however, aggressive drainage can lead to significant total body sodium losses. We describe the course of patients with “Pleurex desalination,” an under-appreciated cause of hypovolemic hyponatremia, highlighting its unique pathophysiology and providing recommendations on how to manage these complex patients.

Patients and Methods:

We included representative patients with “Pleurex desalination” who were evaluated and treated by the renal consult service at Brigham and Women’s between 2017 and 2019.

Results:

We identified 3 patients who were hospitalized with “Pleurex desalination” and had complete data on serum and urine studies, as well as treatment course. We demonstrate that patients with “Pleurex desalination” were removing up to 1 to 2 L of ascitic fluid a day and were admitted with signs and symptoms of profound hypovolemia and hyponatremia. Patients worsened with administration of diuretics and salt restriction and improved with aggressive fluid resuscitation in the form of hypertonic saline, normal saline, and/or intravenous albumin.

Conclusion:

“Pleurex desalination” is an under-recognized cause of hyponatremia; at-risk patients require close observation and periodic resuscitation with intravenous, volume-expanding fluids.
The Impact of HeartMath Resiliency Training on Health Care Providers
Authors: Buchanan Teresa M. , Reilly Patricia M.
Published: October 2019

Background

Health care providers must think clearly and make critical decisions under stressful circumstances. Providing effective strategies for managing stress in the moment helps mitigate the physical, emotional, and psychological impacts associated with caring for others and promotes resiliency. Staff may also utilize these techniques with patients and their families to help alleviate the symptoms of stress that may be experienced as the result of illness.

Aim

The purpose of this study was to measure whether HeartMath techniques reduce stress and improve resiliency in health care providers.

Methods

Study participants were asked to complete the Personal and Organizational Quality Assessment–Revised 4 Scale (2016) immediately before the start of training and then again 4 to 6 weeks after completion of the class. Participants were also asked to voluntarily share their experiences using HeartMath techniques personally or with family, friends, and patients.

Results

Significant improvements were found in 3 of 4 primary scales (organizational stress, emotional stress, and physical stress) and in 6 of 9 subscales on the Personal and Organizational Quality Assessment–Revised 4 Scale indicating a positive impact on employee health, well-being, and performance. Stories shared by participants posttraining indicated that HeartMath techniques were being used personally and with patients as an adjunct in the management of pain, anxiety, and insomnia.

Conclusions

This study supports existing evidence that HeartMath techniques are effective in managing stress and increasing resiliency. These techniques are also valuable tools for health care providers to use with patients and their families in the management of symptoms such as pain, anxiety, and sleeplessness related to hospitalization and illness.
Nasal High Flow Versus Conventional Oxygen Therapy for Postoperative Cardiothoracic Surgery Patients
Authors: Fasolino Tracy , Whitten Joseph , Moylan Melanie
Published: October 2019

Background

Reintubation and complications in postoperative cardiothoracic patients remain high despite medical advancements. A 2-year retrospective, observational study was conducted in postextubated cardiothoracic patients to assess the effectiveness of the current standard—conventional oxygen therapy (COT) compared with a nasal high flow (NHF) therapy.

Objectives

The objective of this study was to understand whether NHF therapy would reduce the need for reintubation and improve clinical outcomes after surgery.

Method

All consecutive postoperative patients who had same-day elective cardiothoracic surgery in a tertiary hospital were included. The 2013 data were from patients' charts who received COT, and the 2014 data were from patients' charts after the implementation of NHF therapy post extubation as a standard of care.

Results

A total of 400 patient charts were analyzed: 221 and 179 patients in the COT and NHF, respectively. No significant difference was seen in the frequency of reintubation (P = .48). Despite both cohorts having the same length of stay (P = .10), patients treated with NHF required less time on supplemental oxygen (P = .001). Day 1 postoperative chest x-ray results did not show any significant differences between groups, whereas day 2 x-rays showed worsening results in the COT cohort (P < .001). Furthermore, the incidence of ventilator-associated pneumonia (VAP) post extubation was significantly higher in the COT cohort, with zero VAP episodes reported in the NHF cohort (P = .02).

Discussion

Although this study was not able to demonstrate the reduction in reintubation between groups, the use of NHF compared with COT seems to reduce the time spent on oxygen therapy and decrease the rate of VAP. Further evidence including randomized controlled trials is required to determine the impact of NHF on reintubation and complications in postoperative cardiothoracic surgery.
Record Linkage Approaches Using Prescription Drug Monitoring Program and Mortality Data for Public Health Analyses and Epidemiologic Studies
Authors: Nechuta Sarah , Mukhopadhyay Sutapa , Krishnaswami Shanthi , Golladay Molly , McPheeters Melissa
Published: October 2019

Background:

The use of Prescription Drug Monitoring Program (PDMP) data has greatly increased in recent years as these data have accumulated as part of the response to the opioid epidemic in the United States. We evaluated the accuracy of record linkage approaches using the Controlled Substance Monitoring Database (Tennessee’s [TN] PDMP, 2012–2016) and mortality data on all drug overdose decedents in Tennessee (2013–2016).

Methods:

We compared total, missed, and false positive (FP) matches (with manual verification of all FPs) across approaches that included a variety of data cleaning and matching methods (probabilistic/fuzzy vs. deterministic) for patient and death linkages, and prescription history. We evaluated the influence of linkage approaches on key prescription measures used in public health analyses. We evaluated characteristics (e.g., age, education, sex) of missed matches and incorrect matches to consider potential bias.

Results:

The most accurate probabilistic/fuzzy matching approach identified 4,714 overdose deaths (vs. the deterministic approach, n = 4,572), with a low FP linkage error (<1%) and high correct match proportion (95% vs. 92% and ~90% for probabilistic approaches not using comprehensive data cleaning). Estimation of all prescription measures improved (vs. deterministic approach). For example, frequency (%) of decedents filling an oxycodone prescription in the last 60 days (n = 1,371 [32%] vs. n = 1,443 [33%]). Missed overdose decedents were more likely to be younger, male, nonwhite, and of higher education.

Conclusion:

Implications of study findings include underreporting, prescribing and outcome misclassification, and reduced generalizability to population risk groups, information of importance to epidemiologists and researchers using PDMP data.
Rituximab in systemic sclerosis
Authors: Caldas Marina Maria Vieira de Figueiredo , Neto Francisco Alves Bezerra , Azevedo Kesley Pablo Morais de , Pimenta Isac Davidson Santiago Fernandes , Oliveira Ana Katherine Da Silveira Gonçalves De , Piuvezam Grasiela
Published: October 2019

Background:

Systemic sclerosis (SSc) is a clinically complex and challenging disease, the most frequent complication of which is interstitial lung disease, which leads to a worse prognosis. In this situation, cyclophosphamide is considered the criterion standard for treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option. The objective is to describe a protocol of a systematic review (SR) that analyzes the scientific evidence on the effects of RTX on SSc.

Methods:

This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases to be searched are PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, COCHRANE, WHOLIS, PAHO, and EMBASE. The studies that would be included in SR are clinical trials that evaluate the use of RTX in patients with SSc who meet the classification criteria for the disease according to American College of Rheumatology and European League Against Rheumatism (2013) and/or LeRoy criteria will be included in the SR. The data to be extracted are related to the characteristics of the studies: authors, year of publication, study location, type of study, sample size and age, patient characteristics, duration of intervention, therapeutic scheme, follow-up time, main variables, and main results.

Results:

In our study, we hope to find articles presenting new evidence supporting treatment of SSc with RTX.

Conclusions:

The SR will present results of scientific evidence for the effects of RTX in SSc. We hope that the results could strengthen clinical decisions for the best treatment of SSc and guide future researches.

PROSPERO registration number:

CRD42019132018.
Hematogone Hyperplasia Masquerading as Acute Lymphoblastic Leukemia With Concurrent Hypercupremia
Authors: Naithani Rahul , Jeyaraman Preethi , Dayal Nitin
Published: October 2019

Alterations in copper homeostasis is an uncommon cause for hematologic alterations frequently presenting with dysplastic features in the bone marrow. Most of these alterations have been documented in adult patients with copper deficiency. Rare cases show hematogone hyperplasia in these patients. Effects of mild copper excess have not been documented in literature. We are describing a pediatric patient who presented with pancytopenia associated with hypercupraemia (excess of copper). Bone marrow examination showed hematogone hyperplasia. Interestingly, correction of serum copper levels with zinc therapy lead to complete improvement in pancytopenia. Hematogones had also reduced in subsequent marrow biopsy after therapy.
Epidural Spinal Mass as the Presenting Feature of B-Acute Lymphoblastic Leukemia in a Young Child
Authors: Chapman Stacy , Li Jie , Almiski Muhamad , Moffat Hayley , Israels Sara J.
Published: October 2019

An isolated epidural mass is a rare presentation of childhood B-acute lymphoblastic leukemia with an estimated incidence of 0.4%. Of the cases reported in the literature, the majority involve adults presenting with spinal cord compression and/or systemic evidence of disease. We describe a young child presenting with pain leading to a refusal to weight-bear secondary to a sacral epidural mass. A biopsy of the sacral lesion confirmed the diagnosis of B-acute lymphoblastic leukemia. Unique to this case is the young age of the child and the lack of spinal cord compression.
Strategic Development of the Public Health Workforce: A Unified Logic Model for a Multifaceted Program at the Centers for Disease Control and Prevention
Authors: Glynn M. Kathleen , Paek Margaret , Radkey Connor , Arvelo Wences , Greene Elinor , Hardwick Isabella , Neri Antonio
Published: October 2019

Context:

Public health has a responsibility to ensure the ability of its workforce to deliver essential services, including mastering the core public health competencies.

Program:

The Division of Scientific Education and Professional Development (DSEPD) of the Centers for Disease Control and Prevention has a mission to improve health outcomes through a competent, sustainable, and empowered public health workforce. The DSEPD programs offer fellowships and other training opportunities, develop and disseminate quality public health training, and advance public health workforce development science.

Evaluation:

The DSEPD developed a unified division logic model to describe the combined activities and intended outcomes of all DSEPD programs and their intended contribution to a robust public health workforce and to support ongoing program planning and evaluation. The logic model has 4 streams of work that include (1) producing and disseminating quality learning products; (2) implementing and managing fellowship programs that support learning; (3) providing public health service through fellows; and (4) advancing workforce development science through collaboration with other public health leaders.

The underlying program theory is that a robust workforce has sufficient workforce, organizational, and systems capacity to deliver public health essential services and, therefore, to protect the public's health. Three scientific theories support the program theory: the quality of learning; the accepted practice of competency-based programs and the service-learning model; and use of evidence-guided decision making in workforce development programs.

Discussion:

A unified division logic model allows DSEPD to describe its combined approaches to workforce development as a coherent portfolio with well-defined goals and measureable outcomes. The logic model effectively communicates the relationship among division programs, their shared outcomes, and their combined contributions to developing and maintaining a robust public health workforce. A unified logic model can serve as effective frame of reference for division evaluation and as evidence in public health workforce development science.
Surveillance to Monitor the Impact of the Trump Administration on the Health of New York City Residents
Authors: Gould L. Hannah , Sun Eric , Germain Patrick , Gallego Ana , Adams Loren , Huynh Mary , Van Wye Gretchen , Gwynn R. Charon , Barbot Oxiris
Published: October 2019

Context:

The Trump administration has enacted or proposed many policies that could impact public health. These include attempts to dismantle or repeal the Patient Protection and Affordable Care Act (ACA), restricting funding for women's health care, and loosening of environmental regulations.

Objective:

To develop a surveillance system to monitor the public health impacts of the Trump administration in New York City.

Design:

Epidemiologic assessment. Public health surveillance system.

Setting:

New York City.

Participants:

New York City residents.

Main Outcomes Measures:

We identified approximately 25 indicators across 5 domains: access to care, food insecurity, reproductive health, environmental health, and general physical and mental health. Sources of data include the New York City Department of Health and Mental Hygiene's (DOHMH's) health and risk behavior telephone survey, vital statistics, emergency department visits, DOHMH sexual health clinics, Federally Qualified Health Centers, lead and diabetes registries, Medicaid claims, Supplementary Nutrition Assistance Program enrollment, Women, Infant, and Children program enrollment, and 311 call records. Data are collected monthly or quarterly where possible. We identified measures to stratify indicators by individual and area-based measures of immigration and poverty.

Results:

Since April 2017, we have compiled quarterly reports, including establishing a historical baseline of 10 years to account for secular trends and encompass the establishment and enactment of the ACA. Indicators are interpreted within the context of changes in programming or local policy that might explain trends.

Conclusions:

We have successfully established an adaptive surveillance system that is poised to rapidly detect changes in the health of New York City residents resulting from changes by the Trump administration to public health policy. The development of such systems is a critical function for health departments across the country to play a role in the current political and policy environment.
Responding to a Mumps Outbreak Impacting Immigrants and Low–English-Proficiency Populations
Authors: Koeller Sarah , Meyer Diane , Shearer Matthew P. , Hosangadi Divya , Snyder Michael , Nuzzo Jennifer B.
Published: October 2019

Objectives:

To examine outbreak response–associated costs, lessons learned, and challenges encountered during a local health department's response to a mumps outbreak.

Design:

We conducted semistructured interviews with individuals directly involved in the response to a mumps outbreak and analyzed outbreak response–associated cost data.

Setting:

In March-July 2018, a mumps outbreak occurred in Chester County, Pennsylvania. The outbreak primarily affected an immigrant community, some of whom spoke little or no English and were uninsured and/or undocumented. This necessitated an urgent response from the Chester County Health Department, which implemented a variety of public health interventions, including outreach to local health care providers and the execution of vaccination clinics at 2 local mushroom farms where case contacts worked. A total of 39 suspected or confirmed mumps cases were reported in Chester County, and 22 suspected or confirmed cases were reported by 2 neighboring jurisdictions.

Participants:

Health department employees (n = 7) and community partners (n = 2). Areas of expertise included emergency preparedness, nursing, medicine, disease surveillance, and epidemiology.

Main Outcome Measure:

Operational challenges encountered and lessons learned during the mumps outbreak response, including outbreak response–associated costs, which could inform other communities' planning and preparedness for outbreaks in similar populations and improve outbreak response operations.

Results:

Immigration status emerged as a key challenge, which highlighted the importance of building trust through community outreach and partnerships and the need for culturally competent communication. In addition, vaccine availability, accessibility, and cost played a major role in response operations and necessitated the involvement of community partners to mitigate these barriers. Outbreak response–associated costs totaled $35 305.

Conclusions:

The challenges that occurred in this outbreak are broadly relevant to outbreaks that affect similar immigrant communities. Health departments that serve such populations can utilize these lessons to develop improved outbreak response plans that account for these challenges.
Analysis of Escherichia coli and Listeria monocytogenes Isolate Subtyping and Reporting Capacity by Public Health Laboratories, United States (2013-2017)
Authors: Martinez DeAndrea , LeBlanc Tanya Telfair , Hise Kelley B.
Published: October 2019

Objectives:

To demonstrate the performance of 53 laboratories required to submit 90% or more of their pulsed-field gel electrophoresis (PFGE) subtyping results for Escherichia coli O157:H7 (E coli O157:H7) and Listeria monocytogenes (L monocytogenes) to the PulseNet national databases at the Centers for Disease Control and Prevention (CDC) within 4 working days of receiving isolates.

Methods:

We examined data from 53 laboratories during 2013-2017 to ascertain whether E. coli O157:H7 and L monocytogenes PFGE data were reported to the PulseNet national databases within 4 working days.

Results:

In the study period, 45 laboratories that submitted reports during the period (86.8%) met the target for timely submission of 10 606 (94.85%) E coli O157:H7 isolates into the PulseNet national database. For L monocytogenes isolates, 32 laboratories submitted reports (76.95%) that achieved timely submission of 3119 (93.35%) isolates.

Conclusions:

This study uncovered areas for improvement to advance public health in the CDC-funded laboratories.
Reliability and Validity of Upper Extremity Patient-Reported Outcome Measures in Assessing Traumatic Finger Amputation Management
Authors: Yoon Alfred P. , Kaur Surinder , Chou Ching-Han , Chung Kevin C.
Published: October 2019

Background:

This study investigates the psychometric properties of patient-reported outcome instruments for assessing outcomes in postsurgical traumatic digit amputation patients. The authors hypothesize that the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire are the most valid and reliable instruments.

Methods:

The authors studied traumatic digit amputation patients as part of the Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness (FRANCHISE) study initiated by The Plastic Surgery Foundation. The MHQ, DASH questionnaire, Patient-Reported Outcomes Measurement Information System (PROMIS), and 36-Item Short-Form Health Survey were used to assess patients at least 1 year postoperatively. Internal consistency was measured by Cronbach’s alpha and criterion validity with Pearson correlation coefficient (r). Construct validity was tested with four predefined hypotheses. Discriminant validity was analyzed by receiver operating characteristic curves.

Results:

One hundred sixty-eight replantation and 74 revision amputation patients met the inclusion criteria. All instruments demonstrated fair to good internal consistency in both cohorts (0.7 < α < 0.9). The MHQ and DASH questionnaire scores correlated strongly (r > 0.60) in both cohorts. The 36-Item Short-Form Health Survey had moderate to weak correlation with the remaining instruments, and its mental component had poor discriminant validity (area under the curve, 0.64 to 0.67). The MHQ, DASH questionnaire, and PROMIS demonstrated good construct validity confirming 75 to 100 percent of predefined hypotheses, whereas the 36-Item Short-Form Health Survey confirmed only 25 percent.

Conclusions:

The authors recommend using the Michigan Hand Outcomes Questionnaire or the Disabilities of the Arm, Shoulder and Hand questionnaire when assessing patient-reported outcomes in digit amputation patients based on good internal consistency and validity. The Patient-Reported Outcomes Measurement Information System has fair validity and reliability but should be an adjunct instrument. The 36-Item Short-Form Health Survey should not be used as a primary assessment tool, but as an adjunct to assess overall quality of life.
Social Integration, Marital Status, and Ovarian Cancer Risk: A 20-Year Prospective Cohort Study
Authors: Trudel-Fitzgerald Claudia , Poole Elizabeth M. , Sood Anil K. , Okereke Olivia I. , Kawachi Ichiro , Kubzansky Laura D. , Tworoger Shelley S.
Published: October 2019

Objective

Low social integration and divorce/widowhood are chronic psychosocial stressors that may affect health. When assessed after cancer diagnosis, they have been associated with poorer survival, but their role in cancer development, particularly ovarian cancer (OvCA), is less understood. We investigated whether social integration and marital status were related to OvCA risk in a large population-based study.

Methods

Women from the Nurses’ Health Study completed the Berkman-Syme Social Network Index and reported their marital status every 4 years starting in 1992 (N = 72,206), and were followed up until 2012 (20-year follow-up period). Multivariate Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of OvCA risk, considering relevant potential confounders, in lagged analyses whereby psychosocial indicators were assessed 4 to 8 years (n = 436 cases) and 8 to 12 years (n = 306 cases) before diagnosis to account for the effects of prediagnostic symptoms on social measures. Secondary analyses evaluated the stability of and cumulative exposure to these social factors on OvCA risk.

Results

Being socially isolated versus integrated was related to an increased OvCA risk 8 to 12 years later (HR = 1.51, 95% CI = 1.07–2.13), but not 4 to 8 years later. Compared with married women, OvCA risk was significantly higher in widowed but not in separated/divorced individuals, with both time periods (e.g., 8–12 years later: HRwidowed = 1.57 [95% CI = 1.15–2.14] versus HRseparated/divorced = 1.13 [95% CI = 0.74–1.72]). Estimates were comparable or stronger when investigating stability in and cumulative effects of social indicators.

Conclusions

Results suggest higher OvCA risk among socially isolated and widowed women, particularly when such psychosocial stressors were experienced a decade before diagnosis or were sustained over time.