bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Transforaminal Endoscopic Discectomy Versus Microendoscopic Discectomy for Lumbar Disc Herniation
Authors: Chen Zihao , Zhang Liangming , Dong Jianwen , Xie Peigen , Liu Bin , Wang Qiyou , Chen Ruiqiang , Shu Tao , Li Shangfu , Feng Feng , Yang Bu , He Lei , Yang Yang , Liu Zhongyu , Pang Mao , Rong Limin 
Published: November 2019

Study Design.
A prospective randomized controlled study.

Objective.
To clarify whether percutaneous transforaminal endoscopic discectomy (PTED) has better clinical outcomes and less surgical trauma compared with microendoscopic discectomy (MED).

Summary of Background Data.
Two kinds of minimally invasive spine surgeries, PTED and MED, are now widely used for the treatment of lumbar disc herniation (LDH). It is still a controversial issue to choose the proper surgical approach.

Methods.
In this single-center, open-label, randomized controlled trial, patients were included if they had persistent signs and symptoms of radiculopathy with corresponding imaging-confirmed LDH, and were randomly allocated to PTED or MED group. The primary outcome was the score of Oswestry Disability Index (ODI) and the secondary outcomes included the score of Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain and physical function scales, European Quality of Life-5 Dimensions, and Visual Analogue Scales for back pain and leg pain.

Results.
A total of 250 participants were randomly assigned to two treatment groups, 241 of that received the specific surgical procedure. Two hundred twenty-two patients (92.1%) have completed the 2-year follow-up. Both the primary and secondary outcomes did not differ significantly between the two treatment groups at each prespecified follow-up time (P > 0.05). For PTED, the postoperative improvement of ODI score in the median herniation subgroup was less compared with paramedian subgroup. For MED, less improvement of ODI score was found in far-lateral herniation subgroup compared with paramedian subgroup. Total complication rate over the course of 2 year was 13.44% in PTED group and 15.57% in MED group (P = 0.639). Ten cases (8.40%) in PTED group and five cases (4.10%) in MED group suffered from residue/recurrence of herniation, for which reoperation was required.

Conclusion.
Over the 2-year follow-up period, PTED did not show superior clinical outcomes and did not appear to be safer procedure for patients with LDH compared with MED. PTED had inferior results for median disc herniation, whereas MED did not appear to be the best option for far-lateral disc herniation.

Level of Evidence: 2
Racial and Ethnic Differences in Self-Assessed Facial Aging in Women: Results From a Multinational Study
Authors: Alexis Andrew F. , Grimes Pearl , Boyd Charles , Downie Jeanine , Drinkwater Adrienne , Garcia Julie K. , Gallagher Conor J. 
Published: November 2019

BACKGROUND
Racial/ethnic variations in skin structure and function may contribute to differential manifestations of facial aging in various races/ethnicities.

OBJECTIVE
To examine self-assessed differences in facial aging in women by race/ethnicity and Fitzpatrick skin phototypes.

METHODS
Women aged 18 to 75 years in the United States, Canada, the United Kingdom, and Australia compared their features against photonumeric rating scales depicting degrees of severity for 10 facial aging characteristics. Impact of race/ethnicity (black, Hispanic, Asian, and Caucasian) and skin phototypes on severity was assessed.

RESULTS
In total, 3,267 women completed the study. Black women reported the least severe facial aging; Caucasian women reported the most severe facial aging, with Asian and Hispanic women falling between these groups. Similarly, women with a skin phototype V/VI reported lesser aging severity than women with phototypes I through IV. More than 30% of black women did not report the presence of moderate/severe aging of facial areas until 60 to 79 years; most Hispanics and Asians did not report moderate/severe facial aging until 50 to 69 years and Caucasians, 40 to 59 years.

CONCLUSION
In this diverse sample, black women reported less severe aging of facial features compared with Hispanic, Asian, and Caucasian women. These results were supported by Fitzpatrick skin phototype analyses.
Effective Half-life of 134Cs and 137Cs in Fukushima Prefecture When Compared to Theoretical Decay Models
Authors: Hayes Joshua M. , Johnson Thomas E. , Anderson Donovan , Nanba Kenji 
Published: November 2019

Abstract
On 11 March 2011, a 9.0 magnitude earthquake struck the Tohoku region of Japan. The earthquake caused a 15 m tsunami that bombarded the east coast of the island nation. Among the losses was the damage to the Fukushima Daiichi nuclear reactor that lost onsite power and was unable to cool the reactor cores. The reactors melted down and released a plume of radionuclides into the environment. Radiocesiums (134Cs and 137Cs) are the long-lived radionuclides of concern that were deposited along the plume and were distributed on the soil. Radiological decay models are typically used to determine the reduction in external radiation dose over time. However, these radiological decay models do not take into account physical removal by wind and water erosion, or sedimentation in soil outside expected depths. Thirty-five fixed dose-rate monitors were used to record dose rates at 1 mo intervals from the time of installation in Fukushima Prefecture in April 2012 until December 2018 and were used to estimate the effective half-life for radiocesium contamination based on external radiation dose rates. The effective half-life of cesium in the environment was calculated to be 3.2 ± 0.5 y, compared to a theoretical half-life of 7.8 y.
Taking the leap from clinical practice to academic faculty: A beginner's guide
Authors: Korkosz Jennifer A. , Fuller Andrea J. , Sheehy Susan B. , Taylor Laura A. , Seibert Diane C. , Johnson Heather L. 
Published: November 2019

ABSTRACT
Exploring new roles and responsibilities available to clinicians offers a path to renovate a nurse practitioner's career. The role of academician and nurse faculty broadens career horizons, presents a sense of autonomy, and offers unique opportunities to teach, participate in research, build leadership skills, and contribute to the health care delivery system at a higher level. Advance practice nurses often consider a shift to academia but are concerned about the unfamiliarity of the entire process. This article offers elements a clinician will likely encounter throughout the transition to a faculty role. These include expectations for the application and interview, negotiating for a position, and orientation to the role of an academic.
Impact of periprocedural myocardial injury on long-term clinical outcomes of chronic total occlusion patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis
Authors: Liu Mei-Jun , Chen Chao-Feng , Gao Xiao-Fei , Liu Xiao-Hua , Xu Yi-Zhou 
Published: November 2019

Background:Several studies have evaluated the long-term clinical outcomes of periprocedural myocardial injury for chronic total occlusions patients. However, the results of these studies were inconsistent. To determine whether the periprocedural myocardial injury has adverse effects on long-term clinical outcomes in chronic total occlusion patients undergoing percutaneous coronary intervention.Methods:We searched Cochrane Library, PubMed, and Embase for eligible articles from their date of inception up to March 2019. Long-term clinical outcomes included major adverse cardiac events, all-cause death, cardiac death, myocardial infarction, and target vessel revascularization. Odds ratios with 95% confidence intervals were calculated as summary statistics by using Review Manager software.Results:A total of 8 observational studies involving 5879 chronic total occlusions patients were included in this meta-analysis. These results of this meta-analysis indicated that periprocedural myocardial injury was associated with a higher risk of major adverse cardiac events (odds ratio, 1.94; 95% confidence interval, 1.22–3.08;P= 0.005), a higher risk of all-cause death (odds ratio, 1.30; 95% confidence interval, 1.02–1.64;P= 0.03), a higher risk of cardiac death (odds ratio, 2.59; 95% confidence interval, 1.41–4.78;P= 0.002), a higher risk of myocardial infarction (odds ratio, 3.07; 95% confidence interval, 1.90–4.98;P< 0.00001), and a higher risk of target vessel revascularization (odds ratio, 2.07; 95% confidence interval, 1.35–3.16;P=0.0008) than non-periprocedural myocardial injury.Conclusion:Periprocedural myocardial injury was associated with significantly increased risk of major adverse cardiac events, all-cause death, cardiac death, myocardial infarction, and target vessel revascularization in chronic total occlusion patients undergoing percutaneous coronary intervention at long-term follow-up.
The different faces of the macrophage in asthma
Authors: van der Veen T. Anienke , de Groot Linsey E.S. , Melgert Barbro N. 
Published: November 2019

Purpose of review
Asthma is a chronic inflammatory disease in which changes in macrophage polarization have been shown to contribute to the pathogenesis. The present review discusses the contribution of changes in macrophage function to asthma related to polarization changes and elaborates on possible therapeutic strategies targeting macrophage function and polarization.

Recent findings
Macrophage function alterations were shown to contribute to asthma pathology in several ways. One is by impaired phagocytosis and efferocytosis. Another is by changing inflammation, by altered (anti)inflammatory cytokine production and induction of the inflammasome. Finally, macrophages can contribute to remodeling in asthma, although little evidence is present in humans yet.
Novel therapeutic strategies targeting macrophages include dampening inflammation by changing polarization or by inhibiting the NLRP3 inflammasome, and by targeting efferocytosis. However, many of these studies were performed in animal models leaving their translation to the clinic for future research.

Summary
The present review emphasizes the contribution of altered macrophage function to asthma, gives insight in possible new therapeutic strategies targeting macrophages, and indicates which knowledge gaps remain open.
Effects of epinephrine for out-of-hospital cardiac arrest
Authors: Huan Lu , Qin Fei , Wu Yin 
Published: November 2019

Abstract

Aim:
Our objective is to assess the effects of epinephrine for out of hospital cardiac arrest.

Background:
Cardiac arrest was the most serious medical incidents with an estimated incidence in the United States of 95.7 per 100,000 person years. Though epinephrine improved coronary and cerebral perfusion, improving a return of spontaneous circulation, potentially harmful effects on the heart lead to greater myocardial oxygen demand. Concerns about the effect of epinephrine for out-of-hospital cardiac arrest were controversial and called for a higher argument to determine whether the effects of epinephrine is safe and effective for shor and long terms outcomes.

Method:
Searching databases consist of all kinds of searching tools, such as Medline, the Cochrane Library, Embase, PubMed, etc. All the included studies should meet our demand of this meta-analysis. In the all interest outcomes blow we take the full advantage of STATA to assess, the main measure is Risk Ratio (RR) with 95% confidence, the publication bias are assessed by Egger Test.

Result:
In current systematic review and meta-analysis of randomized trials investigating epinephrine for out of hospital cardiac arrest, we found that epinephrine was associated with a significantly higher likelihood of ROSC (RR = 3.05, I2 = 23.1%, P = .0001) and survival to hospital discharge (RR = 1.40, I2 = 36.3%, P = .008) compared with non-adrenaline administration. Conversely, epinephrine did not increase CPC 1 or 2 (RR = 1.15, I2 = 40.5%, P = .340) and hospital admission (RR = 2.07, I2 = 88.2%, P = .0001).

Conclusion:
In conclusion, in this systematic review and meta-analysis involving studies, the use of epinephrine resulted in a significantly higher likelihood of survival to hospital discharge and ROSC than the non-epinephrine administration, but, there was no significant between group difference in the rate of a favorable neurologic outcome.
Training and financial intervention for encouraging maternal health service utilization
Authors: Shen Yuan , Li Qiang , Liu Xiaoning , Xiao Shengbin , Yan Hong 
Published: November 2019

Abstract

Background:
The rising maternal and child healthcare costs and the lack of training and educational resources for healthcare workers have reduced service quality in primary health centers of China. We sought to compare strategies promoting healthcare service utilization in rural western China.

Method:
A randomized community trial was carried out in Zhen’an country between 2007 and 2009. Two cross-sectional surveys were conducted to compare the outcomes of financial subsidy for pregnant women seeking antenatal care and clinical training provided to healthcare workers by difference-in-difference estimation.

Results:
In all, 1113 women completed the questionnaires. The proportion of postnatal visits increased three times in the training group, reaching 35.7%. The number of women who received advice from their doctors regarding nutrition and warning signs necessitating immediate medical attention also improved significantly (5.8% and 8.2%, respectively). Furthermore, the percentage of women who underwent blood tests increased significantly to 19.5% in the training group. Compared to the financial group, the training group had more women who breastfed for longer than 4 months (15.8%) and provided timely complementary feeding (8.9%).

Conclusion:
The training intervention appeared to have improved prenatal care utilization. Essential obstetric training helped enhance knowledge and self-efficacy among healthcare workers.
Simultaneous bilateral ulnar neuropathy: an unusual complication caused by neuroleptic treatment-induced tardive dyskinesia
Authors: Wei Yi-Ping , Yang Shan-Wei 
Published: November 2019

Abstract

Rationale:
In the past decade, only a few studies have focused on simultaneous bilateral ulnar neuropathy.

Patient concerns:
A 54-year-old Asian male who has suffered from paranoid schizophrenia for 2 years. He reported that flexion contracture occurring over his fourth and fifth fingers on both hands appeared since six months after he started taking the antipsychotic drug. The electromyogram revealed bilateral ulnar neuropathy with chronic axonal degeneration at the elbow level. McGowan classification was performed to evaluate the severity of the ulnar nerve injury, and the patient was diagnosed with a grade 3 injury on his left hand and a grade 2 injury on his right hand.

Diagnosis:
Simultaneous bilateral ulnar neuropathy at the elbow, a complication caused by tardive dyskinesia in a patient under the high-dose, first-generation, antipsychotic drug.

Interventions:
We consulted a psychiatrist to assist in adjusting the patient's kind of the antipsychotic drug and performed the anterior transposition of ulnar nerve to avoid nerve entrapment caused by tardive dyskinesia.

Outcomes:
Numbness of the palms continued to regress over the following 6 months after the anterior transposition of the ulnar nerve. Regression of the involuntary movements, including repeated bending of the elbows, and shaking of both feet, was noted from the patient but was incomplete.

Lessons:
Two literatures concluded that parkinsonian rigidity is the main cause of simultaneous bilateral ulnar neuropathy by Sampath et al and Kurlan et al. Unlike the cases of stereotyped posture-caused neural compression reported previously, we inferred that repeated involuntary motion caused by first-generation antipsychotic drug might have been one of the causes of the patient's nerve compression.
Comparison of in-hospital use of mechanical chest compression devices for out-of-hospital cardiac arrest patients
Authors: Kim Hyun Tae , Kim Jae Guk , Jang Yong Soo , Kang Gu Hyun , Kim Wonhee , Choi Hyun Young , Jun Gwang Soo 
Published: November 2019

Abstract
This study aimed to investigate the prognostic difference between AUTOPULSE and LUCAS for out-of-hospital cardiac arrest (OHCA) adult patients.
A retrospective observational study was performed nationwide. Adult OHCA patients after receiving in-hospital mechanical chest compression from 2012 to 2016 were included. The primary outcomes were sustained return of spontaneous circulation (ROSC) of more than 20 minutes and survival to discharge.
Among 142,906 OHCA patients, 820 patients were finally included. In multivariate analysis, female (OR, 0.57; 95% CI, 0.33–0.99), witnessed arrest (OR, 2.10; 95% CI, 1.20–3.69), and arrest cause of non-cardiac origin (OR, 0.25; 95% CI, 0.10–0.62) were significantly associated with the increase in ROSC. LUCAS showed a lower survival than AUTOPULSE (OR, 0.23; 95% CI, 0.06–0.84), although it showed no significant association with ROSC. Percutaneous coronary intervention (OR, 6.30; 95% CI, 1.53–25.95) and target temperature management (TTM; OR, 7.30; 95% CI, 2.27–23.49) were the independent factors for survival. We categorized mechanical CPR recipients by witness to compare prognostic effectiveness of AUTOPULSE and LUCAS. In the witnessed subgroup, female (OR, 0.46; 95% CI, 0.24–0.89) was a prognostic factor for ROSC and shockable rhythm (OR, 5.04; 95% CI, 1.00–25.30), percutaneous coronary intervention (OR, 12.42; 95% CI, 2.04–75.53), and TTM (OR, 9.03; 95% CI, 1.86–43.78) for survival. In the unwitnessed subgroup, no prognostic factors were found for ROSC, and TTM (OR, 99.00; 95% CI, 8.9–1100.62) was found to be an independent factor for survival. LUCAS showed no significant increase in ROSC or survival in comparison with AUTOPULSE in both subgroups.
The in-hospital use of LUCAS may have a deleterious effect for survival compared with AUTOPULSE.
Clinical effectiveness of ultrasound guided subacromial-subdeltoid bursa injection of botulinum toxin type A in hemiplegic shoulder pain
Authors: Wu Tao , Song Hai-Xin , Li Yang Zheng , Ye Ye , Li Jian-Hua , Hu Xing Yue 
Published: November 2019

Abstract
Hemiplegic shoulder pain (HSP), which occurs in most patients with hemiplegia, causes considerable distress and worsens outcomes in rehabilitation. Although they have received the treatments such as anti-inflammatory drugs or physical therapy, many of the individuals remain suffering from shoulder pain 6 months after acute stroke event. In this retrospective study, we evaluated the effectiveness of ultrasound guided subacromial-subdeltoid (SASD) bursa injections with botulinum toxin type A (BoNT/A) compared to steroids for refractory HSP.
The data were collected retrospectively by reviewing the patient's medical records and pain questionnaires in our rehabilitation center. In total, 38 patients who received ultrasound guided SASD bursa injection (BoNT/A group, n = 18; corticosteroid group, n = 20) were included. The pain visual analog scale (VAS) score at rest and during arm passive abduction, Fugl-Meyer score of upper limbs (F-M score) were evaluated before, 2, 4, 8, and 12 weeks after injection.
Both 2 groups obtained a significant improvement of VAS score at rest or during arms passive abduction compared to baseline score (within group compare, P < .05). There were no significant differences of pain score improvement between two groups at week 2, 4, 8, and 12 after injection either at rest or during passive arm abduction (between 2 groups compare, P > .05). There were also no differences in results of the post treatment F-M score between 2 groups (between 2 groups compare, P > .05). Similarly, during the follow-up period no collateral effects were reported after BoNT/A injection.
SASD bursa BoNT/A injection can substantially reduce the pain as corticosteroid in patients with HSP. BoNT/A injection could be a useful strategy for replacing steroids as a treatment for refractory HSP especially in the patients who cannot tolerate the steroids injection.
Association of the incidence of venous air embolism on coronary computed tomography angiography with the intravenous access route preparation process
Authors: Kayano Shingo , Ota Hideki , Yamaguchi Takayoshi , Ono Katsunori , Takase Kei 
Published: November 2019

Abstract
Venous air embolism (VAE) can be observed in the right heart system on contrast-enhanced computed tomography (CT), following injection of contrast media with a power injector system. Although most VAEs are mostly asymptomatic, they may result in paradoxical air embolism (PAE).
To evaluate whether the incidence of VAE on coronary CT angiography is associated with the process of preparation of the intravenous access route.
We retrospectively evaluated 692 coronary CT examinations at 3 institutions. Trained CT nurses placed an intravenous cannula in the forearm. Tubes connected to the cannula were prepared in the following ways: A, using an interposed three-way cock and a 20-mL syringe filled with normal saline to collect air contamination in the tube; B, through direct connection to the power injector system without the interposed 3-way cock; and C, using an interposed three-way cock and a 100-mL normal saline drip infusion bottle system to keep the tube patent. The incidence and location of VAE and preparation of intravenous injection were assessed.
The overall incidence of VAE was 55.3% (383/692), most frequently observed in the right atrium (81.5%, 312/383). Its incidence varied significantly across the 3 techniques (A: 21.6% (35/162), B: 63.2% (237/375) and C: 71.6% (111/155); P < .001). No patient demonstrated any symptom associated with VAE.
Using a 3-way cock with syringe demonstrated the lowest incidence of VAE on coronary CT angiography. It is thus recommended to reduce potential complication risks related to intravenous contrast media injection.
Higher Rates of Preventive Health Care With Commercial Insurance Compared With Medicaid
Authors: Goudie Anthony , Martin Bradley , Li Chenghui , Lewis Kanna , Han Xiaotong , Kathe Niranjan , Wilson J. Craig , Thompson Joseph 
Published: November 2019

Background:
A requirement of the Arkansas Medicaid Section 1115 demonstration waiver was to evaluate the level of care received for Medicaid expansion eligible beneficiaries enrolled in commercial Qualified Health Plans (QHPs) in the Health Care Independence “Private Option” Program. This allowed for a direct comparison of Medicaid and commercial system performance serving similar newly covered adults.

Research Design:
In 2014, assignment to either Medicaid or a QHP was made based upon a psychometrically derived continuous composite score to exceptional health care needs assessment screener using a sharp a priori threshold cutpoint. Using a regression discontinuity design we compared preventive care (flu vaccination and screening rates) services in the 2 programs over 3 years.

Results:
Compared with Medicaid enrollees, a higher percentage of QHP enrollees consistently received eligible preventive care screenings with 15.3, and 6.9% more receiving at least 1 or all eligible screenings, respectively. For individual preventive care outcomes and compared with Medicaid enrollees over the 3 years under study, a higher percentage of eligible QHP enrollees received a flu shot, cholesterol screenings, glycated hemoglobin assessment, and cervical and breast cancer periodic assessments. No differences were found for colorectal periodic assessments.

Conclusions:
These findings suggest that at least for preventive services, the Medicaid federal equal access requirement is not being met for those within Medicaid fee-for-service coverage. This persisted across all 3 years of the program. Differential payment rates for services between Medicaid and QHPs are likely a major contributing factor.