bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative Three-Dimensional Fluorescein Angiography-Guided Pars Plana Vitrectomy for the Treatment of Proliferative Diabetic Retinopathy: The Maximized Utility of the Digital Assisted Vitrectomy
Authors: Imai Hisanori , Tetsumoto Akira , Inoue Saki , Takano Fumio , Yamada Hiroko , Hayashida Mayuka , Otsuka Keiko , Miki Akiko , Kusuhara Sentaro , Nakamura Makoto 
Published: April 2020

Purpose:
To show the usefulness of the intraoperative three-dimensional fluorescein angiography (3D-FA)-guided pars plana vitrectomy.

Methods:
The NGENUITY 3D visualization system was used for the digital assisted vitrectomy. Three-dimensional fluorescein angiography-guided pars plana vitrectomy was performed in three patients with vitreous hemorrhage secondary to proliferative diabetic retinopathy. We investigated both whether several angiographic findings can be successfully displayed on the screen during 3D-FA and whether pars plana vitrectomy can be performed simultaneously on the same screen while implementing 3D-FA.

Results:
In all cases, the abnormal FA findings including hypofluorescence due to non-perfusion areas, and the hyperfluorescence due to macular edema and fibrovascular proliferative membrane were successfully displayed on the screen. The segmentation and delamination of fibrovascular proliferative membrane and panretinal photocoagulation for detected non-perfusion areas were able to be performed on the same screen while implementing 3D-FA.

Conclusion:
Three-dimensional fluorescein angiography-guided pars plana vitrectomy is a novel approach that fully utilizes the advantages of digital assisted vitrectomy and a promising option for the treatment of proliferative diabetic retinopathy.
Loteprednol etabonate gel 0.5% vs prednisolone acetate suspension 1% for the treatment of inflammation after cataract surgery in children
Authors: Vittitow Jason L. , Williams Jon I. 
Published: April 2020

Purpose:
To compare loteprednol etabonate (LE) gel 0.5% with prednisolone acetate suspension (PA) 1% for the treatment of inflammation after cataract surgery in children.

Setting:
Eleven sites in the United States.

Design:
Randomized, double-masked, parallel-group, noninferiority study.

Methods:
Eligible patients were aged 11 years or younger and candidates for routine, uncomplicated cataract surgery. Patients were randomized to a 4-week postsurgical regimen with LE gel 0.5% or PA 1%, twice on the day of surgery, 4 times daily for 2 weeks, twice daily for 1 week, and once daily for 1 week. Assessments included anterior chamber (AC) cells/flare, anterior chamber inflammation (ACI), synechiae, precipitates on the intraocular lens/cornea, visual acuity, and intraocular pressure.

Results:
The intent-to-treat population comprised 105 patients (LE gel, n = 53; PA 1%, n = 52) including 52 patients aged 3 years or younger. Patients achieved a similar mean ACI grade on postoperative day 14 (primary efficacy endpoint) whether treated with LE gel 0.5% or PA 1% (difference = 0.006, 2-sided 95% CI, −0.281 to 0.292). Similar ACI outcomes additionally were observed in patients aged 3 years or younger. LE gel 0.5% and PA 1% also appeared equally effective in resolving inflammation at all visits (days 7, 14, and 28 postsurgery), based on categorical distributions of ACI, AC cells, and AC flare scores/grades (P ≥ .06). Synechiae and corneal/IOL precipitates occurred infrequently with no significant differences between groups. No safety or tolerability concerns were identified, including no treatment-related IOP increases.

Conclusions:
LE gel 0.5% was safe and effective in treating pediatric postcataract surgical inflammation, with similar outcomes as PA 1%.
Paid Sick Leave and Sleep
Authors: Collins Cyleste , DeRigne LeaAnne , Bai Rong , Stoddard Dare Patricia 
Published: April 2020

Objective:
This study examines links between paid sick leave benefits and sleep as an indicator of well-being.

Methods:
Using data from 12,780 employed adult US workers in the 2018 National Health Interview Survey, the relationship between paid sick leave and sleep was explored while controlling for demographic and health status variables.

Results:
Logistic multiple regression analyses revealed that compared with workers without paid sick leave, workers with paid sick leave had significantly higher odds of staying asleep, lower odds of feeling rested, and marginally significantly higher odds of having little trouble falling asleep. The groups did not differ regarding the odds of taking sleep medication or getting the ideal amount of sleep.

Conclusion:
The findings suggest a link between sleep quality and access to paid sick leave, adding to a growing list of health and well-being variables associated with paid sick leave benefits.
The role of radiation for pancreatic adenocarcinoma
Authors: Gamboa Adriana C. , Lee Rachel M. , Maithel Shishir K. 
Published: April 2020

Abstract
Pancreatic cancer is an aggressive malignancy with a high recurrence rate even after curative-intent resection. Improvements in survival have not been achieved in the last 25 years thus highlighting the need for effective multimodal treatment strategies. The role of radiation therapy for pancreatic cancer remains ill-defined due to historical lack of a standard definition of resectability, and the use of antiquated radiation delivery techniques and chemotherapy regimens. Current level I data regarding neoadjuvant chemoradiotherapy for resectable and borderline resectable pancreatic adenocarcinoma (PDAC) are limited to 2 randomized controlled trials and several retrospective studies and suggest that it may lead to an increased likelihood of a margin-negative resection and certainly allows for improved patient selection for pancreaticoduodenectomy when compared to upfront surgery. In the adjuvant setting, data are similarly lacking but suggest that chemoradiotherapy may be beneficial for patients at high risk of locoregional recurrence. Here we review existing data regarding the role of radiation in PDAC.
Outcomes Following Revision Stapes Surgery in Children: A Single-Surgeon, Single-Center 15-Year Experience
Authors: Jervis-Bardy Joshua , Gau Victoria L. , Allsopp Tristan , King Deanne , Page Joshua Cody , Dornhoffer John L. 
Published: April 2020

Objective:
To review a single surgeon experience with revision pediatric stapes surgery for congenital stapes fixation (CSF) and tympanosclerosis (TS). Secondly, to determine whether hearing outcomes following revision surgery may be predicted by a thorough work-up aimed at assessing whether an extruded or malpositioned prosthesis is likely to be encountered intraoperatively.

Setting:
Tertiary referral center.

Study Design:
Retrospective chart review.

Patients:
Fifteen patients having revision surgery for fixation of the stapes footplate over a 15-year period.

Main Outcome Measures:
Hearing results based on pre- and post-revision pure-tone average air-bone gap (PTA-ABG) and speech recognition threshold testing (SRT).

Results:
Overall, the mean improvement of PTA-ABG following revision surgery was 11.9 dB (standard deviation [SD] 15.2) while SRTs improved by a mean of 12.3 (SD 19.9). Outcomes were significantly better in patients who reported a history of trauma following their initial surgery, when there was otoscopic evidence of an extruding or extruded prosthesis and/or a pre-revision CT (where performed) suggested an extruded or malpositioned prosthesis. No patients had a significant postoperative sensorineural hearing loss.

Conclusion:
Revision stapes surgery in children is a safe procedure in experienced hands which nonetheless should only be contemplated in patients in whom preoperative work-up suggests an extruded or malpositioned prosthesis is likely to be encountered intraoperatively.
Rat Model of External Auditory Canal Stenosis
Authors: Lang Dustin M. , Antonelli Patrick J. , Dirain Carolyn O. 
Published: April 2020

Hypothesis:
Circumferential electrocautery injury of the rat external auditory canal (EAC) can induce a reproducible animal model of acquired stenosis.

Background:
Acquired EAC stenosis may occur as a result of chronic inflammation or trauma to the EAC skin and is characterized by narrowing of the EAC, retention of debris, and hearing loss. Treatment is surgery but it is often complicated by restenosis. A reliable and inexpensive animal model of EAC stenosis has not been described. There have been no studies correlating the extent of EAC injury with the extent of stenosis.

Methods:
Rats received a 25, 50, or 75% circumferential EAC injury with electrocautery. The extent of resulting stenosis was quantified 21 days following injury. The nature of the injury and healing response was assessed with histology.

Results:
A 25% circumferential injury led to 4 to 34% stenosis (mean, 13%), 50% injury resulted in 43 to 100% stenosis (mean, 73%), and 75% injury resulted in 94 to 100% stenosis (mean=99%, p < 0.0001). The 50% circumferential injury produced 30 to 75% stenosis in five of eight ears, the remainder had >75% stenosis. Wounded ears showed evidence of intact cartilage and epithelium, with increased thickness of the subepithelial layer and localized fibrosis.

Conclusions:
Electrocautery injury in the ventral aspect of the rat EAC resulted in reproducible EAC stenosis. This rat model may be useful in studying therapy to prevent acquired EAC stenosis due to acute injury. The correlation of the extent of injury (circumference) with resulting stenosis may inform clinical management of EAC injuries.
Vitamin D Deficiency, Hypocalcemia, and Hearing Loss in Children
Authors: Mehta Charmee H. , Close Michaela F. , Dornhoffer James R. , Liu Yuan F. , Nguyen Shaun A. , McRackan Theodore R. , Meyer Ted A. 
Published: April 2020

Objective:
Characterize relations between vitamin D deficiency (VDD), hypocalcemia, and hearing loss (HL) in children.

Study Design:
Retrospective review.

Setting:
Tertiary referral hospital.

Patients:
Children in the Audiological and Genetic Database with a diagnosis of VDD, rickets, or osteomalacia.

Intervention:
None.

Main Outcome Measures:
Prevalence, type, severity (4-tone pure-tone average, PTA), and progression of HL. HL was defined as greater than 15 dB HL at any threshold by pure tone, greater than 20 dB HL by sound field audiometry, or greater than 25 dB in infants less than 1 year of age.

Results:
Of 888 children with VDD, 474 (53.4%) had HL, with 17% having moderate-profound HL. Compared with an age-matched cohort of 13,320 children drawn from the same database, children with VDD were significantly more likely to have sensorineural HL (SNHL) (adjusted odds ratios [aOR] 1.26 [95% confidence interval [CI] 1.01–1.58]). Among children with VDD, children with femur fracture had a significantly higher rate of HL (81% versus 53%, p = 0.008) and children with hypocalcemia had a significantly higher rate of moderate-profound HL (36% versus 18%, p = 0.016). Additionally, hypocalcemia with and without VDD was associated with SNHL (aOR 2.30 [1.07–4.56]).

Conclusions:
Both vitamin D deficiency and hypocalcemia were found to be independently associated with SNHL, a type of HL that is less likely to improve over time. Recognition of VDD and hypocalcemia as independent risk factors for the development of SNHL could allow for better evaluation and treatment of this patient population. Routine audiological evaluation should be considered in this population.
Bisphosphonate Therapy for Treating Osteonecrosis in Pediatric Leukemia Patients: A Systematic Review
Authors: Daneshdoost Shanaz M. , El Abiad Jad M. , Ruble Kathy J. , Jones Lynne C. , Crane Janet L. , Morris Carol D. , Levin Adam S. 
Published: April 2020

Background:
Despite improved outcomes in children with leukemia, complications such as osteonecrosis are common. We conducted a systematic review to investigate the role of bisphosphonates in reducing pain, improving mobility, and stabilizing lesions in pediatric leukemia survivors.

Methods:
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched the PubMed, Embase, Cochrane, Web of Science, Scopus, CINAHL, and ClinicalTrials.gov databases. Five of 221 articles retrieved met our inclusion criteria.

Results:
Bisphosphonates, especially when combined with dietary calcium and vitamin D supplements and physical therapy (supplements/PT) were associated with improved pain and mobility in 54% and 50% of patients, respectively. A significantly greater proportion of patients treated with bisphosphonates (83%) reported mild/moderate pain or no pain compared with those with supplements/PT alone (36%) (P<0.001). Sixty-six percent of patients treated with bisphosphonates achieved improved/full mobility compared with 27% of those treated with supplements/PT alone (P=0.02). However, 46% of patients showed progressive joint destruction despite bisphosphonate therapy. No adverse events were reported, except for acute phase reactions to intravenous therapies.

Conclusions:
Bisphosphonates, when combined with supplements/PT, were associated with less pain and improved mobility, but not prevention of joint destruction in pediatric leukemia patients with osteonecrosis.
Highlighting Contributions of Behavioral and Social Sciences in Advancing Public Health: Where We've Come, Where We're Headed
Authors: Alber Julia M. , Green Lawrence W. , Gambescia Stephen F. , McLeroy Kenneth R. , Sofalvi Alan , Auld M. Elaine 
Published: April 2020

Context:
Social and behavioral sciences, a cross-disciplinary field that examines the interaction among behavioral, biological, environmental, and social factors, has contributed immensely to some public health achievements over the last century. Through collaboration with community organizations and partners, social and behavioral scientists have conducted numerous program interventions involving community engagement and advocacy efforts at the local, state, federal, and international levels.

Contributions of Social and Behavioral Sciences:
This article traces select historical underpinnings of the applications of social and behavioral sciences theories and evidence to public health and highlights 4 areas in which health education specialists have distinctly contributed to public health achievements by building on theory and evidence. Applied social and behavioral sciences have formed the basis of various health education interventions. These 4 areas include the following: (1) Theory, Model Development, and the Professionalization of Health Education; (2) Participation and Community Engagement; (3) Health Communication; and (4) Advocacy and Policy.

Discussion:
We present contemporary challenges and recommendations for strengthening the theory, research, and practice of health education within the context of social and behavioral sciences in addressing emerging public health issues.
Outbreak Response Capacity Assessments and Improvements Among Public Health Department Health Care–Associated Infection Programs—United States, 2015-2017
Authors: Franklin Steven M. , Crist Matthew B. , Perkins Kiran M. , Perz Joseph F. 
Published: April 2020

Context:
The Centers for Disease Control and Prevention awarded $85 million to health care–associated infection and antibiotic resistance (HAI/AR) programs in March 2015 as part of Infection Control Assessment and Response (ICAR) activities in the Epidemiology and Laboratory Capacity cooperative agreement Domestic Ebola Supplement.

Program:
One goal of this funding was to assess and improve program capacity to respond to potential health care outbreaks (eg, HAI clusters). All 55 funded programs (in 49 state and 6 local health departments) participated.

Implementation:
The Centers for Disease Control and Prevention developed guidance and tools for HAI/AR programs to document relevant response capacities, assess policies, and measure progress. HAI/AR programs completed an interim assessment in 2016 and a final progress report in 2017.

Evaluation:
During the project period, 78% (n = 43) of the programs developed new investigation tools, 85% (n = 47) trained staff on outbreak response, and 96% (n = 53) of the programs reported hiring staff to assist with outbreak response activities. Staffing and expertise to support HAI outbreak response increased substantially among awardees reporting staffing limitations on the interim assessment, including in domains such as on-site infection control assessment (n = 20; 83%), laboratory capacity (n = 20; 91%), and data management/analytics (n = 14; 67%). By 2017, reporting requirements in 100% of the programs addressed possible HAI/AR outbreaks; 93% (n = 51) also addressed sentinel events such as identification of novel AR threats. More than 90% (n = 50) of programs enhanced capacities for tracking response activities; in 2016, these systems captured 6665 events (range, 3-1379; median = 46). Health departments also reported wide-ranging efforts to engage regulatory, public health, and health care partners to improve HAI/AR outbreak reporting and investigation.

Discussion:
Broad capacity for responding to HAI/AR outbreaks was enhanced using Ebola ICAR supplemental funding. As response activities expand, health department programs will be challenged to continue building expertise, reporting infrastructure, investigation resources, and effective relations with health care partners.
Wildfire Smoke Risk Communication Efficacy: A Content Analysis of Washington State's 2018 Statewide Smoke Event Public Health Messaging
Authors: Van Deventer Darcy , Marecaux Justine , Doubleday Annie , Errett Nicole , Isaksen Tania M. Busch 
Published: April 2020

Context:
Wildfire events are increasing in prevalence and intensity in the Pacific Northwest. Effective communication of health risks and actions to reduce exposure to wildfire smoke is imperative.

Objective:
We assessed the content of wildfire smoke risk messages from government organizations and mainstream media during a major wildfire smoke event in August 2018.

Design:
We conducted a content analysis of wildfire smoke risk information communicated by local and state government organizations and the mainstream media.

Setting:
Eight Washington State counties during a statewide wildfire smoke event in August 2018.

Main Outcome Measure:
Leveraging the Extended Parallel Process Model and information in the existing literature on wildfire smoke and health, we assessed messages for the presence of information regarding health risk, personal interventions, administrative interventions, vulnerable populations, and trusted sources of information. Summary statistics were calculated to identify common messages about recommended interventions, vulnerable populations cited, and trusted sources of public health information.

Results:
Of the 273 identified government and media messages on wildfire smoke, the majority (71% and 66%) contained information about health risks. However, only 46% and 33% of government and media messages contained information about personal interventions to reduce risk, and 37% and 14% of government and media messages contained information about administrative interventions to reduce risk. Less than half of government and media messages (28% and 31%) contained information specific to vulnerable populations, and 58% and 46% of government and media messages contained any reference to a trusted source of information.

Conclusions:
While information about wildfire smoke and health risks was communicated during Washington's August 2018 wildfire smoke event, there remains considerable opportunity to include additional information about interventions, vulnerable populations, and trusted sources of information. We recommend several opportunities to improve and evaluate risk communication and risk reduction before, during, and after future wildfire smoke events.
Decreasing Chronic Lung Disease Associated with Bubble CPAP Technology: Experience at Five Years
Authors: Miller Tricia A. , Li Jing , Riddell Stella , Barkley Steven C. 
Published: April 2020

Introduction:

Bubble continuous positive airway pressure (bCPAP) is associated with a decreased risk for chronic lung disease (CLD) in preterm neonates. This report examined the effectiveness of adopting bCPAP to reduce respiratory complications and medication usage in a community hospital NICU.

Methods:
The efficacy of bCPAP was assessed by retrospective examination and comparison of 45 neonates who received bCPAP and 87 neonates who received conventional ventilation only. Data on medication usage were also collected and analyzed.

Results:
After introduction of the bCPAP protocol, the median number of days on oxygen decreased in the bCPAP group compared with the conventional ventilation only group (median = 33 days, IQR = 7.5–66 vs median = 0, IQR = 0–0; P < 0.001). The exposure to conventional ventilation decreased in the bCPAP group compared with the conventional ventilation only group (median = 18 days, IQR = 5–42.5 vs median = 0, IQR = 0–7; P < 0.001). Postimplementation of bCPAP revealed decreases in CLD from 26 (30%) in the conventional ventilation only group to 2 (4%) in the bCPAP group (P = 0.002); there was also a significant decrease in the use of sedative medications in the bCPAP group compared with the conventional ventilation only group (mean = 5.20 doses, SD = 31.97 vs mean = 1.43, SD = 9.98; P < 0.001).

Conclusion:
The use of bCPAP results in significant decreases in the use of conventional ventilation, the risk for CLD, and the need for sedative medication.
Trends in the Surgical Management of Lower Extremity Gustilo Type IIIB/IIIC Injuries
Authors: Burns Jack C. , DeCoster Ryan C. , Dugan Adam J. , Davenport Daniel L. , Vasconez Henry C. 
Published: April 2020

Background:
Over the past 20 years, innovations in microsurgical technique have coincided with advances in orthoplastic approaches. However, no single algorithm exists to guide management of limb salvage versus amputation. As such, one would expect these procedures to be performed at equal rates given studies showing similar outcomes. Anecdotally, the observation at the authors’ institution is that amputations are being performed more frequently. The purpose of this study was to determine trends in lower extremity trauma management.

Methods:
A retrospective cohort study was conducted at a Level I trauma center on patients with Gustilo type IIIB/IIIC lower extremity trauma from 2005 to 2014. Overall, 148 patients were included. Patients were subdivided into amputation (n = 69) and reconstruction (n = 79) cohorts. The Spearman rank correlation coefficient was used to compare trends in amputation and reconstruction groups. Plastic surgery consultation data were analyzed using the Mann-Whitney U and chi-square tests and the Pearson correlation coefficient.

Results:
Amputation was performed more frequently over the study period (r = 0.292; p < 0.001). Plastic surgeons were consulted in 67.5 percent of cases. A plastic surgery consultation was obtained in only 30 percent of amputation cases (p < 0.001).

Conclusions:
Although the data show a trend toward amputation and a shift in management of lower extremity trauma, the observed trend may be attributable in part to deviation from an orthoplastic approach to lower extremity trauma. However, lower extremity reconstruction remains a viable option in select patients, and advances in microsurgery can provide excellent outcomes in the face of severe lower extremity trauma.