bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conceptualizing and measuring sustainability of prevention programs, policies, and practices
Authors: Palinkas Lawrence A , Spear Suzanne E , Mendon Sapna J , Villamar Juan , Reynolds Charles , Green Costella D , Olson Charlotte , Adade Audrey , Brown C Hendricks 
Published: November 2019

Abstract
A large knowledge gap exists regarding the measurement of sustainability of evidence-based prevention programs for mental and behavioral health. We interviewed 45 representatives of 10 grantees and 9 program officers within 4 Substance Abuse and Mental Health Services Administration prevention grant initiatives to identify experiences with implementation and sustainability barriers and facilitators; what “sustainability” means and what it will take to sustain their programs; and which Consolidated Framework for Implementation Research (CFIR) elements are important for sustainability. Lists of sustainability determinants and outcomes were then compiled from each data set and compared with one another. Analysis of themes from interviews and free lists revealed considerable overlap between sustainability determinants and outcomes. Four sustainability elements were identified by all three data sets (ongoing coalitions, collaborations, and networks and partnerships; infrastructure and capacity to support sustainability; community need for program; and ongoing evaluation of performance and outcomes), and 11 elements were identified by two of three data sets (availability of funding; consistency with organizational culture; evidence of positive outcomes; development of a plan for implementation and sustainment; presence of a champion; institutionalization and integration of program; institutional support and commitment; community buy-in and support; program continuity; supportive leadership; and opportunities for staff training). All but one of the CFIR domain elements (pressure from other states, tribes, or communities) were endorsed as important to sustainability by 50% or more of participants. It may be more important to implement a standardized process of eliciting determinants and outcomes of sustainability than to implement a single standardized instrument.
A retrospective multisite examination of depression screening practices, scores, and correlates in pediatric diabetes care
Authors: Mulvaney Shelagh A , Mara Constance A , Kichler Jessica C , Majidi Shideh , Driscoll Kimberly A , Westen Sarah C , Rawlinson Alana , Jacobsen Laura M , Adams Rebecca N , Hood Korey K , Monaghan Maureen 
Published: November 2019

Abstract
Psychosocial guidelines recommend routine screening of depressive symptoms in adolescents and young adults (AYA) with diabetes. Best practices for screening in routine care and patient characteristics associated with depressive symptoms require further investigation. The purpose of this study was to examine psychometric properties of the Patient Health Questionnaire (PHQ-2 and PHQ-9); document rates of depressive symptoms and related clinical actions; and evaluate associations with patient characteristics. The Patient Health Questionnaire (PHQ-2 or PHQ-9) was administered at five pediatric academic medical centers with 2,138 youth with type 1 diabetes. Screening was part of routine clinical care; retrospective data from electronic health records were collected for the first screening date as well as 12 months prior. The PHQ demonstrated good psychometric properties. Evaluation of item-level PHQ-9 data identified 5.0% of AYA with at least moderate depressive symptoms who would not have been flagged for further screening using the PHQ-2 only. On the PHQ-9, 10.0% of AYA with type 1 diabetes endorsed elevated depressive symptoms and 7.0% endorsed thoughts of self-harm. Patients with moderate or greater depressive symptoms had a 43.9% documented referral rate for mental health treatment. Higher BMI, older age, public insurance, shorter diabetes duration, higher HbA1C, and a diabetic ketoacidosis (DKA) event in the past year were associated with depressive symptoms. The PHQ-9 identified AYA with elevated depressive symptoms that would not have been identified using the PHQ-2. Depressive symptoms were associated with negative diabetes indicators. To improve referral rates, standardized methods for provision and documentation of referrals are needed.
Making a Federal Case: Youth Groups, Students and the 1975 European Economic Community Referendum Campaign to Keep Britain in Europe
Authors: Smedley Stuart 
Published: November 2019

Abstract
To persuade the electorate to vote ‘Yes’ in the June 1975 referendum on the United Kingdom’s membership of the European Economic Community, Britain in Europe, the pro-European campaign organization, adopted a pragmatic approach, focusing on the economic benefits of membership and warning about the potentially grave consequences of withdrawal. Importantly, they avoided discussing proposed future advances in European integration. However, this theme was of importance to pro-European youth and student campaign groups—the subject of this article. Through a detailed analysis of their campaign literature, this article further transforms understanding of the 1975 referendum and, especially, the nature of the ‘Yes’ campaign by demonstrating how radical youth groups’ arguments for continued membership were. It argues that young activists yearned to discuss sovereignty and deeper integration in great detail as they offered idealistic visions for how the EEC could develop and benefit Britain. The article also advances knowledge of youth politics in the turbulent 1970s. Greater light is shone on the frustration pro-European youth groups felt towards the main Britain in Europe campaign. Meanwhile, it serves as a case study on the extent to which the perspectives of party-political youth groups and their superiors differed on a specific, highly salient policy issue.
Addressing Maternal Mortality: The Pregnant Cardiac Patient
Authors: Wolfe D.S. , Hameed A.B. , Taub C.C. , Zaidi A.N. , Bortnick A.E. 
Published: November 2019

(Am J Obstet Gynecol. 2019;220(2):167.e1–167.e8)
There has been an upward trend in maternal mortality in the United States over the past 3 years. One major contributor to this trend is cardiovascular disease, which accounted for 15.5% of maternal deaths between 2011 and 2013. To combat the rise in maternal mortality, obstetric and gynecological experts recommend the creation of models of care suited to manage high-complexity pregnant patients. A possible treatment solution would include cardiovascular screening, patient education, and multidisciplinary team planning.
Scratching the Surface: A Review of Dermatitis
Authors: Woo Taylor E. , Somayaji Ranjani , Haber R.M. , Parsons Laurie 
Published: November 2019

ABSTRACT
Eczematous reactions such as atopic dermatitis and contact dermatitis are prevalent worldwide. Despite contrasting pathophysiology, the diagnosis and management of these dermatitides can be challenging for healthcare providers. Differences in the distribution of the affected areas, duration of onset, and associated symptoms may help to distinguish these conditions. Diagnosis of the respective conditions is useful in developing appropriate management plans. Herein, the authors present a case-based review illustrating these different disease entities. Management of these conditions, including the use of topical and systemic therapies, is discussed.

GENERAL PURPOSE
To present a case-based review illustrating atopic and contact dermatitis, including management of these conditions using topical and systemic therapies.

TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant should be better able to:
1. Review the prevalence, etiology, and consequences of the various types of dermatitis.
2. Describe the clinical manifestations and differential diagnosis of the various types of dermatitis.
3. Outline the treatment options for the various types of dermatitis.
Suspending Student Selections to Alpha Omega Alpha Honor Medical Society: How One School Is Navigating the Intersection of Equity and Wellness
Authors: Lynch Giselle , Holloway Terrell , Muller David , Palermo Ann-Gel 
Published: November 2019

Medical education must provide students with a delicate balance of academic rigor, equity, and wellness. While the medical education community espouses all these values, the authors believe the way medical students are evaluated and rewarded undermines equity and wellness. Alpha Omega Alpha Honor Medical Society (AΩA) membership is arguably the highest honor that a medical student can achieve. In the short term, it opens doors to the most selective training opportunities, and in the long term, ushers students into an elite group of future physician leaders. Yet recent data have demonstrated that AΩA is disproportionately awarded to white students.
At Icahn School of Medicine at Mount Sinai (ISMMS), the authors observed that students underrepresented in science and medicine were persistently underrepresented among those selected for AΩA. They describe efforts at ISMMS to reduce bias in the selection process and the ultimate decision to suspend medical student selection for AΩA altogether. The authors argue that selection to AΩA reinforces the structural biases and social privilege that are embedded in medical education and undermines the ability to deliver an educational experience that has as its core tenets equity and wellness. Suspending participation in student selection for AΩA is an important step toward recognizing that medical school learning environments continue to privilege white students over students who are underrepresented in medicine.
Early results of revision dual mobility uncemented cups with impaction autologous and synthetic bone graft composite in revision hip arthroplasty for cavitary acetabular defects: A retrospective case series
Authors: Abdelazim Haytham , Elerian Sherif , Abdelrahman Amr Ahmed , Nageeb Mahmoud Ahmed 
Published: November 2019

Background:The presence of cavitary acetabular defects can present a major challenge during revision hip arthroplasty. The purpose of this study was to retrospectively review the early clinical and radiographic outcomes of a dual-mobility, cementless acetabular shell system when combined with autologous or synthetic bone graft substitute composite in revision hip arthroplasty for cavitary acetabular defects.Methods:Fourteen revision hip arthroplasties for acetabular protrusion and cavitary acetabular defects were performed at our institutions between May, 2015 to June, 2016. A direct lateral approach was used for all patients. All patients were assessed with the Oxford Hip Score. Serial postoperative radiographs were assessed for signs of osseointegration and acetabular component migration. Failures were defined as gross acetabular component migration and deterioration of patient self-reported outcome score postoperatively.Results:After a mean follow-up of 28.9 mo, the Oxford Hip Score and hip pain scores were significantly improved (P≤0.01). Radiographically sufficient bone graft osseointegration was obtained in all patients with no detected acetabular component migration.Conclusions:This study showed good overall short-term functional and radiographic outcomes of the dual-mobility, uncemented acetabular shell system in combination with autologous or synthetic bone graft composite in revision hip arthroplasty for cavitary acetabular defects.Level of Evidence:Level IV.
Expanding the Spectrum of Radiation Necrosis After Stereotactic Radiosurgery (SRS) for Intracranial Metastases From Lung Cancer
Authors: Sharma Akanksha , Mountjoy Luke J. , Butterfield Richard J. , Zhang Nan , Ross Helen J. , Schild Steven E. , Sio Terence T. , Daniels Thomas B. , Paripati Harshita R. , Mrugala Maciej M. , Vora Sujay A. , Patel Naresh P. , Zimmerman Richard S. , Ashman Jonathan B. , Porter Alyx B. 
Published: November 2019

Objective:Radiation therapy (RT) is the primary treatment of intracranial metastasis (ICM) from lung cancer (LC). Radiation necrosis (RN) has been reported post-RT with an incidence of 5% to 24%. We reviewed the spectrum of imaging changes in patients treated with RT for ICM from LC in an effort to identify potential risk factors for RN.Methods:We reviewed 63 patients with LC and ICM who received RT (radiosurgery [stereotactic radiosurgery] with/without whole brain radiation therapy) at our institution between 2013 and 2018. Data evaluated included demographics, tumor type, ICM burden and location, chemotherapy, surgery, and RT details as well as treatment choices and outcomes.Results:Of the 63 patients, clinical and radiographic criteria for RN were noted in 24 (38%) as early as 2 months and as late as 5 years posttreatment. Six patients required surgical resection due to refractory symptoms revealing pathology-proven RN and occasionally tumor. Patients were significantly more likely to develop RN if they had surgical resection of an ICM (45.8% vs. 20.5%,P=0.05). No differences were found in location, size, or genetic profile of lesions. In total, 80% of patients received treatment for symptoms and/or radiographic change. This was generally a combination of steroids, bevacizumab, laser interstitial thermal treatment, or surgical resection. Most patients required >1 treatment modality.Conclusions:This review of outcomes of RT for ICM in LC demonstrates a higher rate of RN than previously reported in the literature in those having had a surgical resection plus stereotactic radiosurgery. Our observation of RN as late as 5 years post-RT for ICM necessitates clinician awareness.
Clinical Outcomes of Patients With Unresectable Cholangiocarcinoma Treated With Proton Beam Therapy
Authors: Hung Sheng-Ping , Huang Bing-Shen , Hsieh Cheng-En , Lee Ching-Hsin , Tsang Ngan-Ming , Chang Joseph Tung-Chieh , Chen Jen-Shi , Chou Wen-Chi , Tseng Jeng-Hwei , Hong Ji-Hong 
Published: November 2019

Objective:
To investigate the clinical outcomes and failure patterns of patients with unresectable cholangiocarcinoma (CC) who had been treated with proton beam therapy (PBT).

Methods:
The authors retrospectively examined 30 patients with unresectable CC who had undergone PBT between November 2015 and December 2017. Survival curves were plotted with the Kaplan-Meier method. Independent predictors of survival were identified by multivariate Cox proportional hazard regression analyses. Complications were assessed using the Common Terminology Criteria for Adverse Events v4.0.

Results:
The median tumor size was 7 cm. Seventeen patients (56.7%) had regional lymph node metastases. The median radiation dose was 72.6 cobalt gray equivalents, and 23 patients (76.7%) received concurrent chemotherapy. The 1-year local control, regional control, and distant metastases-free rates were 88%, 86%, and 68%, respectively. The median overall survival and progression-free survival were 19.3 and 10.4 months, respectively. The median jaundice-free survival was 13 months, with a 1-year biliary tract infection (BTI)-free rate of 58%. Patients who received concurrent chemotherapy had a better median progression-free survival (12.1 vs. 4.7 mo). The most common form of acute toxicity from PBT was acute skin reactions which were rarely severe (grade III: 7% of patients). Three and 2 patients had grade III-IV toxicities and radiation-induced liver disease. There were no deaths caused by PBT or concurrent chemotherapy.

Conclusions:
PBT is clinically useful in patients with unresectable CC, even in the presence of large tumors or regional nodal metastases. Its use may induce durable symptom relief, without increasing acute or late toxicity.
An Epidemiological Study of Chinese Children with Developmental Dyslexia
Authors: Cai Lei , Chen Yuxia , Hu Xiaoyun , Guo Yangfeng , Zhao Xiaoli , Sun Tao , Wu Yujia , Li Xiuhong 
Published: November 2019

Abstract

Objective:
The epidemiological studies of Chinese developmental dyslexia (DD) in China are still limited. The current study aimed to investigate the prevalence rate, risk factors, and psychiatric comorbidities of Chinese DD in Guangzhou, a city in South China.

Method:
A total of 1661 students from second to fifth grades were recruited. The dyslexic students were identified by evaluating learning disability through the Pupil Rating Scale–Revised Screening for Learning Disability (PRS) scale by the head teachers and word recognition through the standard test. Students with a PRS score of <65 received the Raven’s test, and those with intelligence quotient scores below 80 in the Raven’s test were excluded. Psychiatric comorbidities were assessed by the Strength and Difficulties Questionnaire completed by parents.

Results:
The prevalence rate of Chinese DD was 4.9% in Guangzhou city. There were significant differences in gender, the paternal educational level, and reading experience before the age of 6 years between the DD group and the non-DD group. Male gender (odds ratio [OR] = 4.17), low paternal educational level (p = 0.045), and lack of reading experience before the age of 6 years (OR = 1.99) were the risk factors for DD. The DD cases had a higher risk of hyperactivity and inattention (OR = 3.21).

Conclusion:
This study showed that the prevalence rate of DD was 4.9% in Guangzhou city. Male gender, low paternal educational level, and lack of reading experience before the age of 6 years were the risk factors for Chinese DD. The high comorbidity rate of hyperactivity and inattention in the Chinese DD population needs further evaluation.
Trends in Cancer Incidence Among American Indians and Alaska Natives and Non-Hispanic Whites in the United States, 1999–2015
Authors: Gopalani Sameer V. , Janitz Amanda E. , Martinez Sydney A. , Gutman Pamela , Khan Sohail , Campbell Janis E. 
Published: November 2019

Background:
Female breast, prostate, lung, and colorectal cancers are the leading incident cancers among American Indian and Alaska Native (AI/AN) and non-Hispanic White (NHW) persons in the United States. To understand racial differences, we assessed incidence rates, analyzed trends, and examined geographic variation in incidence by Indian Health Service regions.

Methods:
To assess differences in incidence, we used age-adjusted incidence rates to calculate rate ratios (RRs) and 95% confidence intervals (CIs). Using joinpoint regression, we analyzed incidence trends over time for the four leading cancers from 1999 to 2015.

Results:
For all four cancers, overall and age-specific incidence rates were lower among AI/ANs than NHWs. By Indian Health Service regions, incidence rates for lung cancer were higher among AI/ANs than NHWs in Alaska (RR: 1.46; 95% CI: 1.37, 1.56) and Northern (RR: 1.29; 95% CI: 1.25, 1.33) and Southern (RR: 1.06; 95% CI: 1.03, 1.09) Plains. Similarly, colorectal cancer incidence rates were higher in AI/ANs than NHWs in Alaska (RR: 2.29; 95% CI: 2.14, 2.45) and Northern (RR: 1.04; 95% CI: 1.00, 1.09) and Southern (RR: 1.11; 95% CI: 1.07, 1.15) Plains. Also, AI/AN women in Alaska had a higher incidence rate for breast cancer than NHW women (RR: 1.05; 95% CI: 1.05, 1.20). From 1999 to 2015, incidence rates for all four cancers decreased in NHWs, but only rates for prostate (average annual percent change: –4.70) and colorectal (average annual percent change: –1.80) cancers decreased considerably in AI/ANs.

Conclusion:
Findings from this study highlight the racial and regional differences in cancer incidence.
Long-term Exposure to Neighborhood Deprivation and Intimate Partner Violence Among Women: A UK Birth Cohort Study
Authors: Yakubovich Alexa R. , Heron Jon , Feder Gene , Fraser Abigail , Humphreys David K. 
Published: November 2019

Background:
Intimate partner violence is the most common form of violence perpetrated against women. To our knowledge, the effect of neighborhood disadvantage on intimate partner violence against women has never been investigated prospectively outside the United States.

Methods:
We used data from the Avon Longitudinal Study of Parents and Children in the United Kingdom, which followed our target sample, 7,219 women, from birth and their mothers (from pregnancy). At age 21, 2,128 participants self-reported the frequency of experiencing physical, psychological, or sexual intimate partner violence since age 18. Participants’ exposure to neighborhood-level deprivation and family-level socioeconomic characteristics (e.g., income) were measured at 10 time points from baseline (gestation) until children were 18 years old. We estimated the effect of cumulative exposure to greater neighborhood-level deprivation on the risk of experiencing intimate partner violence using marginal structural models with stabilized inverse probability weights, accounting for time-varying confounding by socioeconomic indicators and sample attrition.

Results:
A one-unit increase in cumulative exposure to more severe neighborhood deprivation was associated with a 62% increase in participants’ frequency of experiencing intimate partner violence (95% confidence interval 11%, 237%) and 36% increase in their risk of experiencing any intimate partner violence (95% confidence interval 1%, 85%).

Conclusions:
In our study, cumulative exposure to greater neighborhood deprivation over the first 18 years of life was associated with women’s increased risk of experiencing intimate partner violence in early adulthood. Future studies should test this association across contexts, including underlying mechanisms, and evaluate preventive strategies that target structural disparities.
Diagnostic Reference Levels, Deterministic and Stochastic Risks in Pediatric Interventional Cardiology Procedures
Authors: Rizk Chadia , Fares Georges , Vanhavere Filip , Saliba Zakhia , Farah Jad 
Published: November 2019

Abstract
To establish diagnostic reference levels (DRLs) and investigate deterministic and stochastic risks in pediatric interventional cardiology (IC) procedures. Exposure parameters were retrospectively reviewed for 373 patients treated between May 2016 and November 2018 at a single specialized hospital. Weight specific DRLs were derived for pediatric IC procedures. Additionally, peak skin dose (Dskin,max) was measured using thermoluminescent dosimeters for a sample of 7 diagnostic and 43 therapeutic procedures. Finally, using PCXMC software, organ doses were computed and the risk of exposure-induced cancer death (REID) was estimated using the risk models of the Biological Effects of Ionizing Radiation VII committee. DRLs for ventricular septal defect (VSD) occlusions, lacking in the literature, in terms of air kerma at patient entrance reference point (388 and 629 mGy) and total air kerma-area product (28 and 61 Gycm2) were proposed for patients weight-groups 5 − < 15 kg and 15 − < 30 kg, respectively. The mean (range) Dskin,max was 15 (1–30) mGy and 94 (1–491) mGy for diagnostic and therapeutic procedures, respectively. Meanwhile, VSD occlusion involved the highest organ doses where the lungs, liver, stomach, and breasts mean doses were 57, 37, 6, and 10 mGy, respectively, and the associated REID were 0.5% and 0.3% in female and male patients, respectively. DRLs were proposed for pediatric IC procedures; these will help optimize patient exposure. Dskin,max values were lower than the 2 Gy threshold for skin injuries. Pediatric organ doses and the REID were the highest during VSD occlusion and may be critical for repetitive procedures.