bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effectiveness of Cervical Medial Branch Radiofrequency Ablation for Chronic Facet Joint Syndrome in Patients Selected by a Practical Medial Branch Block Paradigm
Authors: Burnham Taylor , Conger Aaron , Salazar Fabio , Petersen Russell , Kendall Richard , Cunningham Shellie , Teramoto Masaru , McCormick Zachary L 
Published: December 2019

Abstract

Background
Cervical medial branch radiofrequency ablation (CMBRFA) is an effective treatment for facetogenic pain in patients selected by Spine Intervention Society (SIS) guidelines of 100% symptom improvement with dual medial branch blocks (MBBs) ± placebo block. Patient selection for CMBRFA using ≥80% symptom improvement after dual concordant MBBs is common; however, this has not been studied.

Objective
To evaluate the effectiveness of CMBRFA and compare outcomes in individuals selected by 80–99% vs 100% symptom improvement with dual concordant MBBs.

Design
Cross-sectional cohort study.

Methods
Medical records of 87 consecutive patients were reviewed; 50 met inclusion criteria. A standardized telephone survey was performed at six or more months post-CMBRFA to query numerical rating scale (NRS) pain and patient global impression of change (PGIC) scores. The primary outcomes were the proportion of patients reporting ≥50% reduction of index pain.

Results
At a mean follow-up time of 16.9 ± 12.7 months, 54% (95% confidence interval [CI] = 35–73%) and 54% (95% CI = 32–74%) of the 80–99% and 100% MBBs groups, respectively, reported ≥50% pain reduction. Between-group comparison showed a relative risk of 0.99 (95% CI = 0.59–1.66) for meeting the primary outcome. Seventy percent (95% CI = 56–81%) of patients reported a PGIC score consistent with “improved or very much improved” at follow-up.

Conclusions
CMBRFA is an effective treatment in patients who report ≥80% symptom relief with dual concordant MBBs. The present study demonstrated an overall ≥50% pain reduction rate of 54% and no significant difference between those selected by 80–99% vs 100% symptom relief with dual concordant MBBs.
Democratizing health system data to impact social and environmental health contexts: a novel collaborative community data-sharing model
Authors: Boulware L E , Harris G B , Harewood P , Johnson F F , Maxson P , Bhavsar N , Blackwelder S S , Poley S S , Arnold K , Akindele B , Ferranti J , Lyn M 
Published: December 2019

Abstract

Background
Community health data are infrequently viewed in the context of social and environmental health determinants. We developed a novel data-sharing model to democratize health system data and to facilitate community and population health improvement.

Methods
Durham County, the City of Durham in North Carolina, Durham health systems and other stakeholders have developed a data-sharing model to inform local community health efforts. Aggregated health system data obtained through clinical encounters are shared publicly, providing data on the prevalence of health conditions of interest to the community.

Results
A community-owned web platform called the Durham Neighborhood Compass provides aggregate health data (e.g. on diabetes, heart disease, stroke and other conditions of interest) in the context of neighborhood social (e.g. income distribution, education level, demographics) and environmental (e.g. housing prices, crime rates, travel routes, school quality, grocery store proximity) contexts. Health data are aggregated annually to help community stakeholders track changes in health and health contexts over time.

Conclusions
The Durham Neighborhood Compass is among the first collaborative public efforts to democratize health system data in the context of social and environmental health determinants. This model could be adapted elsewhere to support local community and population health improvement initiatives.
Self-Preservation in the Workplace: The Importance of Well-Being for Social Work Practitioners and Field Supervisors
Authors: Martin Elisa M , Myers Karen , Brickman Kirstiana 
Published: December 2019

AbstractThe risks in the human services workplace to social workers’ emotional, psychological, and physical well-being is well known. Self-care is seen as a way to minimize workplace risks, including burnout, compassion fatigue, secondary traumatic stress, and vicarious traumatization. This article examines the reported self-care practices of social work practitioners and their agencies, and the barriers that get in the way. Forty-two participants worked in agency settings and supervised students. All reported engaging in some type of self-care practice, and almost all reported some type of support from their workplace; however, 38 reported barriers to self-care. Even with self-care practices in place personally and in the workplace, obstacles remain. Social work educators need to be cognizant of these factors to ensure that field supervisors are well supported in their own self-care practices and are equipped to assist students in developing these positive practices early in their careers to help sustain workers in the social work profession.
Triclocarban Exposure Exaggerates Spontaneous Colonic Inflammation in Il-10−/− Mice
Authors: Xie Minhao , Zhang Hongna , Wang Weicang , Sherman Heather L , Minter Lisa M , Cai Zongwei , Zhang Guodong 
Published: December 2019

Abstract
Triclocarban (3,4,4′-trichlorocarbanilide, TCC) is a high-volume chemical used as an antimicrobial ingredient in many consumer and personal care products. In 2016, the Food and Drug Administration removed TCC from over-the-counter hand washing products. However, TCC remains approved to use in many other products and is a ubiquitous contaminant in the environment; furthermore, many common food crops can efficiently accumulate environmental TCC, resulting in potential human exposure through oral ingestion of contaminated food products. Therefore, human exposure to TCC could be a long-lasting and serious problem. A better understanding of its impact on human health could lead to important impact for public health and regulatory policy. Using a spontaneous colonic inflammation model in Il-10−/− mice, here we demonstrate that exposure to TCC, at doses relevant to human exposure, exaggerates spontaneous colonic inflammation in Il-10−/− mice, with reduced colon length, increase fecal concentration of lipocalin 2, enhanced gene expression of Il-6 and Ifn-γ in the colon, and exaggerated crypt damage in the colon. Collectively, these results support that TCC could be a potential environmental risk factor of colitis and associated gut diseases.
Multilevel Disaster Simulation in Nursing: Lessons Learned in Undergraduate and Nurse Practitioner Student Collaboration
Authors: Primeau Marlena Seibert , Benton Anna M. 
Published: December 2019

Abstract
Disaster simulation in nursing education has become fairly common, including both single discipline and interprofessional collaborative events. However, there is a distinct lack of information on disaster simulation involving intraprofessional, multilevel nursing students working collaboratively. Our established undergraduate disaster simulation is a required event for our final-semester senior nursing students. To collect baseline information, a quality improvement program was initiated during one simulation, with six graduate family nurse practitioner students involved as on-scene clinicians in the clinical areas. We found that several basic assumptions were incorrect and that adjustments in training were needed to make this collaborative simulation successful.
Early Prediction of Sepsis From Clinical Data: The PhysioNet/Computing in Cardiology Challenge 2019
Authors: Reyna Matthew A. , Josef Christopher S. , Jeter Russell , Shashikumar Supreeth P. , Westover M. Brandon , Nemati Shamim , Clifford Gari D. , Sharma Ashish 
Published: December 2019

Objectives:
Sepsis is a major public health concern with significant morbidity, mortality, and healthcare expenses. Early detection and antibiotic treatment of sepsis improve outcomes. However, although professional critical care societies have proposed new clinical criteria that aid sepsis recognition, the fundamental need for early detection and treatment remains unmet. In response, researchers have proposed algorithms for early sepsis detection, but directly comparing such methods has not been possible because of different patient cohorts, clinical variables and sepsis criteria, prediction tasks, evaluation metrics, and other differences. To address these issues, the PhysioNet/Computing in Cardiology Challenge 2019 facilitated the development of automated, open-source algorithms for the early detection of sepsis from clinical data.

Design:
Participants submitted containerized algorithms to a cloud-based testing environment, where we graded entries for their binary classification performance using a novel clinical utility-based evaluation metric. We designed this scoring function specifically for the Challenge to reward algorithms for early predictions and penalize them for late or missed predictions and for false alarms.

Setting:
ICUs in three separate hospital systems. We shared data from two systems publicly and sequestered data from all three systems for scoring.

Patients:
We sourced over 60,000 ICU patients with up to 40 clinical variables for each hour of a patient’s ICU stay. We applied Sepsis-3 clinical criteria for sepsis onset.

Interventions:
None.

Measurements and Main Results:
A total of 104 groups from academia and industry participated, contributing 853 submissions. Furthermore, 90 abstracts based on Challenge entries were accepted for presentation at Computing in Cardiology.

Conclusions:
Diverse computational approaches predict the onset of sepsis several hours before clinical recognition, but generalizability to different hospital systems remains a challenge.
Molecular prediction of metastasis in cutaneous squamous cell carcinoma
Authors: Mulvaney Patrick M. , Schmults Chrysalyne D. 
Published: December 2019

Purpose of review
Cutaneous squamous cell carcinoma (cSCC) is a highly prevalent malignancy frequently occurring on body surfaces chronically exposed to ultraviolet radiation. While a large majority of tumors remain localized to the skin and immediate subcutaneous tissue and are cured with surgical excision, a small subset of patients with cSCC will develop metastatic disease. Risk stratification for cSCC is performed using clinical staging systems, but given a high mutational burden and advances in targeted and immunotherapy, there is growing interest in molecular predictors of high-risk disease.

Recent findings
Recent literature on the risk for metastasis in cSCC includes notable findings in genes involved in cell-cycle regulation, tumor suppression, tissue invasion and microenvironment, interactions with the host-immune system, and epigenetic regulation.

Summary
cSCC is a highly mutated tumor with complex carcinogenesis. Regulators of tumor growth and local invasion are numerous and increasingly well-understood but drivers of metastasis are less established. Areas of importance include central system regulators (NOTCH, miRNAs), proteins involved in tissue invasion (podoplanin, E-cadherin), and targets of existing and emerging therapeutics (PD-1, epidermal growth factor receptor). Given the complexity of cSCC carcinogenesis, the use of machine learning algorithms and computational genomics may provide ultimate insight and prospective studies are needed to verify clinical relevance.
Molecular characterization of endometrial cancer and therapeutic implications
Authors: Winterhoff Boris , Thomaier Lauren , Mullany Sally , Powell Matthew A. 
Published: December 2019

Purpose of review
The present article reviews molecular subtyping and genomic characterization of endometrial carcinoma, and the associated therapeutic and prognostic implications.

Recent findings
Endometrial cancer has historically been classified through histology into endometrioid and nonendometrioid subtypes with poor prognostic predictability. Molecular classification through genomic analysis now allows for a major advance in characterization. Four distinct subgroups have been identified: polymerase (POLE) ultramutated, microsatellite unstable, copy number-low--microsatellite stable, and copy number-high—‘serous-like’. These subtypes have prognostic implications and may aid in the identification of early-stage patients who are at high risk for recurrence. Through analysis of surrogate markers (POLE, MSI, and p53) and other validated molecular alterations (L1CAM), it is possible to obtain an integrated molecular risk profile that relates to prognosis. Studies utilizing this risk profile in order to identify patients who may benefit from adjuvant treatment for early-stage disease are on-going.

Summary
Molecular characterization of endometrial cancer into subgroups has enhanced prognostic and therapeutic implications, contrary to traditional risk stratification. Further development of an integrated molecular risk profile may identify patients who could most benefit from adjuvant treatment following surgery and tailor treatment decisions in the recurrent setting.
The Role of Obesity in Iatrogenic Encephaloceles of the Temporal Bone
Authors: Lindquist Nathan R. , Appelbaum Eric N. , Sweeney Alex D. , Vrabec Jeffrey T. 
Published: December 2019

Objective:
Acquired encephaloceles of the temporal bone may be traumatic, spontaneous, or from chronic ear disease or previous surgery. Iatrogenic encephaloceles arise in the setting of previous mastoidectomy and traditionally involve both bony dehiscence and dural injury. We aim to classify and analyze the pathogenesis, clinical presentation, and treatment options for patients with iatrogenic tegmen defects and encephaloceles of the temporal bone.

Study Design:
Retrospective chart review.

Setting:
Single tertiary academic center.

Patients:
Subjects with iatrogenic tegmen defects and encephaloceles of the temporal bone were included.

Intervention:
Patient demographics, history, symptoms, radiographic data, intraoperative findings, management, follow-up, and outcomes were recorded.

Outcome Measures:
Primary outcome measures included patient characteristics, time from primary otologic surgery to surgical repair, location of the defect, and management strategy including surgical approach, methods, and follow-up.

Results:
Iatrogenic tegmen injuries or encephaloceles were identified in 18 patients and divided into intentional or unintentional. The latter group presented immediately, early, or late, as determined by intraoperative identification or from delayed symptoms. Eleven patients presented late with previously unrecognized encephaloceles. Compared with patients presenting with incidentally noted tegmen dehiscence during revision mastoidectomy, a significant proportion of patients with late encephaloceles had BMI ≥30 kg/m2 (p = 0.03).

Conclusion:
The majority of iatrogenic encephaloceles are unintentional, unrecognized, and may present many years after primary surgery. Similar to spontaneous encephaloceles of the temporal bone, obesity is associated with iatrogenic encephaloceles, although the rate of progression and timing is unclear. We recommend primary repair of any unintentional tegmen defect encountered during mastoid surgery, especially in obese patients.
Reliability of Tablet-based Hearing Testing in Nicaraguan Schoolchildren: A Detailed Analysis
Authors: Magro Isabelle , Clavier Odile , Mojica Karen , Rieke Catherine , Eisen Eric , Fried Debra , Stein-Meyers Anita , Fellows Abigail , Buckey Jay , Saunders James 
Published: December 2019

Objective:
Determine whether an electronic tablet-based Wireless Automated Hearing-Test System can perform high-quality audiometry to assess schoolchildren for hearing loss in the field in Nicaragua.

Study Design:
Cross-sectional.

Setting:
A school and hospital-based audiology clinic in Jinotega, Nicaragua.

Subjects and Methods:
Second and third graders (n = 120) were randomly selected for hearing testing in a school. Air conduction hearing thresholds were obtained bilaterally using a Wireless Automated Hearing-Test System at 1000, 2000, and 4000 Hz. Referral criteria were set at more than 25 dBHL at one or more frequencies. A cohort of children was retested with conventional audiometry in a hospital-based sound booth. Factors influencing false-positive examinations, including ambient noise and behavior, were examined.

Results:
All children with hearing loss were detected using an automated, manual, or two-step (those referred from automated testing were tested manually) protocol in the school (sensitivity = 100%). Specificity was 76% for automated testing, 97% for manual testing, and 99% for the two-step protocol. The variability between thresholds obtained with automated testing was greater than manual testing when compared with conventional audiometry. The percentage of participant responses when no stimulus tone was presented during automated testing was higher in children with false-positive examinations.

Conclusion:
A Wireless Automated Hearing-Test System identified all children with hearing loss in a challenging field setting. A two-step protocol (those referred from automated testing are tested manually) reduced false-positive examinations and unnecessary referrals. Children who respond frequently when no tone is presented are more likely to have false-positive automated examinations and should be tested manually.
Serum Levels of Insulin-like Growth Factor 1 and Insulin-like Growth Factor–binding Protein 2 as a Novel Biomarker in the Detection of Pancreatic Adenocarcinoma
Authors: Wlodarczyk Barbara , Borkowska Anna , Wlodarczyk Przemyslaw , Malecka-Panas Ewa , Gasiorowska Anita 
Published: December 2019

Background:
Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor–binding protein 2 (IGFBP-2) are proteins that belong to the IGF axis, which is involved in glucose and lipid metabolism and may as well promote carcinogenesis.

Goals:
The aim of this study was to evaluate the serum concentration levels of IGF-1 and IGFBP-2 in patients with newly diagnosed pancreatic adenocarcinoma (PDAC) to verify their possible role in the diagnosis of the disease.

Study:
The study included 69 patients with PDAC and 20 healthy controls. The concentrations of IGF-1 and IGFBP-2 were estimated by means of ELISA. The study protocol was approved by the Bioethics Committee at the Medical University of Lodz in Poland.

Results:
PDAC patients compared with controls have a significantly lower mean serum IGF-1 level (45.83±30.03 vs. 70.66±60.57 ng/mL; P<0.0001). In contrast, in PDAC patients, the mean IGFBP-2 level was significantly higher compared with the control group (225.06±86.37 vs. 51.92±29.40 ng/mL; P<0.0001). The results show that, at the 0.01 sensitivity level, the IGF-1/IGFBP-2 ratio <0.85 points indicates PDAC presence. At this level of sensitivity, the test has a specificity of 0.097 (α=0.01; β=0.097; IGF-1/IGFBP-2≤0.85).

Conclusions:
Our results show that IGF-1 to IGFBP-2 ratio ≤0.85 may be a powerful PDAC indicator. Further studies in this area in a larger patient group are necessary to confirm our findings.
Comparison of the effectiveness and outcome of microendoscopic and open discectomy in patients suffering from lumbar disc herniation
Authors: Yadav Ram Ishwar , Long Ling , Yanming Cao 
Published: December 2019

Abstract

Background:
The purpose of our study is to compare the outcomes and effectiveness of MED vs OLD for lumbar disc herniation.

Objectives:
To identify the functional outcomes in terms of ODI score, VAS score complications in terms of intraoperative blood loss, use of general anesthesia, and morbidity in terms of total hospital stay between MED and OLD.

Methods:
In our randomized prospective study we analyzed 60 patients with clinical signs and symptoms with 2 weeks of failed conservative treatment plus MRI or CT scan findings of lumbar disc herniation who underwent MED and OLD. The study was undertaken from November 2017 to January 2019 at Guangzhou Medical University of Second Affiliated Hospital, department of orthopedic surgery in spinal Unit, Guangzhou, China. Patients were divided into 2 groups i.e. who underwent MED group and the OLD group then we compared the preoperative and postoperative ODI and VAS score, duration of total hospital stay, intraoperative blood loss, and operation time.

Results:
We evaluated 60 patients. Among them, 30 underwent MED (15 female and 15 male) and 30 underwent OLD 14 male 16 female. Surgical and anesthesia time was significantly shorter, blood loss and hospital stay were significantly reduced in patients having MED than OLD (<0.005). The improvement in the ODI in both groups was clinically significant and statistically (P < .005) at postoperative 1st day (with greater improvement in the MED group), at 6 weeks (P > .005), month 6 (>0.005) statistically no significant. The clinical improvement was similar in both groups. VAS and ODI scores improved significantly postoperatively in both groups. However, the MED group was superior to the OLD group with less time in bed, shorter operation time, less blood loss which is clinically and statistically significant (P < .05).

Conclusions:
The standard surgical treatment of lumbar disc herniation has been open discectomy but there has been a trend towards minimally invasive procedures. MED for lumbar spine disc herniation is a well-known but developing field, which is increasingly spreading in the last few years. The success rate of MED is about approximately 90%. Both methods are equally effective in relieving radicular pain. MED was superior in terms of total hospital stay, morbidity, and earlier return to work and anesthetic exposure, blood loss, intra-op time comparing to OLD. MED is a safe and effective alternative to conventional OLD for patients with lumbar disc herniation.
Serum microRNA-135a as a diagnostic biomarker in non-small cell lung cancer
Authors: Zou Yuanwu , Jing Chengbao , Liu Li , Wang Ting 
Published: December 2019

Abstract
The purpose of our research was to evaluate diagnostic performance of serum microRNA-135a (miR-135a) in non-small cell lung cancer (NSCLC).
Quantitative real time-polymerase chain reaction was employed to detect the expression serum of miR-135a in NSCLC patients and controls. The influence of serum miR-135a level on clinical characteristics of NSCLC patients was explored through the Chi-square test. Serum carcinoembryonic antigen (CEA) level was estimated via enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curve was plotted to elucidate diagnostic roles of serum miR-135a and CEA in NSCLC.
The expression level of serum miR-135a was significantly lower in NSCLC patients than in healthy controls (0.40 ± 0.29 vs 1.00 ± 0.40, P < .001). Moreover, miR-135a expression was related to lymph node metastasis (P = .021), tumor differentiation (P = .020), and tumor node metastasis stage (P = .031). ROC curve showed serum miR-135a level could discriminate NSCLC patients from healthy controls (P < .0001) with a corresponding cutoff value of 0.665, and a sensitivity and specificity of 81.3% and 83.1%, respectively. The area under the curve was 0.888. In diagnosis analysis on the combination of miR-135a and CEA, when its specificity was maintained at 90%, diagnosis cut-off point reached 0.678.
Serum miR-135a level is significantly downregulated in NSCLC and serves as a potential diagnostic biomarker for the disease.