bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vape Shop Owners/Managers’ Opinions About FDA Regulation of E-Cigarettes
Authors: Berg Carla J , Barker Dianne C , Sussman Steve , Getachew Betelihem , Pulvers Kim , Wagener Theodore L , Hayes Rashelle B , Henriksen Lisa 
Published: July 2020

Abstract

Introduction
In the United States, prominent sources of vaping products are specialty vape shops, which are subject to Food and Drug Administration (FDA) regulation. This study interviewed vape shop owners/managers to assess: (1) reasons for entering into or engaging in vape shop retail; (2) personnel training, particularly with regard to FDA and state regulations; and (3) how existing regulations are perceived and the anticipated impact of future regulation.

Aims and Methods
The current study involved phone–based semi-structured interviews of 45 vape shop owners/managers in six metropolitan statistical areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle) during Summer 2018 as FDA regulations regarding minimum age verification, bans on product sampling, and health warnings (among others) were first being implemented.

Results
Vape shop owners/managers reported: (1) entering the industry with positive intentions for their customers, (2) training their personnel to adhere to regulations and provide good customer service, and (3) significant concerns about the impact of FDA regulations. With regard to the latter, participants reported mistrust of the intentions of the FDA regulations, financial implications of the regulations (particularly for small businesses), difficulty understanding and interpreting the regulations, insufficient evidence to support the regulations, negative impact on customer service, negative impact on product offerings and product innovation/advancement, and negative implications of flavor bans and/or restrictions on sale of flavors.

Conclusions
These findings indicate the complexities in implementing tobacco regulations, particularly from the perspective of the vape shop industry. Current findings should inform future regulatory actions and efforts to assess compliance with regulations.

Implications
Current and impending FDA regulation of vaping products present a critical period for examining regulatory impact on the vape shop industry. Current results indicated that many vape shop owners/managers reporting positive intentions for engaging in the vaping product industry and in training vape shop personnel to adhere to regulations. However, the majority reported concerns about FDA regulation and other state/local regulations that could have negative implications for their industry. Particular concerns include difficulty understanding the regulations due to complexity, vagueness, and changes in language and/or interpretation over time. These issues have implications for compliance that must be addressed.
Cirq® Robotic Assistance for Minimally Invasive C1-C2 Posterior Instrumentation: Report on Feasibility and Safety
Authors: Farah Kaissar , Meyer Mikael , Prost Solene , Dufour Henry , Blondel Benjamin , Fuentes Stephane 
Published: July 2020

Abstract

BACKGROUND
Accurate screw placement remains very challenging especially in the upper cervical spine.

OBJECTIVE
To present our first experience of a percutaneous posterior C1-C2 fixation for a traumatic fracture.

METHODS
This is a case report of a non-neurological patient, harboring a type II odontoid fracture. She underwent a posterior percutaneous fixation using Cirq® Robotic Assistance coupled to the AIRO® intraoperative computed tomography (iCT)-scan and BrainLab® navigation system (all by BrainLab AG). Routine CT was performed on postoperative day 2 to evaluate pedicle screw placement. The effective dose was calculated.

RESULTS
The C1-C2 posterior percutaneous fixation was performed with cannulated VERTEX® Reconstruction System (Medtronic). Overall, 4 screws were placed. All of them were rated as acceptable (100%). Radiation dose received by the patient was 4.13 mSv. Radiation dose received by the surgical staff was 0 mSv. Postoperative course was excellent.

CONCLUSION
Posterior percutaneous fixation using Cirq® Robotic Assistance coupled with iCT navigation system is a major innovation that can improve pedicle screw positioning's accuracy with acceptable patient radiation and reduced surgical team exposure.
Intraoperative Neurophysiology for Optimization of Percutaneous Spinothalamic Cordotomy for Intractable Cancer Pain
Authors: Sapir Yechiam , Korn Akiva , Bitan-Talmor Yifat , Vendrov Irina , Berger Assaf , Shofty Ben , Zegerman Alexander , Strauss Ido 
Published: July 2020

Abstract

BACKGROUND
Percutaneous ablation of the cervical spinothalamic tract (STT) remains a therapeutic remedy for intractable cancer pain. However, it is accompanied by the risk of collateral damage to essential spinal cord circuitry, including the corticospinal tract (CST). Recent studies describe threshold-based mapping of the CST with the objective of motor bundle preservation during intramedullary spinal cord and supratentorial surgery.

OBJECTIVE
To assess the possibility that application of spinal cord mapping using intraoperative neuromonitoring in percutaneous cordotomy procedures may aid in minimizing iatrogenic motor tract injury.

METHODS
We retrospectively reviewed the files of 11 patients who underwent percutaneous cervical cordotomy for intractable oncological pain. We performed quantitative electromyogram (EMG) recordings to stimulation of the ablation needle prior to the STT-ablative stage. We compared evoked motor and sensory electrical thresholds, and the electrical span between them as a reliable method to confirm safe electrode location inside the STT.

RESULTS
Quantified EMG data were collected in 11 patients suffering from intractable cancer pain. The threshold range for evoking motor activity was 0.3 to 1.2 V. Stimulation artifacts were detected from trapezius muscles even at the lowest stimulation intensity, while thenar muscles were found to be maximally sensitive and specific. The minimal stimulation intensity difference between the motor and the sensory threshold, set as “Δ-threshold,” was 0.26 V, with no new motor deficit at 3 days or 1 month postoperatively.

CONCLUSION
Selective STT ablation is an effective procedure for treating intractable pain. It can be aided by quantitative evoked EMG recordings, with tailored parameters and thresholds.
Risk Factors for Wire Fracture or Tethering in Deep Brain Stimulation: A 15-Year Experience
Authors: Mackel Charles E , Papavassiliou Efstathios , Alterman Ron L 
Published: July 2020

Abstract

BACKGROUND
In deep brain stimulation (DBS), tunneled lead and extension wires connect the implantable pulse generator to the subcortical electrode, but circuit discontinuity and wire revision compromise a significant portion of treatments.

OBJECTIVE
To identify factors predisposing to fracture or tethering of the lead or extension wire in patients undergoing DBS.

METHOD
Retrospective review of wire-related complications was performed in a consecutive series of patients treated with DBS at a tertiary academic medical center over 15 yr.

RESULTS
A total of 275 patients had 513 extension wires implanted or revised. There were 258 extensions of 40 cm implanted with a postauricular connector (50.3%), 229 extensions of 60 cm with a parietal connector (44.6%), and 26 extensions 40 cm with a parietal connector (5.1%). In total, 26 lead or extension wires (5.1%) were replaced for fracture. Fracture rates for 60 cm extensions with a parietal connector, 40 cm wires with a postauricular connector, and 40 cm extensions with a parietal connector were 0.2, 1.4, and 12.9 fractures per 100 wire-years, significantly different on log-rank test. Total 16 (89%) 40 cm extension wires with a postauricular connector had fracture implicating the lead wire. Tethering occurred only in patients with 60 cm extensions with parietal connectors (1.14 tetherings per 100 wire-years). Reoperation rate correlated with younger age, dystonia, and target in the GPI.

CONCLUSION
The 40 cm extensions with parietal connectors have the highest fracture risk and should be avoided. Postauricular connectors risk lead wire fracture and should be employed cautiously. The 60 cm parietal wires may reduce fracture risk but increase tethering risk.
Massive star formation in the Carina nebula complex and Gum 31. I. the Carina nebula complex
Authors: Fujita Shinji , Sano Hidetoshi , Enokiya Rei , Hayashi Katsuhiro , Kohno Mikito , Tsuge Kisetsu , Tachihara Kengo , Nishimura Atsushi , Ohama Akio , Yamane Yumiko , Ohno Takahiro , Yamada Rin , Fukui Yasuo 
Published: July 2020

AbstractHerein, we present results from observations of the 12CO (J = 1–0), 13CO (J = 1–0), and 12CO (J = 2–1) emission lines toward the Carina nebula complex (CNC) obtained with the Mopra and NANTEN2 telescopes. We focused on massive-star-forming regions associated with the CNC including the three star clusters Tr 14, Tr 15, and Tr 16, and the isolated WR-star HD 92740. We found that the molecular clouds in the CNC are separated into mainly four clouds at velocities −27, −20, −14, and −8 km s−1. Their masses are 0.7 × 104 M⊙, 5.0 × 104 M⊙, 1.6 × 104 M⊙, and 0.7 × 104 M⊙, respectively. Most are likely associated with the star clusters, because of their high 12CO (J = 2–1)/12CO (J = 1–0) intensity ratios and their correspondence to the Spitzer 8 μm distributions. In addition, these clouds show the observational signatures of cloud–cloud collisions. In particular, there is a V-shaped structure in the position–velocity diagram and a complementary spatial distribution between the −20 km s−1 cloud and the −14 km s−1 cloud. Furthermore, we found that SiO emission, which is a tracer of a shocked molecular gas, is enhanced between the colliding clouds by using ALMA archive data. Based on these observational signatures, we propose a scenario wherein the formation of massive stars in the clusters was triggered by a collision between the two clouds. By using the path length of the collision and the assumed velocity separation, we estimate the timescale of the collision to be ∼1 Myr. This is comparable to the ages of the clusters estimated in previous studies.
Ethical Advice for an Intensive Care Triage Protocol in the COVID-19 Pandemic: Lessons Learned from The Netherlands
Authors: Verweij Marcel , van de Vathorst Suzanne , Schermer Maartje , Willems Dick , de Vries Martine 
Published: July 2020

Abstract
At the height of the COVID-19 crisis in the Netherlands a shortness of intensive care beds was looming. Dutch professional medical organizations asked a group of ethicists for assistance in drafting guidelines and criteria for selection of patients for intensive care (IC) treatment in case of absolute scarcity, when medical selection criteria would no longer suffice. This article describes the Dutch context, the process of drafting the advice and reflects on the role of ethicists and lessons learned. We argue that timely interaction between clinical and ethical expertise is necessary since the distinction between medical and non-medical considerations is not as clearcut as sometimes assumed. Furthermore, pragmatic considerations related to the specifics of an epidemic are of importance, for example, in relation to prioritizing health care workers. As a consequence, any protocol already present before the pandemic would need alterations to fit the current situation. The ‘fair innings’ criterion we proposed, rephrased as an argument of intergenerational solidarity, was considered reasonable by professionals as well as patient organizations. While it is desirable to draft ethical guidelines in ‘peacetime’ as a matter of pandemic preparedness, the pressure of an actual crisis facilitates decision-making, although it will also complicate a more democratic approach.
Transcranial Doppler Evaluation of the Cerebral Vasculature in Women Patients who Have Migraine with Aura
Authors: Petrušić Igor , Podgorac Ana , Radojičić Aleksandra , Zidverc-Trajković Jasna 
Published: July 2020

Abstract

Background
Previous studies suggest that increased cerebrovascular reactivity might be a feature of patients who have migraine with aura (MwA). The correlation between the clinical presentation of migraine with aura and transcranial Doppler parameters remains unclear.

Objective
The main aim of this study was to explore cerebral blood flow, vascular resistance, and cerebrovascular reactivity in women MwA. Also, the relationships between hemodynamic conditions and aura characteristics are examined.

Design
Cross-sectional study.

Setting
Headache Center, Neurology Clinic, Clinical Center of Serbia.

Subjects
Fifty-four women MwA and 49 healthy controls (HCs).

Methods
Transcranial Doppler sonography examination was used to determine blood flow mean velocity (MV) and pulsatility index (PI), as well as breath-holding index (BHI), in 15 arterial segments comprising the circle of Willis.

Results
A total of 54 women MwA and 49 HCs were studied. The PIs of all segments of the left and right middle cerebral arteries and the left and right anterior cerebral arteries were significantly higher in MwA with regards to HCs. Also, both the left and right BHIs were significantly higher in MwA than HCs. In addition, MVs of the right vertebral artery and the first segment of the basilar artery were significantly lower in MwA than HCs. Longer duration of migraine aura showed a weak negative correlation with the PI of the left posterior cerebral artery.

Conclusions
Our findings suggest increased vessel pulsatility, abnormal cerebrovascular reactivity, and decreased cerebral blood flow velocity in several arterial segments of the Willis circle in women MwA.
Identifying Multisite Chronic Pain with Electronic Health Records Data
Authors: Von Korff Michael , DeBar Lynn L , Deyo Richard A , Mayhew Meghan , Kerns Robert D , Goulet Joseph L , Brandt Cynthia 
Published: July 2020

Abstract

Background
Multisite chronic pain (MSCP) is associated with increased chronic pain impact, but methods for identifying MSCP for epidemiological research have not been evaluated.

Objective
We assessed the validity of identifying MSCP using electronic health care data compared with survey questionnaires.

Methods
Stratified random samples of adults served by Kaiser Permanente Northwest and Washington (N = 2,059) were drawn for a survey, oversampling persons with frequent use of health care for pain. MSCP and single-site chronic pain were identified by two methods, with electronic health care data and with self-report of common chronic pain conditions by survey questionnaire. Analyses were weighted to adjust for stratified sampling.

Results
MSCP was somewhat less common when ascertained by electronic health records (14.7% weighted prevalence) than by survey questionnaire (25.9% weighted prevalence). Agreement of the two MSCP classifications was low (kappa agreement statistic of 0.21). Ascertainment of MSCP with electronic health records was 30.9% sensitive, 91.0% specific, and had a positive predictive value of 54.5% relative to MSCP identified by self-report as the standard. After adjusting for age and gender, patients with MSCP identified by either electronic health records or self-report showed higher levels of pain-related disability, pain severity, depressive symptoms, and long-term opioid use than persons with single-site chronic pain identified by the same method.

Conclusions
Identification of MSCP with electronic health care data was insufficiently accurate to be used as a surrogate or screener for MSCP identified by self-report, but both methods identified persons with heightened chronic pain impact.
Potential role of hypovitaminosis D and vitamin D supplementation during COVID-19 pandemic
Authors: Verdoia M , De Luca G 
Published: July 2020

Summary
Vitamin D deficiency is a pandemic disorder affecting over 1 billion of subjects worldwide and displaying a broad spectrum of implications on cardiovascular and inflammatory disorders. Since the initial reports of the association between hypovitaminosis D and COVID-19, Vitamin D has been pointed as a potentially interesting treatment for SARS-CoV-2 infection. We provide an overview on the current status of vitamin D deficiency, the mechanisms of action of vitamin D and the current literature on the topic, with a special focus on the potential implications for COVID-19 pandemic.
The Racialized Glass Escalator and Safety Net: Wages and Job Quality in “Meds and Eds” among Working-Class Men
Authors: Dill Janette , Hodges Melissa J 
Published: July 2020

Abstract
Past research has shown that minority men are more likely than others to enter female-dominated occupations, but less is known about the quality of their jobs in these fields in contrast to other employment options. We use the 2004 and 2008 panels of the Survey of Income and Program Participation (SIPP) to examine whether the female-dominated industries of education and health care produce better job quality in terms of wages, benefits, hours, and job security for working-class men relative to other industries, with emphasis on differences by race-ethnicity. We find that although workers in the education and health care industries fared better during the Great Recession compared to those in other industries, effects for wages, health insurance, hours, and layoff for working-class Men of Color were substantially lower compared to those of White men. We find strong evidence of a racialized glass escalator, but also a racialized safety net in the care sector post-recession: the health care and education industries provide better job quality for White men than for Men of Color, though they are less likely to be in these jobs, and these sectors were more protective of White men as compared to minorities during the recession.
Dropout, response, and abstinence outcomes of a national text-messaging smoking cessation intervention for teens, SmokeFreeTeen
Authors: Chan Charmaine , Kamke Kristyn , Assuah Freda , El-Toukhy Sherine 
Published: July 2020

Abstract
Although text-messaging interventions are effective for smoking cessation, few target teens in the USA and little is known about their effectiveness. The purpose of this manuscript is to examine correlates of dropout, response to smoking status prompts, and abstinence rates among subscribers of SmokeFreeTeen, a free, publicly available text-messaging smoking cessation intervention sponsored by the National Cancer Institute’s SmokeFree.Gov initiative, on quit day through 1 month follow-up. In a sample of teens (N = 2,685), aged 13–19, we examined demographics, smoking frequency, cigarettes smoked per day, prequit intervention time (i.e., maximum of 14 days of prequit day preparation), and number of quit attempts as correlates of response and abstinence rates among program initiators (i.e., participants who reached quit day but dropped out on or before intervention end) and completers (i.e., participants who reached quit day and completed the intervention). We also conducted Cox regression analysis of time from quit day to dropout by daily and nondaily smoking status. Two-thirds (n = 1,733, 64.54%) dropped out before the intervention ended, with dropout rates peaking on quit day (n = 289, 13.10%). Response rate to smoking status prompts remained below 30% throughout the intervention. At intervention end and 1 month follow-up, abstinence was 2.63% and 2.55% among program initiators, whereas abstinence was 6.09% and 6.01% among program completers. Dropout, response, and abstinence rates did not consistently differ by subscriber characteristics. Prequit time was associated with decreased likelihood of dropping out (adjusted hazards ratio: 0.94, confidence interval [CI]: 0.93–0.95), responding to smoking status prompts (adjusted odds ratio [aOR]: 0.94, CI: 0.92–0.96), and being abstinent (aOR: 0.96, CI: 0.93–0.99) on quit day. Two or more quit attempts were associated with increased response (aOR: 1.61, CI: 1.16–2.23) and abstinence (aOR: 1.91, CI: 1.25–2.92) rates on Day 7. In a first assessment of SmokeFreeTeen outcomes, we document high dropouts and low response and abstinence rates. SmokeFreeTeen produced abstinence rates lower than comparable text-messaging interventions targeting teens and young adults. Improving SmokeFreeTeen’s reach, engagement, and effectiveness is needed.
Local public health officials and COVID-19: Evidence from China
Authors: Jiang John (Xuefeng) , Wang Maobin 
Published: July 2020

AbstractLocal public health authorities are at the forefront of fighting COVID-19. They monitor its spread in the local population and advise the local government on whether to close schools and businesses. Examining their role in battling COVID-19 will inform the public how best to prepare for a public health emergency. This study examined whether more competent local public health officials in China are more effective in fighting COVID-19, where competence was measured by the public health officials’ professional background. Only 38% of the heads of the public health departments of Chinese cities have a medical background. Cities with medical professionals as the head of public health departments had lower infection rates and death rates from COVID-19. The results were significant only at the start of the outbreak. Our results suggest that we should staff local public health authorities with competent professionals to better combat a pandemic.
A study of risk analysis and prognosis models for the mortality of sepsis based on real-world data in China
Authors: Lu Yu , Kong Qing , Li Jing , Jiang Tao , Tang Zihui 
Published: July 2020

AbstractBackgroundThe study aimed to explore the factors associated with the mortality of sepsis and to develop prognosis models for predicting outcomes based on real-world data in China. Methods: Data regarding sepsis patients’ medical records were extracted from the hospital information systems in four hospitals. The data included general information, laboratory tests, score systems, and supportive treatment for sepsis. In total, 507 medical records with complete data were available for data analysis. Multiple variable regression (MR) analysis used to explore associations, and to develop prognosis modelsResultsThe mortality of sepsis was 0.3124 in the total sample. A univariate analysis indicated 23 variables significantly associated with the mortality of sepsis (p <0.05 for all). The MLR analysis showed independent and significant variables of age, GCS, SOFA, shock, breath rate, TBIL, CHE, BUN, LAC, OI, HCO3-, IMV, and ALB (P <0.05 for all). Prognosis models have a high predictive performance (AUC = 0.885, 95% CI: 0.854–0.917 in model2). Conclusion: The study showed evidence of independent and significant factors associated with the mortality of sepsis, including age, GCS, SOFA, septic shock, breath rate, TBIL, CHE, BUN, LAC, OI, HCO3-, IMV, and ALB. Prognosis models with a high performance were developed. (Trial registration: ClinicalTrials.gov Identifier: NCTNCT03883061 retrospectively registered 19 Mar 2019.)