bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining Training Motivations Among Public Health Workers
Authors: Apathy Nate C. , Yeager Valerie A. 
Published: February 2019

Context:
As public health needs and priorities evolve, maintaining a trained public health workforce is critical to the success of public health efforts. Researchers have examined training needs in various contexts and subpopulations, but a nationally representative study of what motivates public health workers to seek out training has yet to be conducted. By understanding these motivations, public health agencies and policy makers can appeal to worker motivations in both training programs and organizational incentives.

Objective:
The purpose of this article was to describe overall training motivations and identify patterns of training motivations among public health workers. This study also explored whether or not training needs differ across prevalent motivational patterns.

Design and Participants:
Using data from the 2017 Public Health Workforce Interests and Needs Survey (PH WINS), the study used latent class analysis (LCA) to identify motivational patterns and logistic regression to analyze associations with training needs.

Results:
The most prominent motivation to seek training was personal growth (82.7% of respondents). LCA identified 4 motivational classes of public health workers: those motivated by organizational pressure and requirements (31.8%), those motivated indiscriminately by all factors (28.4%), those motivated primarily by personal growth (21.7%), and those motivated by organizational accommodations and supports (18.2%). Motivational class was not associated with indicating training needs in any of 8 training domains, nor was it associated with indicating any training need in any domain.

Conclusions:
Public health agencies should consider the different motivational classes present in the public health workforce. In particular, motivational classes that represent organizational choices suggest that public health agencies should both motivate workers with organizational requirements and pressure from managers and offer institutional support via paid travel and covered time for training.
Unleashing the Creativity and Innovation of Our Greatest Resource—The Governmental Public Health Workforce
Authors: Locke Rachel , Castrucci Brian C. , Gambatese Melissa , Sellers Katie , Fraser Michael 
Published: February 2019

Context:
Creativity and innovation in the governmental public health workforce will be required to generate new ideas to solve complex problems that extend beyond traditional public health functions such as disease surveillance and monitoring. Creativity and innovation can promote and advance necessary organizational transformation as well as improve organizational culture and workplace environment by motivating employees intrinsically. However, there is little empirical evidence on how rewarding creativity and innovation in governmental public health departments is associated with organizational culture and workplace environments.

Objective:
This study describes (1) the degree to which creativity and innovation are rewarded in governmental public health agencies and (2) associations between rewarding creativity and innovation and worker satisfaction, intent to leave, and workplace characteristics.

Design:
The cross-sectional Public Health Workforce Interests and Needs Survey (PH WINS) was administered using a Web-based platform in fall 2017.

Settings and Participants:
Data used for these analyses were drawn from the 2017 PH WINS of governmental health department employees. This included state health agency and local health department staff. PH WINS included responses from 47 604 staff members, which reflected a 48% overall response rate. PH WINS excludes local health departments with fewer than 25 staff or serving fewer than 25 000 people.

Results:
Fewer than half of all workers, regardless of demographic group and work setting, reported that creativity and innovation were rewarded in their workplace. Most measures of worker satisfaction and workplace environment were significantly more positive for those who reported that creativity and innovation were rewarded in their workplace.

Conclusion:
This research suggests that promoting creativity and innovation in governmental public health agencies not only could help lead the transformation of governmental public health agencies but could also improve worker satisfaction and the workplace environment in governmental public health agencies.
Major Depressive Disorder in Medical Illness: A Review of Assessment, Prevalence, and Treatment Options
Authors: Thom Robyn , Silbersweig David A. , Boland Robert J. 
Published: February 2019

ABSTRACT
Major depression, as well as other depressive disorders, is commonly comorbid with other medical illnesses, particularly chronic and systemic medical illnesses. The co-occurrence of the disorders is so common that it challenges our notions of the meaning of comorbidity and our desire to neatly separate psychiatric and medical illnesses. The overlap between symptoms of physical illness and the neurovegetative symptoms of major depression and the initial normative emotional response to physical illness add to the challenge of accurate diagnosis and timely treatment of depression in the medically ill. We review the literature on the comorbidity of depression and the various medical illnesses, including diagnostic and treatment approaches. The differential diagnosis for major depression among medically ill patients should include delirium and medication-induced symptoms. We suggest that major depression itself may be best conceptualized as a systemic illness whose pathophysiology overlaps with other systemic medical illnesses. The initial treatment strategies for major depression in medical illness are like those for the general population; however, the comorbid medical illnesses may interfere with remission. To illustrate these points, we describe a patient with clinical characteristics covered in this review who experienced major depression as well as several chronic illnesses, including hypersensitivity pneumonitis, multiple sclerosis, chronic pain due to degenerative joint disease, and diabetes mellitus.
Prevalence and Incidence of Rheumatoid Arthritis in Canadian First Nations and Non–First Nations People
Authors: Hitchon Carol A. , Khan Sazzadul , Elias Brenda , Lix Lisa M. , Peschken Christine A. 
Published: February 2019

Background
The aim of this study was to determine the prevalence, incidence, and onset age at rheumatoid arthritis (RA) diagnosis in First Nations (FN) and non-FN populations in Manitoba, Canada.

Methods
Population-based administrative health records from April 1, 1995, to March 31, 2010, were accessed for all Manitobans. The FN population was identified using the Federal Indian Registry File. Crude and adjusted RA prevalence and incidence rates (adjusted for age, sex, health region of residence) were compared using Poisson regression and reported as relative rates (RRs) with 95% confidence intervals (CIs). Mean (CI) diagnosis age and physician visits were compared with Student t tests.

Results
Rheumatoid arthritis crude prevalence increased between 2000 and 2010 to 0.65%; adjusted RA prevalence in females was 1.0% and in males was 0.53%. The 2009/2010 adjusted RA prevalence was higher in FN than non-FN (RR, 2.55; CI, 2.08–3.12) particularly for ages 29 to 48 years (RR, 4.52; CI, 2.71–7.56). Between 2000 and 2010, crude RA incidence decreased from 46.7/100,000 to 13.4/100,000. Adjusted RA incidence remained higher in FN than non-FN (2000–2010 RR, 2.1; CI, 1.7–2.6; p < 0.0001) particularly for ages 29 to 48 years (RR, 4.6; CI, 2.8–7.4; p < 0.0001). The FN population was younger at diagnosis than the non-FN population (mean age, 39.6 years [CI, 38.3–40.8 years] vs. 53.3 years [CI, 52.7–53.9 years]; p < 0.0001). The FN population had more physician visits but fewer rheumatology visits than the non-FN population.

Conclusions
Rheumatoid arthritis prevalence is increasing, and RA incidence is decreasing in Manitoba. The FN population has a greater prevalence and incidence of RA and is younger at diagnosis than the non-FN population. When combined with fewer rheumatology visits, this significant care gap highlights the need to optimize rheumatology care delivery to the FN population.
Acceleration of Double Inversion Recovery Sequences in Multiple Sclerosis With Compressed Sensing
Authors: Eichinger Paul , Hock Andreas , Schön Simon , Preibisch Christine , Kirschke Jan S. , Mühlau Mark , Zimmer Claus , Wiestler Benedikt 
Published: February 2019

Objective
The aim of this study was to assess the performance of double inversion recovery (DIR) sequences accelerated by compressed sensing (CS) in a clinical setting.

Materials and Methods
We included 106 patients with MS (62 female [58%]; mean age, 44.9 ± 11.0 years) in this prospective study. In addition to a full magnetic resonance imaging protocol including a conventional SENSE accelerated DIR, we acquired a CS DIR (time reduction, 51%). We generated subtraction maps between the two DIR sequences to visualize focal intensity differences. Two neuroradiologists independently assessed these maps for intensity differences, which were categorized into definite MS lesions, possible lesions, or definite artifacts. Counts of focal intensity differences were compared using a Wilcoxon rank sum test. Moreover, conventional lesion counts were acquired for both sequences in independent readouts, and agreement between the DIR variants was assessed with intraclass correlation coefficients.

Results
No hyperintensity that was rated as definite lesion was missed in the CS DIR. Two possible lesions were only detected in the conventional DIR, one only in the CS DIR (no significant difference, P = 0.57). The conventional DIR showed significantly more definite artifacts within the white matter (P = 0.024) and highly significantly more at the cortical-sulcal interface (P < 0.001). For both readers, intraclass correlation coefficient between the lesion counts in the two DIR variants was near perfect (0.985 for reader 1 and 0.981 for reader 2).

Conclusions
Compressed sensing can be used to substantially reduce scan time of DIR sequences without compromising diagnostic quality. Moreover, the CS accelerated DIR proved to be significantly less prone to imaging artifacts.
Predicting Response to Immunotherapy by Evaluating Tumors, Lymphoid Cell-Rich Organs, and Immune-Related Adverse Events Using FDG-PET/CT
Authors: Nobashi Tomomi , Baratto Lucia , Reddy Sunil A. , Srinivas Sandhya , Toriihara Akira , Hatami Negin , Yohannan Thomas K. , Mittra Erik 
Published: February 2019

Purpose
To investigate whether the evaluation of tumors, lymphoid cell-rich organs, and immune-related adverse events (IRAE) with 18F-FDG PET/CT can predict the efficacy and outcome of immunotherapy.

Methods
Forty patients who underwent 18F-FDG-PET/CT scans before and after therapy with immune checkpoint inhibitors from December 2013 to December 2016 were retrospectively enrolled (malignant melanoma, n = 21; malignant lymphoma, n = 11; renal cell carcinoma, n = 8). SUVmax of the baseline and first restaging scans were evaluated in tumors, spleen, bone marrow, thyroid and pituitary glands, and were correlated to best overall response in the first year after therapy; IRAE-affected areas were also evaluated.

Results
Interval change between the baseline and first restaging scans showed that patients with a clinical benefit had a significant decrease in tumor parameters (P < 0.001). All patients with an increase of SUVmax in the thyroid of more than 1.5 (n = 5) on the first restaging scan had a complete response (CR) in 1 year. Patients with CR within 1 year (n = 22) were significantly associated with a favorable long-term outcome (P = 0.002). Nine patients with IRAE findings had CR at final evaluation. Among IRAE, thyroiditis was seen significantly earlier than arthritis (P = 0.040).

Conclusions
The decrease of tumor parameters at early time-point PET scans was seen in patients with immunotherapy who had clinical benefit within 1 year. PET-detectable IRAE was useful for prediction of a favorable outcome. Early development of thyroiditis may particularly represent an early response indicator to immunotherapy.
Pattern of FDG and MET Distribution in High- and Low-Grade Gliomas on PET Images
Authors: Takahashi Miwako , Soma Tsutomu , Mukasa Akitake , Tanaka Shota , Yanagisawa Shunsuke , Momose Toshimitsu 
Published: February 2019

Purpose of the Report
This study aimed to determine the most effective metabolic index of FDG-PET and MET-PET to differentiate high- and low-grade gliomas, and then to characterize tumor metabolism according to the 2016 WHO classification. We also developed a new calculation method of potential infiltrative tumor volume to overcome the current limitations of tumor evaluation according to metabolic index, which focuses solely on tumor core area.

Materials and Methods
Patients who underwent both FDG-PET and MET-PET, as well as surgical treatment, were retrospectively identified. All tumors were diagnosed histologically and included 44 high-grade and 19 low-grade gliomas. Metabolic indices of tumor-to-normal (T/N) ratio and maximum value within the tumor itself were compared between high- and low-grade tumors. A calculation method for potential infiltrative tumor volume was developed and compared between these 2 grades.

Results
T/N, calculated as tumor value divided by normal cortex value, was the most effective (area under the curve, 0.800 for FDG-PET; area under the curve, 0.773 for MET-PET) for differentiating high- and low-grade gliomas. Potential infiltrative volume effectively distinguished between high- and low-grade glioma (43.8 ± 30.2 mL vs 14.0 ± 12.6 mL; P = 0.005 [t test]). A combination of T/N, with a cutoff value of 0.9 or higher on FDG-PET and/or 3.0 or higher on MET-PET, and potential infiltrative volume, with a cutoff value of 20.0 mL or higher, provided a diagnostic accuracy of 89% in distinguishing high- from low-grade gliomas.

Conclusions
Evaluation of potential infiltrative volume surrounding the tumor core area, in addition to the T/N ratio of the tumor core, may help distinguish between high- and low-grade gliomas.
Tumor Identification of Less Aggressive or Indolent Lymphoma With Whole-Body 11C-Acetate PET/CT
Authors: Tsuchiya Junichi , Yamamoto Masahide , Bae Hyeyeol , Oshima Takumi , Yoneyama Tomohiro , Miura Osamu , Tateishi Ukihide 
Published: February 2019

Purpose
The aim of this study was to investigate the diagnostic performance of whole-body [11C]acetate PET/CT in less aggressive or indolent lymphomas, wherein [18F]FDG PET/CT would exhibit limited sensitivity.

Methods
Between September 2016 and May 2018, we prospectively evaluated 17 patients (9 men, 8 women; mean age [range], 71 [45–87] years) with pathologically proven less aggressive or indolent lymphomas according to Non-Hodgkin's Lymphoma Classification Project, using both [18F]FDG PET/CT and [11C]acetate PET/CT (performed on the same day). Detected nodal lesions were recorded according to the Ann Arbor classification. Extranodal (EN) lesions were also evaluated. We compared whole-body lesion detection between [18F] FDG PET/CT and [11C]acetate PET/CT using the McNemar test.

Results
In all patients, significantly more nodal and EN lesions were detected using [11C]acetate PET/CT than [18F]FDG PET/CT (nodal: 84 vs 64 regions; P < 0.001; EN: 26 vs 19 regions, P = 0.039). Bone lesions were detected in 8 and 5 patients using [11C]acetate PET/CT and [18F]FDG PET/CT, respectively (P = 0.25). Among the 14 patients (82.4%) who underwent bone marrow biopsy, bone marrow involvement was detected with sensitivities of 100% (6/6 patients) and 80% (5/6 patients) using [11C]acetate PET/CT and [18F]FDG PET/CT, respectively. Multiple areas of focal uptake in the spleen of 1 patient were exhibited on [18F]FDG PET/CT but not [11C]acetate PET/CT.

Conclusions
[11C]acetate PET/CT exhibited greater sensitivity than [18F]FDG PET/CT for lesion detection in patients with less aggressive or indolent lymphomas, thus promising applicability as a physiological tracer in the study of such lesions.
Effect of Sentinel Node Biopsy in Clinically N0, BRAF V600E–Mutated, Small Papillary Thyroid Carcinoma
Authors: Puccini Marco , Manca Gianpiero , Neri Carlo Maria , Boni Giuseppe , Coli Virginia , Garau Ludovico Maria , Colletti Patrick M. , Rubello Domenico , Buccianti Piero 
Published: February 2019

Purpose
BRAF V600E mutation papillary thyroid cancer (PTC) is more aggressive with a higher risk of lymph node involvement and a poorer prognosis. Prior studies failed to demonstrate the superiority of prophylactic lymphadenectomy. We investigated the utility of additional radio-guided sentinel node biopsy (SNB).

Methods
We analyzed 15 patients with N0 PTC by ultrasound and BRAF mutation on preoperative biopsy treated with total thyroidectomy (TT) or TT + prophylactic central neck dissection (PCND) alone or with SNB. Conventional surgery was performed before SNB. We recorded primary tumor diameter, multifocality, extrathyroid infiltration, neoplastic emboli, and tall cell variant. At follow-up, we evaluated basal and stimulated thyroglobulin and ultrasound or radioiodine scintigraphy.

Results
Of 15 consecutive patients, 5 received conventional surgery alone, and 10 had SNB. For the first group, 4 underwent TT, and 1 had TT + PCND. Among the SNB group, 1 had no sentinel node detected and underwent a simple TT, 2 had TT + PCND+ SNB in the lateral compartment, and 7 had TT + SNB in 1 to 3 neck compartments. Micrometastases were found in 1 of 3 PCND specimens. Sentinel node biopsy revealed metastasis in 3 of 6 central compartment biopsies, in 2 of 6 biopsies in the ipsilateral lateral compartment, and in none of 2 biopsies in the contralateral compartment. Sentinel node biopsy allowed the removal of micrometastases in 4 of 10 patients. At 53 months' (mean) follow-up, no relapse was documented.

Conclusions
Radio-guided SNB correctly and efficiently stages cN0 BRAF–mutated PTC patients. Sentinel node biopsy could limit time-consuming, risk-exposing compartmental prophylactic dissections.
Hepatocellular Carcinoma Mimicking Neuroendocrine Tumor Metastasis on 68Ga-DOTATATE PET/CT
Authors: Ulaner Gary A. , Bodei Lisa 
Published: February 2019

Abstract

68Ga-DOTATATE is a radiolabeled somatostatin analog used for the detection and characterization of somatostatin receptor (SSR)–overexpressing tumors, particularly well-differentiated neuroendocrine tumors. We present a case of a 65-year-old man with well-differentiated pancreatic neuroendocrine tumor post–Whipple surgery and a new liver lesion on CT. 68Ga-DOTATATE PET/CT was performed for SSR characterization and restaging, which demonstrated the lesion to be intensely SSR positive and interpreted as a neuroendocrine metastasis. However, subsequent pathology proved the lesion to be a hepatocellular carcinoma. This case adds hepatocellular carcinoma as a potentially DOTATATE-avid malignancy to be considered in the differential diagnoses of SSR-positive liver lesions.
Primary Pulmonary Paraganglioma Revealed by FDG PET/CT
Authors: Shen Guohua , Su Minggang , Kuang Anren 
Published: February 2019

Abstract
Primary pulmonary paraganglioma is a rare type of extra-adrenal paragangliomas arising from neuroectodermal-derived paraganglionic tissue. We report herein the case of a 49-year-old woman with a round-like well-defined nodule in the right middle lobe detected by chest CT. FDG PET/CT also revealed this homogeneous nodule with increased FDG accumulation. Finally, the patient underwent right middle lobe resection, and the pathological findings demonstrated the diagnosis of pulmonary paraganglioma.
Resolution of Hypoxic Tissue in Cerebellar Hemispheres After Arterial Bypass Surgery in a Patient With Symptomatic Bilateral Vertebral Artery Occlusion
Authors: Oikawa Kohki , Kobayashi Masakazu , Beppu Takaaki , Terasaki Kazunori , Ogasawara Kuniaki 
Published: February 2019

Abstract
A 48-year-old man experienced recurrent vertigo refractory to antiplatelet medications. Cerebral angiography showed occlusion of bilateral vertebral arteries with poor collateral circulation. PET using 15O2 gas showed reduced blood flow and metabolic rate of oxygen and elevated oxygen extraction fraction in bilateral cerebellar hemispheres. Subsequent 18F-FRP170 (1-(2-18F-fluoro-1-[hydroxymethyl]ethoxy)methyl-2-nitroimidazole) PET, which depicts hypoxic but viable tissue, revealed elevated tracer uptake in the same regions. After superficial temporal artery-posterior cerebral artery anastomosis, 15O-gas PET showed normalization of blood flow, metabolic rate of oxygen, and oxygen extraction fraction in bilateral cerebellar hemispheres. Abnormally elevated 18F-FRP-170 uptake was also resolved in those regions.
Acral Involvement of Lymphoblastic Lymphoma Revealed on FDG PET/CT
Authors: Wen Zhe , Zhuang Hongming 
Published: February 2019

Abstract
Lymphoma rarely involves hand or foot. We presented the FDG PET/CT findings of lymphoblastic lymphoma in a 28-year-old man who had recurrent disease in many bones, including those of the hand and foot without any lymph node involvement 17 years after initial diagnosis.
68Ga-PSMA Uptake in Prostate Cancer Sciatic Nerve Metastasis
Authors: Gouveia Patrícia Barros , Violante Liliana Catarina Sobral , Teixeira Ricardo Jorge Valpaços , da Silva Trindade Duarte Luís Hugo 
Published: February 2019

Abstract
Most prostate cancers spread to regional lymph nodes, axial skeleton and lungs. Perineural malignant involvement is very rare. We present a 68Ga-PSMA PET/CT image of a sciatic nerve metastasis in a 65-year-old man with recurrent prostate cancer.
Facial Resurfacing With Prefabricated Induced Expanded Skin Flap
Authors: Yang Da-Ping , Zhang Pan 
Published: February 2019

Abstract
Massive facial damages extremely affect the facial appearance and function. In existing publications, the surgical flap transfer was still prior to other methods in repairing the facial injury. Among them, the prefabricated induced expanded skin flap seems more effective based on the facial specific features and damage range. In this study, a literature research was carried out in the database of PubMed. A total of 85 patients were included and all of them underwent the method of prefabricated expanded flap to reconstruct the massive facial defects. The prefabricated induced expanded skin flaps harvested from the neck and chest area have prominent advantage in resetting massive facial deformities. All the flaps survived demonstrated an excellent texture and color match with the facial defects areas. However, the unsolved problems are still existed in these flaps and further research is necessary to obtain a satisfactory outcome for both patients and surgeons.
Fat Grafting in the Management of War Injuries
Authors: Mazzola Riccardo F. , Mazzola Isabella C. 
Published: February 2019

Abstract
The healing potential of fat grafting was empirically noted by the surgeons who were confronted with the dramatic facial disfigurements resulting from World War 1. Fat was transplanted into the wounds either en bloc or in parcels to promote the healing capacity or to correct the uneven, depressed scars from gunshot wounds, enabling the poor soldiers to step back to society and families in a shorter period of time.
The idea of transplanting fat into the wound of the facially disfigured started with Hippolyte Morestin (1869–1919), surgeon in chief at Val-de Grace Military Hospital in Paris and was widely adopted by HD Gillies (1882–1960), Erich Lexer (1867–1937), Gustavo Sanvenero Rosselli (1897–1974), and others, achieving amazing results. Successful treatment of facially injured individuals showed the importance of plastic surgical procedures, the social role of the discipline, basis for obtaining the official recognition as surgical specialty.