bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurotrauma From Border Wall Jumping: 6 Years at the Mexican–American Border Wall
Authors: Ramey Wyatt L , Walter Christina M , Zeller Jeffrey , Dumont Travis M , Lemole G Michael , Hurlbert R John 
Published: January 2019

Abstract

BACKGROUND
The border between the United States (US) and Mexico is an international boundary spanning 3000 km, where unauthorized crossings occur regularly. We examine patterns of neurotrauma, health care utilization, and financial costs at our level 1 trauma center incurred by patients from wall-jumping into the US.

OBJECTIVE
To determine the clinical and socioeconomic consequences from neurotrauma as a result of jumping over the US–Mexico border wall.

METHODS
Medical records of patients at (Banner University of Arizona Medical Center - Tucson) were retrospectively reviewed from January 2012 through December 2017. Demographics, clinical status, radiographic findings, treatment, length of stay, and financial data were analyzed for all patients suffering neurotrauma during that time.

RESULTS
Over 6 yr, 64 patients sustained cranial or spinal injuries directly from jumping or falling onto US soil from the border wall. Fifty (78%) suffered spinal injuries, 15 (23%) experienced cranial injury, and 1 patient had both. Total medical charges were available in 36 patients and summed $3.6 M, of which 22% was reimbursed, an amount significantly lower than expected from more conventional trauma. Neurotrauma steadily declined over the 6-yr observation period, dropping in 2017 to 6% of rates observed in 2012.

CONCLUSION
In the Southern US, neurotrauma from unauthorized border crossings occurs commonly as a result of wall-jumping. These injuries represent a clinical and costly extreme of border-related trauma, and future efforts from both sides of the border wall are needed to decrease the detrimental impacts felt both by immigrants and surrounding health care systems.
Can Removing Tar Information From Cigarette Packages Reduce Smokers’ Misconceptions About Low-Tar Cigarettes? An Experiment From One of the World’s Lowest Tar Yield Markets, South Korea
Authors: Paek Hye-Jin , Dewhirst Timothy , Hove Thomas 
Published: January 2019

AbstractIntroductionDespite regulations that forbid cigarette packages from displaying messages such as “mild,” “low-tar,” and “light,” many smokers still have misperceptions about “light” or “low-tar” cigarettes. One reason may be that tar amount displays continue to be permitted. This study examines whether removing tar delivery information from packaging reduces consumer misperceptions about “low-tar” cigarettes.MethodsAn online experiment was conducted in South Korea among 531 smokers who were randomly assigned to one of two conditions: with and without tar information on cigarette packages. Participants evaluated which type of cigarette was mildest, least harmful, easiest for nonsmokers to start smoking, and easiest for smokers to quit.ResultsTen out of 12 chi-square tests showed that people judged the lowest reported tar delivery cigarette to be the mildest (p &lt; .01), least harmful (p &lt; .05), easiest to start (p &lt; .05), and easiest to quit (p &lt; .05)—less so in the “no-tar” condition than the “tar” condition. A higher level of misbeliefs about supposed low-tar cigarettes were found in the “tar” condition compared to the “no-tar” condition for all three brands (t = 5.85, 4.07, 3.82, respectively, p &lt; .001). Regression analyses showed that the “no-tar” condition negatively predicted the level of misbeliefs after controlling for demographic and smoking-related variables (B [SE] = −.72 (.12), −.50 (.12), −.48 (.13), respectively, p &lt; .001).ConclusionsBanning reported tar deliveries from cigarette packages is likely to reduce smokers’ misconceptions about “low-tar” cigarettes. When reported tar deliveries are absent, smokers have inconsistent judgments about differently packaged cigarettes.ImplicationsWhen cigarette packages depict lower reported tar number deliveries, participants erroneously perceive them to be less harmful than packages displaying higher tar numbers. These misperceptions of harm may prompt smokers who might otherwise attempt to quit smoking to instead consume cigarettes with lower tar deliveries due to the mistaken belief that they will reduce their risk.
Gap Analysis to Identify Clinical Education Needs of Aeromedical Evacuation Clinicians
Authors: De Jong Marla J. , Dukes Susan F. , Losekamp Tiffany 
Published: January 2019

Background
The Air Force has unique challenges in ensuring clinical proficiency for en route care clinicians. These challenges pertain to existing care environments, training opportunities, and the spectrum of training needed to care for patients with polytrauma and complicated medical conditions while being transported between medical treatment facilities.

Objective
The purpose of this study was to identify the clinical education needs of students entering the United States Air Force School of Aerospace Medicine Flight Nurse (FN) or Aeromedical Evacuation Technician (AET) course and Air Force FNs and AETs assigned to active duty aeromedical evacuation units.

Method
We recruited 198 students enrolled in the FN or AET course and 103 active duty FN and AET aircrew members and conducted a gap analysis to identify the clinical education needs of Air Force FNs and AETs.

Results
Training gaps were identified for active duty Air Force, Air Force Reserve, and Air National Guard FNs and AETs. The greatest learning needs included use of the portable therapeutic liquid oxygen unit, manual resuscitators, and negative pressure wound therapy systems, and care of special populations such as patients with a burn injury or mental health disorder.

Conclusions
Results of the gap analysis can be used to select and develop educational and simulation training scenarios designed to foster clinical competence.
Effectiveness comparisons of acupuncture for premature ejaculation
Authors: Dai Hengheng , Li Haisong , Wang Jisheng , Bao Binghao , Yan Yubing , Wang Bin , Sun Song 
Published: January 2019

Abstract

Background:
As one of the common male sexual dysfunction diseases, the treatment effect of premature ejaculation is often difficult to guarantee. In China, there are many randomized clinical trials that confirm that acupuncture has a good therapeutic effect on premature ejaculation. The aim of this study was to compare the efficacy and safety of acupuncture for premature ejaculation from intravaginal ejaculation latency (IELT), premature ejaculation diagnostic tool (PEDT), Arab premature ejaculation index (AIPE), and premature ejaculation index (IPE).

Methods:
We will use PubMed, EMBASE, Nursing and Related Health Literature Cumulative Index, Joint and Supplemental Drug Database, Cochrane Center Controlled Trials Registry (CENTRAL), China Biomedical Literature Database (CBM) and China Knowledge Infrastructure (CNKI), The Chinese Science and Technology Periodical Database (VIP), and Wanfang Database conduct systematic searches until October 31, 2018. At the same time, manually search for gray documents, including unpublished meeting articles. The primary outcome included intravaginal ejaculation latency (IELT). Secondary outcomes were premature ejaculation diagnostic tools (PEDT), Arab premature ejaculation index (AIPE), and premature ejaculation index (IPE). The quality and evidence that the risk of inclusion of the BiB tool will be assessed will be assessed on a scale.

Results:
This study will generate a comprehensive review of current evidence of acupuncture for premature ejaculation.

Conclusion:
The study will provide updated evidence to evaluate the efficacy and safety of acupuncture for premature ejaculation.

Ethics and Communication:
Because this research is based on a meta-analysis of published research, ethical recognition and patient consent are unnecessary.

Agreement registration number:
PROSPERO CRD42018111661.
Mobile thoracic schwannoma combined with intraosseous schwannomas
Authors: Jia Shunjie , Zheng Wenbiao , Ruan Jianwei , Chen Tao , Huang Yang , Guan Junhui 
Published: January 2019

Abstract

Rationale:
Mobile schwannomas have been rarely reported in the lumbar and thoracic spine. These entities are usually intradural extramedullary involving less than 3 vertebrae. Here, we present a rare case of thoracic schwannoma moving over 4 vertebral levels from the primary site combined with intraosseous schwannomas.

Patient concerns:
A 64-year-old woman presented with back pain for several months.

Diagnoses:
Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) showed 2 intraosseous tumors at the T7 and T8 levels and an intradural extramedullary tumor at the T5-6 levels.

Interventions:
The patient underwent a surgical resection of the intraosseous tumors at the T7 and T8 levels, and the tumor at the T5-6 levels was not found. Postoperative MRI showed that the intradural extramedullary tumor had moved to the T3-4 levels. Subsequently, the patient developed gait disturbance and numbness on bilateral lower limbs. During the second operation, we found the tumor at the T1-2 levels. Eventually, the tumor was completely removed.

Outcomes:
Histopathological examination showed schwannomas. After a 3-month follow-up, the symptoms were significantly relieved, and there was no clinical or radiological recurrence.

Lessons:
The clinicians should be aware of the coincidence of intraosseous schwannomas and mobile schwannoma. Careful preoperative MRIs are essential for early diagnosis of mobile tumors. Intraoperative localization of the mobile tumor is imperative to prevent unnecessary laminotomy.
Compound heterozygous mutations in PARK2 causing early-onset Parkinson disease
Authors: Fang Yu-Qing , Mao Fei , Zhu Mei-Jia , Li Xiu-Hua 
Published: January 2019

Abstract

Rationale:
Parkinson disease (PD) is a complex neurodegenerative movement disorder characterized by resting tremor, muscular rigidity, bradykinesia, and so on. Genetics has been regarded as an important role in the development of PD. PARK2, an autosomal recessive gene, is the most common one referring to early-onset Parkinson disease (EOPD). Strangely, only a single heterozygous mutation in PARK2 was found in a small minority of patients with PD, which has been reported quite rarely and is difficult to explain.

Patient concerns:
We described a case of 36-year-old male patient, complaining of progressive tremor for 10 years. He 1st presented uncontrolled resting tremor of his left arm. Besides, he also had trouble in completing fine motor tasks such as writing and buttoning. Six years later, tremor of the ipsilateral leg gradually occurred. On neurologic examinations, pronounced parkinsonian symptoms were noted, including resting tremor, body bradykinesia, and hypomimia. The positron emission tomography-computed tomography showed the distribution of dopamine transporter in both putamens decreased obviously. No family history was indentified. He came to hospital because his disease aggravated in the past 4 months.

Diagnosis:
This patient was diagnosed with PD according to the movement disorder society clinical diagnostic criteria for PD.

Interventions and outcomes:
With regard to the sequencing of this patient, a heterozygous point mutation of G403C in PARK2 was detected, which was inherited from his unaffected mother, leading to an amino acid alternation of glycine to arginine. Furthermore, deletion mutation of exon 6 in PARK2 was also found in this patient, which was inherited from his normal father. He accepted madopar and benzhexol and showed stable efficacy. To our knowledge, it is the 1st case report to explain the synergistic action of both heterozygous pathogenic point mutation in PARK2 and deletion mutation of exon 6 leading to EOPD.

Lessons:
Compound heterozygous mutations in PARK2 with point mutation of G403C and deletion mutation of exon 6 might contribute to the development of EOPD.
High preoperative C-reactive protein level is a risk factor for acute exacerbation of interstitial lung disease after non-pulmonary surgery
Authors: Takao Shun , Masuda Takeshi , Yamaguchi Kakuhiro , Sakamoto Shinjiro , Horimasu Yasushi , Nakashima Taku , Miyamoto Shintaro , Iwamoto Hiroshi , Fujitaka Kazunori , Hamada Hironobu , Hattori Noboru 
Published: January 2019

Abstract
Several studies have investigated the incidence of and risk factors for acute exacerbation (AE) in patients with interstitial lung disease (ILD) after lung resection surgery. However, the incidence and risk factors for AE-ILD after non-pulmonary surgery are not known. The aim of this study was to investigate the incidence of and risk factors for AE-ILD after non-pulmonary surgery.
Eighty patients who were diagnosed with ILD on preoperative chest computed tomography (CT) imaging and underwent non-pulmonary surgery under general anesthesia at Hiroshima University Hospital between September 2011 and September 2017 were enrolled. We retrospectively compared the preoperative patient characteristics, laboratory findings, and factors associated with anesthetic management between the patients who developed AE-ILD and those who did not.
The incidence of AE-ILD after non-pulmonary surgery was 6.3% and the mortality rate was 80%. Univariate logistic analysis showed that a usual interstitial pneumonia pattern on computed tomography, a high C-reactive protein (CRP) level, a long operating time, high blood loss, and blood transfusion during surgery were significant risk factors for AE-ILD. In multivariate analysis, only a high CRP level (odds ratio 2.556, 95% confidence interval 1.110–5.889, P = .028) was identified as an independent risk factor for AE-ILD after non-pulmonary surgery.
The risk of AE-ILD should be kept in mind in patients with ILD and a high CRP level before non-pulmonary surgery. These patients should also be monitored carefully for development of AE-ILD after surgery.
Atypical teratoid rhabdoid tumor mimicking type II neurofibromatosis
Authors: Shen Zhipeng , Wang Ning , Shi Wujie , Zhang Peiliang , Weng Jianbin , Zeng Hanhai 
Published: January 2019

Abstract

Rationale:
Brain magnetic resonance imaging (MRI) images of atypical teratoid rhabdoid tumor (ATRT) often present heterogeneous signals of various cells without remarkable features of the disease. We describe a unique case of atypical brain MRI images presenting as an type II neurofibromatosis and explore some diagnostic hints.

Patient concerns:
A 1-year-and-7-month-old boy admitted to our department with a 7-day history of drowsiness and 2-day history of emesis, and his presenting complaint was repeated vomit. On physical examination, he had drowsiness, positive sun set sign, slow light reflection, high muscular tension of limbs and 55 cm head circumference. MRI presented masses of bilateral auditory nerve distribution area, the fourth ventricle and right frontal lobe, obstructive hydrocephalus, and amplified cisterna magna. Particularly, dumbbell shape tumor in left cerebellopontine angle area and the fourth ventricle showed iso- or hypo-intensity on T1-weighted image and mix-intensity on T2-weighted image with irregular frontier, obvious mutual high and low signal on T2-weighted image, and growing along cerebrospinal fluid pathway.

Diagnosis:
The diagnosis of type II neurofibromatosis (NF-II) was considered pre-operatively. After surgery, postoperative histopathology confirmed the diagnosis of ATRT.

Interventions:
After ventriculo-peritoneal (VP) shunt, no evidence of tumor was inspected in cerebrospinal fluid, and enhancement MRI showed heterogeneous contrast signal on dumbbell shape tumor. We executed an incomplete microsurgery for dumbbell shape lesion in left auditory nerve distribution area and the fourth ventricle for differential diagnosis and facilitating further treatment.

Outcomes:
The patient did not recover well postoperatively and suffered from severe pulmonary infection. Refusing further intervention in view of poor prognosis of ATRT, the patient was transferred to another hospital for rehabilitation care. The patient died from progressive tumor and respiratory failure after 2 months.

Lessons:
The diagnosis of ATRT can be challenging, in our case due to the disturbance of bilateral auditory nerve distribution area tumors. Under MRI, Irregular frontier, obvious mutual high and low signal on T2-weighted image, growing along cerebrospinal fluid pathway, and heterogeneous contrast enhancement should lead the clinician to strongly consider ATRT.
Does pre-scanning training improve the image quality of children receiving magnetic resonance imaging?
Authors: Li Jie , Li Qiancheng , Dai Xiuhong , Li Jiong , Zhang Xinxian 
Published: January 2019

Abstract

Background:
Magnetic resonance imaging (MRI) is often used in children for its clear display of body parts. But it is usually hard to acquire high-quality images, for the uncooperative ability of children. It is believed that pre-MRI training could ensure the high quality of images. The current meta-analysis was done to analyze the current evidences in this field.

Methods:
PubMed, Cochrane Library, and Web of Science were systematically searched up to July 2018, for studies assessing the effects of training on pediatric MRI. Data, including image quality, failed scanning rate, and sedation use, were extracted and analyzed using Revman 5.2 software.

Results:
There were 5 studies with 379 subjects in the meta-analysis. Training and control groups were quite comparable when accepted image quality was reviewed (P = .30), but a lower rate of excellent image quality was found in subjects with training (P = .02). The pooling results found no significance between training and control group in sedation use (P = .09) and successful MRI scanning (P = .63).

Conclusions:
It is cautious to conclude that pre-MRI training does not improve the image quality and reduce sedation use among children, for the limited number of studies and sample size. More trials should be encouraged to demonstrate this issue.
Provider Prediction of Disposition for Children With an Acute Exacerbation of Asthma Presenting to the Pediatric Emergency Department
Authors: Caperell Kerry , Pettigrew Justen , Gerughty Andrew , Stevenson Michelle 
Published: January 2019

Objective
The aim of this study was to evaluate the accuracy of the initial impression of emergency department providers on the disposition of children with asthma exacerbation.

Methods
We conducted a prospective survey of physicians and other providers in the emergency department of a children's hospital and parents of children presenting with asthma exacerbation. The treating provider completed a survey after finishing the examination and immediately upon exiting the patient's room. Providers predicted the disposition of the child. Additionally, the providers indicated the likelihood of admission using several 10-cm visual analog scales (VASs). Physician accuracy was calculated, and logistic regression models and receiver operator characteristic curves were generated.

Results
Complete data were available for 177 subjects. Medical doctors/nurse practitioners made correct predictions in 129 (79.6%; 95% confidence interval [CI], 73.4–85.8) of 162 encounters. Respiratory therapists were correct in 69 (67.6%; 95% CI, 58.6%–76.7%) of 102 encounters, and parents were correct in 116 (67.4%; 95% CI, 60.4%–74.4%) of 172 encounters. Logistic regression with disposition as the dependent variable revealed that provider VAS for likelihood of admission (odds ratio, 23.717; 95% CI, 9.298–60.495) was associated with admission. A receiver operator characteristic curve generated for actual disposition versus “likelihood of admission” VAS had an area under the curve of 0.856 (95% CI, 0.793–0.919). For admission, a VAS of greater than 7 was 89.9% specific, greater than 7.6 was 92.9% specific, and greater than 8.6 was 96% specific.

Conclusions
Emergency department providers correctly predicted disposition 80% of the time. Providers were particularly likely to correctly predict admission. A VAS score of 7 or greater is nearly 90% specific for admission, with specificity increasing at higher values.
A Finding of Hepatic Abscess in a Teenager Presenting With Abdominal Pain
Authors: Hoffman Jenna W. , Ranasuriya Dunisha 
Published: January 2019

Abstract
Pyogenic hepatic abscess is a rare infection, but it is an important diagnosis to consider because the current mortality is approximately 5%. We present a case of abdominal pain in a 16-year-old male patient whose presentation was initially concerning for appendicitis but was later diagnosed as having a pyogenic hepatic abscess. It is important to direct the patient to the proper treatment including source control with drainage and antibiotics to decrease morbidity and mortality.
Characteristics of Successful Transitions From Inpatient to Outpatient Electroconvulsive Therapy
Authors: LAPID MARIA I. , MCNALLY FORSYTH DIANE , HEGARD TERESA L. , JAZDZEWSKI EMILY A. , CLOBES JANE E. , RYAN DEBRA A. , SOLA CHRISTOPHER , SUTOR BRUCE , KUNG SIMON 
Published: January 2019

Objectives:
The purpose of this study was to identify clinical and psychosocial factors involved in transitioning hospitalized patients receiving electroconvulsive therapy (ECT) from the inpatient to the outpatient setting and to propose an algorithm to guide clinicians with this process.

Methods:
A retrospective chart review was completed for adult patients discharged from a psychiatric hospital from 2002 to 2012 who had an acute course of ECT that was initiated in the hospital and completed as an outpatient. We reviewed demographic and clinical information and outcomes, including ECT treatments.

Results:
Among the 277 patients who were identified, the mean age was 52.2 years, 60% were women, and 66% were married. The mean length of hospital stay was 12.9 days, and the mean number of ECT treatments was 4.9 as an inpatient and 3.1 as an outpatient. The most frequent primary diagnosis was depression. Most patients (81%) had a responsible adult at home. Patients had good cognitive functioning at both baseline and discharge, and showed improved functional status at discharge (P<0.001 for change in scores on the Global Assessment of Functioning from admission to discharge).

Conclusions:
Factors such as improved cognitive and functional status from admission to discharge, a medically uncomplicated course, and a responsible adult at home were observed among patients transitioned from inpatient to outpatient ECT. On the basis of these study results, a review of the literature, and clinical experience, an algorithm to assist clinical decisions for ECT transitioning was developed.
Trauma Does Not Predict Patients’ Experiences With Constant Observation
Authors: KROLL DAVID S. , THOM ROBYN , VAN LUNTEREN JENNIFER , TORETTA CARA , CROWLEY BRITTANY , KNOTTS PAULA , FROMSON JOHN 
Published: January 2019

Objective:
Little is known about which patient factors are associated with a positive or negative experience of constant observation (CO) in a general hospital or emergency department. We hypothesized that posttraumatic stress disorder (PTSD) would predict a more negative experience with CO.

Methods:
A survey regarding the positive and negative aspects of being observed by a staff member was administered to 83 patients who were admitted to an inpatient psychiatric unit after experiencing CO; 55 of these patients had a history of trauma and 13 were diagnosed with PTSD. A total score reflecting the overall positive or negative experience of CO was calculated for each survey response. The survey also included 4 follow-up questions regarding the importance of individual observer characteristics (eg, sex), which were scored individually along a Likert scale.

Results:
Neither PTSD, trauma history, nor any other participant characteristic was associated with either a positive or negative overall experience with CO. Female participants were more likely than males to consider the sex and age of their staff observers to be important.

Conclusions:
Neither PTSD nor trauma history predicts a negative or positive experience with CO. A predictive model regarding which patients are likely to experience CO positively or negatively remains to be established.