bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skeletal muscle mass depletion in patients with hepatitis C virus infection
Authors: Fukui Aiko , Kawabe Naoto , Hashimoto Senju , Kamei Hiroyuki , Yoshioka Kentaro 
Published: September 2018

Objective
The aim was to assess the relationship between muscle mass depletion and chronic hepatitis C virus (HCV) infection.

Patients and methods
We retrospectively evaluated abdominal computed tomography data for 611 patients. The participants included 302 patients with HCV infection and 309 patients with gallstones (as a control). The skeletal muscle mass at the level of the third lumber vertebra (L3) was measured from the computed tomography images and normalized for height to calculate the L3 skeletal muscle index (L3-SMI, cm2/m2). Statistical analysis was carried out separately for each sex, given that L3-SMI differs significantly between men and women.

Results
L3-SMI showed no significant difference between chronic hepatitis patients and gallstone patients in either sex. L3-SMI was significantly lower in male cirrhotic patients than in those with chronic hepatitis (P<0.001). The Child–Pugh score was correlated negatively with L3-SMI in male patients with HCV-related cirrhosis (ρ=0.200, P=0.031). In addition, the BMI in both sexes was associated with L3-SMI in the gallstone and chronic hepatitis group, in the chronic hepatitis and liver cirrhosis group, and in the liver cirrhosis group.

Conclusion
Skeletal muscle mass is not affected by chronic HCV infection in patients without cirrhosis and decreases in accordance with liver disease progression in male patients with chronic HCV infection.
An Examination of Multilevel Factors Influencing Colorectal Cancer Screening in Primary Care Accountable Care Organization Settings: A Mixed-Methods Study
Authors: Kim Jungyoon , Wang Hongmei , Young Lufei , Michaud Tzeyu L. , Siahpush Mohammad , Farazi Paraskevi A. , Chen Li-Wu 
Published: September 2018

Objective:
To identify patient, provider, and delivery system–level factors associated with colorectal cancer (CRC) screening and validate findings across multiple data sets.

Design:
A concurrent mixed-methods design using electronic health records, provider survey, and provider interview.

Setting:
Eight primary care accountable care organization clinics in Nebraska.

Measures:
Patients' demographic/social characteristics, health utilization behaviors, and perceptions toward CRC screening; provider demographics and practice patterns; and clinics' delivery systems (eg, reminder system).

Analysis:
Quantitative (frequencies, logistic regression, and t tests) and qualitative analyses (thematic coding).

Results:
At the patient level, being 65 years of age and older (odds ratio [OR] = 1.34, P < .001), being non-Hispanic white (OR = 1.93, P < .001), having insurance (OR = 1.90, P = .01), having an annual physical examination (OR = 2.36, P < .001), and having chronic conditions (OR = 1.65 for 1-2 conditions, P < .001) were associated positively with screening, compared with their counterparts. The top 5 patient-level barriers included discomfort/pain of the procedure (60.3%), finance/cost (57.4%), other priority health issues (39.7%), lack of awareness (36.8%), and health literacy (26.5%). At the provider level, being female (OR = 1.88, P < .001), having medical doctor credentials (OR = 3.05, P < .001), and having a daily patient load less than 15 (OR = 1.50, P = .01) were positively related to CRC screening. None of the delivery system factors were significant except the reminder system. Interview data provided in-depth information on how these factors help or hinder CRC screening. Discrepancies in findings were observed in chronic condition, colonoscopy performed by primary doctors, and the clinic-level system factors.

Conclusions:
This study informs practitioners and policy makers on the effective multilevel strategies to promote CRC screening in primary care accountable care organization or equivalent settings. Some inconsistent findings between data sources require additional prospective cohort studies to validate those identified factors in question. The strategies may include (1) developing programs targeting relatively younger age groups or racial/ethnic minorities, (2) adapting multilevel/multicomponent interventions to address low demands and access of local population, (3) promoting annual physical examination as a cost-effective strategy, and (4) supporting organizational capacity and infrastructure (eg, IT system) to facilitate implementation of evidence-based interventions.
Improving Referrals for HIV Care Through Organizational Network Analysis
Authors: Thomas James C. , Agala Bernard , Xiong Khou , Powell Richard 
Published: September 2018

Context:
The link between testing for HIV and obtaining antiretroviral therapy (ART) is central to the HIV/AIDS control strategies of UNAIDS (the “90-90-90” goals) and the International Association of Providers of AIDS Care (“Test and Start”). To ensure that 90% of those diagnosed with HIV/AIDS begin ART and 90% of those on ART achieve viral suppression, service providers not providing all services need to refer patients to other organizations.

Setting:
Homa Bay, Kenya.

Objective:
Homa Bay county's HIV/AIDS prevalence is one of the country's highest. We identified the organizations providing some aspect of HIV/AIDS care and investigated ways in which they work together, or do not, to cover the comprehensive needs of those they serve.

Design and Participants:
We identified 56 organizations and interviewed a representative from each about his or her organization's services and its connections with the other 55, with particular interest in referrals from sites that test for HIV but do not treat infections to sites that do treat infections.

Main Outcome Measure:
Referral connections.

Results:
Referral connections among the 56 in the past 30 days were relatively rare, averaging fewer than 2; 13 organizations made no referrals at all. Notably, 5 facilities that test for HIV did not refer their clients to an ART provider. We found 2 distinct clusters of connected organizations: one in Homa Bay Township and the other in Rangwe subcounty. When we convened the organizations and presented our results to them, they expressed interest in establishing better connections and referrals.

Conclusions:
Homa Bay has an opportunity to improve care for people with HIV/AIDS, in particular ensuring that those testing positive receive treatment, simply by making better use of the services already available. This can be achieved by informing each organization of the services provided by each of the others and by bringing the organizations together to plan and monitor the services' coordination. These steps could be implemented separately in each of the 2 organizational clusters.
Determinants of Community-Related Expenses of US Tax-Exempt Hospitals, 2013
Authors: Begun James W. , Trinh Hanh Q. 
Published: September 2018

Context:
Tax-exempt hospitals in the United States are required to report community benefit expenses on their federal tax forms. Two categories of expenses critical to the public health mission of hospitals are the “community health improvement” and “community-building” expense categories. The community health improvement expenses formally qualify as a community benefit, whereas community-building expenses do not. Increasing both types of spending would be consistent with the growing evidence on the effects of social determinants on population health.

Objective:
To identify characteristics associated with the level of community health improvement and community-building expenses reported by tax-exempt hospitals.

Design:
The general acute care hospital is the unit of analysis. We utilize secondary data for all US general acute care hospitals that filed their own Internal Revenue Service Form 990 Schedule H for 2013 (n = 1508). We apply linear regression analysis to an explanatory model with 8 independent variables.

Measures:
The primary dependent variables are percentage of operating expenses devoted to community health improvement and to community building. The independent variables include 4 hospital-level measures, 3 county-level measures, and a measure of state requirements for community benefit.

Results:
The level of community health improvement expenses is positively associated with bed size, system membership, profit margin, and urban location. In states where tax-exempt hospitals are required to demonstrate community benefit to the state, there is lower community health improvement spending. Teaching hospitals also demonstrate lower community health improvement spending. Results for community-building expenses mirror those for community health improvement except that teaching hospital status and per capita income lose significance and hospital competition gains significance in the negative direction.

Conclusions:
Leaders among tax-exempt hospitals in community-related spending are hospitals that are larger, more profitable, members of systems, and located in urban areas and in states that do not have community benefit requirements.
Associations Between State Tobacco Control Policies and Adolescent ENDS Use
Authors: Hawkins Summer Sherburne , Ghiani Marco , Baum Christopher F. 
Published: September 2018

Background:
Despite an increase in adolescent use of electronic nicotine delivery systems (ENDS), little is known about the role of tobacco control policies on ENDS use.

Objective:
For aim 1, we examined how trends in adolescent use of cigarettes were affected by the introduction of ENDS; for aim 2, we examined the associations between ENDS age restrictions, cigarette taxes, and smoke-free legislation and adolescent use of ENDS and cigarettes.

Design and Setting:
Repeated cross-sections of the 1999-2015 Youth Risk Behavior Surveys linked to state-level tobacco control policies.

Participants:
938 486 adolescents aged 14 to 18 years from 45 states.

Main Outcome Measures:
For aim 1, we examined adolescent use of cigarettes. For aim 2, we examined adolescent use of ENDS, only ENDS, and cigarettes.

Results:
We found there was an overall decreasing trend in adolescent use of cigarettes, but the actual decline was greater than the predicted decline for 17- and 18-year-olds. While we found no associations between ENDS use and ENDS age restrictions or cigarette taxes, ENDS use was 3.8 percentage points higher in those states with smoke-free legislation for combustible tobacco products.

Conclusions:
Our findings highlight that ENDS age restrictions may not be adequate to curb ENDS use and additional local- and state-level policies governing ENDS are needed.
Imaging Brain Metastasis Patients With 18F-(2S,4R)-4-Fluoroglutamine
Authors: Xu Xiaoxia , Zhu Hua , Liu Fei , Zhang Yan , Yang Jianhua , Zhang Lifang , Zhu Lin , Li Nan , Kung Hank F. , Yang Zhi 
Published: September 2018

Purpose
There is a need for an alternative PET probe, which does not show normal brain tissue uptake in the evaluation of metastasis to the brain. Therefore, we investigate the feasibility of 18F-labeled glutamine analog, 18F-(2S,4R)-4-fluoroglutamine (18F-FGln), as a new metabolic probe to detect brain metastasis.

Methods
Patients (7 men and 7 women; age, 25–67 years) with suspected brain metastasis were enrolled for this study. All patients were imaged first with 18F-FGln PET (3 patients for 1-hour dynamic whole-body PET/CT scans, and 11 patients for static whole-body scans at 30 ± 10 minutes after injection), followed by a whole-body 18F-FDG PET performed in the same week. The characteristics of 18F-FGln PET imaging in brain metastasis patients were compared with that of 18F-FDG PET and/or contrast-enhanced MRI patient-by-patient. A composite of all functional and anatomic imaging studies served as the imaging comparator.

Results
Initial study in 3 patients using 1-hour dynamic scan showed that 30 ± 10 minutes after injection is optimal for identifying brain metastasis with a high-contrast ratio. All patients were positive for brain metastasis on this studies that demonstrated 38 lesions in 6 anatomic regions on the imaging comparator. The per-lesion detection rates for 18F-FGln PET and 18F-FDG PET were 81.6% and 36.8%, respectively. The average tumor-to-normal brain ratio of 18F-FGln PET was significantly better than that of 18F-FDG PET in all patients (4.97 ± 2.23 vs 1.22 ± 0.69, P < 0.05). Furthermore, our results suggest that 18F-FGln uptake in brain metastasis appeared to be independent of tumor size and peripheral edema. In addition, in 14 brain metastatic lesions visualized by both 18F-FDG PET and 18F-FGln PET imaging, a positive correlation of SUVmax was observed (r = 0.780, P < 0.01). As to the extracranial metastasis, both tracers showed a concordant increased radioactive uptake except in liver and bone.

Conclusions
The initial imaging of 18F-FGln presenting a promising new PET radiotracer for patients with brain metastasis and its utility in the liver and bone metastatic lesions may require more caution due to uptake in normal structures.
Chemokine Receptor 4 Expression in Primary Sjögren’s Syndrome
Authors: Cytawa Wojciech , Kircher Stefan , Schirbel Andreas , Shirai Takahiro , Fukushima Kazuhito , Buck Andreas K. , Wester Hans-Jürgen , Lapa Constantin 
Published: September 2018

Abstract

68Ga-pentixafor is a novel radioligand of C-X-C motif chemokine receptor 4. A 55-year-old woman with a history of primary Sjögren’s syndrome underwent 68Ga-pentixafor PET/CT for staging of lymphoma originating from mucosa-associated lymphoid tissue. Whereas no lymphoma manifestation could be detected, imaging revealed bilateral intense radiotracer uptake in both parotid and submandibular salivary glands, consistent with inflammatory cell infiltration.
Oropharyngeal Squamous Cell Carcinoma Metastasis to Distal Skeletal Muscle on FDG PET/CT
Authors: Drew Zachary James 
Published: September 2018

Abstract
We present a case of a tongue squamous cell carcinoma (SCC) metastasizing to distal skeletal muscle detected on FDG PET/CT imaging. A 48-year-old man with locally recurrent tongue SCC underwent a restaging FDG PET/CT to investigate neck and unilateral leg pain. The PET scan showed large, intensely FDG-avid lesions in the right scalene and left hamstring muscles, which were biopsy proven as metastatic SCC. Skeletal muscle metastases from oropharyngeal SCCs are rare; however, PET/CT has allowed increased detection of atypical metastatic sites. Such cases support the consideration of metastasis for muscular lesions in head and neck cancer patients.
Accumulation of 131I in Esophageal Diverticulum Diagnosed by SPECT/CT
Authors: Rizzo Alessio , Zagaria Luca , Perotti Germano , Annunziata Salvatore , Salvatori Massimo 
Published: September 2018

Abstract
A 72-year-old man underwent total thyroidectomy and radioiodine remnant ablation for papillary thyroid cancer in 2016. The posttherapy whole-body scan showed uptake in the neck, classified as residual thyroid tissue. Two years later, the patient came to our observation to perform a second radioiodine therapy for high levels of thyroglobulin. The planar posttherapy scan showed a focal radioiodine area in the neck. SPECT/CT diagnosed a voluminous esophageal diverticulum located in the upper third of the esophagus. A CT performed to discover the source of thyroglobulin excluded locoregional or distant metastases and confirmed the presence of a Zenker diverticulum.
Congenital Penile Rhabdomyosarcoma on FDG PET/CT
Authors: Wu Chenxi , Zhuang Hongming 
Published: September 2018

Abstract
Primary penile malignancy is uncommon. Congenital primary penile rhabdomyosarcoma diagnosed in an infant is extremely rare. We present the FDG PET/CT findings in a 1-month-old boy with penile mass. The images showed hypermetabolic lesion at the base of the penis and left inguinal lymph node. Pathological examination demonstrated rhabdomyosarcoma.
The Coexistence of a Horseshoe Kidney and Meckel Diverticulum With Dramatic Mobility Revealed Through 99mTc Pertechnetate Imaging
Authors: Yang Jun , Dong Meng-jie , Xu Qin , Zhang Jun 
Published: September 2018

Abstract
A previously healthy 11-year-old boy with intermittent abdominal pain and bloody stool underwent Meckel scintigraphy. On the initial images, there was a faint U-shaped activity in the mid-abdominal region, which gradually faded and evolved into distinct foci of radiotracer accumulation in the later images. One of the foci changed its location during the study, suspected as moving Meckel diverticulum. A horseshoe kidney was noted by subsequent CT images, which corresponded to nonmoving foci. A Meckel diverticulum was confirmed after exploratory laparotomy, accounted for moving focus on Merkel scintigraphy.
Uterosacral Ligament Suspension: A Radiographic Study of Suture Location in Live Subjects
Authors: Smith Benjamin C. , Herfel Charles V. , Yeung Jennifer , Shatkin-Margolis Abigail , Crisp Catrina C. , Kleeman Steven D. , Pauls Rachel N. 
Published: September 2018

Objectives
This study aimed to describe uterosacral ligament suspension (USLS) suture location relative to the surrounding anatomy in a living model using computed tomographic imaging.

Methods
This was an institutional review board–approved prospective descriptive study. Women aged 18 to 85 years undergoing vaginal hysterectomy with USLS were eligible. A size ‘small’ titanium vascular clip was applied to the base of each USLS suture. Computed tomography of the pelvis was performed on postoperative day 1. Preoperative and postoperative neurologic questionnaires and physical examinations were performed. A sample size of 15 subjects was deemed appropriate for this pilot study.

Results
Seventeen subjects were enrolled: 2 excluded and 15 analyzed. The median (interquartile range) age of the subjects was 57 (22) years. The closest branch of the internal iliac complex was 2.6 (0.9) cm (median [interquartile range]) from the proximal suture on the right and 2.6 (0.5) cm on the left. The right ureter was 2.1 (0.7) cm from the right proximal suture. The left ureter was 2.3 (1.0) cm from the left proximal suture. The rectal lumen were 3.0 (1.6) cm from the right proximal suture and 2.8 (1.4) cm from the left proximal suture. No subjects were found to have neurologic involvement of the sutures based on neurologic questionnaire responses and physical examination.

Conclusions
In live subjects, our study confirms that the vasculature, ureter, and rectum of the pelvic side wall are near suture placement for USLS. This information highlights the importance of careful dissection and awareness of anatomic landmarks.
Effect of Bariatric Surgery on Urinary Incontinence in Obese Women: A Meta-analysis and Systematic Review
Authors: Zhang Jindong , Gao Liang , Liu Maoyu , Liu Chuan 
Published: September 2018

Objectives
The aim of this study was to explore the effectiveness of bariatric surgery in obese women with urinary incontinence (UI) through meta-analysis.

Methods
Searches of PubMed, the Cochrane Library, and EMBASE databases were performed using “weight loss surgery/bariatric surgery/gastric bypass surgery” and “incontinentia urinae/uracratia/urinary incontinence/uroclepsia” in the title/abstract before January 2018. Then, meta-analysis was analyzed by Review Manager 5.3 (Cochrane Collaboration, Oxford, United Kingdom). The standardized mean difference (SMD) and odds ratio (OR) were used to describe results of continuous variables and dichotomous variables, respectively.

Results
Pooled data showed that bariatric surgery reduced the incidence of UI in obese women at the follow-up of 6 months (OR, 3.27; 95% confidence interval [CI], 2.55–4.21; P < 0.00001) and 12 months (OR, 4.04; 95% CI, 2.62–6.22; P < 0.00001) and significantly reduced the body mass index at 6 months (SMD, 1.86; 95% CI, 1.19–2.53; P < 0.00001) and 12 months (SMD, 2.04; 95% CI, 1.44–2.64; P < 0.00001). In addition, bariatric surgery could also significantly increase the quality of life (SMD, 0.53; 95% CI, 0.27–0.80; P < 0.00001) and improve the function of pelvic floor disorders (SMD, 0.55; 95% CI, 0.38–0.72; P < 0.00001) based on quality-of-life questionnaires and Pelvic Floor Distress Inventory 20, respectively.

Conclusions
This meta-analysis demonstrated that bariatric surgery is an effective choice for obese women with UI. However, more randomized controlled trials are required to confirm this result.
Perioperative Complication Rates After Colpopexy in African American and Hispanic Women
Authors: Roberts Kasey , Sheyn David , Emi Bretschneider C. , Mahajan Sangeeta T. , Mangel Jeffrey 
Published: September 2018

Objectives
The objective of this study was to determine if race affects complication rates after colpopexy.

Methods
This was an observational study exempt from institutional review board review. Data were obtained from the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2015. Current Procedural Terminology codes were used to identify patients with a history of colpopexy. Patients were stratified into 3 groups: White, Hispanic, and African American. Descriptive statistics were reported as means with standard deviations. Three-group comparison was performed using Kruskal-Wallis or 1-way analysis of variance. Pairwise analysis was performed with Student t test, Wilcoxon rank sum test, χ2test, or Fisher exact test. Stepwise backward multivariable logistic regression was used to identify factors associated with the composite complication rate.

Results
A total of 13,206 patients met the inclusion and exclusion criteria. Seven hundred thirty-eight patients (5.5%) were African American, and 1210 (9.2%) were Hispanic. The overall complication rate for African Americans, Hispanics, and Whites was 15.0%, 12.0%, and 11.5% (P = 0.006), respectively. The most common complication in the African American group was postoperative transfusion. Multivariable logistic regression found significant associations with perioperative complications and being African American (adjusted odds ratio [aOR], 1.29), higher body mass index (aOR, 1.02), inpatient status (aOR, 1.45), coagulopathy (aOR, 2.77), preoperative transfusion (aOR, 5.09), American Society of Anesthesiologists class 3 or higher (aOR, 1.45), higher preoperative white blood cell count (aOR, 1.04), concomitant sling placement (aOR, 1.19), longer operating time (aOR, 1.003), and longer length of stay (aOR, 1.05).

Conclusions
African Americans are at an increased risk of perioperative complications after colpopexy, although the reason for this increase is unknown.
Anterior Ischemic Optic Neuropathy After Dental Extraction
Authors: Kravitz Elizabeth , Foroozan Rod 
Published: September 2018

Background:
While often idiopathic, anterior ischemic optic neuropathy occasionally may occur from an identifiable cause.

Methods:
Observational case report.

Results:
A 19-year-old woman with unremarkable medical and ophthalmic histories developed visual loss from nonarteritic anterior ischemic optic neuropathy in her right eye after otherwise uneventful dental extraction of the inferior third molars.

Conclusions:
Anterior ischemic optic neuropathy may rarely occur after dental extraction. Potential pathophysiologic mechanisms of this rare occurrence are discussed.