bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predisposing Conditions to Pediatric Hepatocellular Carcinoma and Association With Outcomes
Authors: Cowell Elizabeth , Patel Kalyani , Heczey Andras , Finegold Milton , Venkatramani Rajkumar , Wu Hao , López‐Terrada Dolores , Miloh Tamir 
Published: February 2019

ABSTRACTObjectives:Hepatocellular carcinoma (HCC) has been linked to chronic viral or metabolic liver disease and other conditions. The characteristics of children with HCC have not been fully elucidated and outcomes in children with predisposing liver disease are not well defined.Methods:Patients ⩽21 years old with HCC managed at our institution and through external consultation between 1996 and 2016 were included. Demographics, clinical history, and pathology were tabulated. Fisher exact test and Wilcoxon test were employed for subgroup comparison, and survival differences were evaluated by Kaplan‐Meier method.Results:Sixty‐one cases of HCC were identified. Seven of 16 patients (44%) at our institution and 18 of 45 consult patients (40%) had a predisposing condition: cryptogenic cirrhosis/steatosis (9), genetic (7), biliary pathology (4), viral hepatitis (1), and other (4). Thirteen of 27 patients with de novo HCC had fibrolamellar HCC. Clinical characteristics were grouped by presence or absence of predisposing conditions: age at diagnosis (7.2 vs 10.2 years, P < 0.05), metastatic disease at presentation (15% vs 44%, P = n.s), and tumor size >4 cm (20% vs 100%, P < 0.05). In patients treated at our institution, 5 of 7 with predisposing conditions received liver transplant and achieved complete remission, whereas only 3 of 9 patients with de novo HCC received curative surgery and this group had decreased median overall survival (P < 0.05).Conclusions:The majority of children with HCC did not have predisposing liver or associated disease. These patients were diagnosed later with more advanced stage disease and had significantly decreased overall survival.
Targeted Polo-like Kinase Inhibition Combined With Aurora Kinase Inhibition in Pediatric Acute Leukemia Cells
Authors: Jayanthan Aarthi , Hofmann Bradley , Meier-Stephenson Vanessa , Perinpanayagam Maneka , Dunn Sandra E. , Boklan Jessica , Trippett Tanya M. , Truong Tony H. , Narendran Aru 
Published: February 2019

Background:
Recent studies have shown that cell cycle events are tightly controlled by complex and shared activities of a select group of kinases. Among these, polo-like kinases (Plks) are regulatory mitotic proteins that are overexpressed in several types of cancer and are associated with poor prognosis.

Materials and Methods:
We have evaluated, in preclinical in vitro studies, the activity of a panel of Plk inhibitors against cell lines derived from refractory pediatric leukemia, as well as primary leukemia cells, in culture. Through in vitro growth inhibition studies, Western blot analysis for the expression and activation of key regulators of cell growth and survival and gene silencing studies, we specifically examined the ability of these agents to induce cytotoxicity through the activation of apoptosis and their capacity to interact and modulate the expression and phosphorylation of Aurora kinases.

Results:
Our findings show that the various Plk-1 inhibitors in development show potential utility for the treatment of pediatric leukemia and exhibit a wide range of phosphorylation and target modulatory capabilities. Finally, we provide evidence for a complex interregulatory relationship between Plk-1 and Aurora kinases enabling the identification of synergy and biologic correlates of drug combinations targeting the 2 distinct enzyme systems.

Discussion:
This information provide the rationale for the evaluation of Plk-1 as an effective target for therapeutics in refractory pediatric leukemia and indicate compensatory activities between Plk-1 and Aurora kinases, providing insight into some of the complex mechanisms involved in the process of cell division.
Langerhans Cell Histiocytosis Presenting as Enterocolitis and Shock in Neonate
Authors: Barón González de Suso Luisa , Olmedilla Jódar Marta , Pérez Alonso Vanesa , Melgar Bonis Ana 
Published: February 2019

Introduction:
Enterocolitis is a relatively common disease in neonatal period that can be a result of many underlying pathologies. One of them, which is an unusual disorder especially in neonatal age and with gastrointestinal involvement, is Langerhans cell histiocytosis (LCH). This case shows a severe neonatal LCH with digestive involvement which required intensive care and had an abnormal presentation, being hard to diagnose attributable to the diversity of symptoms.

Case Report:
Eleven-day-old newborn presented for excessive weight loss followed by deterioration to shock, abdominal distension, digestive bleeding, and purpuric exanthema. Exploratory laparotomy identified aggressive enterocolitis. After stabilization, a significant hepatosplenomegaly persists as well as bicytopenia, pyrexia, and cutaneous lesions evolving tangible purple. LCH was diagnosed through histology of cutaneous biopsy.

Conclusions:
Gastrointestinal involvement in neonatal LCH is infrequent and its symptoms can be really unspecific. It is important to know that the first clinical manifestation is usually dermatologic with very diverse morphologies. Having a high suspect rate will lead us to an early diagnosis with its correspondent impact upon the outcome.
Effect of Acupuncture on Cognitive Function and Quality of Life in Patients With Idiopathic Trigeminal Neuralgia
Authors: Gao Jie , Zhao Chongfa , Jiang Wenchen , Zheng Baosen , He Yongjin 
Published: February 2019

Abstract
To estimate the effect of acupuncture on idiopathic trigeminal neuralgia (ITN), we recruited 116 patients with ITN from December 2016 to April 2018 and further divided into them into two groups: acupuncture intervention group (n = 62) and sham control group (n = 54). Clinical pain, cognitive function, and quality of life (QoL) assessed with the 36-Item Short Form Health Survey (SF-36) were evaluated at the initial time of treatment, at the end of treatment, and 6 weeks after the treatment. Pain intensity, headache, and generalized body pain showed significant decrease both at the end of treatment and after 6 weeks of treatment when compared with initial time. The scores of the cognitive tests (Mini-Mental State Examination, Trail Making Test, Verbal Fluency Test, tracing score, and memory score) and five aspects of the SF-36 assessment (role emotional, general health, body pain, role physical, and mental health scores) showed significant improvement at the end of treatment compared with the initial time. Whereas after 6 weeks of treatment, the Mini-Mental State Examination, memory score, and Trail Making Test-A score and four aspects of the SF-36 assessment (vitality, bodily pain, mental health, and role physical) showed significant improvement when compared with the end of treatment. Acupuncture can be used as an alternative treatment to improve cognitive function and QoL of patients with ITN.
Pre-Kraepelin Names for Mental Disorders
Authors: Blashfield Roger K. 
Published: February 2019

Abstract
Psychiatric classifications before the early 1900s generally are viewed as chaotic and not worthy of analysis. Sixteen different classificatory systems were identified that were pre-World War I and that were pre-Kraepelinian. A total of 827 names were collected from these 16 classifications. As expected, classification unreliability was a problem in these systems. Across the seven American classifications, the average match rate in names was 15% (i.e., 15% of the diagnoses in one system appeared with the same name in another system). The names that were most consistently recognized across these 16 classifications were “mania,” “acute mania,” “chronic mania,” “melancholia,” “general paralysis,” “senile dementia,” “epileptic insanity,” “hysterical insanity,” “moral insanity,” “idiocy,” and “cretinism.” These 11 names summarize 19th century American views of psychopathology.
Is There Anybody Out There? Attachment Style and Interpersonal Facilitators as Protective Factors Against Complicated Grief Among Suicide-Loss Survivors
Authors: Levi-Belz Yossi , Lev-Ari Lilac 
Published: February 2019

Abstract
Losing a loved one to suicide may have detrimental effects, one of them being suffering from complicated grief (CG). To date, no studies have fully examined the psychological processes that delineate the risk and resilience factors that contribute to CG among suicide-loss survivors (SLSs). We hypothesized that social support and self-disclosure would moderate the relationship between attachment styles and CG for SLS. Questionnaires assessing attachment style, self-disclosure, social support, and CG were completed by 156 SLS participants. A regression model revealed that secure attachment negatively predicted CG, but self-disclosure moderated this association. Secure attachment seems to be a resilient factor for CG. However, SLS with low secure attachment but high in self-disclosure ability use this behavior as a way to impede CG. The capacity to seek out other people, to share experiences with them, and to accept comfort from them may offer a means for SLS to better deal with their tragedy.
Hermeneutic Phenomenological Study of Military Nursing Officers
Authors: Conlon Lisa , Wiechula Rick , Garlick Amanda 
Published: February 2019

Background
Nurses working in military trauma teams often work in hostile and remote locations. They are faced with the burden of carrying out their duties while ensuring the safety of their patients and themselves in areas of conflict and humanitarian crisis. The stories and experiences of military nurses often go untold. In a phenomenological study, six Australian Defence Force Nursing Officers share their stories of working as members of military trauma teams.

Objectives
The aim of this study was to gain an understanding of the lived experiences of nursing officers when working as a member of a military trauma team.

Methods
A hermeneutic phenomenological approach was used to conduct this research. In-depth interviews were conducted with six participants.

Results
The following themes were identified: telling their stories; the role—who we are and what we do; the environment—it is so different; training—will it ever fully prepare you; working in teams—there’s no “I” in team; and leadership—will the real leader please stand up!

Discussion
This study has provided an insight into the experiences of six Australian military nurses working in trauma teams—experiences that were rarely given voice outside the military. Central to this experience is the need to have these stories told.
Decision Readiness to Disclose Human Immunodeficiency Virus–positive Status to Family Members
Authors: Laschober Tanja C. , Serovich Julianne M. , Brown-Smith Monique J. , Kimberly Judy A. , Lescano Celia M. 
Published: February 2019

Background
People living with human immunodeficiency virus (HIV) (PLWH) are faced with the often difficult decision of whether, when, and how to disclose their seropositive status. This study draws on the transtheoretical model of change to examine men and women's decision readiness to disclose their HIV-positive status to family members and to assess predictors (decisional balance and decision self-efficacy) of their decision readiness.

Methods
Cross-sectional data were collected from 346 PLWH—191 males and 155 females. Participants self-reported on their disclosure decision readiness, decisional balance, and decision self-efficacy. Data were analyzed using χ2 tests, general linear models, and multinomial logistic regression models.

Results
Two thirds of PLWH were in the 3 lower stages of decision readiness, with the majority starting to think about disclosure. One third of PLWH were in the 3 higher stages of decision readiness (close to deciding or have made the decision to disclose). Decisional balance and decision self-efficacy predicted decision readiness. Overall, few gender differences emerged.

Conclusions
These findings can help researchers, clinicians, and health care providers to better understand and support PLWH as they move through the decision making process.
Proportion of Incident Human Immunodeficiency Virus Cases Among Men Who Have Sex With Men Attributable to Gonorrhea and Chlamydia: A Modeling Analysis
Authors: Jones Jeb , Weiss Kevin , Mermin Jonathan , Dietz Patricia , Rosenberg Eli S. , Gift Thomas L. , Chesson Harrell , Sullivan Patrick S. , Lyles Cynthia , Bernstein Kyle T. , Jenness Samuel M. 
Published: February 2019

Background
Sexually transmitted infections (STIs) are associated with an increased risk of human immunodeficiency virus (HIV) acquisition and transmission. We estimated the proportion of HIV incidence among men who have sex with men attributable to infection with the 2 most common bacterial STIs, Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT).

Methods
We used a stochastic, agent-based model of a sexual network of MSM with cocirculating HIV, NG, and CT infections. Relative risk (RR) multipliers, specific to anatomic site of infection, modified the risk of HIV transmission and acquisition based on STI status. We estimated the effect of NG and CT on HIV incidence overall and on HIV acquisition and HIV transmission separately. Each scenario was simulated for 10 years. The population attributable fraction (PAF) was determined for each combination of RRs by comparing the incidence in the final year of a scenario to a scenario in which the RRs associated with NG and CT were set to 1.0.

Results
Overall, 10.2% (interquartile range [IQR], 7.9–12.4) of HIV infections were attributable to NG/CT infection. Then in sensitivity analyses, the PAF for HIV transmission ranged from 3.1% (IQR, 0.5–5.2) to 20.4% (IQR, 17.8–22.5) and the PAF for HIV acquisition ranged from 2.0% (IQR, −0.7 to 4.3) to 13.8% (IQR, 11.7–16.0).

Conclusions
Despite challenges in estimating the causal impact of NG/CT on HIV risk, modeling is an alternative approach to quantifying plausible ranges of effects given uncertainty in the biological cofactors. Our estimates represent idealized public health interventions in which STI could be maximally prevented, setting targets for real-world STI interventions that seek to reduce HIV incidence.
Antibiotic Prescription in Young Children With Respiratory Syncytial Virus–Associated Respiratory Failure and Associated Outcomes
Authors: Shein Steven L. , Kong Michele , McKee Bryan , O’Riordan MaryAnn , Toltzis Philip , Randolph Adrienne G. 
Published: February 2019

Objectives:
To describe antibiotic prescribing practices during the first 2 days of mechanical ventilation among previously healthy young children with respiratory syncytial virus–associated lower respiratory tract infection and evaluate associations between the prescription of antibiotics at onset of mechanical ventilation with clinical outcomes.

Design:
Retrospective cohort study.

Setting:
Forty-six children’s hospitals in the United States.

Patients:
Children less than 2 years old discharged between 2012 and 2016 with an International Classification of Diseases diagnosis of respiratory syncytial virus–associated lower respiratory tract infection, no identified comorbid conditions, and receipt of mechanical ventilation.

Interventions:
Antibiotic prescription during the first 2 days of mechanical ventilation.

Measurements and Main Results:
We compared duration of mechanical ventilation and hospital length of stay between children prescribed antibiotics on both of the first 2 days of mechanical ventilation and children not prescribed antibiotics during the first 2 days of mechanical ventilation. We included 2,107 PICU children with respiratory syncytial virus–associated lower respiratory tract infection (60% male, median age of 1 mo [interquartile range, 1–4 mo]). The overall proportion of antibiotic prescription on both of the first 2 days of mechanical ventilation was 82%, decreasing over the study period (p = 0.004) and varying from 36% to 100% across centers. In the bivariate analysis, antibiotic prescription was associated with a shorter duration of mechanical ventilation (6 d [4–9 d] vs 8 d [6–11 d]; p < 0.001) and a shorter hospital length of stay (11 d [8–16 d] vs 13 d [10–18 d]; p < 0.001). After adjustment for center, demographics, and vasoactive medication prescription, antibiotic prescription was associated with a 1.21-day shorter duration of mechanical ventilation and a 2.07-day shorter length of stay. Ultimately, 95% of children were prescribed antibiotics sometime during hospitalization, but timing, duration, and antibiotic choice varied markedly.

Conclusions:
Although highly variable across centers and decreasing over time, the practice of instituting antibiotics after intubation in young children with respiratory syncytial virus–associated lower respiratory tract infection was associated with a shortened clinical course after adjustment for the limited available covariates. A prudent approach to identify and optimally treat bacterial coinfection is needed.
The Methods of PH WINS 2017: Approaches to Refreshing Nationally Representative State-Level Estimates and Creating Nationally Representative Local-Level Estimates of Public Health Workforce Interests and Needs
Authors: Leider Jonathon P. , Pineau Vicki , Bogaert Kyle , Ma Qiao , Sellers Katie 
Published: February 2019

Context:
The Public Health Workforce Interests and Needs Survey (PH WINS) was first fielded in 2014 and is the largest public health workforce survey in the nation. This article elucidates the methods used for the 2017 PH WINS fielding.

Program or Policy:
PH WINS was fielded to a nationally representative sample of State Health Agency Central Office (SHA-CO) staff, as well as local health department (LHD) staff. The instrument largely mirrored 2014, though the training needs section was revised, and a validated item measuring burnout in staff was added.

Implementation:
Staff lists were collected directly from all participating state and local agencies. Forty-seven state health agencies (SHAs), 26 large LHDs, and 71 midsize LHDs participated. All SHAs were surveyed using a census approach. The nationally representative SHA-CO frame is representative of all central office staff members. The nationally representative local frame was a complex survey design, wherein staff from LHDs were randomly sampled across 20 strata, based on agency size and geographic region. Staff were also contributed with certainty from large LHDs in nondecentralized states. The frame is representative of staff at LHDs serving more than 25 000 people and with 25 or more staff members. Other LHDs are excluded, and so PH WINS is not representative of smaller LHDs. Balanced repeated replication weights were used to adjust variance estimates for the complex design.

Evaluation:
Overall, 47 604 people responded to PH WINS in 2017 across all frames. PH WINS 2017 achieved a response rate of 48%. The design effect for the SHA-CO frame was 1.46 and was 16.42 for the local frame.

Discussion:
PH WINS now offers a nationally representative sample of both SHA-CO and LHD staff across 4 major domains: workplace environment, training needs, emerging concepts in public health, and demographics. Both practice and academia can use PH WINS to better understand the perceptions and needs of staff, address training gaps, and work to recruit and retain quality staff.
Changes in the State Governmental Public Health Workforce: Demographics and Perceptions, 2014-2017
Authors: Bogaert Kyle , Castrucci Brian C. , Gould Elizabeth , Sellers Katie , Leider Jonathon P. 
Published: February 2019

Context:
Workforce is a critical cog in the governmental public health enterprise in the United States. Until 2014, workforce research was largely conducted at the organizational level. However, the fieldings of the Public Health Workforce Interests and Needs Survey allow for nationally representative comparisons with individual respondents.

Objective:
Using data from agencies that participated in 2014 and 2017, we conducted multi–cross-sectional comparisons of the Public Health Workforce Interests and Needs Survey data.

Design:
The Public Health Workforce Interests and Needs Survey participants at the State Health Agency Central Offices were surveyed using a Web-based platform. Balanced repeated replication weights were used to account for differential designs between 2014 and 2017.

Setting:
Thirty-three state health agency central offices that participated in both 2014 and 2017.

Participants:
Permanently employed governmental public health staff.

Main Outcome Measures:
We examined changes in perceptions of the workplace environment, job and pay satisfaction, intent to leave, awareness of emerging concepts in public health, and demographic/worker characteristics. Pearson and Rao-Scott–adjusted χ2 analyses were used to compare changes between 2014 and 2017.

Results:
The percentage of staff who are people of color increased from 29% (95% confidence interval, 28%-30%) to 37% (95% confidence interval, 36%-38%) from 2014 to 2017 across 33 states. Approximately 26% of staff were younger than 40 years in 2014 compared with 29% in 2017 (P < .001). Job satisfaction increased in 17 states overall (P < .05, n = 5) and decreased in 16 states (P < .05, n = 5) but did not change in aggregate. Overall, the percentage of staff considering leaving the organization in the next year or retiring within 5 years is up from 44% to 48% (P < .001).

Conclusions:
Global measures of satisfaction are relatively high and consistent between 2014 and 2017. Demographics are shifting toward a marginally younger workforce as many retire, and a significant portion of staff indicates that they are considering leaving their organization or planning to retire.
Top Training Needs of the Governmental Public Health Workforce
Authors: Bogaert Kyle , Castrucci Brian C. , Gould Elizabeth , Rider Nikki , Whang Christina , Corcoran Elizabeth 
Published: February 2019

Context:
Workforce development in governmental public health has historically focused on discipline-specific skills. However, as the field of public health has evolved, crosscutting skills have become critical. The 2017 fielding of the Public Health Workforce Interests and Needs Survey (PH WINS) provides a national benchmark for gaps in crosscutting skills in state and local health departments.

Objective:
The purpose of this article is to identify top areas of training needs in the governmental public health workforce using data from PH WINS 2017.

Design:
PH WINS participants in state and local health departments were surveyed in fall 2017 using a Web-based platform. Balanced repeated replication weights were used to account for complex sample design.

Setting:
Forty-seven state health agencies, 26 large city health departments, and a nationally representative sample of mid-to-large local health departments.

Participants:
Permanently employed governmental public health staff.

Main Outcome Measures:
Training needs were determined by combining self-reported skill importance and proficiency. Skills reported to be of high importance, and low levels of proficiency were coded as training needs. Focus area gaps were defined as having a training need in at least one skill in the focus area.

Results:
The largest area of training need, regardless of supervisory status, was in budgeting and financial management (55%; 95% confidence interval [CI], 53-56), with a large gap also identified in systems and strategic thinking (49%; 95% CI, 47-50). There was some variation by supervisory status, with training needs for nonsupervisors in change management and in developing a vision for a healthy community for management.

Conclusions:
The PH WINS training needs assessment provides the first nationally representative data on training needs for the state and local health department workforce. Across state and local health departments, there are common critical training needs essential for the current and future practice of public health.