bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health promotion in Brazil: qualitative survey with primary school teachers
Authors: Graciano Andrea Monteiro de Castro , Cardoso Natalia Mendes Matos , Teixeira Suélen Alves , Mattos Flavio de Freitas , Gomes Viviane Elisângela , Borges-Oliveira Ana Cristina 
Published: July 2018

Summary
School health promotion programs can reduce common health problems like obesity, diabetes and respiratory complications. This qualitative study aimed to investigate the perceptions of a group of teachers regarding issues related to the promotion of health in school. The 15 teachers sampled were from public primary schools in a city in southeastern Brazil. Interviews with teachers were conducted and data was analyzed employing content. Teacher practices regarding the promotion of health appeared to be aimed at their students and their daily habits and their practices. Teachers described approaching health promotion through their lesson content and suggested that the school should seek help from other institutions in their health promotion activities like prevention activities, monitoring of improvements in student and teacher health. Teachers mentioned a strong relationship between knowledge and the pursuit of good health. The need to identify major determinants of the disease/health process was highlighted and the connection between lifestyle, socio-economic status and the disease/health process was described. Awareness of the influence concerning both the environment and the school surroundings was demonstrated. It is important that the teachers are aware of the environment that surrounds them as well as the reality of the lives of all those involved with the school.
Optimism and Psychological Resilience are Beneficially Associated With Measures of Clinical and Experimental Pain in Adults With or at Risk for Knee Osteoarthritis
Authors: Thompson Kathryn A. , Bulls Hailey W. , Sibille Kimberly T. , Bartley Emily J. , Glover Toni L. , Terry Ellen L. , Vaughn Ivana A. , Cardoso Josue S. , Sotolongo Adriana , Staud Roland , Hughes Laura B. , Edberg Jeffrey C. , Redden David T. , Bradley Laurence A. , Goodin Burel R. , Fillingim Roger B. 
Published: July 2018

Objectives:This cross-sectional study examined the associations among optimism, psychological resilience, endogenous pain inhibition, and clinical knee pain severity. Two hypotheses were tested. First, we hypothesized that experimentally tested endogenous pain inhibition would mediate the relationship between optimism and clinical knee pain severity. Second, it was also hypothesized that optimism would moderate the relationships of psychological resilience with endogenous pain inhibition and clinical knee pain severity, particularly for individuals with high optimism.Methods:A total of 150 individuals with or at risk for symptomatic knee osteoarthritis completed the Life Orientation Test-Revised, the Brief Resilience Scale, and the revised Short-Form McGill Pain Questionnaire-2 to assess optimism, psychological resilience, and clinical knee pain severity, respectively. Endogenous pain inhibition was examined experimentally using a conditioned pain modulation (CPM) protocol with algometry (test stimulus) and a cold pressor task (conditioning stimulus).Results:As hypothesized, results showed that increased CPM significantly mediated the association between higher optimism and lower clinical knee pain severity. Further, optimism moderated the association between psychological resilience and CPM. However, contrary to our hypothesis, greater psychological resilience was associated with enhanced CPM in individuals with low optimism only.Discussion:This study suggests that an optimistic outlook may beneficially impact clinical pain severity by altering endogenous pain modulatory capacity. Furthermore, individuals with low optimism (ie, pessimists) may be more adept at engaging resources that promote psychological resilience, which in turn, enhances endogenous pain modulatory capacity. Therefore, this study supports consideration of psychological resilience factors when evaluating experimental and clinical pain outcomes.
Opportunistic CT Screening for Osteoporosis in Patients With Pelvic and Acetabular Trauma: Technique and Potential Clinical Impact
Authors: Donohue David , Decker Summer , Ford Jonathan , Foley Robert , Dunbar Kirstin , Kumm Todd , Achors Kyle , Mir Hassan 
Published: July 2018

Objectives:
To present a technique for the use of computed tomography (CT) scans in opportunistic screening for osteoporosis in patients with pelvic and acetabular fractures and to quantify the potential clinical impact in a geriatric trauma population.

Design:
Retrospective cohort study.

Setting:
Level 1 trauma center.

Patients:
A total of 335 patients older than 60 years of age who presented to a Level 1 trauma center with a diagnosis of pelvic or acetabular fracture and were evaluated with a CT scan between the years 2010 and 2016. A subset of 255 patients were evaluated with a dual-energy x-ray absorptiometry scan within 6 months of the CT scan.

Intervention:
Measurement of Hounsfield units (HU) was performed at the midpoint of the femoral neck using a standardized, ovoid section, followed by Livewire measurement. Application of this technique retrospectively to a population of geriatric patients with pelvic or acetabular fractures.

Main Outcome Measurements:
(1) HUs were measured in a cross section at the midpoint of the femoral neck and, discriminant function analysis was used to establish thresholds for normal bone mineral density, osteopenia, and osteoporosis. (2) Change in the number of diagnoses of osteoporosis after application of the protocol the geriatric trauma cohort.

Results:
Patients with osteopenia were identified correctly 67.5% of the time (14.3% were incorrectly grouped as normal, and 18.3% were grouped as having osteopenia). Patients with osteoporosis were identified correctly 88.9% of the time (the remaining 11.1% were assigned to osteopenic). The results of discriminant function analysis were used to establish CT thresholds for osteopenia (345 HUs) and osteoporosis (262 HUs).

Conclusion:
CT imaging obtained for pelvic and acetabular fractures can identify patients with osteoporosis without additional radiation exposure or cost. The fitted ovoid region of interest is a standard feature in most CT scan platforms and is quite simple to perform.

Level of Evidence:
Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
SHORT-TERM COMPUTER-ASSISTED QUANTIFICATION OF PLUS DISEASE AFTER TREATMENT OF TYPE 1 RETINOPATHY OF PREMATURITY WITH INTRAVITREAL BEVACIZUMAB OR RETINAL LASER PHOTOCOAGULATION
Authors: Cabrera Michelle T. , Chia Thomas , Wallace David K. , Ulrich J. Niklas , Freedman Sharon F. , Ding Leona , Gertsch Kevin R. 
Published: July 2018

Purpose:
To compare objectively measured changes in plus disease after bevacizumab and laser for Type 1 retinopathy of prematurity.

Methods:
ROPtool (a computer program) analyzed fundus images at baseline, 1 week, and subsequent examinations.

Results:
Six infants (9 eyes) were treated with bevacizumab and 7 (12 eyes) with laser. One week after treatment, bevacizumab compared with laser resulted in a greater median percent change from pretreatment in tortuosity (−53.8 vs. −0.2%, P < 0.001) and overall plus disease (−20.1 vs. −3.1%, P < 0.001). Change in dilation did not differ (−3.5 vs. −5.5%, P = 0.48). After week 1, all median ROPtool parameters continued to decrease for both groups. At last follow-up (median 3, range: 2–10 weeks), both bevacizumab and laser significantly decreased tortuosity (−54.3 and −23.8%), dilation (−8.7 and −7.5%), and overall plus disease (−27.3 and −10.3%).

Conclusion:
Improvement in plus disease, in particular tortuosity, likely occurs more quickly after bevacizumab compared with laser, particularly at 1 week after treatment. These results guide clinical expectations for plus disease resolution after both treatment modalities.
Neuroinvasive Seronegative West Nile Virus in the Setting of R-CHOP Chemotherapy for Diffuse Large B-Cell Lymphoma
Authors: Yuen Alexander D. , Liu Jason Y. , Betancourt Jaime 
Published: July 2018

Abstract
West Nile virus (WNV) is a mosquito-borne infectious disease that can produce potentially life-threatening meningoencephalitis in immunocompromised individuals. In 2017, there were 536 human cases of WNV in California, with 43 fatalities reported to the California Department of Public Health. Peak mosquito transmission periods are in the late summer and early fall when mosquitoes are maximally viremic. In addition to risk factors such as advanced age, malignancy, or prior organ transplantation, the probability of progression to severe, neuroinvasive disease has been reported to be significantly higher in individuals suffering from lymphoma receiving rituximab in addition to other oncologic treatments. Here, we describe the case of a patient who recently received chemotherapy with rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone for diffuse large B-cell lymphoma, complicated by meningoencephalitis due to seronegative neuroinvasive WNV infection, ultimately resulting in death.
Hypertrophic Herpes Simplex—Pseudocarcinoma
Authors: Parker Laura R. , Stanford Brian J. , Nahass Ronald G. 
Published: July 2018

Abstract
Individuals with human immunodeficiency virus (HIV) are commonly coinfected with herpes simplex virus type 2 (HSV-2) and human papilloma virus (HPV). Herpes simplex virus type 2 in HIV-infected individuals can present as atypical hypertrophic lesions, and HPV-induced malignant lesions can present as atypical hyperkeratotic lesions. We report a case of an atypical hypertrophic HSV-2 lesion in a well-managed HIV-infected male with a history of nonmalignant Buschke-Lowenstein tumor (giant condyloma) of HPV and squamous cell carcinoma of the scrotum. Determining the definitive diagnosis of hypertrophic HSV-2 in this patient was confounded by the macroscopic clinical presentation of the proliferative lesion and by the patient's history of squamous cell carcinoma, in the same perineal region. Knowledge of hypertrophic HSV-2 is imperative when considering the etiologic agent of anogenital lesions in HIV-infected individuals.
Urban-Acquired Leptospirosis in Washington, DC
Authors: Lerner Andrea , Frost Spencer , Siegel Marc O. 
Published: July 2018

Abstract
Leptospirosis is rarely reported in the United States. Although primarily considered a disease of the tropics or of resource limited areas, leptospirosis is being reported more frequently in industrialized urban areas. We report a case of severe leptospirosis in a man living in Washington, DC, with occupational exposure to rats. A review of the literature was conducted, with a focus on the urban form of the disease, using the MEDLINE database from inception to May 2018.
Experimental muscle hyperalgesia modulates sensorimotor cortical excitability, which is partially altered by unaccustomed exercise
Authors: De Martino Enrico , Zandalasini Matteo , Schabrun Siobhan , Petrini Laura , Graven-Nielsen Thomas 
Published: July 2018

Abstract
Impaired corticomotor function is reported in patients with lateral epicondylalgia, but the causal link to pain or musculotendinous overloading is unclear. In this study, sensorimotor cortical changes were investigated using a model of persistent pain combined with an overloading condition. In 24 healthy subjects, the effect of nerve growth factor (NGF)-induced pain, combined with delayed-onset muscle soreness (DOMS), was examined on pain perception, pressure pain sensitivity, maximal force, and sensorimotor cortical excitability. Two groups (NGF alone and NGF + DOMS) received injections of NGF into the extensor carpi radialis brevis (ECRB) muscle at day 0, day 2, and day 4. At day 4, the NGF + DOMS group undertook wrist eccentric exercise to induce DOMS in the ECRB muscle. Muscle soreness scores, pressure pain thresholds over the ECRB muscle, maximal grip force, transcranial magnetic stimulation mapping of the cortical ECRB muscle representation, and somatosensory-evoked potentials from radial nerve stimulation were recorded at day 0, day 4, and day 6. Compared with day 0, day 4 showed in both groups: (1) increased muscle soreness (P < 0.01); (2) reduced pressure pain thresholds (P < 0.01); (3) increased motor map volume (P < 0.01); and (4) decreased frontal N30 somatosensory-evoked potential. At day 6, compared with day 4, only the DOMS + NGF group showed: (1) increased muscle soreness score (P < 0.01); (2) decreased grip force (P < 0.01); and (3) decreased motor map volume (P < 0.05). The NGF group did not show any difference on the remaining outcomes from day 4 to day 6. These data suggest that sustained muscle pain modulates sensorimotor cortical excitability and that exercise-induced DOMS alters pain-related corticomotor adaptation.
An outcome analysis of nurse practitioner care in a community hospital in Taiwan
Authors: Hu Jia-Ying , Tung Heng-Hsin , Tsay Shiow-Luan , Lin Wei-Cheng 
Published: July 2018

ABSTRACT

Purpose:
The purpose of this study is to examine the outcome of nurse practitioner care.

Data sources:
A descriptive survey design was conducted, with hospital-acquired conditions (HACs) used as an indicator of effectiveness of care. The two test groups included an attending physician–nurse practitioner group and an attending physician–resident physician group, which were compared in terms of effectiveness, using a 360° satisfaction–feedback survey provided to a peer group, as well as patients and their family members.

Conclusion:
According to patients and their family members, as well as the peer group, nurse practitioners performed better in comparison to resident physicians. In addition, the use of an HAC rating as an objective indicator of care efficiency indicated that nurse practitioners surpass resident physicians. This study not only confirmed that the attending physician–nurse practitioner model works well, based on the outcome analysis, but it also provided a new perspective and new evidence to show the value of nurse practitioner care in Taiwan.

Implications for practice:
Continuously increasing the training and education of nurse practitioners, while establishing a more comprehensive system for monitoring and evaluating their efficiency in accordance with hospital guidelines, is recommended and should lead to the provision of better services to meet patients' needs.
Cognitive outcomes after critical illness
Authors: Sakusic Amra , Rabinstein Alejandro A. 
Published: July 2018

Purpose of review
There is an increasing realization in the critical care community that persistent cognitive impairment is a common and disabling complication after ICU care. In this review, we discuss the best available information on the magnitude of the problem, its possible mechanisms, risk factors, management strategies and prognosis.

Recent findings
Estimates of the incidence of persistent cognitive impairment after critical illness vary widely across studies but the most solid prospective information indicates that it may occur in 20–40% of patients discharged from the ICU. From the available evidence, it is difficult to discriminate between de novo cognitive impairment and exacerbation of preexistent cognitive decline. The pathogenesis is multifactorial but inflammatory mechanisms causing derangements of endothelial function and blood–brain barrier integrity might play an important role. Brain atrophy and white matter tract disruption can be structural correlates of the cognitive decline. Prolonged delirium in the ICU is the strongest risk factor for the development of subsequent persistent cognitive impairment. Management strategies are currently limited to those designed to prevent and improve delirium. Cognitive trajectories may vary but a substantial proportion of patients with cognitive impairment 3 months after ICU discharge are still cognitively impaired at 12 months.

Summary
Persistent cognitive impairment is a major complication of critical illness. Our knowledge of this problem remains incomplete. Collaborative research is indispensable to improve our understanding of this disabling sequel and to identify ways to prevent it.
Regulatory dendritic cells: profiling, targeting, and therapeutic application
Authors: Thomson Angus W. , Ezzelarab Mohamed B. 
Published: July 2018

Purpose of review
There is currently increased focus on improved understanding of how dendritic cell tolerogenicity is determined and maintained, and on their therapeutic potential. We review recent progress in profiling of regulatory dendritic cells (DCreg), innovative approaches to enhancing dendritic cell tolerogenicity in situ, ex-vivo generation of DCreg and initial clinical testing of these cells in organ transplantation.

Recent findings
“Omics" studies indicate that the distinctive properties of DCreg are the result of a specific transcriptional program characterized by activation of tolerance-enhancing genes, rather than the retention of an immature state. In situ dendritic cell-directed targeting of nanovesicles bearing immune regulatory molecules can trigger in-vivo expansion of Ag-specific regulatory cells. Innovative approaches to ex-vivo modification of dendritic cells to enhance their regulatory function and capacity to migrate to secondary lymphoid organs has been described. Cross-dressing (with donor major histocompatibility complex molecules) of graft-infiltrating host dendritic cells that regulate antidonor T-cell responses has been implicated in “spontaneous" liver transplant tolerance. Clinical trials of DCreg therapy have begun in living donor renal and liver transplantation.

Summary
Further definition of molecules that can be targeted to promote the function and stability of DCreg in vivo may lead to standardization of DCreg manufacturing for therapeutic application.
Prognostic Value of Pretreatment Metabolic PET Parameters in Cervical Cancer Patients With Metabolic Complete Response After Concurrent Chemoradiotherapy
Authors: Son Seung Hyun , Jeong Shin Young , Chong Gun Oh , Lee Yoon Hee , Park Shin-Hyung , Lee Chang-Hee , Hong Chae Moon , Jeong Ju Hye , Lee Sang-Woo , Ahn Byeong-Cheol , Lee Jaetae 
Published: July 2018

Purpose
Cervical cancer may recur after concurrent chemoradiotherapy (CCRT), even in patients with metabolic complete response (mCR) on post-CCRT 18F-FDG PET. We retrospectively analyzed the value of metabolic parameters, measured by pretreatment PET, as prognostic factors for predicting recurrence and death in cervical cancer patients with mCR.

Methods
In 61 patients who reached mCR on post-CCRT, metabolic PET parameters including SUVmax, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumors, as well as those of the metastatic lymph nodes, were measured by pre-CCRT PET. Total MTV and total TLG were also measured from primary tumors and metastatic lymph nodes. Survival analyses for disease-free survival (DFS) and overall survival (OS) were performed.

Results
Eleven patients (18.0%) presented with recurrence of cervical cancer, and 12 (19.7%) died during follow-up. SUVmax, MTV, TLG of metastatic lymph nodes, and total TLG could significantly predict DFS, and nodal SUVmax could predict OS. Para-aortic lymph node metastasis also significantly correlated with both DFS and OS. In multivariate analysis, nodal SUVmax and para-aortic lymph nodes metastasis were prognostic factors for DFS, and the best predictor was nodal SUVmax. For OS, nodal MTV and para-aortic lymph node metastasis were significant prognostic factors in multivariate analysis, and the best predictor was para-aortic lymph node metastasis.

Conclusions
Metabolic PET parameters, SUVmax or MTV values of metastatic lymph nodes, may be surrogate prognostic markers for recurrence or death in patients with locally advanced cervical cancer who reached mCR after definitive CCRT.
68Ga-PSMA Uptake in Middle Lobe Syndrome
Authors: Pedersen Mette Abildgaard , Bouchelouche Kirsten , Vendelbo Mikkel Holm 
Published: July 2018

Abstract
Prostate cancer cells have abundant expression of the cell surface protein prostate-specific membrane antigen (PSMA). In recent years, PET radioligands detecting this protein has therefore gained substantial interest in prostate cancer staging. It turned out that PSMA expression can be evident in both malignant and benign lesions, and we have previously reported that pulmonary opacities and bronchiectasis can be avid on 68Ga-PSMA PET/CT. Here, we present a case with 68Ga-PSMA accumulation in nonobstructive middle lobe syndrome, which further indicate that benign changes in the lungs may be falsely interpreted as malignant disease.
18F-FDG PET/CT in an Atypical Case of Relapsed IgG4-Related Disease Presenting as Inflammatory Pseudotumor in Gall Bladder Fossa With Extensive Disease Involvement
Authors: Vadi Shelvin Kumar , Kumar Rajender , Mittal Bhagwant Rai , Parihar Ashwin Singh , Singh Harmandeep , Singh Shashank , Rana Surinder 
Published: July 2018

Abstract
Immunoglobulin G4–related disease (IgG4-RD) with multisystem involvement is known to mimic various malignancies and can be diagnosed with high clinical suspicion. We hereby report an atypical case of IgG4-RD, who presented as an inflammatory pseudotumor resembling gall bladder malignancy with hepatic, omental, and subcutaneous involvement. The characteristic tracer uptake pattern described on FDG PET/CT may not be always present in IgG4-RD, especially in the setting of postabdominal surgery. FDG PET/CT revealed the disease progression despite glucocorticoids and aided in response evaluation after second-line drug, rituximab.
18F-FDG PET/CT With Diffusely High FDG Uptake Throughout Subcutaneous Adipose Tissues
Authors: Kong Melissa Cindy , Nadel Helen Ruth 
Published: July 2018

AbstractA 9-year-old girl presented with facial rash, angioedema, fevers, and night sweats. She was diagnosed with chronic active Epstein-Barr virus infection and placed on chronic steroid treatment.18F-FDG PET/CT performed 3 weeks following presentation revealed diffuse subcutaneous soft tissue FDG activation throughout the entire body, with likely localization to white subcutaneous adipose tissue. This highly unusual appearance may have been due to the patient being treated with corticosteroids at the time of the scan.
Supporting self-management in palliative care throughout the cancer care trajectory
Authors: Schulman-Green Dena , Brody Abraham , Gilbertson-White Stephanie , Whittemore Robin , McCorkle Ruth 
Published: July 2018

Purpose of review
Despite increased survivorship and the subsequent need for chronic management of cancer, the association of self-management and palliative care is still emerging within cancer care. Routine and timely use of self-management strategies in the palliative setting can help reduce self-management burden and maximize quality of life. In this review, we consider the complementary relationship of self-management and palliative care and how they support living with cancer as a chronic illness.

Recent findings
Recent studies provide evidence of support among patients, family caregivers and healthcare professionals for integration of self-management interventions into palliative cancer care. As a guiding framework, components of the revised Self and Family Management Framework correspond to the provision of palliative care across the care trajectory, including the phases of curative care, palliative care, end-of-life care and bereavement. Additional work among self-management partners facing cancer and other life-limiting illnesses, that is patients, family caregivers and healthcare professionals, would be useful in developing interventions that incorporate self-management and palliative care to improve health outcomes.

Summary
There is an increasing acceptance of the complementarity of self-management and palliative care in cancer care. Their integration can support patients with cancer and their family caregivers across the care trajectory.