bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Anatomy and Possible Clinical Significance of the Postcentral Branches of Spinal Arteries in the L1–L5 Levels
Authors: Zhao Qinghao , Zhong Enyi , Shi Benchao , Ding Zihai , Jin Dadi , Li Qingchu 
Published: June 2019

Study Design:
This was a dissection-based study of 10 embalmed human cadavers.

Objective:
The objective of this study was to identify and describe the postcentral branches in the L1–L5 intervertebral foramina (IVF) and to determine their possible clinical significance.

Summary of Background Data:
The lower lumbar segmental arteries have been well studied. However, there are few articles with regard to the postcentral branches in the L1–L5 IVF.

Materials and Methods:
Eighty L1–L5 IVF from 10 embalmed cadavers were studied with a surgical microscope, and the postcentral branches were identified. The branches, origin, insertion, and spatial orientation of the postcentral branches in the L1–L5 IVF were examined. The diameter of the arteries was measured using a Vernier caliper.

Results:
In our study, the occurrence rate of a postcentral branch was 100.00% in the 80 IVFs. The postcentral branch was routinely divided into the following 2 types: type 1, postcentral branch main trunks (65.00%), which branch from the spinal arteries or lumbar arteries and then divide into 2 branches (superior and inferior branches), and type 2, superior and inferior branches, which branch straight from the spinal arteries (35.00%). The initial portion of the postcentral branches traveled around the anterolateral edge of the disk to the dorsum.

Conclusions:
Postcentral branches of spinal arteries are common structures in IVF; there are 2 types of postcentral branches. Thorough understanding of the spinal arteries before percutaneous endoscopic lumbar discectomy may be an important step in reducing intraoperative bleeding and ensuring clear visualization, which may result in significant benefits for patients.
Multicultural approaches of cancer pain
Authors: Crombez Patrick , Bron Dominique , Michiels Sandra 
Published: June 2019

Purpose of reviewPain continues to be a prevalent symptom in cancer patients. Patient's ethnicity may influence the experience of pain with variations in pain outcomes among different ethnic groups. The objective of this thematic review is to investigate the relationship between ethnicity and cancer pain experience, assessment and management.Recent findingsCancer pain is not only a biophysiological construct but is rather a multidimensional concept of physiological and psychosocial responses, including the biocultural dimension. Culture can significantly affect patients’ cancer pain-related beliefs and behaviors and patient's ethnicity may influence the experience of pain.We found a scarcity of data and an inconsistent literature that highlights gaps in knowledge, research and clinical practice concerning effective cancer pain management in a multicultural context.SummaryTo face disparities among ethnic minorities in cancer pain management, well-designed randomized controlled trials and robust qualitative research on cancer pain-related issues should inform good clinical practice. A close worldwide collaboration between researchers and clinicians and professional organizations is warranted.
Interactive Effect of Diurnal Temperature Range and Temperature on Mortality, Northeast Asia
Authors: Lee Whanhee , Chung Yeonseung , Michelle Choi Hayon , Kim Dahye , Honda Yasushi , Leon Guo Yue-Liang , Kim Ho 
Published: June 2019

Background:
The diurnal temperature range (DTR) represents temperature variability within a day and has been reported as a potential risk factor for mortality. Previous studies attempted to identify the role of temperature in the DTR–mortality association, but results are inconclusive. The aim of this study was to investigate the interactive effect of temperature and DTR on mortality using a multicountry time series analysis.

Methods:
We collected time series data for mortality and weather variables for 57 communities of three countries (Taiwan, Korea, and Japan) in Northeast Asia (1972–2012). Two-stage time series regression with a distributed lag nonlinear model and meta-analysis was used to estimate the DTR–mortality association changing over temperature strata (six strata were defined based on community-specific temperature percentiles). We first investigated the whole population and then, the subpopulations defined by temperature distribution (cold and warm regions), sex, and age group (people <65 and ≥65 years of age), separately.

Results:
The DTR–mortality association changed over temperature strata. The relative risk (RR) of mortality for 10°C increase in DTR was larger for high-temperature strata compared with cold-temperature strata (e.g., = 1.050; 95% confidence interval [CI] = 1.040, 1.060 at extreme-hot stratum and RR = 1.040; 95% CI = 1.031, 1.050 at extreme-cold stratum); extreme-hot and -cold strata were defined as the days with daily mean temperature above 90th and below 10th percentiles each community’s temperature distribution. Such increasing pattern was more pronounced in cold region and in people who were 65 years or older.

Conclusions:
We found evidence that the DTR–related mortality may increase as temperature increases.
Polybrominated Biphenyl Exposure and Menstrual Cycle Function
Authors: Howards Penelope P. , Terrell Metrecia L. , Jacobson Melanie H. , Taylor Kira C. , Kesner James S. , Meadows Juliana W. , Spencer Jessica B. , Manatunga Amita K. , Marcus Michele 
Published: June 2019

Background:
Brominated flame retardants, including polybrominated biphenyls (PBB), are persistent compounds reported to affect sex hormones in animals; less is known about potential effects in humans. An industrial accident in 1973–1974 exposed Michigan residents to PBB through contaminated food. We examined whether this exposure to PBB had long-term effects on menstrual cycle function.

Methods:
In 2004–2006, we recruited reproductive-aged women in the Michigan PBB Registry who were not pregnant, lactating, or taking hormonal medications. Participants kept daily diaries and provided daily urine samples for up to 6 months. We assayed the urine samples for estrone 3-glucuronide (E13G), pregnanediol 3-glucuronide (Pd3G), and follicle stimulating hormone (FSH). We fit linear mixed models among women aged 35–42 years to describe the relation between serum PBB levels and log-transformed, creatinine-adjusted daily endocrine levels among women who were premenarchal during the exposure incident in 1973–1974 (n = 70).

Results:
We observed that high (>3.0 parts per billion [ppb]) and medium (>1.0–3.0 ppb) PBB exposure were associated with lower E13G levels across the menstrual cycle and lower FSH levels during the follicular phase, compared with low PBB exposure (≤1.0 ppb). High PBB exposure was also associated with lower Pd3G levels across the cycle compared with low PBB exposure, whereas Pd3G levels were similar in women with medium and low PBB exposure.

Conclusion:
Our results are consistent with a hypothesized effect of exposure to an exogenous estrogen agonist but the modest sample size of the study requires cautious interpretation.
Reconstruction of the Congenital Divided Nevus of the Eyelids and Proposal of New Classification
Authors: Suzuki Akiyo , Yotsuyanagi Takatoshi , Yamashita Ken , Yoshimatsu Hidehiko 
Published: June 2019

Background:
Divided nevus is a rare form of congenital nevus that usually occurs on both upper and lower eyelids of one eye, forming one large nevus when the eyelids are closed. Typically, congenital melanocytic nevi of the body are classified according to their size (small < 1.5 cm, medium 1.5–20 cm, and large > 20 cm). However, because divided nevus of the eyelids is usually relatively small, this classification may be too coarse and not adequate. Furthermore, there is no practical classification for divided nevus of eyelids yet.

Methods:
We treated 3 cases of medium and large congenital divided nevus of the eyelids using local flaps based on the idea of esthetic subunits. Also, we proposed a new classification especially for congenital divided nevus of the eyelids based on the idea of esthetic subunits.

Results:
All patients were treated successfully with the reconstructive idea of esthetic subunits for the eyelids. Case 1 (medium size) was reconstructed by orbicularis musculocutaneous flap and case 2 (large size) was reconstructed by expanded flap, and case 3 (medium size) was treated by modified V-Y orbicularis oculi musculocutaneous flap. In all cases, the flap color and texture were well matched and satisfactory results were obtained. Also, by using the new classification, we were able to plan practical scheme for divided nevus reconstruction.

Conclusions:
The use of our proposed classification and esthetic subunits for the divided nevus of the eyelids allows systematic surgical planning, leading to improved reconstructive outcomes.
Women at the helm: Chief executive officer gender and patient experience in the hospital industry
Authors: Silvera Geoffrey A. , Clark Jonathan R. 
Published: June 2019

Background
Health care scholars have recognized the important role leaders play in the improvement of health care delivery systems, yet few have explored the kind of leaders who make a difference or the conditions under which certain health care executives thrive. Recent work in the hospital industry suggests that the role of chief executive officer (CEO) gender may be particularly salient in the context of patient experience (Galstian, Hearld, O’Connor, & Borkowski, 2018).

Purpose
In this article, we bring an explicit theoretical and empirical lens to the issue of CEO gender in the context of patient experience. Our framework provides an explanation of both why (differences between men and women in their tendency for relational orientation) and under what circumstances (the degree of complexity in the executive job environment) CEO gender is most influential.

Methodology/Approach
We test these relationships using data on patient experience in 391 nonrural U.S. hospitals between 2007 and 2011. Our study relies on both archival (e.g., Hospital Consumer Assessment of Healthcare Providers and Systems survey) and collected (e.g., CEO characteristics) data. Fixed-effects regression models are used to estimate the relationship between CEO gender and the interpersonal care experience.

Results
We find evidence that female CEOs improve the interpersonal care experience faster than male CEOs, particularly in the most complex executive job environments, that is, in the most populous urban environments, and in the largest hospital facilities.

Conclusion
Our results not only support the notion that executives tend to rely on personal values and preferences but also that women have an apparent propensity for transforming health care organizations in the direction of patient centeredness, particularly in the most demanding circumstances.

Practice Implications
Hospital boards seeking to improve the patient experience should give careful attention to promoting women to the role of CEO and consider how their own policies may be constraining both the promotion of female executives and the creation of more patient-centered health care organizations.
Changes in Corneal Biomechanical Properties After Descemet Membrane Endothelial Keratoplasty
Authors: Siggel Robert , Christofi Eleftheria , Giasoumi Fanouria , Adler Werner , Siebelmann Sebastian , Bachmann Björn , Cursiefen Claus , Heindl Ludwig M. 
Published: June 2019

Purpose:
To evaluate the course of corneal biomechanical properties (corneal hysteresis and corneal resistance factor) after Descemet membrane endothelial keratoplasty (DMEK) in patients with Fuchs endothelial dystrophy (FECD).

Methods:
In this prospective study, we consecutively included 49 patients with FECD with an indication for DMEK. Central corneal thickness, measured using the Oculus Pentacam, and corneal hysteresis (CH) and corneal resistance factor (CRF), both measured using the Reichert Ocular Response Analyzer, were examined preoperatively, 3 months, and 6 months after DMEK.

Results:
CH was significantly increased 6 months postoperatively (8.66 ± 2.50 mm Hg) compared with preoperative baseline (7.43 ± 1.56 mm Hg). Preoperative CRF (7.89 ± 1.68 mm Hg) increased significantly 6 months after DMEK (8.49 ± 1.71 mm Hg). Preoperative central corneal thickness showed a significant decrease from 629 ± 58 μm to 550 ± 40 μm after 3 months and 535 ± 40 μm after 6 months postoperatively.

Conclusions:
DMEK affects both measured corneal biomechanical properties in patients with FECD: CH and CRF. This has to be taken into account for the accuracy of intraocular pressure measurements.
Pasero Opioid-Induced Sedation Scale in a Pediatric Surgical Ward: A Quality Improvement Project
Authors: Garcia Mayra G. , McMullan Taralyn W. 
Published: June 2019

Abstract
Pediatric patients are at risk for adverse events associated with opioid medication. Sedation scales enable nurses to reach knowledgeable decisions maximizing patient safety during opioid administration. Adult literature has focused on the Pasero Opioid-Induced Sedation Scale (POSS) to address this risk in the adult population; however, literature in the pediatric setting is limited.

Purpose
The purpose of this quality improvement project was to implement the POSS tool in a pediatric setting and reduce adverse outcomes because of opioid oversedation and respiratory depression.

Methods
Two patient cohorts were recruited and evaluated to compare the number of medical emergency team calls, supplemental oxygen use, and length of stay. Bedside nurses received education on opioid-induced sedation and use of the POSS tool. Pretest and posttest surveys were conducted to acquire nurse perceptions of the POSS tool in pediatric postsurgical patients.

Results
No medical emergency team calls occurred in the preintervention and postintervention patient cohorts. Eight percent of the preintervention patient cohort required supplemental oxygen in comparison with no oxygen need in the postintervention group. In the postintervention patient cohort, length of stay averages were 185.85 hours (SD = 325.6) in comparison with 89.09 hours (SD = 76.6) in the preintervention group. Nursing survey results improved in nurses' confidence, usage, and assessment using the POSS tool. This project led to widespread use of POSS in the facility.

Conclusions
POSS is an appropriate tool to assess pediatric patients in acute care units. The POSS tool assists nurses in accurate assessments and reduces adverse events related to opioid-induced sedation.
Anatomical distribution and number of parathyroid glands, and parathyroid function, after total parathyroidectomy and bilateral cervical thymectomy
Authors: Uslu Adam , Okut Gokalp , Tercan Ismail Can , Erkul Zehra , Aykas Ahmet , Karatas Murat , Simsek Cenk , Tatar Erhan 
Published: June 2019

Abstract
The normal distribution of parathyroid glands is well documented. However, this study aims to evaluate the efficacy of total parathyroidectomy (TPTx) and bilateral cervical thymectomy (BCTx) for the treatment of secondary hyperparathyroidism (SHPT) through identifying the location of parathyroid glands with attention to the pattern and frequency of orthotopic and ectopic glands.
Between 2013 and 2018, sixty chronic hemodialysis patients with medically refractory SHPT underwent TPTx & BCTx. The adequacy of the operation was defined by the pathological confirmation of at least 4 parathyroid glands, accompanied by an intact parathormone (iPTH) value of <60 pg/mL on postoperative day 1(POD1). Based on their anatomical localizations, four distinct sites were identified for both the upper (Zone I–IV) and lower parathyroid glands (Zone V–VIII).
The mean follow-up was 15.2 ± 14.6 months. The mean iPTH values on POD1 were normal in 50 patients, with an average of 11.7 ± 14.4 pg/mL. Ten patients (16.6%) had persistent HPT after the operation, three of whom underwent complementary parathyroidectomy. The surgical success rates after first and second operations were both 83.3%. A total of 235 parathyroid glands were detected. Ninety-two percent of the upper parathyroids were located in Zones I and II. However, almost 28% of the lower parathyroids were ectopic and located in Zones VII and VIII.
At least one fourth of the lower parathyroids are ectopic; for this reason, Zones VII and VIII require careful investigation during surgery. For upper parathyroids not found in Zone I–III, total thyroidectomy on the same side is recommended.
IP-10 for the diagnosis of tuberculosis in children
Authors: Zhang Weijun 
Published: June 2019

Abstract

Background:
Tuberculosis (TB) is a highly contagious and chronic disease. The microbiological examination to confirm children TB disease are limited due to paucibacillary Mycobacterium, specimens and detecting facilities. Considering these limitations in diagnosing children TB, new and reliable methods that detect children TB should be developed. Recently, Interferon gamma-induced protein 10 (IP-10) has been identified as a sensitive parameter in detecting children TB. The present study aims to synthesis and analysis the diagnostic value of IP-10 for children TB.

Methods:
We will search PubMed, Embase, the Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, and Chinese Biological Medical Databases. We will search relevant citations up to May 2019. The quality of individual study will be assessed using the Quality Assessment of Diagnostic Accuracy Studies tool-2 (QUADAS-2). Stata 14.0 software will be used to calculate the pooled sensitivity, pooled specificity, pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio (DOR), pre-test probability, post-test probability and the hierarchical summary receiver operating characteristic (HSROC) curve.

Results:
The results of this study will be published in a peer-reviewed journal.

Discussion:
The evidence will indicate that IP-10 test is an alternative immunological test in detecting children TB. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required.

Protocol registration number:
CRD42019129743.
Management and outcomes of hepatorenal syndrome at an urban academic medical center: a retrospective study
Authors: Bashir Muhammad H. , Iqbal Sadat , Miller Regina , Singh Joie , Mubarak Ghassan , Likhtshteyn Michelle , Bigajer Elliot , Gallagher Bridget , Hurairah Abu , Stefanov Dimitre , McFarlane Samy I. , Ferstenberg Richard 
Published: June 2019

Objectives
This study is aimed to evaluate the management of acute kidney injury (AKI) in our inner city, American hospital. We intended to ascertain whether or not there is prompt recognition of AKI in cirrhosis according to International Club of Ascites and acute kidney injury network criteria as well how effective we are at distinguishing among different causes of AKI. We aimed to calculated the mortality of hepatorenal syndrome (HRS) in our hospital, and to evaluate the adequacy of the established treatment of AKI at each stage of its algorithm.

Patients and methods
ICD diagnostic codes were used to identify patients with liver cirrhosis and acute renal failure. A total of 725 patients met the search criteria. We excluded the patients without clinical or imaging evidence of ascites, heart failure, on hemodialysis, baseline creatinine more than 1.5 mg/dl and patients who died within 48 h of developing acute renal failure. 291 patients met the inclusion criteria. All statistical analyses were performed using SPSS version 23.0 software with a two-sided significance level set at P value less than 0.05.

Results
Mean age was 55.7 ± 0.61 and baseline serum creatinine was 0.94 ± 0.14. 66.5% of patients were African American, 27.3%, Hispanic, and 4.3% White. The average rise in creatinine from baseline was 1.36 ± 0.08 mg/dl. 27.2% of patients met the diagnostic criteria of HRS. 92.3% of patients with HRS received intravenous fluids and 75.4% received intravenous albumin within 48 h of acute creatinine rise. The in-hospital mortality rate was 14.1, 23.3, and 41.5% for patients with pre-renal azotemia, ARF, and HRS, respectively (P < 0.01).

Conclusion
This study demonstrates that with present tools, there is significantly higher mortality in HRS despite guideline-based treatment. Biomarkers for early diagnosis of HRS are necessary to avoid delays in initiation of HRS treatment while establishing the diagnosis. As well, worldwide standardization of the treatment of HRS will be important if the outcome is to be improved.
Comparisons of Outcomes of Real-World Patients With Advanced Pancreatic Cancer Treated With FOLFIRINOX Versus Gemcitabine and Nab-Paclitaxel
Authors: Papneja Neha , Zaidi Adnan , Chalchal Haji , Moser Michael , Tan Kiat , Olson Colleen , Haider Kamal , Shaw John , Ahmed Shahid 
Published: June 2019

Objectives
The aim of this study was to compare the efficacy and safety of FOLFIRINOX (5-FU/leucovorin, irinotecan, and oxaliplatin) and gemcitabine/nab-paclitaxel (GnP) in patients with advanced pancreatic cancer.

Methods
Patients with newly diagnosed advanced pancreatic cancer in Saskatchewan, Canada, from 2011 to 2016, who received FOLFIRINOX or GnP were assessed. A Cox proportional multivariate analysis was performed to evaluate prognostic variables.

Results
One hundred nineteen eligible patients with median age of 61 years and male/female ratio of 70:49 were identified. Seventy-seven percent had metastatic disease. Of 119 patients, 86 (72%) received FOLFIRINOX and 33 (28%) were treated with GnP. Median progression-free survival of the FOLFIRINOX group was 6.0 months [95% confidence interval (CI), 4.5–7.5] versus 4.0 months (95% CI, 2.9–5.1) with GnP (P = 0.39). The median overall survival of the FOLFIRINOX group was 9.0 months (95% CI, 7–11) compared with 9.0 months (95% CI, 4.2–13.8) with GnP (P = 0.88). On multivariate analysis, albumin [hazard ratio (HR), 0.63; 95% CI, 0.41–0.97], male sex (HR, 0.65; 95% CI, 0.43–0.97), and second-line therapy (HR, 0.50; 95% CI, 0.28–0.86) were correlated with survival.

Conclusions
Our results showed that real-world patients with advanced pancreatic cancer treated with FOLFIIRNOX or GnP had comparable survival with different safety profile.
Cold Vibration (Buzzy) Versus Anesthetic Patch (EMLA) for Pain Prevention During Cannulation in Children
Authors: Bourdier Stéphanie , Khelif Nedjoua , Velasquez Maria , Usclade Alexandra , Rochette Emmanuelle , Pereira Bruno , Favard Brigitte , Merlin Etienne , Labbé André , Sarret Catherine , Michaud Elodie 
Published: June 2019

Introduction
The purpose of this study was to assess differences in observed pain-related behaviors during cannulation between a device combining cold and vibration (Buzzy) and the standard care (EMLA patch).

Methods
Patients 18 months to 6 years old, requiring venous access in a pediatric emergency department, received either the Buzzy device or the EMLA patch. Predefined week randomization ensured equal allocation to the 2 intervention groups. Pain during cannulation was measured using the Children's Hospital of Eastern Ontario Pain Scale. Parent and nurse reports, cannulation success, and venous access times were also assessed.

Results
In total, 607 included patients were randomized into the Buzzy group (n = 302) or the EMLA group (n = 305). Observed pain-related behaviors scores, parent-assessed pain scores, and nurse-reported pain ratings were higher with Buzzy.

Conclusions
Pain relief by a combination of cold and vibration during cannulation is not as effective as the standard-care method in children 18 months to 6 years old.