bluuebunny/crossref_metadata_2025_split huggingface dataset:
PERFORMANCE EVALUATION OF THE EQUIPMENT FOR MEASURING RADIOACTIVITY IN WHOLE FOODSTUFFS WITHOUT DESTRUCTIVE SAMPLE PREPARATION DEVELOPED AFTER THE FUKUSHIMA NPP ACCIDENT
Authors: Yamada Takahiro , Soga Keisuke , Hachinohe Mayumi , Hachisuka Akiko 
Published: April 2019

Abstract
Recently, several types of instruments for measuring radioactivity in whole foodstuff were developed by manufacturers, in which any sample preparation technique such as machining was avoided, and such types of instruments are employed by agricultural producers or municipality radioactivity testing stations in Fukushima. In this study, radioactivity in various kinds of 91 samples collected by residents were measured by use of instruments for radioactivity measurement in whole samples, and the activity in each sample was also measured by use of the conventional gamma-ray spectrometry technique using calibrated Ge detectors after the sample machining procedure. The results obtained by instruments for measurement in whole samples were roughly proportional to the result obtained by a conventional technique, although large differences or unexpected variations were found in some specimens.
Opportunity, Social Mobility, and Women’s Views on Gender Roles in Central Asia
Authors: Urbaeva Jildyz 
Published: April 2019

Abstract
Central Asian countries represent an important context for understanding intersections between Islam, patriarchy, and women’s well-being. In recent decades, challenges and opportunities resulting from transitions to a market economy exacerbated gender imbalances in labor markets and opportunity structures of the region. Women of the region are highly educated and make significant economic contributions to support their families through employment. However, their views about gender roles remain unclear, and it is also uncertain whether opportunity structures and social mobility have influenced these views. The current study addresses these gaps using probability-based survey data (N = 3,405) from four Central Asian countries: Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan. Latent class analysis reveals three latent profiles of women’s views on gender roles: traditional views, egalitarian views, and dual views. Religious identity, education, opportunity structure, and social mobility intersect with women’s ideas about gender roles.
Cross-cultural Applicability of the 12-Step Model: A Comparison of Narcotics Anonymous in the USA and Iran
Authors: Galanter Marc , White William L. , Hunter Brooke D. 
Published: April 2019

Objective:
Narcotics Anonymous (NA), a nonprofessional 12-step fellowship for people seeking recovery from addiction, reports 27,677 meetings in the USA, where it was founded, but there is limited literature on its adaptability cross-culturally. We studied NA within the Islamic Republic of Iran to ascertain its relative adaptation in a different cultural setting.

Method:
We surveyed 262 NA members in Iran, supplemented by member interviews, and compared demographic and substance use-related characteristics of members, and also the nature of their respective involvement in NA, to the survey results of a previous US survey (n = 527).

Results:
NA in Iran reports 21,974 meetings. The Iranian respondents surveyed differed relatively little (d < 0.50) from US members on demographics and prior ambulatory substance use disorder treatment, but did have fewer female members (means for Iran and US: 42.4 vs 39.0 years; 77% vs 87%; 6% vs 28%, respectively). They were, however, more involved in the fellowship (d > 0.50) in terms of reporting service as sponsors, experience of spiritual awakening, and achievement of diminished craving (scores of 1–10) (85% vs 48%; 95% vs 84%; 1.03 vs 1.89, respectively). Surveyed NA members in Iran publicized the fellowship with public (36%) and religious (20%) figures, and systematically worked the 12 steps in large sponsor-led groups (

JOURNAL/jamed/04.03/01271255-201912000-00013/inline-graphic1/v/2023-07-18T035637Z/r/image-tiff

= 19 members).

Conclusion:
NA, a 12-step program developed in a Western, predominantly Christian-oriented country, was adapted widely in the Islamic Republic of Iran, a setting different in culture, language, ethnicity, and religious orientation. The growth in its membership derives, in part, from specific innovations that may have broader applicability in other settings.
Suppressive Effect of Everolimus on IL-2, IL-10, IL-21, and IFNγ Levels: Implications for the Successful Minimization of Calcineurin Inhibitor Use in Transplantation
Authors: Iwasaki Kenta , Kitahata Nana , Miwa Yuko , Uchida Kazuharu , Matsuoka Yutaka , Horimi Kosei , Kobayashi Takaaki 
Published: April 2019

Background:
Success with calcineurin inhibitors (CNIs) such as cyclosporine A (CSA) and tacrolimus (TAC) in organ transplantation has demonstrated that cytokine suppression is a key factor in patient management. However, the exact effects of recently introduced immunosuppressive agents other than CNI on cytokine expression remain unknown. In this study, the action of the mTOR-inhibitor everolimus (EVR) and that of the antimetabolite mycophenolic acid (MPA) on the transcription of several cytokines was investigated.

Methods:
Peripheral blood mononuclear cells obtained from healthy volunteers were stimulated with anti-CD3/28 microbeads in the presence of CSA, TAC, EVR, and/or MPA for 8 hours. The mRNA levels of each cytokine were measured using quantitative real-time polymerase chain reaction.

Results:
MPA had no inhibitory effect on any of the cytokines tested. EVR showed moderate inhibition of IL-2, IL-10, IL-21, and IFNγ levels. These cytokines were further analyzed to investigate the additive effect of EVR in combination with CNI. The beneficial effect of EVR addition was seen at low concentrations of CSA or TAC, while no additive effect was observed at high concentrations.

Conclusions:
EVR might effectively inhibit the activation of recipient immune cells in combination with a low dose of CNI, maximizing clinical benefit by preventing graft rejection and alleviating CNI-induced adverse effects.
CORRELATION BETWEEN MACULAR MICROSTRUCTURES AND ANISEIKONIA AFTER IDIOPATHIC EPIRETINAL MEMBRANE REMOVAL
Authors: Moon Byung GIL , Yang Young Seong , Chung Heeyoung , Sohn Joonhong 
Published: April 2019

Purpose:
To analyze the correlation between preoperative measurements of macular microstructures and aniseikonia after epiretinal membrane removal.

Methods:
This retrospective study included 32 eyes of 32 patients who underwent epiretinal membrane surgery and were followed up for 12 months. Spectral-domain optical coherence tomography was used to measure the thicknesses of the ganglion cell layer–inner plexiform layer, inner nuclear layer (INL), and outer retinal layer in macular microstructures. The new aniseikonia test was used to measure vertical and horizontal aniseikonia scores.

Results:
There was a significant decrease in central macular thickness and ganglion cell layer–inner plexiform layer thickness at 6 and 12 months postoperatively (all P < 0.001). Vertical aniseikonia scores, horizontal aniseikonia scores, and INL and outer retinal layer thicknesses did not show significant changes. Vertical aniseikonia scores and horizontal aniseikonia scores were significantly associated with INL thicknesses of each meridian at each follow-up time point (all P < 0.05). Preoperative vertical and horizontal INL thicknesses were correlated with vertical aniseikonia scores and horizontal aniseikonia scores at 12 months postoperatively (P = 0.014 and P = 0.002, respectively).

Conclusion:
Aniseikonia values did not change after epiretinal membrane removal and were associated with INL thickness before and after surgery. Thus, preoperative INL thickness could be used as a predictor of surgical prognosis in epiretinal membrane patients.
Adolescent vaccinations: updates for the general practitioner
Authors: Mealey Kathleen , Koenigs Laura M.P. 
Published: April 2019

Purpose of review
Adolescent providers have a unique opportunity to interface with adolescents during a transformative time period. Optimizing vaccinations may protect teens against preventable but potentially deadly diseases. Healthcare providers must be aware of the evolving vaccination data and up-to-date recommendations for vaccinations.

Recent findings
In spite of the Center for Disease Control recommendations, there is a gap between the actual and desired vaccination rates of adolescents. Tetanus, diphtheria, and acellular pertussis, meningococcal against ACWY serotypes, and human papillomavirus (HPV) are vaccinations unique to the adolescent period. There has been a marked increase in pertussis cases over the last 2 decades. Either of the meningitis B vaccines may be given to 16–18 year olds and are effective in controlling college outbreaks. Increasing evidence continues to demonstrate the safety and efficacy of the HPV vaccination, although a substantial number of adolescents remain unvaccinated. Fortunately, there are proven strategies to remedy this.

Summary
Adolescent providers should be aware of the increase in pertussis cases over the past 2 decades and the Category B recommendation for meningococcal B vaccine at 16–18 years, and they should work towards closing the gap between the actual and desired HPV vaccination rates.
Mindfulness-based interventions for adolescent health
Authors: Lin Jessica , Chadi Nicholas , Shrier Lydia 
Published: April 2019

Purpose of review
Mindfulness, the practice of paying attention to the present moment, purposefully and nonjudgmentally, has been gaining popularity as adjunct treatment for adolescents with a range of physical and mental health problems. Research conducted in adults and emerging research conducted in adolescents has shown that mindfulness-based interventions can improve outcomes in several areas. The purpose of this review is to discuss recent research on the effects of mindfulness and suggest exercises that primary care clinicians can offer to their adolescent patients.

Recent findings
Research has shown positive effects of mindfulness across several health conditions commonly encountered during adolescence. Mindfulness-based Interventions can reduce symptoms of anxiety and depression. The application of mindfulness can help with the prevention and treatment of binge eating, over-eating, and restrictive eating disorders. In the treatment of substance use disorders, mindfulness can improve emotion regulation and reduce symptoms of withdrawal and craving. Mindfulness can also lead to improvement in overall quality of life for patients suffering from chronic pain. Lastly, mindfulness can be useful for adolescents with ADHD, sleep problems, chronic illness, and stress related to performance sports.

Summary
Although research in adolescents remains limited, mindfulness holds promise in the treatment of a range of health conditions in adolescents.
Serial Z-plasty for Correction of Cicatricial Conjunctival Constriction Rings
Authors: Bi Xiaoping , Sun Ying , Fan Xianqun 
Published: April 2019

Background:
Cicatricial conjunctival constriction rings caused by trauma seriously influences visual function and causes blepharon deformities. The treatment of cicatricial conjunctival constriction rings is intractable.

Methods:
A 45-year-old male presented severe cicatricial conjunctival constriction ring due to traffic accident injury. This 5-mm diameter constriction ring resulted in the patient's eyelid deformities, including eyelid ptosis, ectropion, and visual obstruction. The patient underwent primary surgery of serial conjunctival Z-plasty for correction of the constriction ring. Conjunctival constriction ring was corrected immediately after Z-plasy. Fornix deepening suturing was adopted to promote formation of fornix and correct eyelid ectropion. A secondary surgery of frontalis flap suspension was adopted to correct ptosis 6 months after Z-plasty.

Results:
The patient achieved a satisfactory and symmetrical appearance with no recurrence of cicatricial conjunctival constriction and no other complications during the 6-month follow-up period.

Conclusion:
In this patient, the authors claimed that serial Z-plasty surgery can effectively be used for correction of cicatricial conjunctival constriction rings. No further material implantation was applied during the operation.
In Vitro Evaluation of the Effects of Different Fixation Methods on Stabilization of Mandibular Body Fractures
Authors: Polat Mehmet Emrah , Dayi Ertunc 
Published: April 2019

Purpose:
Mandibular body fractures are considered to be one of the most affected fracture sites in the maxillofacial region. Although the rates of fracture in this region are high, biomechanical evaluations related to this region are rare. The purpose of this investigation was to reveal the effects of different treatment methods onmandibular body fractures.

Method:
Twenty-five synthetic polyurethane hemi-mandibles were used in this study. The hemi-mandibles, which simulated simple unfavorable mandibular body fractures, were divided into 5 groups (n = 5/group) according to the treatment method. The bone segments were fixed using different osteosynthesis methods and 2.0 mm miniplate/screw systems. The groups consisted of locking or conventional systems, 5 or 11 mm long screws and 4 or 6 holes. The hemi-mandibles were loaded vertically with compressive strength until they reached 120 N.

Results:
The results were analyzed using Tamhane's T2 post hoc test, and the significance level was 0.05. Group 1 had the lowest mechanical resistance of all groups and group 5 had the highest. No significant differences were observed in group 2 or 3.

Conclusion:
The locking system miniplate group showed better fixation stability than the conventional systems for the same screw length, and the number of holes and screw length seemed to be effective for stabilization.
Piezoelectric Drilling Hole Technique in Septal Fixation
Authors: Demirbilek Nevzat , Evren Cenk , Çelik Mustafa 
Published: April 2019

Objectives:
The act of securing the septum to the midline is very important for the success of the operation during septoplasty and septorhinoplasty operations. The authors’ aim in this study is to open a hole in the anterior nasal spine with the Piezoelectric drilling hole technique so as to fix the septum to the midline with a suture passing through that hole.

Methods:
Patients with anterior segmental deviation on whom we performed septoplasty or closed technique septorhinoplasty were included in the study. The patients were divided into 2 groups, as the Classic and Piezo Groups. A total of 63 patients were included in the study; in the Classic Group, we performed septum fixation with suture of the nasal spine to the mucoperiosteum in 27 patients; whereas in the Piezo Group, fixation was performed on 36 patients using the piezo-surgical suture through a nasal spinal opening. Patients were assessed preoperatively and postoperatively by VAS and NOSE scores, and also by postoperative examinations.

Results:
Preoperative and postoperative VAS-NOSE scores were found to be statistically significantly different in both groups (P < 0.0001, P < 0.0001). Redeviation with no need for revision surgery was reported to develop in 1 patient of the classical group (3.7%).

Conclusion:
Piezoelectric drilling hole technique provides stronger fixation in the midline and prevents postoperative redeviation. Its most important superiority over the other methods used in fixing the septum to the nasal spine is its ability to provide adequate stabilization without damaging soft tissue.
Nasal Alar Pressure Ulcer After Orthognathic Surgery: Clinical Presentation and Preventive Recommendations
Authors: Brasileiro Bernardo Ferreira , Van Sickels Joseph E. 
Published: April 2019

Abstract
Nasotracheal intubation is routinely used in patients undergoing oral and maxillofacial surgery when intermaxillary fixation is needed either intraoperatively or postoperative. Various complications can occur such as epistaxis, turbinectomy, retropharyngeal dissection, tympanites, and nasal alar pressure sores or necrosis, especially when there is a prolonged nasotracheal intubation. The first report of a nasal alar necrosis after prolonged nasotracheal intubation was published by Hatcher et al in 1968. Since then several reports of skin necrosis of the nasal alar region have been published and attributed to a prolonged operation or the technique used in tube placement. Pressure ulcers are a localized damage to the skin and underlying soft tissue and usually appear immediately after the procedure. They start with nonblanchable erythematous intact skin and can evolve to partial thickness loss of skin with exposed dermis and scab formation during the healing process. They may be painful and can cause a cosmetic problem for patients. The literature has several studies of nasal alar necrosis after nasotracheal intubation for head and neck reconstructive surgery, but there is no description of this complication after orthognathic surgery. This paper describes the occurrence of skin nasal alar necrosis following a bimaxillary jaw correction and highlights recommendations for its management and prevention.
Low Uric Acid Indicates Risk of Incidence of Trigeminal Neuralgia
Authors: Chang Bowen , Guan Haochen , Zhu Wanchun , Li Shiting 
Published: April 2019

Background and Objective:
Trigeminal neuralgia (TN) is a common cranial nerve disease. Uric acid (URIC), a water-soluble antioxidant discovered in human body, has been recognized in numerous recent studies to exert a crucial part in neuroprotection; however, the influence of URIC on TN remains unclear so far. This study aimed to examine the association of URIC with TN.

Methods:
From January 2017 to September 2018, medical records from the newly diagnosed patients with TN at the Xinhua Hospital were retrospectively recruited and analyzed. The serum URIC, creatinine, blood urea nitrogen, and albumin levels between TN patients and normal subjects were compared through the nonparametric tests. Moreover, the relationship of URIC levels with TN was assessed using the multiple linear regression models.

Results:
Compared with normal subjects (325.7 ± 74.3 μmol/L), URIC contents were remarkably decreased in TN patients (270.2 ± 75.9 μmol/L) (P < 0.05). Besides, URIC was regarded as a protective factor of TN, as verified by multivariate logistic regression models (odds ratio = 0.2, 95% confidence interval = 0.0–0.6; P < 0.05).

Conclusion:
Low URIC content is associated with the risk of incidence of TN, and appropriately increasing the URIC level may prevent TN.
Spontaneous Mediastinal Abscess and Sternal Cleft in the Medically Complex Neonate
Authors: Wiggins Claire J. , Dempsey Robert F. , Monson Laura A. 
Published: April 2019

Abstract
Sternal cleft (SC) is a rare congenital anomaly, occurring with associated developmental anomalies or in isolation. Surgery to reconstruct the sternum is indicated to protect the visceral organs from trauma, to ensure healthy cardiopulmonary function and growth, and to reconstruct the anterior chest wall. Although infection recognized as a postoperative complication following chest wall reconstruction, spontaneous mediastinal infection is rare. To the authors’ knowledge, there is only 1 reported case of spontaneous mediastinal infection with concomitant SC in the literature. Here, the authors present a unique case of a medically complicated infant with a SC who presented with a spontaneous mediastinal abscess.
Determining the incidence of distraction among trauma patients in all modes of transportation
Authors: Le Brittany , Figueroa Cesar , Anderson Craig , Lotfipour Shahram , Barrios Cristobal 
Published: April 2019

BACKGROUND
The use of distracting technology is an increasing source of risk for injury among trauma patients. Both drivers and pedestrians show increased unsafe behavior. The data for prevalence and risk for distraction in trauma has varied widely. Our hypothesis is that distraction is more highly prevalent and widely distributed among all mechanisms of injury and variety of trauma patients.

METHODS
A 10-question survey of adult trauma victims at a Level I trauma center regarding distraction at time of event was performed, examining age, sex, ethnicity, education level, mode of injury and role in the accident (driver, passenger, pedestrian, bicyclist, motorcyclist). Multiple-variable logistic regression was performed to identify risk factors for distraction.

RESULTS
From June 2016 to October 2018, 1,316 patients were surveyed, and 1,011 (76.8%) patients reported their role in the traffic accident. The prevalence of distraction was 21.73% among drivers, 9.01% among passengers, 16.50% among pedestrians, 20.00% among bicyclists, and 8.09% among motorcyclists. Males (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.26–2.67) as well as all Others (OR, 2.09; 95% CI, 1.10–3.98) showed statistically significant increased risk for distraction. Motorcyclist (OR, 0.25; 95% CI, 0.13–0.50) and passenger (OR, 0.37; 95% CI, 0.18–0.77) roles during collision were a lowered risk of distraction. Furthermore, Asian/Pacific Islanders (OR, 1.62; 95% CI, 0.94–2.79) trended toward being at greater risk for distraction.

CONCLUSION
Distraction is prevalent among a wide range of traffic accident victims, not just drivers. Males as well as all Others are more likely to be distracted. In contrast, motorcyclists and passengers are less likely to be distracted. Further studies to assist in determining effective interventions and public safety efforts aimed at specific at-risk groups beyond motor vehicle drivers are warranted.

LEVEL OF EVIDENCE
Epidemiological, level V.
Ventilator-associated events, not ventilator-associated pneumonia, is associated with higher mortality in trauma patients
Authors: Meagher Ashley D. , Lind Margaret , Senekjian Lara , Iwuchukwu Chinenye , Lynch John B. , Cuschieri Joseph , Robinson Bryce R.H. 
Published: April 2019

BACKGROUND
Ventilator-associated events (VAE), using objective diagnostic criteria, are the preferred quality indicator for patients requiring mechanical ventilation (MV) for greater than 48 hours. We aim to identify the occurrence of VAE in our trauma population, the impact on survival, and length of stay, as compared to the traditional definition of ventilator-associated pneumonia (VAP).

METHODS
This retrospective review included adult trauma patients, who were Washington residents, admitted between 2012 and 2017, and required at least 3 days of MV. Exclusions included patients with Abbreviated Injury Scale head score greater than 4 and burn related mechanisms of injury. We matched trauma registry data with our institutional, physician-adjudicated, and culture-confirmed ventilator event database. We compared the clinical outcomes of ventilator-free days, intensive care unit length of stay, hospital length of stay, and likelihood of death between VAE and VAP.

RESULTS
One thousand five hundred thirty-three trauma patients met criteria; 124 (8.1%) patients developed VAE, 114 (7.4%) patients developed VAP, and 63 (4.1%) patients met criteria for both VAE and VAP. After adjusted analyses, patients with VAE were more likely to die (hazard ratio [HR], 2.86; 95% confidence interval [CI], 1.44–5.68), than those with VAP, as well those patients with neither diagnosis (HR, 2.83; 95% CI, 1.83–4.38). Patients with VAP were no more likely to die (HR, 1.55; 95% CI, 0.91–2.68) than those with neither diagnosis. Patients with VAE had fewer ventilator-free days than those with VAP (HR, −2.71; 95% CI, −4.74 to −0.68).

CONCLUSION
Critically injured trauma patients who develop VAE are three times more likely to die and utilize almost 3 days more MV than those that develop VAP. The objective criteria of VAE make it a promising indicator on which quality indicator efforts should be focused. Future studies should be aimed at identification of modifiable risk factors for VAE and their impact on outcome, as these patients are at high risk for death.

LEVEL OF EVIDENCE
Retrospective cohort study, level III.