bluuebunny/crossref_metadata_2025_split huggingface dataset:
Job Satisfaction Among Methadone Maintenance Treatment Clinic Service Providers in Jiangsu, China: A Cross-sectional Survey
Authors: Chen Guohong , Lin Chunqing , Chen Yuheng , Li Li , Luo Sitong , Liu Xiaoyan , Huan Xiping , Cao Xiaobin , McGoogan Jennifer M. , Wu Zunyou 
Published: April 2019

Objective:
Service providers’ job satisfaction is critical to the stability of the work force and thereby the effectiveness of methadone maintenance treatment (MMT) programs. This study aimed to explore MMT clinic service providers’ job satisfaction and associated factors in Jiangsu, China.

Methods:
This secondary study used baseline data of a randomized interventional trial implemented in Jiangsu, China. A survey was conducted among 76 MMT service providers using the computer-assisted self-interview (CASI) method. Job satisfaction responses were assessed via a 30-item scale, with a higher score indicating a higher level of job satisfaction. Perceived institutional support and perceived stigma due to working with drug users were measured using a 9-item scale. Correlation and multiple linear regression analyses were performed to identify factors associated with job satisfaction.

Results:
Correlation analyses found a significant association between job satisfaction and having professional experience in the prevention and control of HIV, other sexually transmitted infections, or other infectious diseases (P = 0.046). Multiple regression analyses revealed that working at MMT clinics affiliated with Center for Disease Control and Prevention sites was associated with a lower level of job satisfaction (P = 0.014), and perception of greater institutional support (P = 0.001) was associated with a higher level of job satisfaction.

Conclusion:
Job satisfaction among MMT clinic service providers was moderate in our study. Our findings suggest that institutional support for providers should be improved, and that acquisition of additional expertise should be encouraged.
Pain Anxiety as a Mechanism Linking Pain Severity and Opioid Misuse and Disability Among Individuals With Chronic Pain
Authors: Rogers Andrew H. , Bakhshaie Jafar , Zvolensky Michael J. , Vowles Kevin E. 
Published: April 2019

Objective:
Chronic pain affects a significant number of individuals in the United States and is associated with several negative health-related outcomes, including possibility of opioid misuse and disability. The identification of factors associated with both opioid misuse and disability is of critical public health importance, and significant research suggests that pain severity has been shown to be associated with both. Pain-related anxiety has been uniquely associated with both opioid misuse and disability, yet little research has examined pain-related anxiety as a potential mechanism linking pain severity with opioid misuse and disability.

Method:
Therefore, the current study examined whether pain-related anxiety explains, in part, the relationship between pain severity, opioid misuse, and disability among 396 adults with chronic pain (55.8% female, Mage 36.61, SD 11.40).

Results:
Cross-sectional analyses indicated that pain-related anxiety significantly mediated the relationship between pain severity, opioid misuse outcomes, and psychosocial disability, but not physical disability.

Conclusions:
These results build upon the literature indicating the importance of pain-related anxiety in those with chronic pain by suggesting this construct may account, in part, for the relation of pain intensity to opioid misuse and psychosocial disability. Future research should longitudinally examine these associations.
Application of machine learning in the diagnosis of axial spondyloarthritis
Authors: Walsh Jessica A. , Rozycki Martin , Yi Esther , Park Yujin 
Published: April 2019

Purpose of reviewIn this review article, we describe the development and application of machine-learning models in the field of rheumatology to improve the detection and diagnosis rates of underdiagnosed rheumatologic conditions, such as ankylosing spondylitis and axial spondyloarthritis (axSpA).Recent findingsIn an attempt to aid in the earlier diagnosis of axSpA, we developed machine-learning models to predict a diagnosis of ankylosing spondylitis and axSpA using administrative claims and electronic medical record data. Machine-learning algorithms based on medical claims data predicted the diagnosis of ankylosing spondylitis better than a model developed based on clinical characteristics of ankylosing spondylitis. With additional clinical data, machine-learning algorithms developed using electronic medical records identified patients with axSpA with 82.6–91.8% accuracy. These two algorithms have helped us understand potential opportunities and challenges associated with each data set and with different analytic approaches. Efforts to refine and validate these machine-learning models are ongoing.SummaryWe discuss the challenges and benefits of machine-learning models in healthcare, along with potential opportunities for its application in the field of rheumatology, particularly in the early diagnosis of axSpA and ankylosing spondylitis.
New therapeutic agents in gastrointestinal stromal tumours
Authors: Falkenhorst Johanna , Hamacher Rainer , Bauer Sebastian 
Published: April 2019

Purpose of review
The aim of this study was to provide an update on the most recent developments regarding systemic treatments in the various molecular subtypes of gastrointestinal stromal tumour (GIST).

Recent findings
Several novel direct inhibitors of KIT and PDGFRA have entered the advanced clinical development in later treatment lines based on promising early clinical trial experience. Both avapritinib and ripretinib are more potent and more specific against various KIT and PDGFRA mutations. For patients with PDGFRA D842V mutations, the next generation of drugs may become the first active treatment options.
Comprehensive molecular testing of KIT/PDGFRA-wildtype GIST may unmask clinically relevant targets, including NTRK fusions.

Summary:
The treatment landscape in GIST is expected to undergo a profound transformation with more potent drugs currently in late-stage clinical development.
Leiomyosarcomas: whole genome sequencing for a whole biology characterization
Authors: Chibon Frédéric , Darbo Elodie , Pérot Gaëlle 
Published: April 2019

Purpose of review
Leiomyosarcoma (LMS) is among the more aggressive sarcomas and still suffers from the lack of efficient systemic treatment after, or before, surgery. During the last decades, one provider of therapeutic improvement has been the targeting of genome alterations. Efforts have thus been done to apply next-generation sequencing approaches to those tumours to decipher their oncogenesis and find out such targets.

Recent findings
Sequencing performed so far, based on exome, mostly confirmed that p53 and RB1 are the two main pathways altered in LMS oncogenesis. There are few point mutations in LMS genome, which is mainly characterized by numerous chromosomal rearrangements. Data from whole genome sequencing are now mandatory to decipher mechanisms triggering chromosomal instability and mutational process.

Summary
Although each LMS appears to have quite private genetic alterations leading to oncogenesis, it is likely that the altered biological pathways are relatively homogeneous within each of the LMS subgroups. Understanding this oncogenesis, thanks to integrated approaches involving whole genome and transcriptome sequencing together with functional and clinical characterizations will certainly give us the keys to relevant and effective new therapeutic approaches.
Infertility treatment decision-making in Ghana and contestations that may arise: a prospective sociological study
Authors: Hiadzi Rosemond A. , Woodward Bryan J. 
Published: April 2019

Introduction:
This study aimed to explore contestations within infertile couples seeking infertility therapy in a sub-Saharan society. Their views regarding infertility treatment were explored, including their arguments for or against different treatment options. The effects of the contributions of the various partners were analyzed.

Material and methods:
Semistructured in-depth interviews were conducted with people seeking infertility treatment at 3 different fertility clinics in Accra, Ghana. Participants were restricted to 45 persons from married heterosexual couples, with 15 respondents (5 male and 10 female) from each setting. Respondents were asked questions relating to the decision-making process toward seeking treatment and the reactions of their partners.

Results:
Contestations tended to relate to 5 main themes: the cause of the infertility and who was to blame; male apathy; reluctance to provide semen samples for evaluation; an absentee husband due to work pressure; and finance relating to the cost of infertility treatment.

Discussion:
This is the first study to highlight the contestations that arise between couples regarding their decision-making about alleviating their infertility via 3 different types of fertility clinics in Accra, Ghana. It is apparent that globalization and changing norms of family life have to a large extent, accounted for the changing ideas and practices surrounding infertility in urban Ghana.
Enlarging Red-to-Purple Nodule on the Forehead
Authors: Martin Kari L. 
Published: April 2019

ABSTRACT
Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. In store-and-forward teledermatology, patient medical information (including history and visual data) obtained in one location is transferred electronically to a provider who is in another location. The construct of this column is such that cases are presented in a standardized teledermatology reader format. This is a case of an enlarging red-to-purple nodule on the forehead.
Tinnitus Severity Change Following Stapedotomy in Patients With Otosclerosis
Authors: Dziendziel Beata , Skarżyński Henryk , Gos Elżbieta , Skarżyński Piotr H. 
Published: April 2019

Objective:
To determine whether stapedotomy was effective in reducing tinnitus severity. In addition, the relationship between reduction in tinnitus and improvement in hearing after stapedotomy was analyzed.

Study Design:
Prospective clinical study.

Setting:
Tertiary referral center.

Patients:
A group of 168 otosclerosis patients diagnosed with chronic tinnitus.

Intervention:
Stapedotomy.

Main Outcome Measures:
The Tinnitus Functional Index questionnaire (TFI) was used to assess tinnitus severity before surgery, and at 3 and 6 months postoperatively. Pure-tone audiometry was conducted before surgery and 6 months postoperatively.

Results:
The TFI Total score before the operation was M = 34.5 (standard deviation [SD] = 1.6) points, and decreased 3 months after stapedotomy to M = 17.5 (SD = 1.7), a statistically significant change (T = –8.200; p < 0.001). A weak correlation was found between the pre- and postoperative difference of TFI Total score and air-conduction thresholds (r = 0.21; p = 0.013) as well as between the TFI Total score and the size of the air-bone gap (r = 0.21; p = 0.013). Preoperatively, 86 patients tinnitus was a not or small problem, and for 82 it was moderate to very big. After stapedotomy, 93 (55%) of patients experienced a significant reduction in tinnitus severity. Of the whole group, 62 patients (37%) reported complete disappearance of their tinnitus. No change in tinnitus severity was reported by 63 patients (38%), and an increase was observed by 12 patients (7%).

Conclusion:
Stapedotomy not only improves hearing but also reduces tinnitus severity. The current results extend knowledge of postoperative results in terms of tinnitus severity, and might benefit patients undergoing tinnitus counseling. It might also be useful to otolaryngologists when making decisions regarding qualification criteria.
Quality improvement and crisis resource management in pediatric resuscitation
Authors: Myers Sage R. , Donoghue Aaron J. 
Published: April 2019

Purpose of review
The pediatric resuscitation environment is a high-stakes, environment in which a multidisciplinary team must work together with patient outcomes dependent, at least in part, on the performance of that team. Given constraints of the environment and the nature of these events, quality improvement work in pediatric resuscitation can be challenging. Ongoing collection of accurate and reliable data on team performance is necessary to inform and evaluate change.

Recent findings
Despite the relative difficulty of quality improvement analysis and intervention implementation in the resuscitation environment, these efforts can have significant impact on patient outcomes. Although there are barriers to accurate data collection in real-life resuscitation, team performance of both technical and nontechnical skills can be reliably measured in video-based quality improvement programs. Training of nontechnical skills, using crisis resource management principles, can improve care delivery in resuscitation.

Summary
Striving toward a learning healthcare system model in resuscitation care delivery can allow for efficient performance improvement. Given the possible impacts on mortality and quality of life of care delivered in the resuscitation environment, all providers who could possibly face a resuscitation event – no matter how rare – should consider how they are evaluating the quality of their care delivery in this arena.
The impact of asymptomatic antibody-mediated rejection on outcome after heart transplantation
Authors: Kfoury Abdallah G. , Miller Dylan V. 
Published: April 2019

Purpose of review
Defining criteria for antibody-mediated rejection (AMR) in heart transplantation were standardized a few years ago, but very little is known about asymptomatic cardiac AMR. We will start the review with a background summarizing the timeline of cardiac AMR. Then we will cover past and current knowledge about asymptomatic cardiac AMR and its impact on outcome after transplantation, with added insight from experience with other solid-organ transplants.

Recent findings
The incidence of asymptomatic cardiac AMR had likely been under-estimated because biopsy surveillance for it in the absence of clinical manifestation was not the norm. Recent data indicate that it may be more common especially when counting concomitant acute cellular rejection (mixed rejection). Also a higher risk of cardiac allograft vasculopathy (CAV) and cardiovascular mortality have been linked to it. The primary implication of these findings is whether therapeutic intervention is warranted, but the appropriate target patient population likely to benefit from treatment is yet to be determined.

Summary
Asymptomatic cardiac AMR is not uncommon and it negatively impacts outcome after heart transplantation.
Barriers to Skin-to-Skin Contact after Cesarean Birth
Authors: Balatero Joelene S. , Spilker Arlene F. , McNiesh Susan G. 
Published: April 2019

Abstract

Objectives:
The aim of this research was to understand obstetric nurses' perceived barriers to immediate skin-to-skin contact (SSC) in the operating room (OR) after cesarean birth.

Methods:
Semistructured, open-ended interviews were conducted via videoconferencing. Conventional content analysis methods were used to analyze the data for common themes. Investigation team consensus was reached to validate the analysis findings.

Results:
Ten nurses who care for women during labor and birth were interviewed. The primary overarching theme was performing safe and effective SSC after cesarean birth. Nurses strongly believe in the benefits of SSC after cesarean and try to implement it as often as possible, but various factors prevented SSC in the OR from occurring on a regular basis. Providing immediate SSC is not considered a priority during the cesarean by all members of the team. All participants reported that there were no formal policies and procedures in their facilities for SSC in the OR. Challenges with safety, nurse staffing, and logistics were described as well as professional barriers, and varying practices between geographical location and facilities. Nurses discussed concepts that were facilitators for changing their current practices to support SSC after cesarean.

Clinical Implications:
Implications: Developing effective policies and procedures that support SSC in the OR after cesarean and changing practice accordingly is recommended. Adequate nurse staffing in the OR is essential.
Daily versus weekly evidence reports for orthopaedic surgeons in India
Authors: Kheterpal Sunita , Busse Jason W. , Baxter Pamela , Sonnadara Ranil , Bhandari Mohit 
Published: April 2019

AbstractBackground:There is a dearth of research regarding the impact of evidence-based medicine (EBM) tools, such as evidence summaries, in developing countries. The goals of this study were to: investigate accessibility, use, and impact of an online EBM knowledge dissemination portal in orthopaedic surgery in India; explore whether receiving daily targeted evidence summaries results in more frequent use of an EBM tool compared with receiving general weekly reports; and identify and explain the barriers and benefits of an online EBM resource in the Indian context.Methods:Forty-four orthopaedic surgeons in Pune, India, were provided free access to OrthoEvidence (OE), a for-profit, online EBM knowledge dissemination portal. Participants were subsequently randomized into 2 groups—1 group received daily targeted evidence summaries while the other received general weekly summaries. This study employed an explanatory sequential mixed methods design that incorporated 2 questionnaires, OE usage data, and semi-structured interviews to gain insight into the surgeons’ usage, perceptions, and impact of OE.Results:There were no observable differences in OE usage between groups. OE was deemed to be comprehensive, practical, useful, and applicable to clinical practice by the majority of surgeons. The exit survey data revealed no differences between groups’ perceptions of the OE tool. semi-structured interviews revealed barriers to keeping up with evidence that included limited access to relevant medical literature and limited incentive to keep up with current evidence.Conclusions:Neither frequency of delivery (daily versus weekly) nor targeted versus general content affected the use of evidence summaries. Facilitating uptake of current evidence into clinical practice among Indian orthopedic surgeons may require additional components beyond dissemination of evidence summaries.
A 25-Year Review of Pediatric Suicides
Authors: Molina D. Kimberley , Farley Norma J. 
Published: April 2019

AbstractChildhood and adolescent suicides have been increasing worldwide in recent years, and the investigation of such deaths is often complex. Forensic pathologists frequently find themselves having to opine as to the manner of death in these difficult cases. The present study was undertaken to identify distinguishing features in childhood and adolescent suicides to assist in the investigation and prevention of these deaths. A 25-year review of pediatric suicides in a metropolitan area was performed, which showed a steady increase in pediatric suicides over time. Male pediatric suicides were more common than female, with both having an average age of 15 years. Gunshots wounds and hanging were the most common methodologies seen, with drug toxicity being more common in females and gunshot wounds more common in males. Approximately 20% of decedents had a psychiatric history, 25% had a previous history of a suicide attempt or ideation, and 24% had a history of drug use. Only a minority of decedents made their intentions known prior to the suicidal act (16%) or left a note of intent (16%). In 62% of cases, a temporal, precipitating event could be identified, of which conflict with a significant other (boyfriend or girlfriend) was the most common. No specific trends over time were identified. While these features may assist forensic pathologists in assessing a possible suicidal death in the pediatric age group, medicolegal death investigators must approach these deaths as they would any violent death in an attempt to accurately determine the manner of death regardless of the societal and familial implications of such a determination.
Acute Methamphetamine-Induced Hepatic and Pancreatic Ischemia
Authors: Merchant Krupa , Schammel Christine , Fulcher James 
Published: April 2019

Abstract
Methamphetamine is a central nervous system stimulant that induces arousal, a positive mood, cardiac stimulation, and an acute improvement in cognitive domains. Its illicit exploitation is rapidly growing in North America. Typically, extended use of the drug induces organ damage via vasoconstriction and subsequent ischemia. This case specifically discusses hepatic and pancreatic pathology resulting from methamphetamine overdose alongside an unusual discovery of globally necrotic von Meyenburg complexes.
A Standard Operation Procedure of Clean and Fast Craniotomy Technique for Retrosigmoid Approach
Authors: Chen Songyu , Yang Ning , Li Weiguo , Xu Shujun , Li Xingang , Ma Xiangyu 
Published: April 2019

Abstract
Clean and fast craniotomy and closure (CAC) for retrosigmoid approach with safe and satisfactory exposure remains our primary goal. A standard operation procedure (SOP) of retrosigmoid approach was developed and reviewed. Between January 2015 and January 2017, 97 patients suffering various lesions underwent surgeries using this technique in the Department of Neurosurgery, Qilu Hospital of Shandong University. The records concerning time of craniotomies, blood losses, and complications were reviewed. By applying this SOP, a craniotomy generally took 15 to 35 minutes, with an average of around 25 minutes. Six cases had a blood loss of more than 30 mL during craniotomy. One patient had cerebrospinal fluid rhinorrhea and another case had subcutaneous effusion. There was no record of venous sinus injury or wound infection. To sum up, the SOP of retrosigmoid approach is simple, reliable and bloodless. In addition to avoiding complications such as venous sinus injury effectively, the SOP also benefits training of residents and early recovery after surgery (ERAS).
“Three Subunit” Classification of Lesser-Form Cleft Lip and Muscle Analysis and Reconstruction of These Subunits Based on the Microanatomic Structures of Muscles in the Normal Upper Lip
Authors: Sun Min , Wang Yong Q. , Li Hai D. , Wu Di , Yin Ning B. , Song Tao 
Published: April 2019

Background:
The main phenotypic features of lesser-form cleft lip include nasal, philtrum, and vermilion deformities. The manifestations of lesser-form cleft lip vary greatly, and it is difficult to rebuild these subunits during the operation.

Methods:
“Three subunits” classification of lesser-form cleft lip was identified as nasal deformity (N), philtrum deformity (P), or vermilion deformity (V); and slight deformity (0) or obvious deformity (1). A total of 200 patients with lesser-form cleft lip were classified into one of the following 8 types: N1P1V1, N1P1V0, N0P1V1, N1P0V1, N0P0V1, N1P0V0, N0P1V0, or N0P0V0. Then the authors discussed the deformities of the lesser-form cleft lip and the reconstruction of the muscles in these subunits based on the microanatomic structure of the nasolabial muscle.

Results:
This retrospective review included 200 patients with a lesser-form cleft lip, who were seen at our center from 2015 to 2017. There were 149 (74.5%) N1P1V1, 11 (5.5%) N1P1V0, 13 (6.5%) N0P1V1, 4 (2.0%) N1P0V1, 8 (4.0%) N0P0V1, 10 (5.0%) N1P0V0, 1 (0.5%) N0P1V0, and 4 (2%) N0P0V0 clefts. The various deformities of nasal floor, philtrum ridge, and vermilion may suggest that the muscle bundles in these subunits are abnormal and the operation should be performed to simulate the running directions and tension lines of these local muscles.

Conclusions:
The microanatomic structure and the tension lines of the nasolabial muscles can provide new perspectives for better understanding and repairing the lesser-form cleft lip in subunits.