bluuebunny/crossref_metadata_2025_split huggingface dataset:
Explaining Mechanisms That Influence Smoke-Free Implementation at the Local Level: A Realist Review of Smoking Bans
Authors: Mlinarić Martin , Hoffmann Laura , Kunst Anton E , Schreuders Michael , Willemsen Marc C , Moor Irene , Richter Matthias 
Published: October 2018

AbstractIntroductionWhile studies have been undertaken to understand the adoption of outdoor and indoor smoking bans, not much is known about why implementation of smoke-free (SF) environments differs at local levels. As most European countries remain at the level of indoor bans, we aim to translate existing evidence into practical recommendations on how to improve SF (outdoor) implementation within European municipalities.MethodsWe applied six methodological steps of a realist review consistent with the RAMESES publication standards for realist syntheses. Literature search was conducted in PubMed/MEDLINE and Web of Science. In total, 3829 references were screened, of which 43 were synthesized. Studies dating from 2004 to 2015 with rigor evidence of SF implementation at the local level were selected. Implementation outcomes were SF enforcement, monitoring, nonsmoking compliance, and public support in cities.ResultsThe explanatory realist framework links four innovation stages with three context-mechanism-outcome (CMO)configurations. We identified “triggering trust,” “increasing priorities,” and “limiting opposing interests” as underlying mechanisms, when (1) establishing, (2) developing, (3) contesting, and (4) implementing local smoking bans. The CMO propositions (CMOs) support practical recommendations, such as (1) providing authorities with local data when establishing and developing bans, (2) developing long-term strategies and implementing state-funded SF programs to prioritize sustained enforcement, and (3) limiting opposing interests through the use of the child protection frame.ConclusionsThis is the first realist review on the implementation of SF enviroments at the local level. The process-oriented theory explains how and why CMOs determine SF development in cities and municipalities from planning until implementation.ImplicationsIn 2015, only 16% of the world’s population lived under the jurisdiction of comprehensive SF laws. The findings of this realist review are useful to implement WHO goals of the Framework Convention on Tobacco Control (FCTC) and specifically SF environments at more local levels and to adjust them to specific contextual circumstances. This paper unpacks three mechanisms that could be triggered by SF strategies developed at local levels and that can result in improved policy implementation. Such evidence is needed to enhance SF strategies at the level of cities and municipalities and to achieve WHO “Healthy Cities Network” objectives.
E-cigarette Usage Is Associated With Increased Past-12-Month Quit Attempts and Successful Smoking Cessation in Two US Population–Based Surveys
Authors: Johnson Linda , Ma Yinjiao , Fisher Sherri L , Ramsey Alex T , Chen Li-Shiun , Hartz Sarah M , Culverhouse Robert C , Grucza Richard A , Saccone Nancy L , Baker Timothy B , Bierut Laura J 
Published: October 2018

Abstract

Introduction
We examined past-12-month quit attempts and smoking cessation from 2006 to 2016 while accounting for demographic shifts in the US population. In addition, we sought to understand whether the current use of electronic cigarettes was associated with a change in past-12-month quit attempts and successful smoking cessation at the population level.

Methods
We analyzed data from 25- to 44-year-olds from the National Health Interview Survey (NHIS) from 2006 to 2016 (N = 26,354) and the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) in 2006–2007, 2010–2011, and 2014–2015 (N = 33,627). Data on e-cigarette use were available in the 2014–2016 NHIS and 2014–2015 TUS-CPS surveys.

Results
Past-12-month quit attempts and smoking cessation increased in recent years compared with 2006. Current e-cigarette use was associated with higher quit attempts (adjusted odds ratio [aOR] = 2.29, 95% confidence interval [CI] = 1.87 to 2.81, p < .001) and greater smoking cessation (aOR = 1.64, 95% CI = 1.21 to 2.21, p = .001) in the NHIS. Multivariable logistic regression of the TUS-CPS data showed that current e-cigarette use was similarly significantly associated with increased past-12-month quit attempts and smoking cessation. Significant interactions were found for smoking frequency (everyday and some-day smoking) and current e-cigarette use for both outcomes (p < .0001) with the strongest positive effects seen in everyday smokers.

Conclusions
Compared with 2006, past-12-month quit attempts and smoking cessation increased among adults aged 25–44 in recent years. Current e-cigarette use was associated with increased past-12-month quit attempts and successful smoking cessation among established smokers. These findings are relevant to future tobacco policy decisions.

Implications
E-cigarettes were introduced into the US market over the past decade. During this period, past-12-month quit attempts and smoking cessation have increased among US adults aged 25–44. These trends are inconsistent with the hypothesis that e-cigarette use is delaying quit attempts and leading to decreased smoking cessation. In contrast, current e-cigarette use was associated with significantly higher past-12-month quit attempts and past-12-month cessation. These findings suggest that e-cigarette use contributes to a reduction in combustible cigarette use among established smokers.
Single-Screw Fixation Compared With Double Screw Fixation for Treatment of Medial Malleolar Fractures: A Prospective Randomized Trial
Authors: Buckley Richard , Kwek Ernest , Duffy Paul , Korley Robert , Puloski Shannon , Buckley Andrew , Martin Ryan , Rydberg Moller Emilia , Schneider Prism 
Published: October 2018

Objectives:
To determine whether single or double screw (DS) fixation of medial malleolar fractures results in better long-term health outcomes.

Design:
Randomized clinical trial; sealed envelope technique.

Setting:
Level 1 Trauma Hospital at University of Calgary, Canada.

Patients:
One hundred forty patients were randomized to receive either 1 or 2 screws to reduce a medial malleolar fracture. Thirteen patients were excluded because of loss to follow-up (n = 127).

Intervention:
Surgical fixation of the medial malleolar fracture was performed using 1 or 2 stainless steel screws.

Main Outcome Measurements:
Primary outcome was comparison of physical functioning summary score on Short Form 36 questionnaires between patients in the 2 groups. Secondary objectives were to compare the Ankle Hindfoot Scale and operating room time. Clinical and radiographic assessment occurred at the time of injury and 2, 6 weeks, 3, 6, 12, and 24 months postoperatively.

Results:
Fourteen patients crossed over from the DS group to the single screw (SS) group based on intraoperative decisions by the surgeon (fragment too small for 2 screws), leaving the SS (n = 75) and DS groups (n = 52). There was no difference in the operating room time, SF36, or Ankle Hindfoot Scale at all follow-up time points.

Conclusions:
SS medial malleolar fixation provides an equally safe and effective method of fracture care as compared to DS fixation. Twenty percent of patients receiving 2 screws can be expected to crossover to receive SS fixation as a safer alternative.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Magnitude and Pace of Improvement in Performance of Hospitals Treating Mechanically Ventilated Children in the United States: Analysis From Two National Databases
Authors: Gupta Punkaj , Gossett Jeffrey M. , Rettiganti Mallikarjuna 
Published: October 2018

Objectives:
To use two national databases to quantify the pace and magnitude of improvement in hospital performance (as measured by mortality) across hospitals caring for critically ill children in the United States.

Design:
We used empirical Bayes shrinkage estimators to obtain shrinkage estimators of observed/expected mortality ratios for each hospital assuming a Gamma Poisson posterior distribution. Revised mortality rates for each hospital were obtained from the shrunken incidence ratios.

Setting:
Pediatric Health Information System participating hospital and Kids’ Inpatient Database participating hospital.

Patients:
Patients less than or equal to 18 years old who received invasive mechanical ventilation during their hospital stay at a Pediatric Health Information System participating hospital (2005–2015) or a Kids’ Inpatient Database participating hospital (1997–2012) were included.

Interventions:
None.

Measurements and Main Results:
A total of 486,838 patients from 48 Pediatric Health Information System hospitals and 798,840 patients from 947 Kids’ Inpatient Database hospitals were included. For the Pediatric Health Information System hospitals, the median shrunken adjusted mortality decreased from 11.66% in 2005 to 7.11% in 2015; for the Kids’ Inpatient Database hospitals, it decreased from 5.79% in 1997 to 3.86% in 2012. By 2015, more than 95% of the Pediatric Health Information System hospitals performed better than or as well as the best 25% of the hospitals in 2005. By 2012, 33.7% of Kids’ Inpatient Database hospitals performed better than or as well as the best 25% of the hospitals in 1997.

Conclusions:
This study provides insight into the magnitude of improvement in patient mortality in hospitals caring for critically ill children in the United States. This study quantifies hospital performance in pediatric critical care over time, and it provides benchmarks against which individual hospitals can assess their own performance. In future pediatric epidemiologic studies, we should identify outcomes other than mortality to quantify improvement in hospital performance.
Variation in Case-Mix Adjusted Unplanned Pediatric Cardiac ICU Readmission Rates*
Authors: Smith Andrew H. , Anand Vijay , Banerjee Mousumi , Bates Katherine E. , Brunetti Marissa A. , Cooper David S. , Lehrich Jessica , Mistry Kshitij P. , Pasquali Sara K. , Shin Andrew Y. , Tabbutt Sarah , Gaies Michael 
Published: October 2018

Objectives:
To identify modifiable factors leading to unplanned readmission and characterize differences in adjusted unplanned readmission rates across hospitals.

Design:
Retrospective cohort study using prospectively collected clinical registry data

Setting:
Pediatric Cardiac Critical Care Consortium clinical registry.

Patients:
Patients admitted to a pediatric cardiac ICU at Pediatric Cardiac Critical Care Consortium hospitals.

Interventions:
None.

Measurements and Main Results:
We examined pediatric cardiac ICU encounters in the Pediatric Cardiac Critical Care Consortium registry from October 2013 to March 2016. The primary outcomes were early (< 48 hr from pediatric cardiac ICU transfer) and late (2–7 d) unplanned readmission. Generalized logit models identified independent predictors of unplanned readmission. We then calculated observed-to-expected ratios of unplanned readmission and identified higher-than or lower-than-expected unplanned readmission rates for those with an observed-to-expected ratios greater than or less than 1, respectively, and a 95% CI that did not cross 1. Of 11,301 pediatric cardiac ICU encounters (16 hospitals), 62% were surgical, and 18% were neonates. There were 175 (1.6%) early unplanned readmission, and 300 (2.7%) late unplanned readmission, most commonly for respiratory (31%), or cardiac (28%) indications. In multivariable analysis, unique modifiable factors were associated with unplanned readmission. Although shorter time between discontinuation of vasoactive infusions and pediatric cardiac ICU transfer was associated with early unplanned readmission, nighttime discharge was independently associated with a greater likelihood of late unplanned readmission. Two hospitals had lower-than-expected unplanned readmission in both the early and late categories, whereas two other hospitals were higher-than-expected in both.

Conclusions:
This analysis demonstrated time from discontinuation of critical care therapies to pediatric cardiac ICU transfer as a significant, modifiable predictor of unplanned readmission. We identified two hospitals with lower-than-expected adjusted rates of both early and late unplanned readmission, suggesting that their systems are well designed to prevent unplanned readmission. This offers the possibility of disseminating best practices to other hospitals through collaborative learning.
Young Children With Gender Nonconforming Behaviors and Preferences
Authors: Reilly Marie , Desousa Vanessa , Garza-Flores Alexandra , Perrin Ellen C. 
Published: October 2018

ABSTRACT:

Background:
There is growing awareness and exposure in both the medical community and the lay media about the characteristics and complex needs of individuals who believe that their gender identity does not match their birth sex. Despite research and lay publications about teens with gender dysphoria and those who identify as transgender, little guidance is available regarding young (prepubertal) children with questions about their gender identity. Although many terms are used to describe these children, we have chosen to describe them as “gender nonconforming” (GNC).

Objective:
Primary care and developmental-behavioral pediatric providers are often the first professionals with whom young gender nonconforming children and their families discuss their concerns about their emerging gender identity. It is important, therefore, that pediatric providers be knowledgeable about the dilemmas, conflicts, and choices that are typical of these children and their families to guide them appropriately.

Overview:
In this special article, we present observations, informed by clinical experience, an emerging body of research, and a developmental-behavioral pediatric framework, of the complex needs of prepubertal gender nonconforming children and their families and an approach to their care. The article begins by outlining the cognitive and biological bases for gender identity development, as well as the natural history of gender nonconforming preferences and behaviors. It then sets the context for understanding the care of GNC children as an area in which developmentally sophisticated providers can play a crucial role in support of the complex developmental patterns and need for advocacy in multiple settings among these children.
Low pretreatment serum concentration of vitamin D at breast cancer diagnosis in postmenopausal women
Authors: Machado Murilo Renato Matos , de Sousa Almeida-Filho Benedito , De Luca Vespoli Heloisa , Schmitt Eneida Boteon , Nahas-Neto Jorge , Nahas Eliana A.P. 
Published: October 2018

AbstractObjective:The aim of the study was to evaluate the rate of and risk factors for low pretreatment vitamin D (VitD) levels in postmenopausal breast cancer (BC) women, compared with postmenopausal women without BC.Methods:A cross-sectional clinical study was conducted to compare 209 women with BC (case group) to 418 women without BC (control group), age range: 45 to 75 years. The case group consisted of women diagnosed with BC, amenorrhea ≥12 months, aged ≥45 years, without use of medication or clinical conditions that might interfere with VitD levels. The control group consisted of women with amenorrhea ≥12 months, aged ≥45 years, without BC. The groups were matched for age and time since menopause, at a case: control ratio of 1:2. Serum 25-hydroxyvitamin-D [25(OH)D] concentration was measured in all women 10 to 20 days after BC diagnosis and before the proposed treatment. Serum levels ≥30 ng/mL were defined as sufficient. The Student'sttest or gamma distribution, χ2test, and logistic regression (odds ratio, OR) were used for statistical analysis.Results:The BC group had a higher body mass index (BMI) and higher percentage of obesity than the control group (57.4% vs 40.2%,P < 0.0001). In addition, rates of insufficient (20-29 ng/mL) and deficient (<20 ng/mL) 25(OH)D levels were higher in BC patients than in controls (55.6% vs 49.3%,P = 0.039 and 26.2% vs 20.3%,P = 0.018), respectively. In risk analysis (adjusted for age, time since menopause, and BMI), BC patients had a 1.5-fold higher risk of developing low VitD levels (OR = 1.52, 95% CI, 1.04-2.22,P = 0.029) than women without BC.Conclusions:Postmenopausal women had an increased risk of VitD deficiency at the time of BC diagnosis, associated with a higher rate of obesity, than women of the same age group without cancer.
Adaptation and translation of the menopause-specific Utian Quality of Life (UQOL) scale to Yoruba language using middle-aged women attending a clinic in Nigeria
Authors: Aberi Obalowu Ismaila , Okebunor Odeigah Louis , Moradeyo Alabi Kola , Ademola Ayinmode Babatunde , Utian Wulf H. 
Published: October 2018

Abstract

Objective:
The main objective of the study is to translate and adapt the menopause-specific Utian Quality of Life (UQOL) scale to Yoruba, an indigenous Nigerian language, using middle-aged women attending a Family Medicine clinic in Nigeria.

Methods:
A total of 322 middle-aged Nigerian women at various menopausal stages were recruited for the study. Their menopausal status was categorized using the Monash Women's Health Program Menopausal Staging Algorithm into pre-, peri-, and postmenopausal groups. The UQOL Yoruba version (YUQOL), Menopause Rating Scale (MRS), and a semistructured sociodemographic questionnaire were interviewer-administered to the women. The collected data were analyzed using IBM SPSS version 21 software.

Results:
The overall scale and the four subscales of YUQOL all had acceptable internal consistency scores; they also demonstrated good construct and criterion validities, except the YUQOL sexual subscale had poor convergent validity (average variance extracted = 0.23).

Conclusions:
This study has validated the YUQOL as a psychometrically sound research instrument for measuring menopause-specific QOL among women undergoing menopausal transition. Its sexual subscale would, however, need to be further tested, preferably in sexually active menopausal women to fully confirm its true psychometric property.
Effect of high-intensity interval training on body composition and inflammatory markers in obese postmenopausal women: a randomized controlled trial
Authors: Nunes Paulo R.P. , Martins Fernanda M. , Souza Aletéia P. , Carneiro Marcelo A.S. , Orsatti Claudio L. , Michelin Márcia A. , Murta Eddie F.C. , de Oliveira Erick P. , Orsatti Fábio L. 
Published: October 2018

Abstract

Objectives:
This study tested whether high-intensity interval training is a time-efficient strategy for improving visceral adiposity tissue and inflammatory markers in obese postmenopausal women when compared with combined training. Moreover, we tested whether change in visceral adiposity tissue is associated with alterations in these inflammatory markers.

Methods:
Postmenopausal women were randomized in two groups: combined training (n = 13) and high-intensity interval training (n = 13). The combined training group performed 60 minutes of walking at 70% of maximum heart rate and resistance exercises at 70% of one repetition maximum. The high-intensity interval training group performed 28 minutes of high-intensity exercises (> 80% of maximum heart rate). Both groups trained three times a week for 12 weeks. Body composition and inflammatory markers were analyzed with dual-energy x-ray absorptiometry scanning and enzyme-linked immunosorbent assay, respectively.

Results:
All groups reduced body fat percentage (P = 0.026), visceral adiposity tissue (P = 0.027), leptin (P = 0.043), and increased interleukin (IL)-1 receptor antagonist (
P
< 0.01). The high-intensity interval training group reduced visceral adiposity tissue (P = 0.021) in a greater magnitude and increased interleukin-6 (P = 0.037) level when compared with the combined training group. Moreover, the visceral adiposity tissue changes explained the changes in IL-6 (56%; P = 0.002) only in the high-intensity interval training group.

Conclusions:
These results suggest that high-intensity interval training is a time-efficient strategy for improving visceral adiposity tissue and inflammatory markers in obese postmenopausal women. Moreover, we observed that serum cytokine changes, at least in part, depend on visceral adiposity tissue alterations.
The Outpatient DIEP: Safety and Viability following a Modified Recovery Protocol
Authors: Martinez Carlos A. , Reis Scott M. , Rednam Rukmini , Boutros Sean G. 
Published: October 2018

Background:
Breast reconstruction with autologous tissue is considered the current state-of-the-art choice following mastectomies, and the deep inferior epigastric perforator (DIEP) flap is often among the favored techniques. Commonly referred to patients as a combination between a tummy tuck and a breast augmentation, it significantly differs by the required expertise and long hospital stays. We present a series attesting to the feasibility and effectiveness of performing this type of reconstruction in an outpatient setting following our recovery protocol.

Methods:
Patients undergoing DIEP flap breast reconstruction followed a recovery protocol that included intraoperative local anesthesia, microfascial incision technique for DIEP harvest, double venous system drainage technique, rib and chest muscle preservation, and prophylactic anticoagulation agents.

Results:
Fourteen patients totaling 27 flaps underwent breast reconstruction following our protocol. All patients were discharged within the initial 23 hours, and no take-backs, partial, or total flap failures were recorded. A case of abdominal incision breakdown was seen in 1 patient during a postoperative visit, without evidence of frank infection. No further complications were observed in the 12-week average observation period.

Conclusion:
With the proper use of a microfascial incision, complemented by rib sparing and appropriate use of injectable anesthetics, routine breast reconstructions with the DIEP flap can be safely performed in an outpatient setting with discharge in the 23-hour window.
Endoscopic Sinus Surgery Associated with Rhinoseptoplasty: A Case-control Study
Authors: Marchica Paolo , Bassetto Franco , Vindigni Vincenzo , Galici Roberto , Dispenza Francesco , Gallina Salvatore , Speciale Riccardo 
Published: October 2018

Objective:To examine the difference between outcomes in the administration of concurrent endoscopic sinus surgery (ESS), septoplasty (SP), and rhinoplasty (RP) and concurrent ESS and SP in 1 single surgical session.Methods:Patients who underwent concurrent ESS and SP from September 2004 to July 2015 were identified. Furthermore, patients among them who underwent functional primary RP were selected. Subjects who had been administered concurrent ESS, SP, and RP (primary RP) were matched for sex, age, sinonasal surgical procedures for treatment of chronic rhinosinusitis with patients underwent concurrent ESS and SP, used as control subjects. A literature review was performed to find previous articles describing results of concurrent procedures among ESS, SP, and RP.Results:Twenty subjects, who underwent concurrent ESS, SP, and RP, were compared with a matched control group made of 20 patients who underwent concurrent ESS and SP, evaluating different postoperative outcomes (postoperative complications, postoperative improvement of respiratory symptoms, persistence of chronic rhinosinusitis symptoms 6 months to 1 year postoperative, need of revision surgery, satisfaction of the patient). ObtainedPvalues showed that there was no statistically significant difference (P> 0.05) as regards the different outcomes, except for postoperative complications, increased because of the invasiveness proper of RP (P< 0.05).Conclusions:Therefore, execution of concurrent ESS, SP, and RP seems to be safe and effective, and additional RP does not modify postoperative outcomes of concurrent ESS and SP except for a little increase of postoperative complications, even if most of them had low impact on result of procedures.