bluuebunny/crossref_metadata_2025_split huggingface dataset:
Activity Level During Acute Concussion May Predict Symptom Recovery Within an Active Duty Military Population
Authors: Remigio-Baker Rosemay A. , Bailie Jason M. , Gregory Emma , Cole Wesley R. , McCulloch Karen L. , Cecchini Amy , Stuessi Keith , Andrews Taylor R. , Mullins Lynita , Ettenhofer Mark L. 
Published: July 2019

Objective:To evaluate the impact on symptom resolution of activity acutely following a concussion and the role of acute-phase symptoms on this relationship among active duty service members (SMs).Setting:Three military installations.Participants:Sixty-two SMs aged 18 to 44 years who sustained a concussion within 72 hours of enrollment.Design:Longitudinal design with data collected within 72 hours of injury (baseline,n= 62) and at 1 week (n= 57), 1 month (n= 50), 3 months (n= 41), and 6 months (n= 40) postinjury.Main Measures:Baseline activity level using a 60-item Activity Questionnaire. Symptom level at baseline and during follow-up using Neurobehavioral Symptoms Inventory.Results:Significant interaction (Pi< .05) was found, with significant main effects (P< .05) limited to SMs with elevated baseline symptomatology. Among these participants, greater baseline total activity was significantly related to greater vestibular symptoms at 1, 3, and 6 months (β = .61, .63, and .59, respectively). Significant associations were also found for particular types of baseline activity (eg, physical; vestibular/balance; military-specific) and symptoms at 1, 3, and/or 6 months postinjury.Conclusion:These results provide support for clinical guidance that symptomatic SMs, particularly those with high levels of acute symptoms, may need to avoid excessive activity acutely following concussion.
Changing Healthcare and School Needs in the First Year After Traumatic Brain Injury
Authors: Keenan Heather T. , Clark Amy E. , Holubkov Richard , Ewing-Cobbs Linda 
Published: July 2019

Objective:
To examine children's unmet and unrecognized healthcare and school needs following traumatic brain injury (TBI).

Setting:
Two pediatric trauma centers.

Participants:
Children with all severity of TBI aged 4 to 15 years.

Design:
Prospective cohort.

Main Measures:
Caregivers provided child health and school service use 3 and 12 months postinjury. Unmet and unrecognized needs were categorized compared with norms on standardized physical, cognitive, socioemotional health, or academic competence measures in conjunction with caregiver report of needs and services. Modified Poisson models examined child and family predictors of unmet and unrecognized needs.

Results:
Of 322 children, 28% had unmet or unrecognized healthcare or school needs at 3 months, decreasing to 24% at 12 months. Unmet healthcare needs changed from primarily physical (79%) at 3 months to cognitive (47%) and/or socioemotional needs (68%) at 12 months. At 3 months, low social capital, preexisting psychological diagnoses, and 6 to 11 years of age predicted higher healthcare needs and severe TBI predicted higher school needs. Twelve months postinjury, prior inpatient rehabilitation, low income, and preexisting psychological diagnoses were associated with higher healthcare needs; family function was important for school and healthcare needs.

Conclusions:
Targeted interventions to provide family supports may increase children's access to services.
Biomarkers of Systemic Inflammation in Ugandan Infants and Children Hospitalized With Respiratory Syncytial Virus Infection
Authors: Sawatzky Julia , Soo Jeremy , Conroy Andrea L. , Bhargava Ravi , Namasopo Sophie , Opoka Robert O. , Hawkes Michael T. 
Published: July 2019

Background:
Optimizing outcomes in respiratory syncytial virus (RSV) pneumonia requires accurate diagnosis and determination of severity that, in resource-limited settings, is often based on clinical assessment alone. We describe host inflammatory biomarkers and clinical outcomes among children hospitalized with RSV lower respiratory tract infection (LRTI) in Uganda and controls with rhinovirus and pneumococcal pneumonia.

Methods:
58 children hospitalized with LRTI were included. We compared 37 patients with RSV, 10 control patients with rhinovirus and 11 control patients with suspected pneumococcal pneumonia.

Results:
Patients in the RSV group had significantly lower levels of C-reactive protein (CRP) and chitinase-3-like protein 1 (CHI3L1) than the pneumococcal pneumonia group (P < 0.05 for both). Among children with RSV, higher admission levels of CRP predicted prolonged time to resolution of tachypnea, tachycardia and fever. Higher levels of CHI3L1 were associated with higher composite clinical severity scores and predicted prolonged time to resolution of tachypnea and tachycardia, time to wean oxygen and time to sit. Higher levels of lipocalin-2 (LCN2) predicted prolonged time to resolution of tachypnea, tachycardia and time to feed. Higher admission levels of all 3 biomarkers were predictive of a higher total volume of oxygen administered during hospitalization (P < 0.05 for all comparisons). Of note, CHI3L1 and LCN2 appeared to predict clinical outcomes more accurately than CRP, the inflammatory biomarker most widely used in clinical practice.

Conclusions:
Our findings suggest that CHI3L1 and LCN2 may be clinically informative biomarkers in childhood RSV LRTI in low-resource settings.
Does fibrinogen serve the host or the microbe in Staphylococcus infection?
Authors: Negrón Oscar , Flick Matthew J. 
Published: July 2019

Purpose of review
Fibrin(ogen) is a multifunctional clotting protein that not only has critical roles in hemostasis but is also important in inflammatory processes that control bacterial infection. As a provisional extracellular matrix protein, fibrin(ogen) functions as a physical barrier, a scaffold for immune cell migration, or as a spatially-defined cue to drive inflammatory cell activation. These mechanisms contribute to overall host antimicrobial defense against infection. However, numerous bacterial species have evolved mechanisms to manipulate host fibrin(ogen) to promote microbial virulence and survival. Staphylococcal species, in particular, express numerous virulence factors capable of engaging fibrin(ogen), promoting fibrin formation, and driving the dissolution of fibrin matrices.

Recent findings
Recent studies have highlighted both new insights into the molecular mechanisms involved in fibrin(ogen)-mediated host defense and pathogen-driven virulence. Of particular interest is the role of fibrin(ogen) in forming host protective biofilms versus pathogen protective barriers and biofilms as well as the role of fibrin(ogen) in mediating direct host antimicrobial responses.

Summary
Current data suggest that the role of fibrin(ogen) in staphylococcal infection is highly context-dependent and that better defining the precise cellular and molecular pathways activated will provide unique opportunities of therapeutic intervention to better treat Staphylococcal disease.
A Randomized Controlled Trial Assessing the Efficacy of Group Psychological First Aid
Authors: Despeaux Katie E. , Lating Jeffrey M. , Everly George S. , Sherman Martin F. , Kirkhart Matthew W. 
Published: July 2019

Abstract
A randomized controlled trial assessed the efficacy of group psychological first aid (PFA) by comparing the Johns Hopkins RAPID-PFA model with a group conversation condition in 119 participants using the state version of State Trait Anxiety Scale and the Positive and Negative Affect Schedules. Both groups showed similar baseline scores, and after watching a distressing 5-minute video, both groups showed similar significant increases in state anxiety scores and negative affect scores, as well as similar decreases in positive affect scores. However, compared with the group conversation condition, the RAPID-PFA group evidenced significantly lower state anxiety scores at postintervention and at 30-minute delay. RAPID-PFA, compared with the group conversation condition, was also more effective in lowering negative affect scores postintervention, and significantly increasing positive affect scores at 30-minute delay. These results support the two primary goals of PFA, which are mitigating acute distress and instilling hope.
Whole-Lesion Computed Tomography–Based Entropy Parameters for the Differentiation of Minimally Invasive and Invasive Adenocarcinomas Appearing as Pulmonary Subsolid Nodules
Authors: Chen Xiangmeng , Feng Bao , Chen Yehang , Hao Yixiu , Duan Xiaobei , Cui Enming , Liu Zhuangsheng , Zhang Chaotong , Long Wansheng 
Published: July 2019

Objective
The aim of this study was to investigate the differentiation of computed tomography (CT)–based entropy parameters between minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) lesions appearing as pulmonary subsolid nodules (SSNs).

Methods
This study was approved by the institutional review board in our hospital. From July 2015 to November 2018, 186 consecutive patients with solitary peripheral pulmonary SSNs that were pathologically confirmed as pulmonary adenocarcinomas (74 MIA and 112 IAC lesions) were included and subdivided into the training data set and the validation data set. Chest CT scans without contrast enhancement were performed in all patients preoperatively. The subjective CT features of the SSNs were reviewed and compared between the MIA and IAC groups. Each SSN was semisegmented with our in-house software, and entropy-related parameters were quantitatively extracted using another in-house software developed in the MATLAB platform. Logistic regression analysis and receiver operating characteristic analysis were performed to evaluate the diagnostic performances. Three diagnostic models including subjective model, entropy model, and combined model were built and analyzed using area under the curve (AUC) analysis.

Results
There were 119 nonsolid nodules and 67 part-solid nodules. Significant differences were found in the subjective CT features among nodule type, lesion size, lobulated shape, and irregular margin between the MIA and IAC groups. Multivariate analysis revealed that part-solid type and lobulated shape were significant independent factors for IAC (P < 0.0001 and P < 0.0001, respectively). Three entropy parameters including Entropy-0.8, Entropy-2.0-32, and Entropy-2.0-64 were identified as independent risk factors for the differentiation of MIA and IAC lesions. The median entropy model value of the MIA group was 0.266 (range, 0.174–0.590), which was significantly lower than the IAC group with value 0.815 (range, 0.623–0.901) (P < 0.0001). Multivariate analysis revealed that the combined model had an excellent diagnostic performance with sensitivity of 88.2%, specificity of 73.0%, and accuracy of 82.1%. The AUC value of the combined model was significantly higher (AUC, 0.869) than that of the subjective model (AUC, 0.809) or the entropy model alone (AUC, 0.836) (P < 0.0001).

Conclusions
The CT–based entropy parameters could help assess the aggressiveness of pulmonary adenocarcinoma via quantitative analysis of intratumoral heterogeneity. The MIA can be differentiated from IAC accurately by using entropy-related parameters in peripheral pulmonary SSNs.
Unexpected Lymphatic Drainage of the Treated Breast
Authors: Raghoo Richard , Pereira Arias-Bouda Lenka M. , Valdés Olmos Renato A. 
Published: July 2019

Abstract
This case highlights the use of lymphoscintigraphy with SPECT/CT in patients with previous chest and/or axillary surgery. A 67-year-old woman with a history of left breast carcinoma treated with lumpectomy and radiotherapy, and a second lumpectomy of the ipsilateral breast for a second breast carcinoma, underwent a lymphoscintigraphy for a new left breast lesion. Planar images visualized an alternative lymphatic drainage to the contralateral axilla and to the left paravertebral area. SPECT/CT confirmed sentinel nodes in both stations.
Added Value of Myocardial Blood Flow Quantification and Calcium Scoring During CZT SPECT Myocardial Perfusion Imaging for Coronary Artery Disease Screening
Authors: Bailly Matthieu , Thibault Frédérique , Courtehoux Maxime , Metrard Gilles , Ribeiro Maria-Joao 
Published: July 2019

Abstract
Dedicated cadmium-zinc-telluride cardiac cameras have been shown to provide accurate measurements of absolute myocardial blood flow and flow reserve when PET is not available. We report the case of a 66-year-old woman who underwent 1-day stress/rest myocardial perfusion imaging (MPI) for coronary artery disease (CAD) screening. Relative MPI analysis was normal, whereas low-dose CT showed high calcium score. Myocardial blood flow and flow reserve were strongly impaired in all territories. Coronary angiography confirmed extended CAD. Flow parameters derived from cadmium-zinc-telluride SPECT MPI acquisition and calcium scoring can improve diagnostic accuracy and confidence of CAD.
In Vivo Microbial Targeting of 99mTc-Labeled Human β-Defensin-3 in a Rat Model of Infection
Authors: Follacchio Giulia Anna , Pala Alessandro , Scaccianoce Sergio , Monteleone Francesco , Colletti Patrick M. , Rubello Domenico , Liberatore Mauro 
Published: July 2019

Objective
Differentiation of infection from aseptic inflammation represents a major clinical issue. None of the commercially available compounds (labeled granulocytes, antigranulocyte antibodies, 67Ga-citrate, labeled immunoglobulin G, 18F-FDG) is capable of this differentiation, producing a nonnegligible false-positive rate. Recently, our group reported on a reliable labeling procedure of the antimicrobial peptide human β-defensin 3 (HBD-3) with 99mTc. The aim of this study was to evaluate in vivo 99mTc-HBD-3 uptake in a rat model of infection.

Methods
Recombinant HBD-3 was radiolabeled with 99mTc. Radiolabeling yield and specific activity of the compound were calculated. Chromatographic behavior and biological activity of 99mTc-HBD-3 were also assessed. An experimental model involving Staphylococcus aureus–induced infection and carrageenan-induced aseptic inflammation was performed in 5 Wistar rats. Serial planar scintigraphic acquisitions were performed from 15 to 180 minutes after 99mTc-HBD-3 intravenous administration. Radiotracer uptake was evaluated qualitatively and semiquantitatively as a target-to-nontarget ratio.

Results
Radiolabeling yield of 99mTc-HBD-3 was 70% with a specific activity of 6 to 8 MBq/μg. A significant and progressive 99mTc-HBD-3 uptake was observed in the site of S. aureus–induced infection, with a maximum average target-to-nontarget ratio of 5.7-fold higher in the infection site compared with an inflammation site observed at 140 minutes.

Conclusions
In vivo imaging with 99mTc-HBD-3 in a rat model of S. aureus–induced infection demonstrated favorable uptake in the infection site compared with sterile inflammation and background. These promising results, together with previous ex vivo uptake and toxicity assessment, suggest the potential of 99mTc-HBD-3 as a novel agent for specific infection imaging.
Quality and Safety in Healthcare, Part LV
Authors: Harolds Jay A. 
Published: July 2019

Abstract
Leadership is very important to reduce burnout and promote happiness in the healthcare workplace. Whereas burnout and unhappiness lead to doctor turnover, more errors, more accidents, and decreased patient satisfaction, joy in the workplace results in better patient care, enhanced engagement and productivity, and more profitability for the healthcare organization. Many leadership characteristics are critical including integrity, putting the well-being of others first, being fair, standing for important principles, being a good role model, being an excellent communicator, encouraging new ideas and adopting them when feasible, and loving people.
68Ga–Prostate-Specific Membrane Antigen-11 PET/CT
Authors: Alçin Göksel , Gündoğan Cihan , Mutlu İlhan Nahit , Çermik Tevfik Fikret 
Published: July 2019

Abstract
A 77-year-old man with newly diagnosed prostate adenocarcinoma with a total prostate-specific antigen level of 6.4 ng/mL and Gleason score 7 (4 + 3) was referred to 68Ga–prostate-specific membrane antigen-11 (PSMA) PET/CT for initial staging. An intense focal PSMA uptake was shown in the right peripheral zone of the prostate gland consistent with the primary tumor. Additionally, PET/CT demonstrated a PSMA-avid soft tissue mass in the left cerebellopontine angle. The patient had a history of left-sided sensorineural hearing loss.
68Ga-PSMA PET/CT Uptake in the Ureter Caused by Ligand Expression in Urothelial Cancer
Authors: Zacho Helle D. , Pedersen Sine H. , Petersen Astrid , Petersen Lars J. 
Published: July 2019

Abstract

68Ga-PSMA PET/CT has become a well-established imaging modality to detect prostate cancer (PCa) metastases in biochemical recurrence. Despite its claimed specificity for PCa, 68Ga-PSMA uptake in tissues unrelated to PCa, particularly in the neovascular tissue of other cancers, has been reported in numerous studies. A 73-year-old man underwent 68Ga-PSMA PET/CT for biochemical recurrence of PCa 7 years after radical prostatectomy. The 68Ga-PSMA PET/CT showed 1 lesion with PSMA uptake in the distal left ureter. Histology revealed a low-grade noninvasive papillary urothelial carcinoma. By immunohistochemistry, PSMA expression was observed in the neoplastic urothelial cells and in the vessels of the papillary structures.
Quality and Safety in Healthcare, Part LVII
Authors: Harolds Jay A. 
Published: July 2019

Abstract
Problems with healthcare organizations frequently result in burnout. Teams are very important not only to decrease burnout, but also to increase wellness and joy in healthcare, by changing the organization for the better. These organizational improvements, and teamwork itself, not only make life better for the workers, but also promote efficiency for the institution, increase quality and safety for patients and workers, and stimulate collaboration among the workers.
68Ga-DOTATATE Uptake by Cervicothoracic (Stellate) Ganglia
Authors: Berg Zachary , Koppula Bhasker Rao 
Published: July 2019

Abstract

68Ga-DOTATATE PET/CT, a functional imaging modality for assessment of well-differentiated neuroendocrine tumors, targeting the somatostatin receptors, has essentially replaced the conventional gamma camera-based imaging with 111In-labeled octreotide. Physiologic distribution, normal variations, and common pitfalls with 68Ga-DOTATATE imaging have been well described in the literature. Here, we describe uptake of 68Ga-DOTATATE in 2 different patients at cervicothoracic junction within the stellate ganglia.
Normal Variant 18F-Sodium Fluoride Uptake in the Falx Cerebri Ossification
Authors: Usmani Sharjeel , Marafi Fahad , Al Kandari Fareeda , Ahmed Najeeb 
Published: July 2019

Abstract
Falx cerebri ossification is an incidental finding. Mostly it is easy to diagnose, but can be challenging in few cases, and should be distinguished from calcified meningioma, hematoma, and meningeal infiltration. We report a case of a 46-year-old woman with breast cancer complaining of back pain. 18F-NaF PET/CT images show focal increase uptake at facet joints of L5/S1 vertebrae and both knees joints, suggesting degenerative disease. There is normal variant 18F-NaF uptake noted in the ossification at the falx cerebri. Recognition of normal and abnormal extraosseous 18F-NaF uptake is important for correct interpretation to avoid unnecessary further investigations.
A Novel Stitching Technique: Adjustable Closed-Loop Sewing Machine Lock Stitching Technique to Bend or Unbend Cartilages
Authors: Sibar Serhat , Manav Safa , Cenetoglu Seyhan , Elmas Cigdem 
Published: July 2019

Abstract
This study aimed to evaluate the effect of a novel adjustable, closed-loop sewing machine lock stitching technique on cartilage shape. This study was performed on 18 rabbits that were divided into 3 groups to evaluate the short- (Group I), medium- (Group II), and long-term (Group III) effects of the technique on cartilage shape. Three cartilage grafts were obtained from the right and left ears of the rabbits and measured angularly. For the cartilage grafts obtained from the right ears, contours were corrected using the stitching technique proposed herein. The cartilage grafts obtained from the left ears were not stitched; these were maintained as the control group. Angular measurements were performed for the stitched cartilage grafts, and all the cartilages grafts obtained were finally embedded into the rabbits’ backs. The rabbits in Groups I, II, and III were euthanized at week 2, 6, and 12, respectively, after which the cartilages were reevaluated for angular measurement and submitted for histopathological examination. A significant improvement from baseline was detected in the angular measurements of the stitched cartilage grafts obtained from the rabbits in each group. For the stitched cartilage grafts obtained from Group II and III rabbits, the angular measurements obtained immediately after stitching were found to be better than those obtained after euthanasia. In histopathological evaluation elevated collagen, perichondrium, and connective tissue levels were detected in grafts obtained from Group III rabbits. The novel stitching technique proposed herein appears to have beneficial long-term effects on the maintenance of cartilage contour.
Virtual Surgical Planning in Craniofacial Surgery
Authors: Teal Lindsey N. , Day Kristopher M. 
Published: July 2019

Background:
Virtual surgical planning (VSP) is increasingly described in craniofacial surgery literature. However, the quality of the literature that has been published is unknown. The objective of this systematic review was to determine the level of evidence of published articles on VSP.

Methods:
In this systematic review, PubMed, Web of Science, and ScienceDirect databases were queried for key terms in craniofacial VSP. Inclusion and exclusion criteria concentrated on patient-specific surgical outcomes in studies that could be rated for level of evidence. The articles were ranked according to their level of evidence, with level I being the highest level of evidence (randomized-controlled trials) and level V being the lowest (eg, case reports).

Results:
The initial keyword search yielded 1524 articles, 273 of which were ranked and included in the systematic review. The average level of evidence for an article published was 4.1 (between level IV and level V). Level IV was the most common level of evidence (65.6%), followed by level V (24.9%), level III (7.3%), level II (2.2%), respectively. There were not any level I articles. The most common study type was case series, accounting for 68.1% of the studies, followed by case reports (23.0%), case-control studies (4.7%), cohort studies (3.3%), and randomized controlled trials (1.1%), respectively.

Conclusion:
Although the quantity of craniofacial VSP studies has proliferated, the quality of the studies has not. In order for VSP literature to feature a higher level of evidence, future studies would require more sophisticated study design, such as prospective cohort or prospective randomized control trials.