bluuebunny/crossref_metadata_2025_split huggingface dataset:
Side effects of immunotherapy: a constant challenge for oncologists
Authors: Scotté Florian , Ratta Raffaele , Beuzeboc Philippe 
Published: March 2019

Purpose of review
Immunotherapeutic strategies have become the new paradigm of cancer care, through their new targeting and safety profile approach, and, de facto, their new monitoring and safety management challenges.

Recent findings
Generalities and specificities of the toxicity management related to immune checkpoint inhibitors (ICIs) are highlighted. Predictive factors of safety are issue of research and the challenge of prevention as well as monitoring are huge to alleviate toxicities and enhance safety and efficacy. Particular situations like steroids association and cost-effectiveness approach are summarized.

Summary
Patients as well as general practitioners, including health-caregivers, should be informed before ICI initiation of the different alert symptoms which should precede immune-related adverse events.
Prevalence and Severity of Child Impairment in a US Sample of Child Maltreatment Investigations
Authors: Helton Jesse J. , Lightfoot Elizabeth , Fu Q. John , Bruhn Christina M. 
Published: March 2019

ABSTRACT:

Objectives:
Although there is agreement that childhood disability is both a risk and result of maltreatment, the extent of disability in the child welfare system remains unclear. Our objective is to determine the prevalence and severity of child impairment in a national sample of child abuse and neglect investigations in the United States.

Methods:
We used data from the National Survey of Child and Adolescent Well-Being II, a study of 2644 children older than 3 years who were subjects of child abuse and neglect investigations. Groups of children were identified by latent profile analysis using continuous standardized measures of intelligence, emotional or behavioral impairments, adaptive behaviors, and social skills.

Results:
Whether the child remained in home or was removed to foster care after an investigation, 3 classes of children were identified: (1) slightly over one-tenth were in an intellectual disability subgroup characterized by marked intellectual impairments alongside delays in daily living functioning, (2) over one-third were in an emotional or behavioral impairment subgroup characterized by both frequent and severe internalizing and externalizing behaviors, and (3) slightly over half were in a typically developing subgroup.

Conclusion:
When using standardized measures of disability, nearly half of the children investigated by child protection in the United States are not typically developing. These findings suggest that those working for the child welfare system need to be attentive to the complex needs of children with intellectual disabilities and emotional or behavioral impairments and their families, many of whom are under significant stress.
The influence of leadership facilitation on relational coordination among primary care team members of accountable care organizations
Authors: Huber Thomas P. , Rodriguez Hector P. , Shortell Stephen M. 
Published: March 2019

Background
Teamwork is a central aspect of integrated care delivery and increasingly critical to primary care practices of accountable care organizations. Although the importance of leadership facilitation in implementing organizational change is well documented, less is known about the extent to which strong leadership facilitation can positively influence relational coordination among primary care team members.

Purpose
The aim of this study was to examine the association of leadership facilitation of change and relational coordination among primary care teams of accountable care organization-affiliated practices and explore the role of team participation and solidarity culture as mediators of the relationship between leadership facilitation and relational coordination among team members.

Methodology/Approach
Survey responses of primary care clinicians and staff (n = 764) were analyzed. Multilevel linear regression estimated the relationships among leadership facilitation, team participation, group solidarity, and relational coordination controlling for age, time, occupation, gender, team tenure, and team size. Models included practice site random effects to account for the clustering of respondents within practices.

Results
Leadership facilitation (β = 0.19, p < .001) and team participation (β = 0.18, p < .001) were positively associated with relational coordination, but solidarity culture was not associated. The association of leadership facilitation and relational coordination was only partially mediated (9%) by team participation.

Conclusions
Leadership facilitation of change is positively associated with relational coordination of primary care team members. The relationship is only partially explained by better team participation, indicating that leadership facilitation has a strong direct effect on relational coordination. Greater solidarity was not associated with better relational coordination and may not contribute to better team task coordination.

Practice Implications
Leadership facilitation of change may have a positive and direct impact on high relational coordination among primary care team members.
The effectiveness of teaching chest compression first in a standardized public cardiopulmonary resuscitation training program
Authors: Hsu Shou-Chien , Kuo Chan-Wei , Weng Yi-Ming , Lin Chi-Chun , Chen Jih-Chang 
Published: March 2019

Abstract
Effectiveness of bystander cardiopulmonary resuscitation (CPR) is known to provide emergency medical services which reduce the number of deaths in patients with out-of-hospital cardiac arrest. The survival at these patients is affected by the training level of the bystander, but the best format of CPR training is unclear. In this pilot study, we aimed to examine whether the sequence of CPR instruction improves learning retention on the course materials.
A total of 95 participants were recruited and divided into 2 groups; Group 1: 49 participants were taught firstly how to recognize a cardiac arrest and activate the emergency response system, and Group 2: 46 participants were taught chest compression first. The performance of participants was observed and evaluated, the results from 1 pre-test and 2 post-tests between 2 groups were then compared.
There was a significantly better improvement of participants in Group 2 regarding the recognition of a cardiac arrest and the activation of the emergency response system than of those in Group 1. At the post-test, participants in Group 2 had an improvement in chest compression compared to those in Group 1, but the difference was not statistically significant.
Our study had revealed that teaching CPR first in a standardized public education program had improved the ability of participants to recognize cardiac arrest and to activate the emergency response system.
Comparison between paclitaxel-coated balloon and standard uncoated balloon in the treatment of femoropopliteal long lesions in diabetics
Authors: Du Xin , Wang Feng , Wu Dan-ming , Zhang Min-hong , Jia Xin , Zhang Ji-wei , Zhuang Bai-xi , Zhao Yu , Guo Ping-fan , Bi Wei , Fu Wei-guo , Guo Wei , Wang Shen-ming 
Published: March 2019

Abstract
Atherosclerotic diseases may include femoropopliteal artery stenosis or occlusion. Percutaneous transluminal angioplasty (PTA) is an effective and minimally invasive treatment strategy for atherosclerotic femoropopliteal artery stenosis/occlusion disease. Balloon angioplasty is a widely used technique in the management of occlusive disease in almost all arterial segments.
We enrolled 111 diabetics with long femoropopliteal lesions, among which 54 received PTA with paclitaxel-coated balloon (the Paclitaxel group), and 57 with standard balloon catheters (the Control group).
The primary outcome was set as angiographic late lumen loss (LLL) within 6 months; the secondary angiographic outcome was binary restenosis. Clinical outcomes included Rutherford clarification, ankle-brachial index (ABI) and rate of clinically driven target lesion revascularization (TLR). Two groups had similar basal clinical features, angiographic and procedural characteristics. Compared to controls, the Paclitaxel group had a significantly lower 6-month LLL rate, 12-month binary restenosis rate, 12-month TLR, lower Rutherford grades at 3 and 6 months, and higher ABI at 3 months. For all factors which might influence outcomes, fasting blood glucose was negatively correlated with ABI; the blood urea nitrogen (BUN) was positively related with the Rutherford clarification grades. In addition, the coronary heart disease (CHD) and smoking histories were positively correlated with residual stenosis after treatment.
Collectively, the paclitaxel-coated balloon angioplasty can yield more favorable angiographic and clinical outcomes than standard uncoated balloon angioplasty, even in the more challenging lesions (the long and occlusive femoropopliteal lesions) in diabetics, when it had a similar safety profile to the traditional balloon. Blood glucose, BUN, CHD, and smoking imply poor curative effects.
Comparison of hemodynamic changes and prognosis between stenting and standardized medical treatment in patients with symptomatic moderate to severe vertebral artery origin stenosis
Authors: Shao Jia-Xin , Ling Yun-Ao , Du Hua-Ping , Zhai Guo-Jie , Xu Yuan , Cao Yong-Jun 
Published: March 2019

Abstract
This study aimed to compare the clinical efficacy of stenting compared with standardized medical treatment in patients with moderate to severe vertebral artery origin stenosis (VAOS).
Patients diagnosed with moderate to severe VAOS and indicated to undergo vertebral artery stenting were enrolled. Patients were divided into stenting group and standardized medical treatment group. All patients underwent transcranial Doppler (TCD) before and after treatment. Incidence of new cerebral infarction, transient ischemic attack (TIA), improvement of clinical symptoms, and National Institutes of Health Stroke Scale (NIHSS) score were observed.
A total of 98 patients were enrolled. Vertebral artery stenting implant was accepted by 43 patients. Two weeks after treatment, the NIHSS score in the stenting group decreased significantly compared to that in the standardized medical treatment group. The modified Rankin Scale (mRS) score in the stenting group at three months was significantly lower than that in the medical treatment group (P = .044). The extent of vascular stenosis in the stent group decreased significantly (76.5 ± 10.0% vs. 13.7 ± 5.9%, t = 35.878, P = .000). The adverse events occurred in 9 (16.4%) patients in the medical treatment group and 5 (11.6%) in the stenting group (P = .506). There was one case with new cerebral infarction in the stenting group, whereas the medical treatment group showed 1 case with TIA and three with new cerebral infarction during follow-up after 3 months. The peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI) of stenosis vertebral artery, and PSV of basilar artery were significantly higher in the stent group than those in the standardized medical group (P < .05).
Stenting for VAOS, rather than standardized medical treatment, can effectively relieve vascular stenosis, alter vertebral-basilar artery hemodynamics, and improve neurological function, with low perioperative complications.
Traditional Chinese medicine on treating diabetic mellitus erectile dysfunction
Authors: Yu Xudong D. , Wang Jisheng S. , Zuo Guang , Wang Xin , Ge Fuxing , Wu Songli , Lim Jingyang , Shang Jianwei , Zhang Yaosheng 
Published: March 2019

Abstract

Background:
Diabetic mellitus erectile dysfunction (DMED) refers to erectile dysfunction (ED) secondary to diabetes. As people's lifestyle changes and the population ages, the incidence of DMED continues to increase. Many clinical trials have proven that Chinese medicine has a significant effect in the treatment of DMED. In this systematic review, we aim to evaluate the effectiveness and safety of traditional Chinese medicine (TCM) for DMED.

Methods:
We will search PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database, China Biomedical Literature CD-ROM Database, and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to February, 2019.We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of DMED.

Ethics and dissemination:
This systematic review will evaluate the efficacy and safety of TCM for treating Diabetic mellitus erectile dysfunction. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process trial.
Periprosthetic femoral fractures around tumor endoprostheses treated with limited revision surgery combined with allograft
Authors: Wu Jianhua , Zhu Dengfeng , Wang Jianjun , Wang Jie , Liu Yongguo , Lei Jun 
Published: March 2019

Abstract

Rationale:
Old periprosthetic femoral fractures (OPFFs) around a tumor prosthesis of the knee present formidable problems for orthopedic oncologists; large bone defects and inappropriate biomechanics of the revision implant design can impair successful reconstruction. Limited literature is available on the reconstruction of OPFFs using revision combined with massive allograft following resection of a bone tumor around the knee joint. In this study, we present the first reported case in the English literature of a limited revision followed by several segmental allografts for the reconstruction of the knee joint.

Patient concerns:
This case involved a 45-year-old female who was treated for a malignant fibrous histiocytoma (MFH) of the knee joint with surgical excision of the lesion and replacement of the defect using endoprosthetic reconstruction when she was 25 years old. Her surgical history was remarkable for a left tumoral knee prosthesis implanted 20 years ago. Nine years before revision, the patient had fall damage; however, she was able to walk independently and with moderate pain. In the 9-year period, prosthesis malfunction caused progressive left lower extremity shortening and a persistent swelling pain in the left thigh.

Diagnoses:
According to her clinical history, imaging results and physical examination, we confirmed the diagnosis of OPFFs potentially due to aseptic loosening and trauma injury.

Interventions:
In this study, we present the first case of OPFFs around a tumor endoprosthesis that was successfully treated using limited revision combined with a massive allograft.

Outcomes:
At 80 months after revision surgery, the patient had made a sufficient recovery from her symptoms. The bone union was complete without tumor recurrence or implant failure.

Lessons:
We propose that if prosthesis fracture is detected, revision surgery should be attempted as early as possible, and for patients with OPFFs, the use of limited revision combined with massive allografts may be useful for safely and adequately reconstructing OPFFs around the knee joint. However, patients should be followed-up closely after surgical treatment because of the high risk of revision.
Treatment of uterine high-grade endometrial stromal sarcoma with apatinib combined with chemotherapy
Authors: Zhang Ying , Chen Chen , Ren Meng , Cong Xiaofeng , Li Zhi , Yang Lei 
Published: March 2019

Abstract

Rationale:
The standard treatment for uterine high-grade endometrial stromal sarcoma (HGESS) is chemotherapy after surgery. However, the traditional combination chemotherapy has certain limitation, for example, the cancer cells will quickly become resistant to the chemotherapy drugs. Apatinib is a small-molecule antiangiogenic agent which has shown promising therapeutic effect against diverse tumor, but it still remains unknown whether apatinib has an antitumor effect in patients with endometrial stromal sarcoma (ESS). Here, we report a case of pulmonary metastasis from uterine HGESS successfully treated with apatinib combined with chemotherapy. We also review relevant literature discussing treatment of ESS.

Patients concerns:
A 54-years-old Chinese woman complained of intermittent pain in the waist and abdomen for 4 months. The patient was diagnosed as uterine fibroids before operation. The surgeon performed a total hysterectomy with bilateral salpingo-oophorectomy, resection of peritoneal disseminated lesions, and the pathological examination revealed a HGESS.

Diagnosis:
Uterine HGESS stage IV with lung metastases.

Interventions:
The patient underwent surgery, chemotherapy, chemotherapy combined with apatinib, apatinib maintenance therapy, and radioactive particle implantation for lung metastasis.

Outcomes:
The patient experienced the above interventions and achieved good results. And continue oral apatinib (500 mg daily) as maintenance therapy. It has been 16 months since the initial diagnosis, and the patient is still in follow-up.

Lessons:
Apatinib combined with chemotherapy and apatinib monotherapy as maintenance therapy could be a new therapeutic strategy for ESS.
The trends and associated factors of preterm deliveries from 2001 to 2011 in Taiwan
Authors: Chen Kou-Huang , Chen I-Chu , Yang Yi-Chieh , Chen Kow-Tong 
Published: March 2019

Abstract
The rate of preterm birth has been increasing worldwide. Most preterm babies are at increased risk of central nervous system impairments as well as respiratory and gastrointestinal complications. The aim of this study was to investigate the trends in preterm birth and associated factors contributing to preterm delivery in Taiwan. Information on obstetric antecedents and risk factors of preterm birth of pregnant women was obtained from the Taiwan National Medical Birth Register database. All live births from 2001 to 2011 in Taiwan were included in this study. A total of 2,334,532 live births from 2001 to 2011 were included in this study. Overall, the proportion of preterm deliveries increased by 11.1% (from 8.2% in 2001 to 9.1% in 2011). Multiple logistic regression analyses showed that nulliparity, multiple births, maternal medical complications, maternal age <20 years or ≥40 years, and medical indication for earlier delivery were positively associated with an increased risk of preterm delivery. Nulliparous women aged younger than 20 years and older than 40 years should be recognized as at-risk for preterm birth.
Risk Factors for Recurrent Acute Kidney Injury in Children Who Undergo Multiple Cardiac Surgeries: A Retrospective Analysis
Authors: Hasson Denise C. , Brinton John T. , Cowherd Ellen , Soranno Danielle E. , Gist Katja M. 
Published: March 2019

Objectives:
Determine the risk factors for repeated episodes of acute kidney injury in children who undergo multiple cardiac surgical procedures.

Design:
Single-center retrospective chart review.

Setting:
Cardiac ICU at a quaternary pediatric care center.

Patients:
Birth to 18 years who underwent at least two cardiac surgical procedures with cardiopulmonary bypass.

Interventions:
None.

Measurements and Main Results:
One-hundred eighty patients underwent two cardiac surgical procedures and 89 underwent three. Acute kidney injury was defined by the Kidney Disease: Improving Global Outcomes serum creatinine criteria. Acute kidney injury frequency was 26% (n = 46) after surgery 1, 20% (n = 36) after surgery 2, and 24% (n = 21) after surgery 3, with most acute kidney injury occurring on postoperative days 1 and 2. The proportion of patients with severe acute kidney injury increased from surgery 1 to surgery 3. Patients with acute kidney injury had a significantly longer duration of ventilation and length of stay after each surgery. The odds of acute kidney injury after surgery 3 was 2.40 times greater if acute kidney injury was present after surgery 1 or 2 (95% CI, 1.26–4.56; p = 0.008) after adjusting for confounders. The time between surgeries was not significantly associated with acute kidney injury (p = 0.85).

Conclusions:
In a heterogeneous population of pediatric patients with congenital heart disease undergoing multiple cardiopulmonary bypass surgeries, odds of acute kidney injury after a third surgery was increased by the presence of acute kidney injury after prior procedures. Time between surgery did not play a role in increasing odds of acute kidney injury. Further studies in a larger multicenter investigation are necessary to confirm these findings.
Current Approach to the Management of Forearm and Elbow Dislocations in Children
Authors: Gottlieb Michael , Suleiman Linda I. 
Published: March 2019

Abstract
Pediatric orthopedic injuries are a common reason for presentation to the emergency department. This article sequentially discusses 2 important upper extremity injuries that require prompt management in the emergency department. Radial head subluxations are discussed with a focus on current evidence for imaging, reduction techniques, and follow-up. Elbow dislocations, although less common than radial head subluxations, are also addressed, highlighting imaging, reduction, immobilization, and follow-up recommendations.
Development and Validation of a Nipple-Specific Scale for the BREAST-Q to Assess Patient-Reported Outcomes following Nipple-Sparing Mastectomy
Authors: Peled Anne Warren , Amara Dominic , Piper Merisa L. , Klassen Anne F. , Tsangaris Elena , Pusic Andrea L. 
Published: March 2019

Background:
Nipple-sparing mastectomy and immediate reconstruction has become increasingly popular for prophylactic and therapeutic indications. Patient-reported outcomes instruments such as the BREAST-Q provide important information regarding patient satisfaction and aesthetic and functional outcomes. However, a validated patient-reported outcomes scale specifically addressing nipple-related outcomes following nipple-sparing mastectomy is not currently available.

Methods:
The authors developed a new scale measuring nipple outcomes by adapting nipple reconstruction questions from the BREAST-Q breast reconstruction module. Patients completed the questions using the think-aloud method and underwent semistructured cognitive interviews to discuss their nipple-sparing mastectomy experience to elicit new concepts. Interviews were coded and additional questions were added based on this analysis after receiving additional input from a multidisciplinary group of breast cancer providers. The final scale was distributed electronically to a larger group with solicitation for any issues that were not addressed in the question set.

Results:
Ten patients completed the initial questionnaire. Analysis of the cognitive interviews identified nipple sensation, position, projection, scarring, symmetry, and surgical expectations as key content areas. After revising the questionnaire, an additional 35 patients completed it electronically. All respondents felt the questions were clear and no additional issues needed to be addressed. Feedback was used to clarify the instructions for how to respond to the questions if bilateral nipple-sparing mastectomy had been performed.

Conclusions:
Through qualitative patient interviews and adaptation of existing BREAST-Q questions, appropriate nipple-focused questions were developed to assess outcomes following nipple-sparing mastectomy. Incorporating these questions into patient-reported outcomes assessment of patients undergoing nipple-sparing mastectomy can help improve future techniques and optimize outcomes.