bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effectiveness of Lumbar Transforaminal Injection of Steroid for the Treatment of Radicular Pain: A Comprehensive Review of the Published Data
Authors: Smith Clark C , McCormick Zachary L , Mattie Ryan , MacVicar John , Duszynski Belinda , Stojanovic Milan P 
Published: June 2019

AbstractObjectiveTo determine the effectiveness of lumbar transforaminal injection of steroid for the treatment of radicular pain.DesignComprehensive systematic review.Outcome MeasuresThe primary outcome of interest was the proportion of individuals with reduction of pain by ≥50%. Additional outcomes of interest were a more-than-two-point reduction in pain score, patient satisfaction, functional improvement, decreased use of pain medication, and avoidance of spinal surgery.ResultsFor patients with disc herniations, using the criterion of ≥50% reduction in pain, success rates across included studies (range) were 63% (58–68%) at one month, 74% (68–80%) at three months, 64% (59–69%) at six months, and 64% (57–71%) at one year. For patients with lumbar spinal stenosis, success rates across included studies (range) were 49% (43–55%) at one month, 48% (35–61%) at three months, 43% (33–53%) at six months, and 59% (45–73%) at one year, but there was a lack of corroboration from appropriately controlled studies.ConclusionsThere is strong evidence that lumbar transforaminal injection of steroids is an effective treatment for radicular pain due to disc herniation. There is a lack of high-quality evidence demonstrating their effectiveness for the treatment of radicular pain due to spinal stenosis, though small studies suggest a possible benefit. Lumbar transforaminal injection of nonparticulate steroids is as effective as injections with particulate steroids.
Vessel-length determination using silicone and air injection: are there artifacts?
Authors: Gao Hui , Chen Ya-Jun , Zhang Yong-Jiang , Maenpuen Phisamai , Lv Song , Zhang Jiao-Lin 
Published: June 2019

AbstractXylem vessels are used by most angiosperm plants for long-distance water and nutrient transport. Vessel length is one of the key functional traits determining plant water-transport efficiency. Additionally, determination of maximum vessel length is necessary for correct sample collection and measurements in hydraulic studies to avoid open-vessel and cutting-under-tension artifacts. Air injection and silicone injection (BLUESIL RTV141A and B mixtures) are two widely used methods for maximum vessel length determination. However, the validity of both methods needs to be carefully tested for species with different vessel lengths. In this study, we tested the air-injection and silicone-injection methods using eight species with different vessel lengths: short (&lt;0.5 m), medium (0.5–1 m) and long (&gt;1 m). We employed a novel approach using RTV141A injection without the RTV141B hardener as a reference method because RTV141A cannot penetrate inter-vessel pit membranes and is not prone to hardening/solidification effects during the injection process. The results revealed that the silicone-injection method substantially underestimated the maximum vessel length of all eight species. However, the air-injection method tended to overestimate the maximum vessel length in five out of eight species. The ratio of underestimation of the silicone-injection method was higher for species with longer vessels, but the overestimation of the air-injection method was independent of the vessel length. Moreover, air injection with different pressures—ranging from 40 to 300 kPa—resulted in comparable results. We conclude that the conventional silicone-injection method can underestimate the vessel length, whereas the air-injection method can overestimate the maximum vessel length, particularly for long-vessel led species. We recommend RTV141A-only injection for determining the maximum vessel length, and it can also be used to validate the use of the air-injection and conventional silicone-injection methods for a given species.
Growth resilience and oxidative burst control as tolerance factors to Ophiostoma novo-ulmi in Ulmus minor
Authors: Martín Juan A , Sobrino-Plata Juan , Coira Begoña , Medel David , Collada Carmen , Gil Luis 
Published: June 2019

AbstractThe Dutch elm disease (DED) pathogens, Ophiostoma ulmi (Buisman) Nannf. and the more aggressive Ophiostoma novo-ulmi Brasier, have decimated European elm populations in the last 100 years. Today, the number of tolerant elm varieties available on the market is limited, partly due to the long breeding cycles and expensive facilities they require. Developing a low-cost technique to allow early screening of elm tolerance based on simple morphological and/or biochemical traits would considerably boost elm breeding and research. Within this general aim, we developed an in vitro plant culture system to (i) characterize stress responses to O. novo-ulmi-root inoculation in two Ulmus minor Mill. clones of contrasting susceptibility level to DED (termed ‘tolerant’ and ‘susceptible’) and (ii) compare the upward dispersal rate of the pathogen in the two clones. Constitutive xylem anatomy was similar in both clones, indicating that differences in plant responses to the pathogen are not attributable to anatomical factors (e.g., conduit size). Susceptible plantlets suffered a significant delay in apical growth and a decrease in chlorophyll content at 21 days post-inoculation (dpi). The rate of pathogen dispersal from roots to aerial tissues was similar in both clones. However, the tolerant clone showed a marked increase in lipid peroxidation at 1 dpi, while the susceptible clone showed enhanced values of lipid peroxidation during most of the experimental period (1–21 dpi). Despite wide stem colonization by the pathogen, the tolerant clone effectively regulated the oxidative stress levels and showed remarkable resilience to inoculation. These results extend current knowledge on elm defense mechanisms, and the proposed in vitro plant culture system emerges as a promising early screening method for tolerance to improve elm breeding.
Age-specific prevalence of TB infection among household contacts of pulmonary TB: Is it time for TB preventive therapy?
Authors: Dolla Chandra Kumar , Padmapriyadarsini Chandrasekaran , Thiruvengadam Kannan , Lokhande Rahul , Kinikar Aarti , Paradkar Mandar , BM Shrinivas , Murali Lakshmi , Gupte Akshay , Gaikwad Sanjay , Selvaraju Sriram , Padmanaban Yashoda , Pattabiraman Sathyamurthy , Pradhan Neeta , Kulkarni Vandana , Shivakumar Shri Vijay Bala Yogendra , Prithivi Munivardhan , Kagal Anju , Karthavarayan Barath Thopili , Suryavanshi Nishi , Gupte Nikhil , Kumaran Paul , Mave Vidya , Gupta Amita 
Published: June 2019

Abstract

Background
Household contacts (HHCs) of TB patients are at high risk of developing evidence of latent TB infection (LTBI) and active disease from the index patient. We estimated the age-specific prevalence of LTBI and the force of infection (FI), as a measure of recent transmission, among HHCs of active TB patients.

Methods
A cross-sectional analysis of HHCs of pulmonary TB patients enrolled in a prospective study, ‘CTRIUMPh’, was conducted at two sites in India. LTBI was defined as either a positive tuberculin skin test (induration ≥5 mm) or QuantiFERON–Gold in tube test (value ≥0.35 IU/ml) and was stratified by age. FI, which is a measure of recent transmission of infection and calculated using changes in age-specific prevalence rates at specific ages, was calculated. Factors associated with LTBI were determined by logistic regression models.

Results
Of 1020 HHCs of 441 adult pulmonary TB cases, there were 566 (55%) females and 289 (28%) children aged ≤15 y. While screening for the study 3% of HHC were diagnosed with active TB. LTBI prevalence among HHCs of pulmonary TB was 47% at &lt;6 y, 53% between 6–14 y and 78% between 15–45 y. FI increased significantly with age, from 0.4 to 1.15 in the HHCs cohort (p=0.05).

Conclusion
This study observed an increased prevalence of LTBI and FI among older children and young adults recently exposed to infectious TB in the household. In addition to awareness of coughing etiquette and general hygiene, expanding access to TB preventive therapy to all HHCs, including older children, may be beneficial to achieve TB elimination by 2035.
INCREASED FOVEAL GANGLION CELL AND INNER PLEXIFORM LAYER THICKNESS IN CHILDREN AGED 6.5 YEARS BORN EXTREMELY PRETERM
Authors: Rosén Rebecka M. , Hellgren Kerstin M. , Venkataraman Abinaya P. , Dominguez Vicent Alberto , Nilsson Maria 
Published: June 2019

Purpose:
To analyze the ganglion cell layer and inner plexiform layer (GCL+) thickness in children born extremely preterm and control children.

Methods:
A study of 6.5-year-old children born before the gestational age of 27 weeks and age-matched controls. The GCL+ thickness and foveal depth (FD) were analyzed in a single optical coherence tomography B-scan. Association with neonatal risk factors and sex was investigated. Extremely preterm was divided into no, mild, and severe retinopathy of prematurity, retinopathy of prematurity treatment, and no, mild, and severe intraventricular hemorrhage.

Results:
Adequate measurements were obtained from 89 children born extremely preterm and 92 controls. Extremely preterm children had increased total (5 µm, P < 0.001) and central (21 µm, P < 0.001) GCL+ thickness and reduced FD (−53 µm, P < 0.001) compared with controls. Extremely preterm children receiving retinopathy of prematurity treatment had increased GCL+ thickness and reduced FD compared with other subgroups. Sex and gestational age were associated with increased central GCL+ thickness and reduced FD. Reduced total GCL+ thickness was associated with severe intraventricular hemorrhage.

Conclusion:
Extremely preterm birth can cause incomplete extrusion of the GCL+ and reduced FD. Retinopathy of prematurity treatment, gestational age, and male sex were associated to increased central GCL+ thickness and reduced FD, while severe intraventricular hemorrhage was associated with reduced total GCL+ thickness.
Comparison of two cohorts of medically at-risk adolescents engaging in substance use (cancer survivors and asthmatics): Clinical predictors for monitoring care
Authors: Hollen Patricia J. , O'Laughlen Mary C. , Hellems Martha A. , Hinton Ivora D. , Xin Wenjun , Patrie James T. 
Published: June 2019

ABSTRACT

Background and purpose:
Medically at-risk adolescents differ in their perception of severity and are vulnerable to substance use because of effects on their medical regimen. The intent in comparing two cohorts, adolescent survivors of cancer and teens with asthma, is to provide clinical predictors to help in monitoring those needing help with substance use decision making.

Methods:
Baseline data were obtained from two randomized controlled trials for a decision-making program of research for medically at-risk adolescents. Multivariate analyses were used to identify clinical predictors for poor decision making as well as lifetime and current substance use (smoking, alcohol use, and marijuana use).

Conclusions:
Predictors for both cohorts for lifetime and current substance use were increasing age and risk motivation. A significant predictor for both cohorts for poor decision making related to substance use was risk motivation, measured as a more positive attitude for engaging in substance use. Negative modeling by peers and family members had an impact on teen survivors' decision making; but, this was not clear for teens with asthma.

Implications for practice:
Research is needed comparing other medically at-risk adolescents to determine which cohorts on the substance use spectrum are less resilient to peer and parent modeling, have unrealistic views of their decision-making skills, and need close monitoring and guidance.
Altered Gray Matter Volume and White Matter Integrity in Sensorineural Hearing Loss Patients: A VBM and TBSS Study
Authors: Qi Rongmiao , Su Lianzi , Zou Liwei , Yang Jianming , Zheng Suisheng 
Published: June 2019

Objective:
The purpose of the present study was to detect structural changes in the brains of patients with sensorineural hearing loss (SNHL) by combining voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS).

Methods:
Thirty-five patients with SNHL (mean age: 39.72 ± 1.81 yr) and 23 age-matched control subjects (mean age: 39.83 ± 1.96 yr) were assessed using three-dimensional, T1-weighted imaging, and diffusion tensor imaging. TBSS and VBM analyses were performed to evaluate grey matter (GM) volume changes and white matter (WM) alternations, as measured by mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD).

Results:
VBM showed decreased GM volume in patients with SNHL in the fusiform gyrus of the right temporal lobe and right middle occipital gyrus. TBSS revealed WM integrity changes, including decreased FA and RD and increased RD in several WM regions. However, MD showed no significant difference between patients with SNHL and age-matched controls.

Conclusion:
Patients with SNHL showed smaller GM volume and WM integrity changes in several regions.
Endoscopic-Assisted Repair of Spontaneous Temporomandibular Joint Herniation Through a Transcanal Approach
Authors: Xie Bingbin , Zhang Shaorong , Liu Yuehui 
Published: June 2019

Objective:
To report of the presentation, diagnosis, and management of a spontaneous temporomandibular joint (TMJ) herniation.

Patients:
A 69-year-old man with a spontaneous TMJ herniation.

Interventions:
Diagnostic evaluation and surgical approaches.

Main Outcome Measures:
Imaging, and medical and surgical treatment outcomes.

Results:
At 14 months follow-up, the patient reported improved tinnitus and on examination there was no evidence of a hypertrophic scar or canal stenosis, no recurrence of TMJ herniation, no signs of otorrhea, otalgia; and with normal TMJ function.

Conclusions:
The advantages of repairing spontaneous TMJ herniation through a transcanal approach using oto-endoscopy include a high definition video of surgical field, minimal invasiveness, and good postoperative cosmetic outcome.
Insurance Loss in the Era of the Affordable Care Act
Authors: Mojtabai Ramin 
Published: June 2019

Background:
Every year, millions of Americans lose their health insurance and remain uninsured for various reasons, potentially impacting access to medical services.

Objective:
To examine trends in health insurance loss in the periods shortly before and after implementation of Patient Protection and Affordable Care Act (ACA) and to assess the association of past-year health insurance loss with access to health services and medications.

Research Design and Subjects:
Trends in health insurance loss were examined in 176,961 nonelderly adult participants of the National Health Interview Survey 2011–2017—a representative cross-sectional annual survey of US general population. Multivariable logistic regression models were used to examine access to health services and medications.

Measures:
Loss of private insurance or Medicaid in the past year; use of emergency room services and hospitalizations; contact with medical providers; affording medical care or medications; cost-related medication nonadherence.

Results:
Private health insurance loss decreased from 3.9%–4.0% in 2011–2013 to 2.7% to 3.1% in 2014–2017 (P<0.001); Medicaid loss decreased from 8.5%–8.9% to 4.6%–6.4% in this period (P<0.001). Nevertheless, as late as 2017, ∼6 million uninsured adults reported having lost private insurance or Medicaid in the past year. Loss of either type of health insurance was associated with lower odds of accessing medical providers, but higher odds of not affording medical care and poor adherence to medication regimens to save costs.

Conclusions:
Implementation of ACA was associated with lower risk of health insurance loss. Nevertheless, health insurance loss remains a major barrier to accessing health services and prescribed medications.
Deep Learning to Classify Intraductal Papillary Mucinous Neoplasms Using Magnetic Resonance Imaging
Authors: Corral Juan E. , Hussein Sarfaraz , Kandel Pujan , Bolan Candice W. , Bagci Ulas , Wallace Michael B. 
Published: June 2019

Objective
This study aimed to evaluate a deep learning protocol to identify neoplasia in intraductal papillary mucinous neoplasia (IPMN) in comparison to current radiographic criteria.

Methods
A computer-aided framework was designed using convolutional neural networks to classify IPMN. The protocol was applied to magnetic resonance images of the pancreas. Features of IPMN were classified according to American Gastroenterology Association guidelines, Fukuoka guidelines, and the new deep learning protocol. Sensitivity and specificity were calculated using surgically resected cystic lesions or healthy controls.

Results
Of 139 cases, 58 (42%) were male; mean (standard deviation) age was 65.3 (11.9) years. Twenty-two percent had normal pancreas; 34%, low-grade dysplasia; 14%, high-grade dysplasia; and 29%, adenocarcinoma. The deep learning protocol sensitivity and specificity to detect dysplasia were 92% and 52%, respectively. Sensitivity and specificity to identify high-grade dysplasia or cancer were 75% and 78%, respectively. Diagnostic performance was similar to radiologic criteria. Areas under the receiver operating curves (95% confidence interval) were 0.76 (0.70–0.84) for American Gastroenterology Association, 0.77 (0.70–0.85) for Fukuoka, and 0.78 (0.71–0.85) for the deep learning protocol (P = 0.90).

Conclusions
The deep learning protocol showed accuracy comparable to current radiographic criteria. Computer-aided frameworks could be implemented as aids for radiologists to identify high-risk IPMN.
Ki-67 Index of 5% is Better Than 2% in Stratifying G1 and G2 of the World Health Organization Grading System in Pancreatic Neuroendocrine Tumors
Authors: Gao Shao-Wei , Huang Chen-Song , Huang Xi-Tai , Chen Liu-Hua , Chen Wei , Cai Jian-Peng , Yin Xiao-Yu 
Published: June 2019

Objective
The World Health Organization (WHO) grading system for the stratification of G1 and G2 pancreatic neuroendocrine tumors (pNETs) using an optimal Ki-67 index cutoff is still controversial. The present study aimed at finding one optimal Ki-67 cutoff value that distinguishes G1 and G2 tumors by analyzing the prognosis of patients with pNET in our center.

Methods
Data from 84 patients with pNET undergoing surgical resection in The First Affiliated Hospital of Sun Yat-sen University between March 2003 and October 2015 were retrospectively analyzed.

Results
The 5-year overall survival rate was 74.2%. Univariate analysis revealed that functional secretion, WHO grade, and TNM stage were significantly associated with long-term survival (all P < 0.05). Multivariate analysis demonstrated that WHO grade (P = 0.023) and TNM stage (P = 0.040) were independent prognostic factors. The receiver operating characteristic curve showed that the Ki-67 index of 5% had the best predictive ability (76.7%) for 5-year survival with a hazard ratio of 44.7. The hazard ratio was only 8.14 when the Ki-67 index cutoff was 2%.

Conclusions
TNM stage and WHO grade were independent prognostic factors of pNETs. A Ki-67 index of 5% is better than 2% in stratifying G1 and G2 pNET tumors.
The Impact of Cannabis Consumption on Mortality, Morbidity, and Cost in Acute Pancreatitis Patients in the United States
Authors: Simons-Linares Carlos Roberto , Barkin Jodie A. , Jang Sunguk , Bhatt Amit , Lopez Rocio , Stevens Tyler , Vargo John , Barkin Jamie S. , Chahal Prabhleen 
Published: June 2019

Objectives
The aim of this study was to identify the prevalence of cannabis use among all patients admitted with acute pancreatitis (AP) in the United States and to investigate the impact of cannabis use on AP mortality, morbidity, and cost of care.

Methods
The National Inpatient Sample database from 2003 to 2013 was queried for all patients with AP and active exposure to cannabis. Outcomes included in-hospital mortality, length of stay, inflation adjusted charges, acute kidney injury, acute respiratory distress syndrome, and shock. Results were adjusted for age, sex, race, Charlson comorbidity index, median income quartile, and hospital characteristics.

Results
More than 2.8 million patients with AP patients were analyzed. Cannabis-exposed (CE) patients' prevalence was 0.3%. Patients exposed to cannabis were younger and mostly males compared with non–cannabis-exposed patients. After adjusting for these factors, the CE group had significantly lower inpatient mortality compared with the noncannabis group (odds ratio, 0.17; 95% confidence interval, 0.06–0.53). Cannabis-exposed patients also had decreased length of stay, inflation-adjusted charges, acute kidney injury, ileus, shock, acute respiratory distress syndrome, and parenteral nutrition requirement.

Conclusions
Cannabis-exposed hospitalized patients with AP had lower age-adjusted, mortality, morbidity, and hospitalization-cost than non–cannabis-exposed patients.
Liver Ultrasound Patterns in Children With Cystic Fibrosis Correlate With Noninvasive Tests of Liver Disease
Authors: Ling Simon C. , Ye Wen , Leung Daniel H. , Navarro Oscar M. , Weymann Alexander , Karnsakul Wikrom , Freeman A. Jay , Magee John C. , Narkewicz Michael R. 
Published: June 2019

ABSTRACTObjectives:Early identification of children with cystic fibrosis (CF) at risk for severe liver disease (CFLD) would enable targeted study of preventative therapies. There is no gold standard test for CFLD. Ultrasonography (US) is used to identify CFLD, but with concerns for its diagnostic accuracy. We aim to determine if differences in standard blood tests, imaging variables and noninvasive liver fibrosis indices correlate with liver US patterns, and thus provide supportive evidence that a heterogeneous US liver pattern reflects clinically relevant liver disease.Methods:We studied baseline research abdominal US and bloodwork from 244 children with pancreatic insufficient CF, ages 3 to 12 years, enrolled in a prospective study of the ability of US to predict CF cirrhosis (PUSH study). Children with a heterogeneous (HTG) liver pattern on US (n = 62) were matched 1 : 2 in design with children with normal US (NL, n = 122). Analyses included children with nodular (NOD, n = 22) and homogeneous hyperechoic (HMG, n = 38) livers.Results:Univariate analysis showed significant differences between US groups for standard blood tests, spleen size, and noninvasive liver fibrosis indices. Multivariable models discriminated NOD versus NL with excellent accuracy (AUROC 0.96). Models also distinguish HTG versus NL (AUROC 0.76), NOD versus HTG (0.78), and HMG versus NL (0.79).Conclusions:Liver US patterns in children with CF correlate with platelet count, spleen size and indices of liver fibrosis. Multivariable models of these biomarkers have excellent discriminating ability for NL versus NOD, and good ability to distinguish other US patterns, suggesting that US patterns correlate with clinically relevant liver disease.