bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mean 6-Year Follow-up of Magnetically Controlled Growing Rod Patients With Early Onset Scoliosis: A Glimpse of What Happens to Graduates
Authors: Cheung Jason Pui Yin , Yiu Karen , Kwan Kenny , Cheung Kenneth M C 
Published: May 2018

Abstract

BACKGROUND
There is no agreement on frequency of distractions of magnetically controlled growing rods (MCGRs) but more frequent and smaller amounts of distractions mimic physiological spine growth. The mid- to long-term follow-up and management at skeletal maturity is unknown.

OBJECTIVE
To analyze patients with mean 6 yr of follow-up and describe the fate of MCGR graduates.

METHODS
Early onset scoliosis (EOS) patients treated with MCGRs with minimum 4 yr of follow-up and/or at graduation were studied. Parameters under study included Cobb angle, spine and instrumented lengths, and rod distraction gains. Relationship between timing of rod exchanges with changes in rate of lengthening was studied.

RESULTS
Ten EOS patients with mean 6.1 yr of follow-up were studied. The greatest Cobb angle correction occurred at the initial implantation surgery and was stable thereafter. Consistent gains in T1-12, T1-S1, and instrumented segment were observed. Rate of lengthening reduced after the first year of use but improved back to initial rates after rod exchange. Seven of the ten patients experienced complications with reoperation rate of 40% for rod distraction failure and proximal foundation problems. Only mild further improvements in all radiological parameters were observed pre- and postfinal surgery. No clinically significant curve progression was observed for rod removal only. All postfinal surgery parameters remained similar at postoperative 2 yr.

CONCLUSION
This study provides an outlook of the end of MCGR treatment. Although this is a fusionless procedure, instrumented segments do experience stiffness limiting further correction and length gain during final surgery whether fusion or rod removal is performed.
Gastrointestinal Events in High-Dose vs Standard-Dose Influenza Vaccine Recipients
Authors: Talbot H Keipp , Dunning Andrew J , Robertson Corwin A , Landolfi Victoria A , Greenberg David P , DiazGranados Carlos A 
Published: May 2018

Abstract
Passive surveillance data had signaled the possibility of gastrointestinal adverse events occurring after the administration of high-dose inactivated influenza vaccine (IIV-HD). However, in a large, prospective randomized clinical trial, rates of serious gastrointestinal events were no greater among IIV-HD recipients than among those who received a standard-dose influenza vaccine.
Room for Improvement: The HIV–Diabetes Care Continuum Over 15 Years in the Women’s Interagency HIV Study
Authors: Colasanti Jonathan , Galaviz Karla I , Christina Mehta C , Palar Kartika , Schneider Michael F , Tien Phyllis , Adimora Adaora A , Alcaide Maria , Cohen Mardge H , Gustafson Deborah , Karim Roksana , Merenstein Daniel , Sharma Anjali , Wingood Gina , Marconi Vincent C , Ofotokun Ighovwerha , Ali Mohammed K 
Published: May 2018

Abstract

Background
Gains in life expectancy through optimal control of HIV infection with antiretroviral therapy (ART) may be threatened if other comorbidities, such as diabetes, are not optimally managed.

Methods
We analyzed cross-sectional data of the Women’s Interagency HIV Study (WIHS) from 2001, 2006, and 2015. We estimated the proportions of HIV-positive and HIV-negative women with diabetes who were engaged in care and achieved treatment goals (hemoglobin A1c [A1c] &lt;7.0%, blood pressure [BP] &lt;140/90 mmHg, low-density lipoprotein [LDL] cholesterol &lt;100 mg/dL, not smoking) and viral suppression. Repeated-measures models were used to estimate the adjusted prevalence of achieving each diabetes treatment goal at each time point, by HIV status.

Results
We included 486 HIV-positive and 258 HIV-negative women with diabetes. In 2001, 91.8% visited a health care provider, 60.7% achieved the A1c target, 70.5% achieved the BP target, 38.5% achieved the LDL cholesterol target, 49.2% were nonsmokers, 23.3% achieved combined ABC targets (A1c, BP, and cholesterol), and 10.9% met combined ABC targets and did not smoke. There were no differences by HIV status, and patterns were similar in 2006 and 2015. Among HIV-positive women, viral suppression increased from 41% in 2001 to 87% in 2015 compared with 8% and 13% achieving the ABC goals and not smoking. Viral suppression was not associated with achievement of diabetes care goals.

Conclusions
Successful management of HIV is outpacing that of diabetes. Future studies are needed to identify factors associated with gaps in the HIV–diabetes care continuum and design interventions to better integrate effective diabetes management into HIV care.
“Macrovascular” Decompression of Dolichoectatic Vertebral Artery Causing Hemifacial Spasm Using Goretex Sling: 2-Dimensional Operative Video
Authors: Munich Stephan A , Morcos Jacques J 
Published: May 2018

Abstract
Hemifacial spasm is characterized by painless and involuntary spasms of the muscles supplied by the facial nerve, most commonly involving the orbicularis oculi. The most common cause of hemifacial spasm is compression of the facial nerve's root by the anterior inferior, or posterior inferior, cerebellar arteries (AICA or PICA). However, in <1% of cases, the compression can be due to a dolichoectatic vertebral artery. Microvascular decompression using Teflon patties may be sufficient when the offending artery is small (eg, AICA or PICA). However, the size and tortuosity of the vertebral artery (especially one that is dolichoectatic) may require a more robust means of decompression (ie, “macrovascular decompression”).
In this operative video we demonstrate our technique for managing a patient with hemifacial spasm due to a dolicoectatic vertebral artery. We use a Goretex® (W.L. Gore & Associates Inc, Newark, Delaware) sling secured to the dura of the posterior petrous ridge to suspend the vertebral and posterior inferior cerebellar arteries, thereby decompressing the root entry zone of the facial nerve. Teflon felt pieces are added as a second layer of security. Key steps to this technique include: (1) visualization of the root entry zone, (2) extensive arachnoid dissection to allow adequate mobilization of the vertebral artery, 12 and (3) securing the sling in a trajectory that prevents kinking of the vertebral artery and its branches.
Who’s Policing the Crowd? A Typology of Officers Who Policed the 2011 Stanley Cup Riot
Authors: Dawson Stephanie E , Davies Garth 
Published: May 2018

Abstract
Moving away from high-profile, hard-lined tactics, approaches to crowd policing have become increasingly geared towards softer, negotiation-based policing methods. Despite their perceived benefits, there exist a number of challenges relating to the successful implementation of these low-profile approaches, most notably being the officers themselves. Given the central role officers play in responding to and managing crowd situations, it is important to know what types of officers are actually deployed to police these events. Utilizing survey data collected in the aftermath of the 2011 Stanley Cup riot, this study employed a cluster analysis to examine the similarities and differences amongst the officers who were deployed to police this event. This technique produced two distinct clusters, which were subsequently used to examine the relationship between officer characteristics and orientations towards crowd policing. By providing a possible explanation for the success and/or failure of a particular crowd management strategy, these results may help police departments in their preparations for future crowd events.
A Model for Sustaining NCLEX-RN Success
Authors: Conklin Patricia S. , Cutright Leonita H. 
Published: May 2018

Abstract
Beginning in 2013, an individualized National Council Licensure Exam (NCLEX-RN®) study process with follow through postgraduation was initiated to achieve benchmark pass rates in a nursing program where pass rates had dropped. Identification of students at risk for NCLEX failure and using resources available through an integrated testing program led to the implementation of an individualized NCLEX preparation process. Since implementation, first-time pass rates exceeded the national norm for baccalaureate test takers by 5.41 percent to 11.5 percent for four consecutive years. This model can be used by schools of nursing to guide students in NCLEX preparation.
Evaluation and management of migraine in midlife women
Authors: Pavlović Jelena M. 
Published: May 2018

Abstract
Migraine is highly prevalent in women and, in addition to the pain component, can be associated with significant disability and loss of productivity. Migraine is often connected to fluctuations in hormones (primarily estrogen), commonly arising in puberty, worsening in perimenopause, and quiescing in late menopause. This Practice Pearl discusses the various types of migraine with respect to hormone fluctuations and details acute as well as preventive treatment.
Sex hormone levels and risk of primary open-angle glaucoma in postmenopausal women
Authors: Kang Jae Hee , Rosner Bernard A. , Wiggs Janey L. , Pasquale Louis R. 
Published: May 2018

Abstract

Objective:
We evaluated the relation of prediagnostic sex hormone levels in postmenopausal women with primary open-angle glaucoma (POAG) and intraocular pressure (IOP).

Methods:
Among postmenopausal participants of the Nurses’ Health Study, POAG cases (n = 189; diagnosed 1990-2008) and controls (n = 189) were matched on age, fasting status, and postmenopausal hormone use at blood draw (1989-1990). Plasma concentrations of estrone sulfate, estradiol, testosterone, sex hormone binding globulin, and dehydroepiandrosterone sulfate were assessed. The primary outcome was POAG; in secondary analyses, among cases only, we evaluated maximum untreated IOP at diagnosis. Multivariable-adjusted logistic/multiple linear regression models were used to evaluate tertiles (Ts) of biomarker levels and the two outcomes, adjusting for various potential confounders.

Results:
We observed no significant associations of estrone, estradiol, sex hormone binding globulin, or dehydroepiandrosterone sulfate with POAG risk or with maximum IOP at glaucoma diagnosis among cases. Suggestive significant associations were observed with highest testosterone and POAG risk (T3 vs T1 multivariable-adjusted odds ratio 1.84; 95% confidence interval 1.02, 3.33; P trend 0.10). Similarly, for maximum IOP at diagnosis among cases only (mean 8 years after blood draw), higher testosterone was significantly associated with higher IOP (multivariable-adjusted difference in IOP T3 vs T1 2.17 mm Hg; 95% confidence interval 0.34, 3.99; P trend 0.02).

Conclusions:
Overall, plasma sex hormone levels in postmenopausal women were not associated with POAG risk; however, a trend of higher testosterone levels being associated with higher POAG risk and higher IOP at diagnosis was observed and needs confirmation.
Rapid Response, Dose Assessment, and Clinical Management of a Plutonium-contaminated Puncture Wound
Authors: Sugarman Stephen L. , Findley William M. , Toohey Richard E. , Dainiak Nicholas 
Published: May 2018

Abstract
Internalization of radionuclides occurs not only by inhalation, ingestion, parenteral injection (i.e., administration of radioactive material for a medical purpose), and direct transdermal absorption, but also by contaminated wounds. In June 2010, a glove-box operator at the U.S. Department of Energy’s Savannah River Site sustained a puncture wound while venting canisters containing legacy materials contaminated with 238Pu. To indicate the canisters had been vented, a flag was inserted into the vent hole. The shaft of the flag penetrated the protective gloves worn by the operator. Initial monitoring performed with a zinc-sulfide alpha detector indicated 300 dpm at the wound site. After being cleared by radiological controls personnel, the patient was taken to the site medical facility where decontamination was attempted and diethylenetriaminepentaacetic acid (DTPA) was administered intravenously within 1.5 h of the incident. The patient was then taken to the Savannah River Site In Vivo Counting Facility where the wound was counted with a Canberra GL 2820 high-purity germanium detector, capable of quantifying contamination by detecting low-energy x rays and gamma rays. In addition to the classic 13, 17, and 20 keV photons associated with 238Pu, the low-yield (0.04%) 43.5 keV peak was also detected. This indicated a level of wound contamination orders of magnitude above the initial estimate of 300 dpm detected with handheld instrumentation. Trace quantities of 241Am were also identified via the 59.5 keV peak. A 24 h urine sample collection was begun on day 1 and continued at varying intervals for over a year. The patient underwent a punch biopsy at 3 h postincident (14,000 dpm removed) and excisional biopsies on days 1 and 9 (removal of an additional 3,200 dpm and 3,800 dpm, respectively). The initial post-DTPA urine sample analysis report indicated excretion in excess of 24,000 dpm 238Pu. Wound mapping was performed in an effort to determine migration from the wound site and indicated minimum local migration. In vivo counts were performed on the liver, axillary lymph nodes, supratrochlear lymph nodes, and skeleton to assess uptake and did not indicate measurable activity. Seventy-one total doses of DTPA were administered at varying frequencies for 317 d post intake. After allowing 100 d for removal of DTPA from the body, five 24 h urine samples were collected and analyzed for dose assessment by using the wound model described in National Council on Radiation Protection and Measurements Report No. 156. The total effective dose averted via physical removal of the contaminant and DTPA administration exceeded 1 Sv, demonstrating that rapid recognition of incident magnitude and prompt medical intervention are critical for dose aversion.
Immunological Markers of Chronic Occupational Radiation Exposure
Authors: Rybkina Valentina L. , Bannikova Maria V. , Adamova Galina V. , Dörr Harald , Scherthan Harry , Azizova Tamara V. 
Published: May 2018

Abstract
This study aimed to identify immunological biomarkers for prolonged occupational radiation exposure and thus studied a random sample of the Mayak Production Association worker cohort (91 individuals). The control group included 43 local individuals never employed at the Mayak Production Association. To identify biomarkers, two groups of workers were formed: the first one included workers chronically exposed to external gamma rays at cumulative doses of 0.5–3.0 Gy (14 individuals); the second one included workers exposed to combined radiation—external gamma rays at doses ranging from 0.7 to 5.1 Gy and internal alpha radiation from incorporated plutonium with 0.3–16.4 kBq body burden (77 individuals). The age range of the study individuals was 66–91 y. Peripheral blood serum protein concentrations of cytokines, immunoglobulins, and matrix metalloproteinase-9 were analyzed using enzyme-linked immunoassay following the manufacturer’s protocol. Flow cytometry was used to analyze levels of various lymphocyte subpopulations. The findings of the current study demonstrate that some immunological characteristics may be considered as biomarkers of prolonged chronic radiation exposure for any radiation type (in the delayed period after the exposure) based on fold differences from controls: M immunoglobulin fold differences were 1.75 ± 0.27 (p = 0.0001) for external gamma-ray exposure and 1.50 ± 0.27 (p = 0.0003) for combined radiation exposure; matrix metalloproteinase‐9 fold differences were 1.5 ± 0.22 (p = 0.008) for external gamma-ray exposure and 1.69 ± 0.24 (p = 0.00007) for combined radiation exposure; A immunoglobulin fold differences were 1.61 ± 0.27 (p = 0.002) for external gamma-ray exposure and 1.56 ± 0.27 (p = 0.00002) for combined radiation exposure; relative concentration of natural killer cell fold differences were 1.53 ± 0.23 (p = 0.01) for external gamma-ray exposure and 1.35 ± 0.22 (p = 0.001) for combined radiation exposure; and relative concentration of T-lymphocytes fold differences were 0.89 ± 0.04 (p = 0.01) for external gamma-ray exposure and 0.95 ± 0.05 (p = 0.003) for combined radiation exposure. Based on fold differences from controls, interferon-gamma (3.50 ± 0.65, p = 0.031), transforming growth factor-beta (2.91 ± 0.389, p = 0.026), and relative blood serum levels of T-helper cells (0.90 ± 0.065, p = 0.02) may be used as immunological markers of chronic external gamma-ray exposure. Moreover, there was a significant inverse linear association of relative concentration of T-helper cells with dose from external gamma rays accumulated over an extended period.
Epidemiology of Late Health Effects in Ukrainian Chornobyl Cleanup Workers
Authors: Bazyka Dimitry , Prysyazhnyuk Anatoly , Gudzenko Natalya , Dyagil Iryna , Belyi David , Chumak Vadim , Buzunov Volodymyr 
Published: May 2018

Abstract
This article summarizes the results of 30 y of follow-up of cancer and noncancer effects in Ukrainian cleanup workers after the Chornobyl accident. The number of power plant employees and first responders with acute radiation syndrome under follow-up by the National Research Center for Radiation Medicine decreased from 179 in 1986–1991 to 105 in 2011–2015. Cancers and leukemia (19) and cardiovascular diseases (21) were the main causes of deaths among acute radiation syndrome survivors (54) during the postaccident period. Increased radiation risks of leukemia in the Ukrainian cohort of 110,645 cleanup workers exposed to low doses are comparable to those among survivors of the atomic bomb explosions in Japan in 1945. Additionally, an excess of chronic lymphocytic leukemia was demonstrated in the cleanup workers cohort for 26 y after the exposure. A significant excess of multiple myeloma incidence [standardized incidence rate (SIR) 1.61 %, 95% confidence interval (CI) 1.01–2.21], thyroid cancer (SIR 4.18, 95% CI 3.76–4.59), female breast cancer (SIR 1.57 CI 1.40–1.73), and all cancers combined (SIR 1.07; 95% CI 1.05–1.09) was registered. High prevalence was demonstrated for cardio- and cerebrovascular diseases and mental health changes. However, the reasons for the increases require further investigation. To monitor other possible late effects of radiation exposure in Chornobyl cleanup workers, analytical cohort and case-control studies need to include cardiovascular pathology, specifically types of potentially radiogenic cancers using a molecular epidemiology approach. Possible effects for further study include increased rates of thyroid, breast, and lung cancers and multiple myeloma; reduction of radiation risks of leukemia to population levels; and increased morbidity and mortality of cleanup workers from cardio- and cerebrovascular pathology.
Predicting the Public Health Consequences of a Nuclear Terrorism Attack: Drawing on The Experiences of Hiroshima and Fukushima
Authors: Jorgensen Timothy J. 
Published: May 2018

Abstract
The increasing threat of nuclear terrorism warrants consideration of the health consequences of a terrorist incident should preventive measures fail. Although there has not yet been a nuclear terrorist attack of any kind, experiences with the aftermath of the bombing of Hiroshima and the core meltdowns at Fukushima can provide useful insight and allow some inferences to be made regarding the types of casualties that might be sustained and the rescue efforts that might be required. There are many parallels between the events at Hiroshima and what might be expected from an improvised nuclear device, and there are parallels between the radioactivity released to the environment at Fukushima and the aftermath of a radiological dispersal device attack. Nevertheless, there are some unique aspects to a ground-detonated improvised nuclear device that pose health threats beyond those seen at Hiroshima (i.e., fallout). And psychological health may be impacted more than physical health in the case of a radiological dispersal device. Preparedness requires consideration of all of these various health hazards in order to determine how best to mitigate the consequences of a nuclear terrorism attack.
Genotoxic Effects in Human Fibroblasts Exposed to Microwave Radiation
Authors: Franchini Valeria , Regalbuto Elisa , De Amicis Andrea , De Sanctis Stefania , Di Cristofaro Sara , Coluzzi Elisa , Marinaccio Jessica , Sgura Antonella , Ceccuzzi Silvio , Doria Andrea , Gallerano Gian Piero , Giovenale Emilio , Ravera Gian Luca , Bei Roberto , Benvenuto Monica , Modesti Andrea , Masuelli Laura , Lista Florigio 
Published: May 2018

Abstract
In the last decades, technological development has led to an increasing use of devices and systems based on microwave radiation. The increased employment of these devices has elicited questions about the potential long-term health consequences associated with microwave radiation exposure. From this perspective, biological effects of microwave radiation have been the focus of many studies, but the reported scientific data are unclear and contradictory. The aim of this study is to evaluate the potential genotoxic and cellular effects associated with in vitro exposure of human fetal and adult fibroblasts to microwave radiation at the frequency of 25 GHz. For this purpose, several genetic and biological end points were evaluated. Results obtained from comet assay, phosphorylation of H2AX histone, and antikinetochore antibody (CREST)-negative micronuclei frequency excluded direct DNA damage to human fetal and adult fibroblasts exposed to microwaves. No induction of apoptosis or changes in prosurvival signalling proteins were detected. Moreover, CREST analysis showed for both the cell lines an increase in the total number of micronuclei and centromere positive micronuclei in exposed samples, indicating aneuploidy induction due to chromosome loss.
Exome Sequencing Discloses Ionizing-radiation-induced DNA Variants in the Genome of Human Gingiva Fibroblasts
Authors: Nath Neetika , Esche Jennifer , Müller Jessica , Jensen Lars R. , Port Matthias , Stanke Mario , Kaderali Lars , Scherthan Harry , Kuss Andreas W. 
Published: May 2018

Abstract
Ionizing radiation can induce genomic lesions such as DNA double-strand breaks whose incomplete or faulty repair can result in mutations, which in turn can influence cellular functions and alter the fate of affected cells and organ systems. Ionizing-radiation-induced sequence alterations/mutations occur in a stochastic manner, which contributes to an increased cancer risk in irradiated individuals. Ionizing radiation exposure, and particularly acute doses at high dose rates (as often observed in radiation accidents), induce alterations in the genome that in part will reflect specific characteristics of the DNA damage response and the repair mechanisms involved. Here, the exome of primary human gingival fibroblasts not exposed or exposed to 0.2, 2, 5, or 10 Gy of x rays was investigated after 16 h of DNA repair for ionizing-radiation-induced mutations. The irradiation effect with varying dose was investigated using three different bioinformatic filters for the analysis of accumulated variants per Mb of genomic DNA and per cytogenetic bands. A highly stringent cutoff of 20‐fold coverage was used for all analyses. Comparing exome DNA from irradiated and nonirradiated cells disclosed a characteristic variation of the frequency of ionizing-radiation-induced single-nucleotide variants as well as small insertions and deletions among chromosomes and their subregions. Increases in ionizing-radiation-induced variants with increasing dose were highly significant (p = 2.2 × 10−16, Kruskal-Wallis test). These results indicate that certain chromosomal regions may be more prone to accumulating particular ionizing-radiation-induced alterations than others, which points to a characteristic metasignature in the irradiated exome.