bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personal Exposure to Radiofrequency Electromagnetic Fields Among Palestinian Adults
Authors: Lahham Adnan , Ayyad Haitham 
Published: April 2019

Abstract
This work deals with the assessment of personal exposure to radiofrequency electromagnetic fields and the study of temporal and spatial daily variations in a group of 24 adults from the West Bank, Palestine. Exposure was measured using a personal exposure meter EME SPY 140. Mean values of exposure levels from different radiofrequency sources were calculated using both naive and robust regression on order statistics approaches. The total daily exposure from all radiofrequency electromagnetic field sources varied widely among participants depending on their location, the mobile network they use, their activities, and their mode of transportation, ranging from about 0.2 V m−1 to 0.9 V m−1. The average total daily exposure of all participants was about 0.48 V m−1. The main contribution to the mean exposure was from WiFi 2G (45%), GSM900 uplink (19%), GSM900 downlink, and FM radiobroadcasting (each by 11%). Other sources including GSM1800, UMTS2100, WiFi 5G, DECT, TETRA, WiMAX, and TV bands all together contributed 14%. During different activities, participants were exposed to the highest exposure level while traveling and to the lowest exposure while they were sleeping. During the day, participants received the highest exposure during the time period from 1600 to 2400 h. Based on thermal effect of radiofrequency electromagnetic fields, all evaluated personal exposures comply with guidelines recommended for the general public by the International Commission on Non-Ionizing Radiation Protection.
Validation Tests of Resuspension Models for a Finite and Infinite Site
Authors: Whicker Jeffrey J. , McNaughton Michael , Ruedig Elizabeth , Fuehne David P. 
Published: April 2019

Abstract
Dose assessment for deposited radionuclides often requires estimates of air concentrations that are derived from measured soil concentrations. For this, dose assessors typically use literature resuspension values that, while empirically based, can vary by orders of magnitude making it difficult to provide accurate dose estimates. Despite the complexities of the physical processes involved in resuspension, the models generally used for dose assessment are relatively simplistic and rarely are the models validated for a specific site, thus making prediction of air concentrations or airborne emissions highly uncertain. Additionally, the size of the contaminated area can have an impact on downwind concentrations, yet literature values do not account for smaller-sized contaminated sites adding additional uncertainty. To test resuspension models for soil-bound radionuclides at finite and infinite spatial scales, measurements of soil and air concentrations are made at (1) a location downwind of a former outfall where 239Pu was released into the environment (a finite site), and (2) uncontaminated locations where regional air sampling provides background measurements of naturally occurring 238U in sampled dust (an infinite site). Measured air concentrations were compared to those predicted using the resuspension factor model and the mass loading model. An area factor was applied to the smaller contaminated site to account for dilution of dust from the contaminated site with dust originating from offsite locations. Results show that when properly parameterized to site conditions, resuspension models can predict air concentrations to within a factor of 10.
Characterization of Extrafocal Dose Influence on the Out-of-Field Dose Distribution by Monte Carlo Simulations and Dose Measurements
Authors: Ghareeb Firass , Lencart Joana , Oliveira Jorge , Santos João A.M. 
Published: April 2019

Abstract
Out-of-field scattered and transmitted extrafocal radiation may induce secondary cancer in long-term survivors of external radiotherapy. Pediatric patients have higher life expectancy and tend to receive higher secondary radiation damage due to geometric and biological factors. The goal of this study is to characterize the location and the magnitude of extrafocal dose regions in the case of three-dimensional conformal radiotherapy and volumetric arc therapy, to apply this information to clinical treatment cases, and to provide mitigation strategies. Extrafocal dose has been investigated in a Varian TrueBeam linac equipped with a high-definition 120 multileaf collimator using different physical and virtual phantoms, dose calculation (including Monte Carlo techniques), and dose measurement methods. All Monte Carlo calculations showed excellent agreement with measurements. Treatment planning system calculations failed to provide reliable results out of the treatment field. Both Monte Carlo calculations and dose measurements showed regions with higher dose (extrafocal dose areas) when compared to the background. These areas start to be noticeable beyond 11 cm from the isocenter in the direction perpendicular to the multileaf collimator leaves’ travel direction. Out-of-field extrafocal doses up to 160% of the mean dose transmitted through the closed multileaf collimator were registered. Two overlapping components were observed in the extrafocal distribution: the first is an almost elliptical blurred dose distribution, and the second is a well-defined rectangular dose distribution. Extra precautions should be taken into consideration when treating pediatric patients with a high-definition 120 multileaf collimator to avoid directing the extrafocal radiation into a radiosensitive organ during external beam therapy.
Prevalence and Severity of Psychiatric Disorders and Suicidal Behavior in Service Members and Veterans With and Without Traumatic Brain Injury: Systematic Review
Authors: Greer Nancy , Sayer Nina A. , Spoont Michele , Taylor Brent C. , Ackland Princess E. , MacDonald Roderick , McKenzie Lauren , Rosebush Christina , Wilt Timothy J. 
Published: April 2019

Objectives:
Assess prevalence and severity of posttraumatic stress disorder, suicidal behavior, and depressive, substance use, and anxiety disorders in US service members or Veterans with and without a deployment-related mild traumatic brain injury (TBI) (mTBI).

Design:
Systematic review using multiple databases (January 2000 to October 2017). We included national or geographically diverse samples.

Main Measure:
Prevalence and severity of psychiatric conditions based on diagnostic codes, clinician assessments, and self-report measures with results stratified by sample type.

Results:
We identified 11 studies on the basis of national samples and 22 studies on the basis of geographically diverse samples. Traumatic brain injury severity was not always ascertained or reported. In national studies, posttraumatic stress disorder, depressive disorder, substance use disorder, and anxiety disorder prevalence were higher in those with TBI than in those without. One national sample reported prevalence of suicide attempts. Across psychiatric conditions, strength of evidence ranged from insufficient to moderate. In geographically diverse samples, the pattern of findings was similar. National studies provided insufficient evidence on psychiatric condition severity; geographically diverse studies found greater severity of posttraumatic stress disorder symptoms with mixed results for symptoms of depressive or substance use disorders.

Conclusions:
Service members and Veterans with TBI history have higher prevalence and possibly severity of selected psychiatric conditions.
Differences in Posttraumatic Stress Disorder, Depression, and Attribution of Symptoms in Service Members With Combat Versus Noncombat Mild Traumatic Brain Injury
Authors: Hardy Morgan , Kennedy Jan , Reid Matthew , Cooper Douglas 
Published: April 2019

Objective:This study compares combat-related mild traumatic brain injury (mTBI) to non-combat-related mTBI in rates of posttraumatic stress disorder (PTSD) and depression after injury, severity of postconcussive symptoms (PCSs), and attribution of those symptoms to mTBI versus PTSD.Participants:A total of 371 active duty service members (SMs) with documented history of mTBI, divided into combat and non-combat-related cohorts.Design:Retrospective cohort study.Main Measures:Diagnoses of PTSD and depression based on medical record review and self-report. PCSs measured using Neurobehavioral Symptom Index. Attribution of symptoms based on a rating scale asking how much mTBI, PTSD, depression, deployment, or readjustment stress contributed to current symptoms.Results:Prevalence of PTSD was significantly higher after a combat-related mTBI, compared with a noncombat mTBI (P= .001). Prevalence of depression did not differ between the 2 groups. PCSs were high in both combat and noncombat mTBIs, with no statistical difference between groups. SMs with PTSD reported higher PCS, regardless of combat status. SMs without PTSD attributed symptoms mainly to mTBI, whereas SMs with PTSD, regardless of combat status, were much more likely to attribute symptoms to PTSD, depression, and deployment/readjustment stress.Conclusions:This research contributes to our understanding of the complex interplay between mTBI and PTSD in both combat and noncombat injuries within the military population and the importance of addressing both simultaneously.
A Randomized Comparative Effectiveness Trial of Family-Problem–Solving Treatment for Adolescent Brain Injury: Parent Outcomes From the Coping with Head Injury through Problem Solving (CHIPS) Study
Authors: Wade Shari L. , Cassedy Amy E. , McNally Kelly A. , Kurowski Brad G. , Kirkwood Michael W. , Stancin Terry , Taylor H. Gerry 
Published: April 2019

Objective:
To examine changes in depression and distress in parents of adolescents receiving family-problem–solving therapy (F-PST) following traumatic brain injury.

Method:
Families of adolescents hospitalized for moderate to severe traumatic brain injury were randomized to face-to-face F-PST (34), therapist-guided online F-PST (56), or self-guided online F-PST (60). Outcomes were assessed pretreatment and 6 and 9 months later. Parents rated depression and distress on the Center for Epidemiological Studies Depression Scale and the Brief Symptom Inventory, respectively. Mixed modeling was used to examine changes over time and treatment moderators.

Results:
The therapist-guided online group had significant reductions in parental depression over time. Analyses of slopes of recovery revealed differential improvement on the Center for Epidemiological Studies Depression Scale between the 2 online groups, with no significant change in depressive symptoms following self-guided F-PST. On the Brief Symptom Inventory Global Severity Index, the therapist-guided online group reported significant improvement from baseline to 6 months that was maintained at 9 months. The face-to-face and self-guided online groups reported significant reductions in distress between 6 and 9 months with corresponding large effect sizes. Differences on the Center for Epidemiological Studies Depression Scale between therapist-guided and self-guided online groups at the 9-month follow-up were more pronounced in families of lower socioeconomic status, t
103 = −2.87; P = .005.

Conclusions:
Findings provide further support for the utility of therapist-guided online F-PST in reducing parental depression and distress following pediatric traumatic brain injury and offer limited evidence of the efficacy of self-guided online treatment for these outcomes. Families of lower socioeconomic status may benefit more from therapist involvement.
Long-Term Correlates of Mild Traumatic Brain Injury on Postconcussion Symptoms After Deployment to Iraq and Afghanistan in the UK Military
Authors: Rona Roberto J. , Jones Margaret , Jones Norman , Fear Nicola T. , Wessely Simon 
Published: April 2019

Objectives:
We assessed whether mild traumatic brain injury (mTBI) reported by UK service personnel between 2007 and 2009 was associated with postconcussion symptoms (PCS) 7 to 8 years later.

Setting:
United Kingdom.

Participants:
A total of 4601 service personnel all of whom had deployed to Iraq and/or Afghanistan.

Design:
Longitudinal study.

Main Outcome Measures:
Nine PCS reported in a survey carried out between 2014 and 2016. The main independent variable was mTBI reported between 2007 and 2009.

Results:
A total of 2318 (50.4%) out of 4601 participants completed the follow-up questionnaire. Mild traumatic brain injury was associated with 2 of 9 PCS. Mild traumatic brain injury at baseline was associated with dizziness at follow-up in the fully adjusted model, in comparison with either “other injury” or “no injury” group. Mild traumatic brain injury was associated with loss of concentration in comparison with “no injury” but in comparison with the “other injury” group, it was not in the fully adjusted model. The prevalence of 7 of the 9 PCS increased over time regardless of mTBI status.

Conclusions:
Mild traumatic brain injury reported in 2007-2009 was associated with dizziness and possibly with loss of concentration 7 years later but not with most PCS. The prevalence of most PCS increased over time independently of mTBI.
Treatment Limitations With PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem): One Centers Experience
Authors: Schear Matthew J. , Ibrahim Kirolos , Winokur Jules , Busuioc Corina , Udell Ira , Steiner Anne 
Published: April 2019

Objectives:
The prosthetic replacement of the ocular surface ecosystem (PROSE) device is used to treat difficult-to-manage ocular surface disease (OSD) and ectasia. Previous studies have demonstrated positive treatment outcomes. This study aims to document treatment failures to better tailor treatment and address limitations with its use.

Methods:
Retrospective chart review of consecutive PROSE fits performed at Northwell Health from 2012 to 2016. Reasons for patient discontinuation of treatment were documented, and potential risk factors for treatment failure were assessed.

Results:
The total number of eyes treated was 125. Fifty five eyes had ectasia, 67 had OSD, and 3 had both ectasia and OSD. A total of 8/125 (6.4%) of eyes failed treatment; 6/8 (75%) of failed treatments had worsening corneal edema, all of which had presumed risk factors for lower endothelial cell counts. Two eyes discontinued use secondary to intractable debris on the device, blurring vision. The most common diseases in patients failing therapy in descending order included: keratoconus and Fuch's dystrophy, ectasia after penetrating keratoplasty, and graft versus host disease. Those with presumed risks factors for lower endothelial cell counts (Fuch's dystrophy and patients with previous penetrating keratoplasty) were more likely to fail (22.2%) compared with those without a risk of a low endothelial cell count (1.6%).

Conclusion:
Although PROSE use has high success, corneal edema secondary to endothelial dysfunction is a potential limitation that may lead to treatment failure. Patients with lower endothelial cell counts after penetrating keratoplasty or with Fuch's dystrophy were more likely to fail treatment.
Descemet Membrane Endothelial Keratoplasty Outcomes During the Initial Learning Curve of Cornea Fellows
Authors: Pereira Nicolas Cesário , Gomes José Álvaro Pereira , Moriyama Aline Silveira , Chaves Luis Fernando , Forseto Adriana dos Santos 
Published: April 2019

Purpose:
To describe the outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed by cornea fellows during their initial learning curve.

Methods:
This prospective study included the first consecutive series of 53 DMEK surgeries performed by 14 corneal fellows at Sorocaba's Ophthalmological Hospital. Best spectacle-corrected visual acuity, endothelial cell density (ECD), and complications were evaluated.

Results:
Of the eyes without ocular comorbidities and with complete visual acuity measurements, 97% of 33 eyes achieved a best spectacle-corrected visual acuity of ≥20/40 in 6 months. The mean (SD) preoperative donor ECD was 2453 (361) cells/mm2, and at 6 months postoperatively, the in vivo mean ECD (SD) was found to be 1300 (587) cells/mm2, an average loss of 47%. Preparation of the DMEK graft by the cornea fellows was successful in all cases. There were 9 eyes (17%) that experienced partial graft detachment requiring rebubbling. A total of 3 eyes (5.7%) failed to clear the cornea, all of which were managed with successful secondary endothelial keratoplasty. None of the eyes experienced pupillary block.

Conclusions:
Establishing DMEK in a fellowship program was successful with the supervision of an experienced DMEK surgeon. Even without the facility of a prestripped DMEK graft by an eye bank and with no backup tissue, no surgery was canceled because of graft preparation failure. Good visual outcomes were achieved with satisfactory ECD at 6-month follow-up, with an acceptable complication rate. Even the 3 eyes that failed to clear the cornea evolved well after secondary endothelial keratoplasty by the cornea fellows.
Association of Antiretroviral Drug Regimen With Viral Suppression in HIV-positive Children on Antiretroviral Therapy in Eswatini
Authors: Chouraya Caspian , Ashburn Kim , Khumalo Philisiwe , Mpango Lydia , Mthethwa Nobuhle , Machekano Rhoderick , Guay Laura , Mofenson Lynne M. 
Published: April 2019

Background:
Global pediatric treatment goals are for 90% of known children living with HIV to be on antiretroviral therapy (ART), with 90% having viral suppression. We used enrollment data from a study evaluating a family-centered HIV care program in Eswatini to describe the ART histories and virologic outcomes of enrolled children living with HIV and identify factors associated with viral suppression (<1000 RNA copies/mL) and undetectability (<400 RNA copies/mL).

Methods:
Factors associated with viral suppression and undetectability were identified using Pearson χ2 for categorical variables and Wilcoxon rank sum tests for continuous variables.

Results:
Three hundred seventy-seven children were enrolled, median age 8.5 years. Median age at HIV diagnosis was 2.1 years; at ART initiation, 2.6 years; and ART duration at enrollment, 4.1 years. Ninety-nine percent were receiving ART; 95.2% were on first-line ART and 4.8% on second-line ART. Most children (43.1%) were receiving nevirapine-based ART (median age 9.2 years), with 31.3% on lopinavir-ritonavir-based (median age 5.4 years) and 25.5%, efavirenz-based ART (median age 10.3 years). Viral suppression (<1000 copies/mL) was observed in 77.9% and undetectability (<400 copies/mL) in 73.5% of children. The only factor significantly associated with viral suppression was ART regimen, with 72.1% of children on nevirapine-based ART versus 86.7% on efavirenz-based ART virally suppressed.

Conclusions:
Although 99% of children enrolled in the study were receiving ART, viral suppression was observed in only 77.9%, with lowest rates among children receiving nevirapine-based ART. These findings highlight the critical importance of monitoring treatment regimen for optimizing treatment outcomes for pediatric HIV.
Comparison of Nonpolio Enteroviruses in Children With Herpangina and Hand, Foot and Mouth Disease in Taiwan
Authors: Yang TienYu Owen , Arthur Huang Kuan-Ying , Chen Mei-Huei , Chen Pau-Chung , Huang Wan-Ting 
Published: April 2019

Background:Nonpolio enterovirus (NPEV) infections are often present with herpangina (HA) and hand, foot and mouth disease (HFMD). Most countries sample NPEVs in HFMD cases, targeting enterovirus A71 (EV-A71) and coxsackievirus A16 (CV-A16) that are associated with outbreaks and severe complications. HA is also monitored in Taiwan and several other countries, but its viral characteristics are underreported.Methods:Through Taiwan’s National Virologic Surveillance, information regarding ~100,000 child respiratory samples (2002–2015) was linked to concurrent (0–6 days before the sampling date) outpatient records from the National Health Insurance databases, including ~15,000 HA-related and ~7000 HFMD-related samples. We assessed sample representation and NPEV positive rates, and estimated total numbers of EV-A71 and CV-A16.Results:There were more HA events (4.0 millions) than HFMD events (1.2 millions) in Taiwan. In every 1000 events with HFMD and HA, 6.0 and 4.1, respectively, respiratory samples were collected. The NPEV positive rate in HFMD-related samples was 48%, consistent across most sampling seasons, and predominantly EV-A71 or CV-A16 (74%). By comparison, the HA-related samples had a lower positive rate overall (43%), occasionally EV-A71 or CV-A16 (13%), and the positive rate depended strongly on HA incidence (P< 10–12). Compared with sampling HFMD alone, inclusion of HA-related information predicted an earlier onset of EV-A71 outbreak in 2011, and predicted 30% more EV-A71 cases.Conclusions:This is the first representative report on viral characteristics of HA. Our findings confirm that HFMD monitoring is a reliable strategy, but there is a measurable additional benefit when HA is also monitored.
Modulation of brain networks by sumatriptan-naproxen in the inflammatory soup migraine model
Authors: Bishop James , Becerra Lino , Barmettler Gabi , Chang Pei-Ching , Kainz Vanessa , Burstein Rami , Borsook David 
Published: April 2019

Abstract
Migraine is a debilitating condition; however, the pharmacological effects on central nervous system networks after successful therapy are poorly understood. Defining this neurocircuitry is critical to our understanding of the disorder and for the development of antimigraine drugs. Using an established inflammatory soup model of migraine-like pathophysiology (N = 12) compared with sham synthetic interstitial fluid migraine induction (N = 12), our aim was to evaluate changes in network-level functional connectivity after sumatriptan-naproxen infusion in awake, conscious rodents (Sprague–Dawley rats). Sumatriptan-naproxen infusion functional magnetic resonance imaging data were analyzed using an independent component analysis approach. Whole-brain analysis yielded significant between-group (inflammatory soup vs synthetic interstitial fluid) alterations in functional connectivity across the cerebellar, default mode, basal ganglia, autonomic, and salience networks. These results demonstrate the large-scale antimigraine effects of sumatriptan-naproxen co-administration after dural sensitization.