bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Prostate-Specific Antigen Test Use, 2000–2005
Authors: Ross Louie E. , Taylor Yhenneko J. , Howard Daniel L. 
Published: January 2017

Objective. This study examined prostate-specific antigen (PSA) test use among men and identified sociodemographic and health-related characteristics associated with its use over time. Methods. The National Health Interview Survey collected information on PSA test use among 16,058 men ≥40 years of age in 2000 and 2005. We examined two outcomes: (7) having had a recent (within two years) screening PSA test and (2) having had three or more PSA tests in the past five years (to indicate frequent use). Results. Marital status, family history of prostate cancer, and having seen a doctor in the past year differed overtime in the unadjusted model. In the adjusted model, recent PSA screening decreased from 2000 to 2005 for single, never-married men, but increased for men with chronic diseases. Frequent PSA test use increased for men with a family history of prostate cancer, men with chronic diseases, and men who had seen a physician in the past year. Significant correlates of higher recent PSA test use included being older, married, and of black race/ethnicity; having higher levels of education and income, health-care coverage, and a usual place of health care; and increased comorbidity. Conclusion. Major organizations are not in agreement about the efficacy of prostate cancer screening; however, men ≥40 years of age continue to use the PSA test. Both recent screening and frequent testing showed variability during the study period and may have implications for the ongoing randomized clinical trials that are expected to clarify whether early detection of prostate cancer with PSA testing increases survival.
Enhanced Surveillance of Norovirus Outbreaks of Gastroenteritis in Georgia
Authors: Widdowson Marc-Alain , Bulens Sandra N. , Beard R. Suzanne , Lane Kimberley M. , Monroe Stephen S. , Lance Susan , Bresee Joseph S. , Glass Roger I. 
Published: January 2017

Objectives. The role of noroviruses in both foodborne and person-to-person outbreaks of acute gastroenteritis (AGE) has been difficult to determine in the U.S. because of lack of routine norovirus testing and of national reporting of person-to-person outbreaks. We conducted a prospective study in one state in which enhanced testing for noroviruses was performed to better understand the relative contribution of all gastroenteric pathogens. Methods. During the two-year period, 2000–2001, we took all fecal specimens from AGE outbreaks reported in Georgia that were negative for bacteria and tested these for norovirus. Results. We investigated 78 AGE outbreaks, from which suitable fecal samples were collected from 57 of them. Norovirus was identified in 25 (44%) outbreaks, bacteria in 20 (35%) outbreaks, and parasites in one (2%) outbreak. Forty-three (75%) of the outbreaks tested were foodborne, of which 17 (40%) were attributable to norovirus and 18 (42%) were attributable to bacteria. Adjusting for incomplete testing, we estimated that 53% of all AGE outbreaks were attributable to norovirus. A total of 2,674 people were reported ill in the 57 outbreaks, and norovirus infections accounted for 1,735 (65%) of these cases. Norovirus outbreaks tended to be larger than bacterial outbreaks, with a median number of 30 vs. 16 cases per outbreak, respectively ( p=0.057). Conclusions. This study provides further evidence that noroviruses are, overall, the most common cause of AGE outbreaks in the U.S. Improved specimen collection, reporting person-to-person outbreaks, and access to molecular assays are needed to further understand the role of these viruses and methods for their prevention.
Promoting Active Transportation as a Partnership between Urban Planning and Public Health: The Columbus Healthy Places Program
Authors: Green Christine Godward , Klein Elizabeth G. 
Published: January 2017

Active transportation has been considered as one method to address the American obesity epidemic. To address obesity prevention through builtenvironment change, the local public health department in Columbus, Ohio, established the Columbus Healthy Places (CHP) program to formally promote active transportation in numerous aspects of community design for the city. In this article, we present a case study of the CHP program and discuss the review of city development rezoning applications as a successful strategy to link public health to urban planning. Prior to the CHP review, 7% of development applications in Columbus included active transportation components; in 2009, 64% of development applications adopted active transportation components specifically recommended by the CHP review. Active transportation recommendations generally included adding bike racks, widening or adding sidewalks, and providing sidewalk connectivity. Recommendations and lessons learned from CHP are provided.
Screening and Monitoring in Men Prescribed Testosterone Therapy in the U.S., 2001–2010
Authors: Baillargeon Jacques , Urban Randall J. , Kuo Yong-Fang , Holmes Holly M. , Raji Mukaila A. , Morgentaler Abraham , Howrey Bret T. , Lin Yu-Li , Ottenbacher Kenneth J. 
Published: January 2017

Objectives. The Endocrine Society recommends testosterone therapy only in men with low serum testosterone levels, consistent symptoms of hypogonadism, and no signs of prostate cancer. We assessed screening and monitoring patterns in men receiving testosterone therapy in the U.S. Methods. We conducted a retrospective cohort study of 61,474 men aged ⩾40 years, and with data available in one of the nation's largest commercial insurance databases, who received at least one prescription for testosterone therapy from 2001 to 2010. Results. In the 12 months before initiating treatment, 73.4% of male testosterone users received a serum testosterone test and 60.7% received a prostate-specific antigen (PSA) test. Among men who were tested, 19.5% did not meet Endocrine Society guidelines for low testosterone. In the 12 months after initiating treatment, 52.4% received a serum testosterone test and 43.3% received a PSA test. Multivariable analyses showed that those seen by either an endocrinologist or urologist were more likely to receive appropriate tests. Conclusions. A substantial number of men prescribed testosterone therapy did not receive testosterone or PSA testing before or after initiating treatment. In addition, almost one out of five treated men had baseline serum testosterone values above the threshold defined as normal by the Endocrine Society. Men treated by endocrinologists and urologists were more likely to have been treated according to guideline recommendations than men treated by other specialties, including primary care.
Toward a Trinitarian Understanding of Mission in Post-Christendom Lands
Authors: Bjork David E. 
Published: January 2017

In John 17:21, Jesus established his relationship with the Father as a pattern for his followers in the context of his mission in the world. What are the implications of that trinitarian perspective on the mission of evangelical Protestant missionaries who work in areas of the world where Christian churches date back many centuries? This article traces the tie between missions and trinitarian reflection and considers the ways in which the perichoretic understanding of the divine Trinity provides an example, pattern, or model that provides an unmistakable source of contextuality, comprehensiveness, and coherence to missional endeavors in post-Christendom lands.
'Salted With Fire' (Mark 9.42-50): Style, Oracles and (Socio)Rhetorical Gospel Criticism
Authors: Henderson Ian H. 
Published: January 2017

Recent rhetorical criticism of the Gospels has tended to focus on formal 'patterns of argumentation' and on their redactional variation in Gospel literary tradition. Partly from fear of backsliding into aesthetic and/or devotional readings, partly from impatience to differentiate specific social movements within early Christianity, New Testament rhetorical criticism has analysed the Gospels essentially from the argumentation-theoretical angle of their presumed displays and specializations of conventional rationalities. Style variation and characterization are treated more as elements in formal argumentation than as persuasive in themselves. The article explores Jesus' strange yet pivotal speech in Mk 9.42-50 to illustrate the inadequacy of an argumentation theory focused on enthymemes and chreias to account for Markan oracular speech ( logia). Mk 9.42-50 is often read as an instance of catchword agglomeration, yet it is one of the Markan Jesus' few major speeches. The speech does have a discernable purpose, not only in the Markan narrative con text, but in itself as a rhetorical unit: Jesus is placing Mark's readers under a curse of office as leaders. Neither Matthew nor Luke found the Markan Jesus' speech sufficiently persuasive in its imprecatory rhetoric to warrant imitation. We must entertain the possibility that here and elsewhere Markan rhetoric demanded too much of either its implied or its historical audiences: Markan rhetorics may have proven too experimental to secure early Christian audiences.
Hypermedia Basal Readers: Three Years of School-Based Research
Authors: Boone Randall , Higgins Kyle 
Published: January 2017

This three-year longitudinal study involved the use of hypermedia computer assisted instruction (CAI) to provide individualized reading instruction within a general classroom environment for students in grades K-3. The software provided reading lessons in a hypermedia format designed as supplementary material for a basal reader series. Because this project was interested in the maintenance of students with mild disabilities in the general education setting, particular attention was given to the reading progress of low-achieving students, as they appeared to be the most at risk for being referred to special education classes. Analysis of the achievement test data indicates: Year One. Entire-class significance was shown with experimental classes outperforming control classes at kindergarten, second grade, and third grade. When the classrooms were broken down into ability groups, low students in the kindergarten, second grade, and third grade experimental classes achieved significantly higher total test scores than their control peers. Year Two. No entire class significance was shown at the first, second, or third grade levels. When the classrooms were broken down into ability groups, at the first, second, and third grade levels, the low group students in the experimental classrooms had significantly higher total test scores than the students in the control classroom low groups. Year Three. When comparing entire classes on total test scores, no entire class significance was shown at the kindergarten, second, or third grade levels. When classrooms were divided into ability groups, low students in the kindergarten experimental class achieved significantly higher total test scores than the control students.
Interactive Multimedia Research Questions: Results from the Delphi Study
Authors: Ferretti Ralph P. 
Published: January 2017

There is a growing interest in the pedagogical possibilities afforded by interactive multimedia technology, and this interest spans such dimensions as content area and the student's developmental level and abilities. At the same time, teachers and researchers are concerned about how to best use this promising technology. The Center for Special Education Technology responded to this situation by conducting a Delphi study to identify research questions that should guide the study of interactive multimedia in special education. The Delphi study was comprised of two questionnaires. In the first questionnaire, respondents were asked to identify the five most important research needs in interactive multimedia. These responses were compiled and then returned to respondents in a second questionnaire. In the second questionnaire, respondents performed two tasks. In the first task, they were asked to judge the importance of each response obtained from the first questionnaire. In the second task, they selected and justified responses that described the five most important multimedia research needs. Descriptive analyses showed that respondents were most frequently concerned about design issues affecting the efficacy of educational interactive multimedia. These issues focused on instructional strategies and methods, the multimedia environment, navigational tools, and strategies for promoting transfer of skill. Two other themes emerged from this study. First, experts were interested in how the characteristics of persons with different disabilities affected the efficacy of educational interactive multimedia. Second, they were concerned about the technical and training resources that are needed to use multimedia in practice.
Effects of Hyperbaric Oxygen and Irradiation on Experimental Skin Flaps in Rats
Authors: Nemiroff Paul M. , Merwin Gerald E. , Brant Timothy , Cassisi Nicholas J. 
Published: January 2017

This study investigated the effects of hyperbaric oxygen (HBO) and irradiation (RT) on experimental skin flaps in rats under varying conditions. Animals were assigned at random to 1 of 15 groups that represented all possible ordering effects of HBO, RT, and flap, as well as controls that included flap‐only, RT‐only, and HBO‐only groups. Cranially based skin flaps measuring 3×9 cm were elevated on the dorsum. The surviving length was evaluated with fluorescein dye 7 days after the operation. Rats receiving HBO were subjected to four consecutive 2‐hour treatments of 100% oxygen at 2.5 atmospheres with half‐hour intervals of room air. Depending on the treatment condition, HBO was given either 48 hours or 24 hours before flap elevation, or within 4 hours or 48 hours after flap elevation. Rats receiving RT (60Co) were given a single dose of 1000 rads to the dorsum. Results showed that all groups receiving HBO within 4 hours after flap elevation had significantly greater flap survival length (P<05), with as much as a 22% greater length of surviving flap. HBO given 48 hours before flap elevation also significantly improved flap survival over controls (P<.05). RT appeared to have no immediate significant effect on flap survival. However, rats receiving RT, regardless of other factors, gained significantly less weight than did controls (P<.001). Findings clearly indicate that, to be effective, HBO needs to be given as soon after surgery as possible.
The Effects of Povidone‐Iodine Preparation on the Incidence of Post‐Tympanostomy Otorrhea
Authors: Baldwin Robert L. , Aland Jack 
Published: January 2017

Persistent otorrhea after tympanostomy tube placement in children is a common complication. Previous reports have suggested that bacteria present within the ear canal may be the cause of postoperative drainage. Preparation of the ear canal with povidone‐iodine solutions has been recommended to decrease these infections. A prospective study evaluating the efficacy of povidone‐iodine ear canal preparation before myringotomy and tube placement was performed in 111 children (220 ears) with documented chronic otitis media with effusion. One ear in each patient was prepared with povidone‐iodine. The contralateral ear in each child was used as control. Postoperative otorrhea developed in seven (6.3%) of the treated ears within 14 days, compared to eleven (10%) of the ears in the control group. The difference was not statistically significant (p > 0.05). Purulent or mucoid middle ear effusions and edematous or granuiar middle ear mucosa were associated with a significantly higher Incidence of postoperative otorrhea (p < 0.0S). This study suggests that postoperative otorrhea is generally a consequence of preoperative middle ear condition rather than contamination from the external canal. Antimicrobial therapy should be considered when purulent effusion or granulation tissue is seen.
Practical Management of Bell's Palsy
Authors: Hughes Gordon B. 
Published: January 2017

Bell's palsy is an acute unilateral weakness or paralysis of the face resulting from peripheral facial nerve dysfunction. While there is no readily Identifiable cause, there is some recovery of function within 6 months. This article offers practical guidelines for diagnosing and treating Bell's palsy. These guidelines are based on the author's experience with 63 patients over the last 8 years. Physical examination should reveal diffuse nerve involvement, normal otoscopic findings, and no skin blebs or blisters and parotid masses. Other cranial nerve palsies may be present. Diagnostic testing should Include basic audiometry if available, and computed tomography or magnetic resonance imaging scanning if paralysis Is present. Facial photography is recommended. Topognostic testing is not helpful because It no longer guides the surgical approach, and prognostic tests are not necessary if the face is not paralyzed. The only sufficiently sensitive test to determine the need for possible surgery is electroneurography. Eye care Is critical in all but the mildest cases, and steroids may also be helpful. Surgery is rarely needed and should consist only of middle fossa total decompression; simple decompression of the tympanic and mastoid segments is seldom helpful. The natural history of the disease and the limited role of surgery provide new guidelines for practical management of Bell's palsy.
Third place — resident basic science award 1993: Control of the mucosal microcirculation in the upper respiratory tract
Authors: Smith Timothy L. , Prazma Jiri , Coleman Clarence C. , Drake Amelia F. , Boucher Richard C. 
Published: January 2017

This study was designed to investigate the regulatory mechanisms of the mucosal microvascular network in the upper respiratory tract. Tracheal mucosal circulation was observed using a specially constructed chamber that allowed direct microscopic visualization of mucosal arterioles. Solutions of increasing hypertonicity (500 and 900 mOsm) applied to the tracheal epithelium resulted in increasing dilation of the underlying mucosal arterioles (p < 0.001). Nomega‐nitro‐L‐arginine methyl ester (L‐NAME, 1 mmol/L), a specific inhibitor of nitric oxide synthesis, added to a hypertonic solution inhibited dilation of mucosal arterioles (p < 0.001). Addition of the substrate for nitric oxide synthesis, L‐arginine (0.6 mmol/L) to the hypertonic solution containing L‐NAME resulted in dilation of mucosal arterioles once again. These data demonstrate that nitric oxide is a crucial mediator in the response of mucosal arterioles to the hypertonic stimulus presented to the epithelial surface of the trachea. Further elucidation of the control of the mucosal microcirculation in the upper respiratory tract could be implemented in new treatment for pathologic processes of the upper respiratory tract such as mucosal congestion and edema
The safety and efficacy of bedside tracheotomy
Authors: Futran Neal D. , Dutcher Paul O. , Roberts Jay K. 
Published: January 2017

Many institutions require that tracheotomies be performed in the operating room. Movement of critically ill patients dependent on multiple life support systems is technically difficult, labor intensive, and potentially dangerous for the patients. Between 1983 and 1992, 1088 tracheotomies were performed on patients ages 1 week to 94 years at the University of Rochester affiliated hospitals on critically ill patients as isolated procedures. The procedure was performed in the Intensive Care Units (ICU) on 996 patients, (92.9%), whereas 92 patients (7.1%) had tracheotomies in the operating room (OR1). An additional 346 tracheotomies took place in the operating room in conjunction with other head and neck procedures (OR2). Incidence of perioperative bleeding (within 48 hours) was 2.3% in the ICU group, 2.1% in the ORI group, and 2.0% in the OR2 group. Incidence of stomal infection was also similar among the three groups at 1.8%, 2.1%, and 1.5%, respectively. Tube dislodgement in all groups was a complication. No statistical differences were noted among the three groups (ICU, OR1, OR2) at the p < 0.01 level. Criteria for performing the tracheotomy in the ICU are delineated and discussed.
The retreat of Hemophilus Influenzae type B invasive disease: Analysis of an immunization program and implications for OTO‐HNS
Authors: Beck Richard A. , Kambiss Scott , Bass James W. 
Published: January 2017

Hemophilus influenzae type b (Hib) is the most common cause of bacterial meningitis among children under 5 years old. Hib is also responsible for other invasive diseases including epiglottitis, cellulitis, sepsis, pneumonia, and osteomyelitis. A child's cumulative risk of systemic Hib disease during the first 5 years of life is approximately 1 in 200. A polysaccharide Hib vaccine was first marketed in 1985, and newer, more effective conjugated vaccines have been licensed since 1987. Immunization schedules have Included Increasingly younger children. No studies have been published that analyze the effects of a vigorous immunization program on a sample population representative of the United States at large. Records of pediatric patients ages 5 years and younger who were treated for Hib meningitis or epiglottitis (N = 373) at all U.S. Army medical facilities between 1986 and 1991 were reviewed. The combined incidence of these diseases declined by more than 86% in the study group during this period. The largest decrease occurred in infants less than 1 year old, before vaccines were licensed for use in this group. Meanwhile, the number of cases of bacterial meningitis due to other organisms in this cohort remained unchanged. Economic modeling validates the cost‐effectiveness of vaccination. The impact of these preliminary trends on health care systems and otolaryngology‐head and neck surgery will be significant. Almost two thirds of Hib disease has involved infants under 15 months old, for whom a conjugated vaccine has been available only since October 1990. The change in disease frequency will have substantial bearing on training programs, because management of neurologic sequelae and the emergent airway require the expertise of otolaryngologists. In the face of medical onslaught, Hib invasive disease is in retreat
Reliability of Microvascular Free Flaps in Head and Neck Reconstruction
Authors: Truelson John M. , Leach Joseph L. , Close Lanny Garth 
Published: January 2017

Reliable reconstructive techniques are essential in the surgical treatment of head and neck cancer patients. Free flaps have often been used as reconstructive options of last resort in the head and neck because of the need for added technical skill, a longer operating time, and a perception of poor reliability. This study reviews our experience with 39 free flaps performed by the Otolaryngology—Head and Neck Surgery Service. For the first 17 cases, an interrupted anastomotic technique was used; a running technique was performed in the remaining 22 cases. The average total ischemic time (3.7 vs. 2.7 hours; p < 0.001) was significantly less with a running technique. There were 10 complications: 7 minor wound problems, 1 death from aspiration without surgical wound/flap problem, and 2 cases requiring second flaps (1 flap necrosis, 1 fistula with healthy free flap). No statistical correlation was found between complications and ischemic time, suture technique, age, or hospital (five hospitals). Free flaps are reliable and may obviate the need for sacrifice of trunk muscles for wound closure (e.g., fasciocutaneous free flaps instead of myocutaneous flaps); therefore we recommend revascularized free flaps as the primary mode of reconstruction for head and neck defects.