bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inciting Events Associated With Lumbar Facet Joint Pain
Authors: Odonkor Charles A. , Chen Yian , Adekoya Peju , Marascalchi Bryan J. , Chaudhry-Richter Hira , Tang Teresa , Abruzzese Christopher , Cohen Berklee K. , Cohen Steven P. 
Published: July 2017

BACKGROUND:
Low back pain is the leading cause of years lost to disability with approximately 15%–25% of the chronic back pain population suffering from lumbar facet arthropathy. No large-scale study has sought to systematically identify inciting events for lumbar facet arthropathy. The aim of this study is to quantify the proportion of individuals with lumbar facetogenic pain who report a specific precipitating event(s) and to determine if there is a correlation between these events and treatment outcome.

METHODS:
Institutional electronic medical records were searched based on the current procedural terminology (CPT) codes representing lumbar facet joint radiofrequency ablation for procedures performed between January 2007 and December 2015. All patients had obtained ≥50% pain relief based on 6-hour pain diaries after 1 or more diagnostic facet blocks. A positive outcome was defined as ≥50% pain relief sustained for longer than 3-month after procedure, without additional procedural interventions.

RESULTS:
One thousand sixty-nine people were included in analysis. In the 52% of individuals who described an inciting event, the most commonly reported causes were falls (11%), motor vehicle collisions (11%), sports-related injuries (11%, of which weightlifting accounted for 62%), nonspine postsurgical injuries (2%), and “other” (17%). Six hundred seventeen (57.7%) individuals experienced ≥50% pain relief sustained for >3 months. Patients whose pain was preceded by an inciting event were more likely to have a positive outcome than those who could not recall a specific precipitating factor (odds ratio, 1.5; confidence interval, 1.02–2.1, P = .01). Another factor associated with outcome was shorter duration of pain (8.1 ± 9.2 vs 9.7 ± 10.1 years, P = .02), with an observed modifier effect of age on outcomes. For a 1-year increase in age, there was a 10% increase in the odds of a positive response.

CONCLUSIONS:
Inciting events are common in patients diagnosed with lumbar facetogenic pain and may be associated with a positive outcome.
Low End-Tidal Carbon Dioxide at the Onset of Emergent Trauma Surgery Is Associated With Nonsurvival: A Case Series
Authors: Dudaryk Roman , Bodzin Danielle K. , Ray Juliet J. , Jabaley Craig S. , McNeer Richard R. , Epstein Richard H. 
Published: July 2017

BACKGROUND:
End-tidal carbon dioxide (Etco
2) is a valuable marker of the return of adequate circulation after cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative Etco
2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series. If there is a threshold below which survival was extremely unlikely, it might be useful in guiding decision-making in the early termination of futile resuscitative efforts.

METHODS:
After institutional review board approval, a data set was created to investigate the relationship between Etco
2 values at the onset of emergent trauma surgery and nonsurvival. Patients who were admitted and transferred to the operating room (OR) directly from a resuscitation bay were identified using the Ryder Center trauma registry (October 1, 2013, to June 30, 2016). Electronic records from the hospital’s anesthesia information management system were queried to identify the matching anesthesia records. The maximum Etco
2 values within 5 and 10 minutes of the onset of mechanical ventilation in the OR were determined for patients undergoing general anesthesia with mechanical ventilation. Patients were divided into 2 groups: those who were discharged from the hospital alive (survivors) and those who died in the hospital before discharge (nonsurvivors). The threshold Etco
2 giving a positive predictive value of 100% for in-hospital mortality was determined from a graphical analysis of the data. Association of determined threshold and mortality was analyzed using the 2-tailed Fisher exact test.

RESULTS:
There were 1135 patients who met the inclusion criteria. Within the first 5 minutes of the onset of mechanical ventilation in the OR, if the maximum Etco
2 value was ≤20 mm Hg, hospital mortality was 100% (21/21, 95% binomial confidence interval, 83.2%–100%).

CONCLUSIONS:
A maximum Etco
2 ≤20 mm Hg within 5 minutes of the onset of mechanical ventilation in the OR may be useful in decision-making related to the termination of resuscitative efforts during emergent trauma surgery. However, a large-scale study is needed to establish the statistical reliability of this finding before potential adoption.
Radiation dose reduction in multidetector CT in fracture evaluation
Authors: Yi Jung Woo , Park Hee Jin , Lee So Yeon , Rho Myung Ho , Hong Hyun Pyo , Choi Yoon Jung , Kim Mi Sung 
Published: July 2017

Objective:
To evaluate whether multidetector CT with low-dose radiation (low-dose CT) of joints can be useful when evaluating fractures.

Methods:
Our study included CT scans of 398 patients, 103 shoulder cases, 109 wrist cases, 98 pelvis cases and 88 ankle cases. There were 191 females and 207 males. The low-dose CTs were performed using identical voltage and parameters with the exception of decreased (half of standard dose) tube current. Low-dose and standard-dose images were compared with regards to objective image quality, subjective evaluation of image quality and diagnostic performance for the fractures.

Results:
There was no significant difference of image noise between standard-dose CT and low-dose CT in every joint (p &gt; 0.05). Each mean value of subjective score did not show significant difference according to the dosage of the CT scan. There were no statistically significant differences in the sensitivity (96–100%), specificity (95.2–100%) or accuracy (97.9–100%) between standard-dose CT and low-dose CT (p values, 0.1336–1.000).

Conclusion:
The evaluation of extremities for fractures using low-dose CT can reduce radiation exposure by about 50% compared with standard-dose CT without affecting image quality or diagnostic performance.

Advances in knowledge:
Low-dose CT of the extremities (shoulder, pelvis, ankle and wrist) can reduce radiation dose by about 50% compared with standard-dose CT and does not significantly affect image quality or diagnostic performance in fracture detection.
Role of extra cranial stereotactic body radiation therapy in the management of Stage IV melanoma
Authors: Franceschini Davide , Franzese Ciro , De Rose Fiorenza , Navarria Pierina , D’Agostino Giuseppe R , Comito Tiziana , Tozzi Angelo , Tronconi Maria C , Di Guardo Lorenza , Del Vecchio Michele , Scorsetti Marta 
Published: July 2017

Objective:
To investigate the role of extracranial stereotactic body radiation therapy (SBRT) in the management of oligometastatic melanoma.

Methods:
Patients affected by Stage IV melanoma, with less than three extracranial metastatic lesions, who received SBRT were included in this analysis. Acute and late toxicity, local control (LC), overall survival (OS) and progression-free survival (PFS) were analysed.

Results:
31 patients were included in the study. 16 patients (51.6%) were treated for lung meta­stases, 8 patients for liver metastases (25.8%) and 7 (22.6%) for nodal metastases. 38 lesions were irradiated.
With a median follow-up time of 13 months, 11 patients (35.4%) were still alive, in four cases (12.9%) with no evidence of disease. Median OS was 10.6 months, and OS at 6, 12 and 24 months was 77, 41 and 21% respectively. LC at 12 and 24 months was 96.6 and 82.8%. 23 patients (74.2%) developed distant metastases. Median PFS was 5.8 months, and PFS at 6, 12 and 24 months was 48.2, 18.5 and 13.9% respectively.
Number of irradiated lesions showed a statistically significant correlation only with LC (p = 0.03). Response of the irradiated lesion was related to OS (p = 0.019). Local response showed also a borderline correlation with PFS (p = 0.07).

Conclusion:
SBRT for extracranial metastases from melanoma is feasible and well tolerated. Response of the irradiated lesions is predictive of OS.

Advances in knowledge:
SBRT for melanoma extracranial metastases is feasible and the response of the irradiated lesions is predictive of OS.
Shifting paradigm of maternal and perinatal death review system in Bangladesh: A real time approach to address sustainable developmental goal 3 by 2030
Authors: Biswas Animesh 
Published: July 2017

Recently, Bangladesh has made remarkable progress in reducing maternal and neonatal morality, even though the millennium developmental goal to reduce maternal and neonatal mortality was not achieved. Sustainable Developmental Goal (SDG) 3 has already been set for a new target to reduce maternal and neonatal deaths by 2030. The country takes this timely initiative to introduce a maternal and perinatal death review system. This review will discuss the shifting paradigm of the maternal and perinatal death review system in Bangladesh and its challenges in reaching the SDG on time. This review uses existing literature on the maternal and perinatal death review system in Bangladesh, and other systems in similar settings, as well as reports, case studies, news, government letters and meeting minutes. Bangladesh introduced the maternal and perinatal death review system in 2010. Prior to this there was no such comprehensive death review system practiced in Bangladesh. The system was established within the government health system and has brought about positive effects and outcomes. Therefore, the Ministry of Health and Family Welfare of Bangladesh gradually scaled up the maternal and perinatal death review system nationwide in 2016 within the government health system. The present death review system highlighted real-time data use, using the district health information software(DHIS-2). Health mangers are able to take remedial action plans and implement strategies based on findings in DHIS-2. Therefore, effective utilization of data can play a pivotal role in the reduction of maternal and perinatal deaths in Bangladesh. Overall, the maternal and perinatal death review system provides a great opportunity to achieve the SDG 3 on time. However, the system needs continuous monitoring at different levels to ensure its quality and validity of information, as well as effective utilization of findings for planning and implementation under a measureable accountability framework.
Tests, scans and investigations, 12. Barium enema
Authors: Peate Ian 
Published: July 2017

Barium enema is a medical imaging procedure undertaken in order to help make a diagnosis; it is a type of diagnostic radiography. During the test, a white liquid containing barium is passed into the bowel through the bottom: the barium coating results in a relatively clear silhouette of the colon. This is a common type of test, yet it can instil fear and anxiety in the person having the procedure performed. This article provides an overview of the anatomy and physiology of the lower gastrointestinal tract, a discussion of the test, an outline of the reasons why such a test may be required and how it is performed. The possible risks associated with this investigation are provided. The role that the healthcare assistant and the assistant practitioner (HCA and AP) plays in assisting the person prior to, during and after the test is discussed.
A positive psychology workshop for trainee assistant practitioners
Authors: Macfarlane Jan , Mackey Charlotte , Carson Jerome 
Published: July 2017

This article discusses, first, how trainee assistant practitioners (TAPs) can learn transferable positive psychological interventions to enable them to flourish at work and in higher education.Second, they can also learn the importance of maintaining their wellbeing when dealing with the demands of providing supportive, high-quality care in a changeable workforce environment.An overview is provided of a one-day pilot workshop, delivered as a summer school, to learners beginning their second year of study, with an outline of the range of interventions used. Results are presented showing that the pilot workshops achieved their goals. Students finished the workshops with a significantly greater appreciation of their own strengths and recognised their need to be more self-compassionate.Finally, the potential of further developing the workshop/toolkit to enhance personal and professional self-efficacy is considered.
Emotional labour in paramedic practice: student awareness of professional demands
Authors: Jennings Kath 
Published: July 2017

Purpose: The purpose of this study was to explore student paramedics' awareness of the emotional demands of their future role, particularly regarding the delivery of compassionate care. Problem: There is a dominance of nursing literature in the discourse around compassionate care and emotional labour, and a paucity of research in the paramedic literature. Methods: A survey was issued to a small convenience sample of paramedic students. Excel was used to organise data collected, which was then presented graphically as tables and charts. Results: Key findings were drawn out and it was found that there were some correlations between the literature reviewed and results generated. Conclusion: Student paramedics had identified factors affecting their emotions in placement very early on in their studies. There was evidence of students covering up their emotions whilst in placement. The research reinforced the need for further larger scale and longitudinal studies.
Human Patient Simulator based CBRN Casualty Management Training
Authors: Gautam Sima , Sharma Navneet , Sharma Rakesh Kumar , Basu Mitra 
Published: July 2017

<p>Chemical, biological, radiological and nuclear (CBRN) emergency are becoming an impending threat. Effective preparedness needs to be raised for prompt response of CBRN incidents. During mass casualty incidents the strategy of the first responders must be beyond the triage, evacuation and medical first aid. Response process is advanced by the presence of CBRN contaminants and it becomes more complex when the rescue operations have to be performed immediately after the incident. Methodological approach is required to identify and decontaminate the CBRN victims. To manage CBRN emergencies, skill based training of appropriate degree is a key to the right level of preparedness. Intervention by first responders requires specialised inputs in knowledge, skills and aptitude. In India, CBRN defence training has traditionally been a military oriented domain, involving the quick reaction team, quick reaction medical team, rapid action medical team, etc. The training concept discussed in this study contemplates around standardised simulated CBRN casualty referred to as CBRN human patient simulator (HPS), which conceptualised in the division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi. HPS provides an opportunity to learn about the health impact of CBRN contaminants and practise medical management. Simulation as training and planning tools, offers repeatability, controllability, possibility for evaluation and provides a platform to learn from costly mistakes. Group training and demonstrations conducted on the HPS offers an additive benefit to enhance performance as a team and also help to reduce errors. This paper provides the information on the potentials of simulation based training of emergency response teams in the management of CBRN victims.</p><p> </p>
Methodological Proposal about the Role of Landscape in the Tourism Development Process in Rural Areas: The Case of Molise Region (Italy)
Authors: Mastronardi Luigi , Giaccio Vincenzo , Giannelli Agostino , Stanisci Angela 
Published: July 2017

Abstract
The landscape has always been a fundamental factor in defining tourist flow attraction for local development. In this paper, landscape related to tourism have been analysed using three different measurements through appropriate performance indicators and rationalised with the aim of identifying a scheme of mutual relations. Applying advanced statistical methods of ranking and data synthesis, the area investigated (Molise, Italy) has been divided into different zones. Each area described has a specific relation between tourism and landscape useful in the implementation of optimal promotion strategies and valorisation of the area. In marginal areas, tourism can have an excellent growth potential, since they are characterized by the high quality of the landscape. However, the analysis highlights some gap areas, which means the existence of areas with high quality of the natural and agricultural landscape is not associated with an appropriate tourism development, or areas where the high tourism development is not associated with an appreciable quality of the landscape.
Reduced Protein Expression in a Virus Attenuated by Codon Deoptimization
Authors: Jack Benjamin R , Boutz Daniel R , Paff Matthew L , Smith Bartram L , Bull James J , Wilke Claus O 
Published: July 2017

Abstract
A general means of viral attenuation involves the extensive recoding of synonymous codons in the viral genome. The mechanistic underpinnings of this approach remain unclear, however. Using quantitative proteomics and RNA sequencing, we explore the molecular basis of attenuation in a strain of bacteriophage T7 whose major capsid gene was engineered to carry 182 suboptimal codons. We do not detect transcriptional effects from recoding. Proteomic observations reveal that translation is halved for the recoded major capsid gene, and a more modest reduction applies to several coexpressed downstream genes. We observe no changes in protein abundances of other coexpressed genes that are encoded upstream. Viral burst size, like capsid protein abundance, is also decreased by half. Together, these observations suggest that, in this virus, reduced translation of an essential polycistronic transcript and diminished virion assembly form the molecular basis of attenuation.
Randomized Controlled Trial of a Home-Based Walking Program to Reduce Moderate to Severe Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors
Authors: Nyrop Kirsten A. , Callahan Leigh F. , Cleveland Rebecca J. , Arbeeva Liubov L. , Hackney Betsy S. , Muss Hyman B. 
Published: July 2017

Abstract

Background
In postmenopausal women diagnosed with breast cancer (BC), most BC tumors are hormone receptor positive and guidelines recommend adjuvant endocrine therapy that includes an aromatase inhibitor (AI). This study investigates the impact of a 6-week, home-based, self-directed walking program on the commonly reported side effect of AI-associated arthralgia (AIAA).

Materials and Methods
In this phase II trial, consented BC patients were randomized to walking Intervention (n = 31) or Wait List Control (WLC; n = 31). Eligibility criteria included: stage 0–III BC, on AI for at least 4 weeks, ≥3 on a 5-point scale inquiring about joint symptom intensity “at its worst,” and exercising ≤150 minutes per week. Outcomes were self-reported joint symptoms and psychosocial measures. Analyses comparing Intervention and WLC groups were conducted on an intention-to-treat basis to assess intervention impact at 6 weeks (postintervention) and at 6-months follow-up. Adjusted means were calculated to assess differences in two groups.

Results
In our final sample (n = 62), mean age was 64 years, 74% were white, and 63% had a body mass index of 30 or higher. At postintervention, Intervention group participants reported significantly increased walking minutes per week, reduced stiffness, less difficulty with activities of daily living (ADL), and less perceived helplessness in managing joint symptoms. At 6-months follow-up (postwalking period in both Intervention and WLC), walking minutes per week had decreased significantly; however, improvements in stiffness and difficulty with ADLs were maintained.

Conclusion
This study adds to the growing evidence base suggesting exercise as a safe alternative or adjunct to medications for the management of AIAA.
Estudio etnobotánico del mortiño (vaccinium floribundum) como alimento ancestral y potencial alimento funcional
Authors: Coba Santamaría Pablo , Coronel Daniel , Verdugo Karla , Paredes María Fernanda , Yugsi Elizabeth , Huachi Laura 
Published: July 2017

<div class="page" title="Page 1"><div class="section"><div class="layoutArea"><div class="column"><p><span>El mortiño es un arbusto silvestre endémico de Ecuador y Colombia. Posee una baya de agradable sabor, frutos de especies emparentadas al él eran consumidos desde antes de la Conquista, elevándola a fruta ceremonial. Tradición que se ha derivado a la celebración del Día de los Difuntos en Ecuador. Su propiedad relevante es poseer gran cantidad de polifenoles asistida por el contenido de azúcares, fibra, lípidos, minerales y vitaminas, proantocianidinas, antocianidinas, flavonoides se los utiliza como colorantes alimentarios; así como flavonoides, taninos, ácidos poli fenólicos tienen actividad antioxidante, coadyuvante en la microcirculación retiniana y antiagregación plaquetaria, microcirculación en general, reducción en la insuficiencia venosa crónica, considerado como coadyuvante nutrimental. </span></p></div></div></div></div>
Georeferenciación y estudio de los órdenes de las clases insecta y collembola en el sendero Quishuar (Área Nacional de Recreación El Boliche)
Authors: Landázuri Ondina , Bersosa Fabián , Segovia Alex , Tarabata Byron , Prieto Patsy , Tufiño Rodrigo , Navas Gustavo 
Published: July 2017

Con el objetivo de determinar los órdenes de las clases Insecta y Collembola, presentes en el sendero Quishuar, el 15 de septiembre de 2012, se efectuó un muestreo preliminar de los insectos y collembolos presentes en el sendero Quishuar del Área Nacional de Recreación El Boliche. Para el efecto se realizó el registro en nueve puntos de muestreo distanciados cada uno de ellos por 100 m, donde se realizaron observaciones por 10 minutos tanto en el lado derecho como en el izquierdo del sendero en un área de 1 m2. Los insectos y collembolos fueron extraídos manualmente para luego ser liberados. Los datos registrados fueron organizados y analizados en una matriz usando los programas Excel y Past versión 2.4. La georeferenciación y los puntos trazas fueron incorporados a una herramienta Gis de Software Libre, Quantum GIS (QGis), versión 1.7.4. Los resultados registraron siete órdenes de insectos y un orden no identificado de collembola en los estratos de suelo, herbáceo y arbustivo. Los órdenes con mayor frecuencia fueron: Díptera (Insecto) y un de la clase Collembola. A través de un estudio de similitudes de los puntos de muestreo, se encontró que el mayor porcentaje de similitud se presenta entre los estratos arbustivos y suelo con el 44,4 %.