bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifidus Muscle Atrophy Not Observed Following Two-segment Anterior Interbody Fusion
Authors: Xu Wen-Bin , Liu Jun-Hui , Chen Zhi-Jun , Fang Xiang-Qian , Fan Shun-Wu , Hu Zhi-Jun 
Published: September 2016

Study Design.
Experimental study evaluated magnetic resonance imaging (MRI) and histologic changes in the multifidus muscle after anterior spinal fusion.

Objective.
To determine the effect of spinal fusion on the multifidus muscle in an anterior rabbit model through the use of MRI and histologic evaluation.

Summary of Background Data.
Retraction and splitting approach are known to be important factors in postoperative injury and atrophy of the multifidus muscle. The effect and possible mechanism of spinal fusion as an independent factor remains unknown.

Methods.
Thirty-six New Zealand white rabbits were divided into two groups. Animals in the fusion group underwent two-level anterior spinal fusion whereas those in the control group underwent similar surgery without spinal fusion. The status of the multifidus muscle was evaluated with MRI and histological analysis at preoperative, 3 weeks, 6 weeks, 3 months, 6 months, and 12 months postoperatively.

Results.
All rabbits in the fusion group achieved solid fusion. The mean T1-weighted and T2-weighted signal intensity ratios of gross multifidus to psoas muscles were all approximately 1.0 postoperatively, with no remarkable difference between the groups. The mean lesser diameter of myofibrils in either group did not significantly differ between the preoperative and postoperative specimens. There was no significant fibrotic change or fatty degeneration for either group. Decrease in acetylcholine activity or granular degeneration of the neuromuscular junction were not observed, and normal shape and size were found in nearly all samples at all time points in both groups (P > 0.05).

Conclusion.
After two-segment anterior spinal fusion, multifidus atrophy was not observed throughout a 12-month follow up. The rabbit model of anterior fusion is better suited to study the effect of fusion alone on the status of the multifidus muscle.

Level of Evidence: 3
Single-stage Reconstruction of Elbow Flexion Associated with Massive Soft-Tissue Defect Using the Latissimus Dorsi Muscle Bipolar Rotational Transfer
Authors: Stevanovic Milan V. , Cuéllar Vanessa G. , Ghiassi Alidad , Sharpe Frances 
Published: September 2016

Introduction:
In the upper extremity, the latissimus dorsi muscle can be used as an ipsilateral rotational muscle flap for soft-tissue coverage or functional reconstruction of arm and elbow. Patients who have both major soft-tissue loss and functional deficits can be successfully treated with a single-stage functional latissimus dorsi rotational muscle transfer that provides simultaneous soft-tissue coverage and functional reconstruction.

Methods:
Our data base was queried for all patients undergoing a rotational latissimus dorsi muscle transfer for simultaneous soft-tissue coverage and functional reconstruction of elbow flexion. Four patients were identified. A chart review documented the mechanism of injury, associated injuries, soft-tissue defect size, number of surgical procedures, length of follow-up, last elbow range of motion, and flexion strength.

Results:
Four patients with loss of elbow flexion due to traumatic loss of the anterior compartment muscles and the overlying soft tissue underwent simultaneous soft-tissue coverage and elbow flexorplasty using the ipsilateral latissimus dorsi as a bipolar muscle rotational tissue transfer. All flaps survived and had a recovery of Medical Research Council Grade 4/5 elbow flexion strength. No additional procedures were required for elbow flexion. The surgical technique is described and supplemented with surgical technique video and patient outcome.

Conclusions:
This patient series augments the data provided in other series supporting the safety and efficacy of this procedure which provides both soft-tissue coverage and functional restoration of elbow flexion as a single-stage procedure in the setting of massive traumatic soft-tissue loss of the arm.
RETINAL DETACHMENT ASSOCIATED WITH PERIPHERAL TEAR OF THE RETINAL PIGMENT EPITHELIUM IN PACHYCHOROID SPECTRUM DISEASE
Authors: Mikhail Mikel , Nofal Nour , Sebag Mikael 
Published: September 2016

Purpose:
To describe a rare case of an exudative retinal detachment associated with a peripheral tear of the retinal pigment epithelium in a young myopic pachychoroid eye.

Methods:
Clinical case report and literature review. Imaging was obtained with color fundus photography, spectral domain optical coherence tomography, fluorescein angiography, and fluorescein angiography.

Results:
A 33-year-old white man presented with an exudative choroidopathy resulting in an exudative neurosensory detachment, associated with peripheral retinal pigment epithelium tears. Spectral domain optical coherence tomography demonstrated a pachychoroid (628 μm) with subfoveal fluid. Despite a secondary pars-plana vitrectomy with silicone oil and later, Densiron-68 (Labtician Ophthalmics Inc) endotamponade, there was an area of persistent subretinal fluid inferiorly. A previously placed scleral buckle was removed, and scleral window surgery performed, with complete resolution of fluid and restoration of vision. Choroidal thickness improved to 333 μm postoperatively.

Conclusion:
Peripheral retinal pigment epithelium tear–associated retinal detachment can be seen in patients with pachychoroid spectrum disease. Scleral window surgery may be considered in the management of these retinal detachments.
YOUNGEST REPORTED CASE OF MACULAR TELANGIECTASIA (MAC TEL) TYPE 2
Authors: Rajesh Bindu , Giridhar Anantharaman 
Published: September 2016

Purpose:
To report the occurrence of macular telangiectasia (Mac Tel) Type 2 in a 28-year-old lady.

Methods:
Retrospective case report.

Results:
A 28-year-old obese diabetic lady presented with mild blurring of vision and reading difficulty for 2 months. Clinical examination revealed the presence of myopic refraction and features suggestive of macular telangiectasia Type 2 on fundus evaluation. Fundus fluorescein angiography and optical coherence tomography confirmed the diagnosis of Mac Tel Type 2, Stage 3. As there was no evidence of subretinal neovascular membrane, she was advised to follow-up regularly.

Conclusion:
Mac Tel Type 2 or idiopathic juxtafoveal telangiectasia is a condition commonly reported in middle age or elderly people. Presentation in a young individual alerts us to the possibility of this condition occurring at an early age and also stresses on the need for meticulous examination to detect subtle signs of the condition in the young.
The Effect of Right Colon Retroflexion on Adenoma Detection
Authors: Cohen Jonah , Grunwald Douglas , Grossberg Laurie B. , Sawhney Mandeep S. 
Published: September 2016

Background:
Although colonoscopy with polypectomy can prevent up to 80% of colorectal cancers, a significant adenoma miss rate still exists, particularly in the right colon. Previous studies addressing right colon retroflexion have revealed discordant evidence regarding the benefit of this maneuver on adenoma detection with concomitant concerns about safety and rates of maneuver success. In this meta-analysis, we sought to determine the effect of right colon retroflexion on improving adenoma detection compared with conventional colonoscopy without retroflexion, as well as determine the rates of retroflexion maneuver success and adverse events.

Methods:
Multiple databases including MEDLINE, Embase, and Web of Science were searched for studies on right colon retroflexion and its impact on adenoma detection compared with conventional colonoscopy. Pooled analyses of adenoma detection and retroflexion success were based on mixed-effects and random-effects models with heterogeneity analyses.

Results:
Eight studies met the inclusion criteria (N=3660). The primary analysis comparing colonoscopy with right-sided retroflexion versus conventional colonoscopy to determine the per-adenoma miss rate in the right colon was 16.9% (95% confidence interval, 12.5%-22.5%). The overall rate of successful retroflexion was 91.9% (95% confidence interval, 86%-95%) and rate of adverse events was 0.03%.

Conclusions:
Colonoscopy with right-sided retroflexion significantly increases the detection of adenomas in the right colon compared with conventional colonoscopy with a high rate of maneuver success and small risk of adverse events. Thus, reexamination of the right colon in retroflexed view should be strongly considered in future standard of care colonoscopy guidelines for quality improvement in colon cancer prevention.
Oocyte cryopreservation for fertility preservation in women with cancer
Authors: Domingo Javier , Garcia-Velasco Juan A. 
Published: September 2016

Purpose of review
It is necessary to clarify the fertility preservation-related points of concern that often frighten patients or physicians when it comes to deciding about oocyte cryopreservation for fertility preservation, which are often perceived as procedure limitations, are sometimes real and often theoretical and may make the prognosis worse.

Recent findings
Letrozole added to gonadotrophins for controlled ovarian stimulation is safe when applied to hormone-sensitive cancer patients as it avoids associated high estradiol levels. This benefit is only for estrogens, but not for progesterone. Triggering ovulation with gonadotropin releasing hormone agonist bolus and adding the gonadotropin releasing hormone antagonist after oocyte retrieval help minimize its effect. A random start is currently widespread as neither results nor offspring are compromised, and it avoids waiting for menstruation and, therefore, delaying treatment.

Summary
The cumulative live birth rate is conditioned by the number of available oocytes and patient's age. Assisted reproductive technologies may help cancer patients to achieve pregnancy with good obstetric outcomes and apparent oncological safety. Although counseling should be provided on an individual basis, fertility preservation in cancer patients and later pregnancy in survivors after adequate treatment and follow-up should not be discouraged.
Local Health Departments' Partners and Challenges in Electronic Exchange of Health Information
Authors: Shah Gulzar H. , Vest Joshua R. , Lovelace Kay , McCullough J. Mac 
Published: September 2016

Background:
Unprecedented amounts of data are produced by the health care and other sectors, presenting opportunities for local health departments (LHDs) to access these data. LHDs will need to participate in health information exchange (HIE) with a number of partners in order to benefit from these data resources. LHDs' participation in HIEs with specific partners has not been studied.

Objectives:
To describe the level of and challenges in LHD participation in HIE with other partners, and variation by LHD population size and governance type.

Data and Methods:
This research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling design. A total of 324 completed responses were received with a 50% response rate. Survey data were cleaned, and bivariate comparisons were conducted using χ2 and Somer's D.

Results:
Substantial variation existed in LHDs' participation in HIE by type of exchange partner. Although 71% participated in HIE with the state departments of health, only 12% with jail/correctional health, 14% with health or county-based purchasing plans, and 15% with home health agencies. Compared with large LHDs (jurisdiction populations of ≥500 000), smaller LHDs were more likely to participate in HIE with state departments of health, but less likely with other exchange partners. The challenges to HIE participation were technological, and organizational/interorganizational in nature and variation existed by LHDs' population size and governance structure with respect to state authority.

Conclusions:
Local public health agencies more commonly participate in HIE with some partners, but may need to improve HIE with many others. National strategies targeting an increase in HIE of LHDs may use our findings to focus those initiatives.
Clinical Data Systems to Support Public Health Practice: A National Survey of Software and Storage Systems Among Local Health Departments
Authors: McCullough J. Mac , Goodin Kate 
Published: September 2016

Context:
Numerous software and data storage systems are employed by local health departments (LHDs) to manage clinical and nonclinical data needs. Leveraging electronic systems may yield improvements in public health practice. However, information is lacking regarding current usage patterns among LHDs.

Objective:
To analyze clinical and nonclinical data storage and software types by LHDs.

Design:
Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County and City Health Officials.

Participants:
A total of 324 LHDs from all 50 states completed the survey (response rate: 50%).

Main Outcome Measures:
Outcome measures included LHD's primary clinical service data system, nonclinical data system(s) used, and plans to adopt electronic clinical data system (if not already in use). Predictors of interest included jurisdiction size and governance type, and other informatics capacities within the LHD. Bivariate analyses were performed using χ2 and t tests.

Results:
Up to 38.4% of LHDs reported using an electronic health record (EHR). Usage was common especially among LHDs that provide primary care and/or dental services. LHDs serving smaller populations and those with state-level governance were both less likely to use an EHR. Paper records were a common data storage approach for both clinical data (28.9%) and nonclinical data (59.4%). Among LHDs without an EHR, 84.7% reported implementation plans.

Conclusions:
Our findings suggest that LHDs are increasingly using EHRs as a clinical data storage solution and that more LHDs are likely to adopt EHRs in the foreseeable future. Yet use of paper records remains common. Correlates of electronic system usage emerged across a range of factors. Program- or system-specific needs may be barriers or facilitators to EHR adoption. Policy makers can tailor resources to address barriers specific to LHD size, governance, service portfolio, existing informatics capabilities, and other pertinent characteristics.
An Iterative, Low-Cost Strategy to Building Information Systems Allows a Small Jurisdiction Local Health Department to Increase Efficiencies and Expand Services
Authors: Lovelace Kay A. , Shah Gulzar H. 
Published: September 2016

Objective and Methods:
The objective of this case study was to describe the process and outcomes of a small local health department's (LHD's) strategy to build and use information systems. The case study is based on a review of documents and semi-structured interviews with key informants in the Pomperaug District Health Department. Interviews were recorded, transcribed, coded, and analyzed.

Results and Conclusions:
The case study here suggests that small LHDs can use a low-resource, incremental strategy to build information systems for improving departmental effectiveness and efficiency. Specifically, we suggest that the elements for this department's success were simple information systems, clear vision, consistent leadership, and the involvement, training, and support of staff.
Using Information Systems to Improve a Mid-Sized Local Health Department's Effectiveness in a Time of Rapid Change
Authors: Lovelace Kay , Shah Gulzar H. 
Published: September 2016

Background:
Informatics capacity building is resource and personnel intensive. Many local health departments (LHDs) face tradeoffs between using their resources to carry out existing mandates and using resources to build their capacity, for example, through informatics, to deliver essential services in a more effective and efficient manner.

Objective:
The purpose of this case study is to describe how a mid-sized LHD built and used information systems to support its strategic objectives, clinical services, and surveillance.

Methods:
The mid-sized LHD described here was chosen for its “best practices” in informatics capacity building and use by NACCHO's study advisory committee. To conduct the case study, authors reviewed departmental documents and conducted semistructured interviews with key informants in the agency. Interviews were recorded, transcribed, thematically coded, and analyzed.

Results and Conclusions:
Findings from the case study suggest that including capacity building in informatics as a strategic priority is one of the most effective ways to ensure that informatics are assessed, updated, and included in resource decisions. Leadership at all levels is critical to the successful implementation of informatics as is proactive partnership with community partners who have overlapping goals. The efficiency and effectiveness of LHDs rely on informatics capacity, especially when resources are challenged.
Electronic Health Records and Meaningful Use in Local Health Departments: Updates From the 2015 NACCHO Informatics Assessment Survey
Authors: Williams Karmen S. , Shah Gulzar H. 
Published: September 2016

Background:
Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data.

Purpose:
The purpose of this study was to gain an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of EHRs in LHDs.

Methods:
Data were drawn from the 2015 Informatics Capacity and Needs Assessment Survey, which used a stratified random sampling design of LHD populations. Oversampling of larger LHDs was conducted and sampling weights were applied. Data were analyzed using descriptive statistics and logistic regression in SPSS.

Results:
Forty-two percent of LHDs indicated the use of an EHR system compared with 58% that use a non-EHR system for the storage of primary health data. Seventy-one percent of LHDs had reviewed some or all of the current systems to determine whether they needed to be improved or replaced, whereas only 6% formally conducted a readiness assessment for health information exchange. Twenty-seven percent of the LHDs had conducted informatics training within the past 12 months. LHD characteristics statistically associated with having an EHR system were having state or centralized governance, not having created a strategic plan related to informatics within the past 2 years throughout LHDs, provided informatics training in the past 12 months, and various levels of control over decisions regarding hardware allocation or acquisition, software selection, software support, and information technology budget allocation.

Conclusion:
A focus on EHR implementation in public health is pertinent to examining the impact of public health programming and interventions for the positive change in population health.
Investigating Informatics Activity, Control, and Training Needs in Large, Medium, and Small Health Departments
Authors: Bakota Eric , Arnold Ryan , Yang Biru 
Published: September 2016

Introduction:
A recent National Association of City & County Health Officials survey shed light on informatics workforce development needs. Local health departments (LHDs) of various jurisdictional sizes and control over informatics may differ on training needs and activity. Understanding the precise nature of this variation will allow stakeholders to appropriately develop workforce development tools to advance the field.

Objective:
To understand the informatics training needs for LHDs of different jurisdictional sizes.

Methods:
Survey responses were analyzed by comparing training needs and LHD population size.

Results:
Larger health departments consistently reported having greater informatics-related capacity and informatics-related training needs. Quantitative data analysis was identified as a primary need for large LHDs. In addition, LHDs that report higher control of informatics/information technology were able to engage in more informatics activities.

Conclusion:
Smaller LHDs need additional resources to improve informatics-related capacity and engagement with the field.
Does physical exercise improve quality of life of advanced cancer patients?
Authors: Navigante Alfredo , Morgado Pablo Cresta 
Published: September 2016

Purpose of review
We discuss the principal issues about physical activity in advanced cancer patients through the analyses of the last articles and our experience in this field.

Recent findings
The efficacy of exercise training intervention could improve quality of life (QOL), fatigue and well being in advanced cancer patients. Several published studies have included, nevertheless, patients with early stage of disease and more recently, populations of patients with local advanced tumors of the breast, rectum and lung, who are undergoing neoadjuvant therapy. Despite the insufficient sample of patients in these studies, physical exercise is considered to improve both cardiopulmonary function and physical muscle fitness. Cancer-related fatigue is a devastating symptom in advanced cancer patients that implies loss of mobility and independence.

Summary
Physical exercise could be a treatment to increase skeletal muscle endurance and improve well being. In palliative medicine, physical activity could be applied to medical assistance or to design prospective and controlled trials so as to evaluate possible usefulness.
A shotgun approach to identify mechanical nociception genes
Authors: Christianson Melissa G. , Mauthner Stephanie E. , Tracey W. Daniel 
Published: September 2016

AbstractThe molecular mechanisms of sensing noxious mechanical force by nociceptive sensory neurons remain poorly understood. Traditional methods for probing mechanical nociception behavioral responses are labor intensive and involve the testing of one animal at a time. This time consuming process of behavioral testing has largely precluded large scale analyses. Indeed, large scale genetic screens that have been performed thus far have been largely restricted to the investigation of ion channel genes [1]. Here we describe a new behavioral assay for mechanical nociception in which tens of animals can be stimulated simultaneously. In this assay, third instar larvae of the genetically tractable organismDrosophila melanogasterare mechanically stimulated with tungsten particles that are fired from a gun. We have used the new assay to carry out a genetic screen in which we investigated the function of 231 nociceptor enriched genes with tissue-specific RNA interference. Targeting of 21 genes resulted in mechanically insensitive phenotypes and targeting of a single gene resulted in a hypersensitive mechanical nociception phenotype. Six of the identified genes were previously uncharacterized and these were named after famed Roman gladiators (Spartacus (CG14186),Commodus (CG1311), Flamma (CG10914), Crixus(CG6685), Spiculus (CG10932),andVerus (CG31324)).