bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence, Diagnosis, Perioperative Monitoring and Treatment of Right Ventricular Dysfunction and/or Pulmonary Arterial Hypertension in Cardiac Surgical Patients in Germany—A Postal Survey
Authors: Schön Julika , Pliet Teresa , Haake Nils , Reinecke Alexander , Habicher Marit , Sander Michael , Markewitz Andreas , Reuter Daniel , Groesdonk Heinrich , Trummer Georg , Pilarzyk Kevin , von der Brelie Michael , Bein Berthold , Schirmer Uwe , Heringlake Matthias 
Published: February 2016

Background Sparse data are available on the prevalence of right ventricular dysfunction and/or pulmonary arterial hypertension in patients scheduled for cardiac surgery in Germany as well as on the intensity and modalities used for diagnosis, perioperative monitoring, and treatment of these comorbidities.
Methods A postal survey including questions on the prevalence of preoperative right ventricular dysfunction and/or pulmonary arterial hypertension in patients undergoing cardiac surgery in 2009 was sent to 81 German heart centers. Total 47 of 81 (58%) heart centers returned the questionnaires. The centers reported data on 51,095 patients, and 49.8% of the procedures were isolated coronary artery bypass grafting.
Results Data on the prevalence of preoperative pulmonary hypertension and/or right ventricular dysfunction were not available in 54% and 64.6% of centers. In the remaining hospitals, 19.5% of patients presented right heart dysfunction and 10% pulmonary arterial hypertension. Preoperative echocardiography was performed in only 45.3% of the coronary artery bypass grafting cases. Preoperative pharmacologic treatment of pulmonary hypertension or right ventricular dysfunction with oral sildenafil, inhaled prostanoids, or nitric oxide was initiated in 71% and 95.7% of the centers, respectively. Intra- and postoperative treatment was most frequently accomplished with phosphodiesterase-III inhibitors.
Conclusion The prevalence of preoperative right heart dysfunction and pulmonary arterial hypertension in cardiac surgical patients in Germany seems to be substantial. However, in more than 50% of the patients, no preoperative data on right ventricular function and pulmonary arterial pressure are available. This may lead to underestimation of perioperative risk and inappropriate management of this high-risk population.
Blunt Cerebrovascular Injury in Cervical Spine Fractures: Are More-Liberal Screening Criteria Warranted?
Authors: Grabowski Gregory , Robertson Ryan N. , Barton Blair M. , Cairns Mark A. , Webb Sharon W. 
Published: February 2016

Study Design Retrospective comparative study. Objective To compare strict Biffl criteria to more-liberal criteria for computed tomography angiography (CTA) when screening for blunt cerebrovascular injury (BCVI). Methods All CTAs performed for blunt injury between 2009 and 2011 at our institution were reviewed. All patients with cervical spine fractures who were evaluated with CTA were included; patients with penetrating trauma and atraumatic reasons for imaging were excluded. We then categorized the patients’ fractures based on the indications for CTA as either within or outside Biffl criteria. For included subjects, the percentage of studies ordered for loose versus strict Biffl criteria and the resulting incidences of BCVI were determined. Results During our study period, 1,000 CTAs were performed, of which 251 met inclusion criteria. Of the injuries, 192 met Biffl criteria (76%). Forty-nine were found to have BCVIs (19.5%). Forty-one injuries were related to fractures meeting Biffl criteria (21.4%), and 8 were related to fractures not meeting those criteria (13.6%). The relative risk of a patient with a Biffl criteria cervical spine injury having a vascular injury compared with those imaged outside of Biffl criteria was 1.57 ( p = 0.19). Conclusions Our data demonstrates that although cervical spine injuries identified by the Biffl criteria trend toward a higher likelihood of concomitant BCVI (21.4%), a significant incidence of 13.6% also exists within the non-Biffl fracture cohort. As a result, a more-liberal screening than proposed by Biffl may be warranted.
Residual stress of as-deposited and rolled wire+arc additive manufacturing Ti–6Al–4V components
Authors: Martina F. , Roy M. J. , Szost B. A. , Terzi S. , Colegrove P. A. , Williams S. W. , Withers P. J. , Meyer J. , Hofmann M. 
Published: February 2016

Wire + arc additive manufacturing components contain significant residual stresses, which manifest in distortion. High-pressure rolling was applied to each layer of a linear Ti–6Al–4V wire + arc additive manufacturing component in between deposition passes. In rolled specimens, out-of-plane distortion was more than halved; a change in the deposits’ geometry due to plastic deformation was observed and process repeatability was increased. The Contour method of residual stresses measurements showed that although the specimens still exhibited tensile stresses (up to 500 MPa), their magnitude was reduced by 60%, particularly at the interface between deposit and substrate. The results were validated with neutron diffraction measurements, which were in good agreement away from the baseplate. This paper is part of a Themed Issue on Measurement, modelling and mitigation of residual stress.
Impact of Initial Ventilatory Strategy in Hematological Patients With Acute Respiratory Failure: A Systematic Review and Meta-Analysis*
Authors: Amado-Rodríguez Laura , Bernal Teresa , López-Alonso Inés , Blázquez-Prieto Jorge , García-Prieto Emilio , Albaiceta Guillermo M. 
Published: February 2016

Objective:
Acute respiratory failure in hematological patients is related to a high mortality. Noninvasive mechanical ventilation may benefit a subset of these patients, but the overall effect on mortality and the risks derived from its failure are unclear. Our objective was to review the impact of initial ventilatory strategy on mortality and the risks related to noninvasive mechanical ventilation failure in this group of patients.

Data Sources:
Data sources, including PubMed and conference proceedings, were searched from the year 2000 to January 2015.

Study Selection:
We selected studies reporting mortality and the need for mechanical ventilation in hematological patients with acute respiratory failure.

Data Extraction:
Two trained reviewers independently conducted study selection, abstracted data, and assessed the risk of bias. Discrepancies between reviewers were resolved through discussion and consensus. The outcomes explored were all-cause mortality after mechanical ventilation and incidence of noninvasive mechanical ventilation failure.

Data Synthesis:
A random-effects model was used in all the analysis. Thirteen studies, involving 2,380 patients, were included. Use of noninvasive mechanical ventilation was related to a better outcome than initial intubation (risk ratio, 0.74; 95% CI, 0.65–0.84). Failure of noninvasive mechanical ventilation did not increase the overall risk of death (risk ratio, 1.02; 95% CI, 0.93–1.13). There were signs of publication bias and substantial heterogeneity among the studies. Compensation of this bias by using the trim-and-fill method showed a significant risk of death after noninvasive mechanical ventilation failure (risk ratio, 1.07; 95% CI, 1.00–1.14). Meta-regression analysis showed that the predicted risk of death for the noninvasive mechanical ventilation group acted as a significant moderator, with a higher risk of death after noninvasive mechanical ventilation failure in those studies reporting lower predicted mortality.

Conclusions:
Noninvasive mechanical ventilation is associated with a lower risk of death in hematological patients with respiratory failure. Noninvasive mechanical ventilation failure may worsen the prognosis, mainly in less severe patients.
Cutaneous Granulomas Associated With Interferon Therapy
Authors: El-Khalawany Mohamed , Mohammad Inass , Aboeldahab Soha , Thabet Aida 
Published: February 2016

Abstract:
Treatment with interferon (IFN) could be associated with variable cutaneous adverse reactions. The aim of this study was to describe the clinicopathological spectrum of cutaneous granulomas associated with IFN therapy and identify the causal relation between IFN therapy and granulomatous reactions. The study included 18 patients (16 males and 2 females) with an average age of 48 years. Clinically, most of the lesions were solitary (83.3%) and located on the face (44.4%) and/or trunk (38.9%). The lesions were commonly presented as nodules (33.3%) or plaques (27.8%) with a common size of 5–10 cm. Granulomatous reactions were localized to the injection site in 4 cases, distributed on other body areas (remote granuloma) in 11 cases, and associated with lung involvement (systemic granuloma) in 3 cases. Histologically, injection site granuloma showed suppurative reaction in 75% and sarcoidal reaction in 25%. Remote granuloma showed tuberculoid reaction in 27.3%, interstitial in 27.3%, and sarcoidal in 45.4%. Systemic granuloma showed sarcoidal reaction in all cases. After withdrawal of IFN, only 3 lesions showed spontaneous complete clearance, whereas most of the lesions (83.3%) showed only partial improvement. Our results suggested that IFN is not a causal agent of all associated cutaneous granulomas but it mostly provokes the appearance of granulomatous reactions in susceptible individuals. Findings that prove this concept include the formation of granuloma in body sites away from the injection site, the heterogeneous pattern of granuloma both clinically and histologically, and incomplete clearance of most of the lesions after withdrawal of IFN.
EZOGABINE (POTIGA) MACULOPATHY
Authors: Zaugg Brian E. , Bell James E. , Taylor Kim Y. , Bernstein Paul S. 
Published: February 2016

Purpose:
To present a case of partially reversible retinal toxicity related to a newer epilepsy medication, ezogabine (Potiga).

Methods:
Case report with multimodal imaging.

Patient:
A patient presented 9 months after starting ezogabine for a screening eye examination with new retinal pigment abnormalities in the maculas of both eyes.

Results:
These macular abnormalities are characterized for the first time with multimodal imaging. They were partially reversible after cessation of the drug.

Conclusion:
Ezogabine toxicity presents as pigmentary changes in the macula on fundus examination and has newly described characteristics on imaging that can guide ophthalmologists when they perform the FDA-recommended 6-month screening visits for ocular toxicity.
OBSERVATION: FLUOCINOLONE ACETONIDE (ILUVIEN) IMPLANT MIGRATION INTO THE ANTERIOR CHAMBER
Authors: Papastavrou Vasileios T. , Zambarakji Hadi , Dooley Ian , Eleftheriadis Haralabos , Jackson Timothy L. 
Published: February 2016

Purpose:
To describe the anterior chamber migration of a fluocinolone acetonide (Iluvien) implant in the context of previous vitrectomy and complicated cataract surgery.

Methods:
Retrospective observational case series. Two patients with a history of vitrectomy and complicated phacoemulsification surgery, one of whom had pseudoexfoliation.

Results:
The implant migrated to the anterior chamber shortly after implantation. One patient had the implant removed after one recurrence; the other used pilocarpine 2% eye drops to reduce the risk of further migration.

Conclusion:
Complicated cataract surgery and vitrectomy can be associated with migration of fluocinolone acetonide implants into the anterior chamber.
Why Do People Work in Public Health? Exploring Recruitment and Retention Among Public Health Workers
Authors: Yeager Valerie A. , Wisniewski Janna M. , Amos Kathleen , Bialek Ron 
Published: February 2016

Context:
The public health workforce is critical to the functioning of the public health system and protection of the population's health. Ensuring a sufficient workforce depends on effectively recruiting and retaining workers.

Objective:
This study examines factors influencing decisions to take and remain in jobs within public health, particularly for workers employed in governmental public health.

Design:
This cross-sectional study employed a secondary data set from a 2010 national survey of US public health workers.

Participants:
Survey respondents were included in this study if they responded to at least 1 survey item related to recruitment and retention. A total of 10 859 survey responses fit this criterion.

Main Outcome Measures:
Data examined demographics of public health workers and factors that influenced decisions to take jobs in and remain in public health.

Results:

Job security (β = 0.42; 95% confidence interval [CI], 0.28-0.56) and competitive benefits (β = 0.49; 95% CI, 0.28-0.70) were significantly and positively associated with governmental employees' decisions to take positions with their current employers compared with public health workers employed by other types of organizations. The same finding held with regard to retention: job security (β = 0.40; 95% CI, 0.23-0.57) and competitive benefits (β = 0.53; 95% CI, 0.24-0.83). Two personal factors, personal commitment to public service (β = 0.30; 95% CI, 0.17-0.42) and wanted a job in the public health field (β = 0.44; 95% CI, 0.18-0.69), were significantly and positively related to governmental employees deciding to remain with their current employers.

Conclusions:
It is important to recognize the value of competitive benefits for both current and potential employees. Public health agencies should maintain these if possible and make the value of these benefits known to policy makers or other agencies setting these benefit policies. Job security associated with governmental public health jobs also appears to offer public health an advantage in recruiting and retaining employees.
Decision Processes and Determinants of Hospital Evacuation and Shelter-in-Place During Hurricane Sandy
Authors: McGinty Meghan D. , Burke Thomas A. , Resnick Beth , Barnett Daniel J. , Smith Katherine C. , Rutkow Lainie 
Published: February 2016

Context:
Evacuation and shelter-in-place decision making for hospitals is complex, and existing literature contains little information about how these decisions are made in practice.

Objective:
To describe decision-making processes and identify determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy.

Design:
Semistructured interviews were conducted from March 2014 to February 2015 with key informants who had authority and responsibility for evacuation and shelter-in-place decisions for hospitals during Hurricane Sandy in 2012. Interviews were recorded, transcribed, and thematically analyzed.

Setting and Participants:
Interviewees included hospital executives and state and local public health, emergency management, and emergency medical service officials from Delaware, Maryland, New Jersey, and New York.

Main Outcome Measure(s):
Interviewees identified decision processes and determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy.

Results:
We interviewed 42 individuals from 32 organizations. Decisions makers reported relying on their instincts rather than employing guides or tools to make evacuation and shelter-in-place decisions during Hurricane Sandy. Risk to patient health from evacuation, prior experience, cost, and ability to maintain continuity of operations were the most influential factors in decision making. Flooding and utility outages, which were predicted to or actually impacted continuity of operations, were the primary determinants of evacuation.

Conclusion:
Evacuation and shelter-in-place decision making for hospitals can be improved by ensuring hospital emergency plans address flooding and include explicit thresholds that, if exceeded, would trigger evacuation. Comparative risk assessments that inform decision making would be enhanced by improved collection, analysis, and communication of data on morbidity and mortality associated with evacuation versus sheltering-in-place of hospitals. In addition, administrators and public officials can improve their preparedness to make evacuation and shelter-in-place decisions by practicing the use of decision-making tools during training and exercises.
Sex Differences in Associations Between Subjective Social Status and C-Reactive Protein in Young Adults
Authors: Freeman Jason A. , Bauldry Shawn , Volpe Vanessa V. , Shanahan Michael J. , Shanahan Lilly 
Published: February 2016

ABSTRACT

Objective
In middle-aged and older samples, perceived subjective socioeconomic status (SSS) is a marker of social rank that is associated with elevated inflammation and cardiovascular disease risk independent of objective indicators of SES (oSES). Whether SSS is uniquely associated with elevated inflammation during young adulthood and whether these linkages differ by sex have not been studied using a nationally representative sample of young adults.

Methods
Data came from the National Longitudinal Study of Adolescent to Adult Health. At Wave IV, young adults aged mostly 24 to 32 years reported their SSS, oSES, and a range of covariates of both SES and elevated inflammation. Trained fieldworkers assessed medication use, body mass index, and waist circumference, and also collected bloodspots from which high-sensitivity C-reactive protein (hs-CRP) was assayed. The sample size for the present analyses was n = 13,236.

Results
Descriptive and bivariate analyses revealed a graded association between SSS and hs-CRP (b = −0.072, standard error [SE] = 0.011, p < .001): as SSS declined, mean levels of hs-CRP increased. When oSES indicators were taken into account, this association was no longer significant in women (b = −0.013, SE = 0.019, p = .514). In men, a small but significant SSS–hs-CRP association remained after adjusting for oSES indicators and additional potential confounders of this association in the final models (b = −0.034, SE = 0.011 p = .003; p < .001 for the sex by SSS interaction).

Conclusions
SSS is independently associated with elevated inflammation in young adults. The associations were stronger in men than in women. These data suggest that subjective, global assessments of social rank might play a role in developing adverse health outcomes.
Differential Autonomic Nervous System Reactivity in Depression and Anxiety During Stress Depending on Type of Stressor
Authors: Hu Mandy X. , Lamers Femke , de Geus Eco J.C. , Penninx Brenda W.J.H. 
Published: February 2016

ABSTRACT

Objectives
It remains unclear whether depressive and anxiety disorders are associated with hyporeactivity or hyperreactivity of the autonomic nervous system (ANS) and whether deviant reactivity occurs in all types of stressors. This study compared ANS reactivity in people with current or remitted depression/anxiety with reactivity in healthy controls during two stress conditions.

Methods
From the Netherlands Study of Depression and Anxiety, data of 804 individuals with current depression/anxiety, 913 individuals with remitted depression/anxiety, and 466 healthy controls (mean age = 44.1 years; 66.4% female) were available. Two conditions were used to evoke stress: a) an n-back task, a cognitively challenging stressor, and 2) a psychiatric interview, evoking personal-emotional stress related to the occurrence of symptoms of depression/anxiety. Indicators of ANS activity were heart rate (HR), root mean square of differences between successive interbeat intervals (RMSSD), respiratory sinus arrhythmia (RSA), and preejection period.

Results
As compared with controls, participants with psychopathology had significant hyporeactivity of HR (controls = 4.1 ± 4.2 beats/min; remitted = 3.5 ± 3.5 beats/min; current psychopathology = 3.1 ± 3.4 beats/min), RMSSD (controls = −6.2 ± 14.5 milliseconds; remitted = −5.4 ± 17.8 milliseconds; current psychopathology = −3.5 ± 15.4 milliseconds), and RSA (controls = −9.3 ± 17.0 milliseconds; remitted = −7.4 ± 16.5 milliseconds; current psychopathology = −6.9 ± 15.0 milliseconds) during the n-back task. In contrast, during the psychiatric interview, they showed significant hyperreactivity of HR (controls = 2.7 ± 3.4 beats/min; remitted = 3.5 ± 3.4 beats/min; current psychopathology = 4.0 ± 3.3 beats/min), RMSSD (controls = −3.4 ± 12.2 milliseconds; remitted = −4.1 ± 12.1 milliseconds; current psychopathology = −5.6 ± 11.8 milliseconds), and RSA (controls = −3.8 ± 8.1 milliseconds; remitted = −4.3 ± 7.9 milliseconds; current psychopathology = −5.0 ± 7.9 milliseconds). The lack of group differences in preejection period reactivity suggests that the found effects were driven by altered cardiac vagal reactivity in depression/anxiety.

Conclusions
The direction of altered ANS reactivity in depressed/anxious patients is dependent on the type of stressor, and only the more ecologically valid stressors may evoke hyperreactivity in these patients.
Untangling the Relationship Between Antiretroviral Therapy Use and Incident Pregnancy: A Marginal Structural Model Analysis Using Data From 47,313 HIV-Positive Women in East Africa
Authors: Elul Batya , Wools-Kaloustian Kara K. , Wu Yingfeng , Musick Beverly S. , Nuwagaba-Biribonwoha Harriet , Nash Denis , Ayaya Samuel , Bukusi Elizabeth , Okong Pius , Otieno Juliana , Wabwire Deo , Kambugu Andrew , Yiannoutsos Constantin T. 
Published: February 2016

Background:
Scale-up of triple-drug antiretroviral therapy (ART) in Africa has transformed the context of childbearing for HIV-positive women and may impact pregnancy incidence in HIV programs.

Methods:
Using observational data from 47,313 HIV-positive women enrolled at 26 HIV clinics in Kenya and Uganda between 2001 and 2009, we calculated the crude cumulative incidence of pregnancy for the pre-ART and on-ART periods. The causal effect of ART use on incident pregnancy was assessed using inverse probability weighted marginal structural models, and the relationship was further explored in multivariable Cox models.

Results:
Crude cumulative pregnancy incidence at 1 year after enrollment/ART initiation was 4.0% and 3.9% during the pre-ART and on-ART periods, respectively. In marginal structural models, ART use was not significantly associated with incident pregnancy [hazard ratio = 1.06; 95% confidence interval (CI): 0.99 to 1.12]. Similarly, in Cox models, there was no significant relationship between ART use and incident pregnancy (cause-specific hazard ratio: 0.98; 95% CI: 0.91 to 1.05), but effect modification was observed. Specifically, women who were pregnant at enrollment and on ART had an increased risk of incident pregnancy compared to those not pregnant at enrollment and not on ART (cause-specific hazard ratio: 1.11; 95% CI: 1.01 to 1.23).

Conclusions:
In this large cohort, ART initiation was not associated with incident pregnancy in the general population of women enrolling in HIV care but rather only among those pregnant at enrollment. This finding further highlights the importance of scaling up access to lifelong treatment for pregnant women.