bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Community Mentorship Program: Providing Community-Engagement Opportunities for Early-Stage Clinical and Translational Scientists to Facilitate Research Translation
Authors: Patino Cecilia M. , Kubicek Katrina , Robles Marisela , Kiger Holly , Dzekov Jeanne 
Published: August 2016

Problem
A goal of the Southern California Clinical and Translational Science Institute (SC-CTSI) at the University of Southern California and Children’s Hospital Los Angeles is to train early-stage clinical and translational scientists (CTSs) to conduct research that improves the health of diverse communities. This goal aligns well with the Institute of Medicine’s recommendations emphasizing community engagement in biomedical research that facilitates research translation. The Community Mentorship Program (CMP), created to complement community-engaged research didactics, matches CTSs with community mentors who help them identify and complete community-engaged experiences that inform their research.

Approach
The CMP was piloted in 2013–2015 by the SC-CTSI Workforce Development and Community Engagement cores. The CMP team matched three CTSs (assistant professors pursuing mentored career development awards) with mentors at community-based organizations (CBOs) aligned with their research interests. Each mentor–mentee pair signed a memorandum of understanding. The CMP team checked in regularly, monitoring progress and addressing challenges in CTSs’ completion of their community-engaged experience.

Outcomes
Each pair completed at least one community-engaged activity informing the CTS’s research. In exit interviews, the CTSs and CBO mentors expressed satisfaction with the program and stated that they would continue to work together. The CTSs reported that the program provided opportunities to develop networks outside academia, build trust within the community, and receive feedback and learn from individuals in communities affected by their research.

Next Steps
The CMP will be expanded to include all eligible early-career CTSs and promoted for use in similar settings outside the SC-CTSI.
Immediate Versus Delayed Computerized Brief Intervention for Illicit Drug Misuse
Authors: Gryczynski Jan , O’Grady Kevin E. , Mitchell Shannon Gwin , Ondersma Steven J. , Schwartz Robert P. 
Published: August 2016

Objective:
Computerized brief interventions are a promising approach for integrating substance use interventions into primary care settings. We sought to examine the effectiveness of a computerized brief intervention for illicit drug misuse, which prior research showed performed no worse than a traditional in-person brief intervention.

Methods:
Community health center patients were screened for eligibility using the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Participants were adult patients (aged 18–62 years; 53% female) with moderate-risk illicit drug use (N = 80), randomized to receive the computerized brief intervention either immediately or at their 3-month follow-up. Assessments were conducted at baseline, 3, and 6-month follow-up, and included the ASSIST and drug hair testing.

Results:
Most participants in the sample (90%) reported moderate-risk marijuana use. Although the sample as a whole reported significant decreases in ASSIST Global Drug Risk scores and ASSIST marijuana-specific scores, no significant differences were detected between “immediate” and “delayed” conditions on either of these measures. Likewise, no significant differences were detected between conditions in drug-positive hair test results at either follow-up.

Conclusions:
This study did not find differences between immediate versus delayed computerized brief intervention in reducing drug use or associated risks, suggesting potential regression to the mean or reactivity to the consent, screening, or assessment process. The findings are discussed in light of the study's limitations and directions for future research.
Contribution of the Suppressor of Variegation 3-9 Homolog 1 in Dorsal Root Ganglia and Spinal Cord Dorsal Horn to Nerve Injury–induced Nociceptive Hypersensitivity
Authors: Zhang Jun , Liang Lingli , Miao Xuerong , Wu Shaogen , Cao Jing , Tao Bo , Mao Qingxiang , Mo Kai , Xiong Ming , Lutz Brianna Marie , Bekker Alex , Tao Yuan-Xiang 
Published: August 2016

Abstract

Background
Peripheral nerve injury–induced gene alterations in the dorsal root ganglion (DRG) and spinal cord likely participate in neuropathic pain genesis. Histone methylation gates gene expression. Whether the suppressor of variegation 3-9 homolog 1 (SUV39H1), a histone methyltransferase, contributes to nerve injury–induced nociceptive hypersensitivity is unknown.

Methods
Quantitative real-time reverse transcription polymerase chain reaction analysis, Western blot analysis, or immunohistochemistry were carried out to examine the expression of SUV39H1 mRNA and protein in rat DRG and dorsal horn and its colocalization with DRG μ-opioid receptor (MOR). The effects of a SUV39H1 inhibitor (chaetocin) or SUV39H1 siRNA on fifth lumbar spinal nerve ligation (SNL)–induced DRG MOR down-regulation and nociceptive hypersensitivity were examined.

Results
SUV39H1 was detected in neuronal nuclei of the DRG and dorsal horn. It was distributed predominantly in small DRG neurons, in which it coexpressed with MOR. The level of SUV39H1 protein in both injured DRG and ipsilateral fifth lumbar dorsal horn was time dependently increased after SNL. SNL also produced an increase in the amount of SUV39H1 mRNA in the injured DRG (n = 6/time point). Intrathecal chaetocin or SUV39H1 siRNA as well as DRG or intraspinal microinjection of SUV39H1 siRNA impaired SNL-induced allodynia and hyperalgesia (n = 5/group/treatment). DRG microinjection of SUV39H1 siRNA also restored SNL-induced DRG MOR down-regulation (n = 6/group).

Conclusions
The findings of this study suggest that SUV39H1 contributes to nerve injury–induced allodynia and hyperalgesia through gating MOR expression in the injured DRG. SUV39H1 may be a potential target for the therapeutic treatment of nerve injury–induced nociceptive hypersensitivity.
Prevalence and Imaging Characteristics of Nonmyelopathic and Myelopathic Spondylotic Cervical Cord Compression
Authors: Kovalova Ivana , Kerkovsky Milos , Kadanka Zdenek , Kadanka Zdenek , Nemec Martin , Jurova Barbora , Dusek Ladislav , Jarkovsky Jiri , Bednarik Josef 
Published: August 2016

Study Design.
Cross-sectional population-based observational study.

Objective.
To estimate the prevalence of nonmyelopathic spondylotic cervical cord compression (NMSCCC) and cervical spondylotic myelopathy (CSM) in a population older than 40 years and to evaluate the magnetic resonance imaging (MRI) characteristics of these conditions.

Summary of Background Data.
The prevalence of neither NMSCCC nor CSM is known and there exists no commonly accepted quantitative MRI definition of cervical cord compression.

Methods.
A group of 183 randomly recruited volunteers, 93 women, median age 66 years, range 40–80 years, underwent MRI examination of the cervical spine and spinal cord on a 1.5 T device using conventional sequences from disc levels C2/C3 to C6/C7. The imaging criterion for cervical cord compression was defined as a change in spinal cord contour at the level of an intervertebral disc on axial or sagittal MRI scan.

Results.
MRI signs of cervical cord compression were found in 108 individuals (59.0%; 95% CI: 51.5%–66.2%); their numbers increased with age from 31.6% in the fifth decade to 66.8% in the eighth. Clinical signs of symptomatic CSM were found in two cases (1.1%), and 75 cases (41.0%) were without compression. An anteroposterior cervical canal diameter at the level of intervertebral disc (CDdisc) of less than 9.9 mm was associated with the highest probability of NMSCCC—odds ratio (OR) = 32.5, followed by a compression ratio of ≤0.5: OR = 11.1.

Conclusion.
The prevalence of NMSCCC in a population older than 40 years is higher than previously reported and increases with age. CDdisc and compression ratio had the highest capacity to discriminate between subjects with and without asymptomatic compression, and their cut-off values could be used to objectify criteria for cervical cord compression.

Level of Evidence: 2
The Impact of Interventions to Improve Sleep on Delirium in the ICU: A Systematic Review and Research Framework*
Authors: Flannery Alexander H. , Oyler Douglas R. , Weinhouse Gerald L. 
Published: August 2016

Objective :
This study aimed to assess whether interventions targeted at improving sleep in the ICU were associated with reductions in ICU delirium. Secondary outcomes include duration of delirium and ICU length of stay.

Data Sources:
MEDLINE, CINAHL, Web of Science, Scopus, WorldCat, and International Pharmaceutical Abstracts were searched from inception to January 2016.

Study Selection:
Studies investigating any type of sleep intervention (nonpharmacologic or pharmacologic) and assessing the impact on ICU delirium were included. Any type of study design was permitted so long as the delirium assessment was made at least daily with a validated delirium assessment tool.

Data Extraction:
The following data were extracted: first author, year of publication, study design, ICU type, components of sleep intervention, use of sleep assessment tool, patient age, sex, severity of illness, sleep measures, delirium assessment tool, incidence of delirium, duration of delirium, and ICU length of stay. The incidence of delirium was used to compare rates of ICU delirium across studies. Methodologic quality of included studies was evaluated using the Effective Public Health Practice Project quality assessment tool.

Data Synthesis:
Of 488 citations screened, 10 studies were identified for inclusion in the final review; six of which demonstrated a statistically significant reduction in the incidence of ICU delirium associated with sleep intervention. Four studies assessed duration of delirium; of which, three reported a shorter duration of delirium with sleep intervention. Two studies associated sleep intervention with a reduced ICU length of stay. In regard to quality assessment and risk of bias, only one study was assessed as strong. Multiple identified confounders and the significant qualitative assessment of heterogeneity limit both the conclusions that can be drawn from these findings and the quantitative pooling of data.

Conclusions:
Although sleep interventions seem to be a promising approach for improving delirium-related outcomes, studies are limited by bias issues, varying methodologies, and multiple confounders, making the evidence base for this conclusion limited at best. Future studies would benefit from a systematic approach to studying the link between sleep intervention and delirium-related outcomes, which is outlined in the context of reviewing the existing literature.
Prognostic Impact of Persistent Thrombocytopenia During Extracorporeal Membrane Oxygenation: A Retrospective Analysis of Prospectively Collected Data From a Cohort of Patients With Left Ventricular Dysfunction After Cardiac Surgery
Authors: Opfermann Philipp , Bevilacqua Michele , Felli Alessia , Mouhieddine Mohamed , Bachleda Teodor , Pichler Tristan , Hiesmayr Michael , Zuckermann Andreas , Dworschak Martin , Steinlechner Barbara 
Published: August 2016

Objective:
The prognostic impact of thrombocytopenia in patients supported by extracorporeal membrane oxygenation after cardiac surgery is uncertain. We investigated whether thrombocytopenia is independently predictive of poor outcome and describe the incidence and time course of thrombocytopenia in extracorporeal membrane oxygenation patients.

Design:
Retrospective analysis of prospectively collected data.

Setting:
Cardiosurgical ICU at a tertiary referral center.

Patients:
Three hundred adult patients supported with venoarterial extracorporeal membrane oxygenation for more than 24 hours because of refractory cardiogenic shock after heart surgery between January 2001 and December 2014.

Interventions:
None.

Measurements and Main Results:
Two-way analysis of variance was used to compare the time course of platelet count changes between survivors and nonsurvivors. Using multiple Cox regression with time-dependent covariates, we investigated the impact of platelet count on 90-day mortality. In nonsurvivors, the daily incidence of moderate (< 100 – 50 × 109/L), severe (49 – 20 × 109/L), and very severe (< 20 × 109/L) thrombocytopenia was 50%, 54%, and 7%, respectively. Platelet count had a biphasic temporal pattern with an initial decrease until day 4–5 after the initiation of extracorporeal membrane oxygenation. Although a significant recovery of the platelet count was observed in survivors, a recovery did not occur in nonsurvivors (p = 0.0001). After adjusting for suspected confounders, moderate, severe, and very severe thrombocytopenia were independently associated with 90-day mortality. The highest risk was associated with severe (hazard ratio, 5.9 [2.7–12.6]; p < 0.0001) and very severe thrombocytopenia (hazard ratio, 25.9 [10.7–62.9], p < 0.0001).

Conclusion:
Thrombocytopenia is an independent risk factor for poor outcome in extracorporeal membrane oxygenation patients after cardiac surgery, with persistent severe thrombocytopenia likely reflecting a high degree of physiologic imbalance.
Hospital Volume and Outcomes of Noninvasive Ventilation in Patients Hospitalized With an Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Authors: Stefan Mihaela S. , Pekow Penelope S. , Shieh Meng-Shiou , Hill Nicholas S. , Rothberg Michael B. , Fisher Kimberly A. , Lindenauer Peter K. 
Published: August 2016

Objective:
To determine the relationship between hospital noninvasive ventilation caseload and outcomes among patients with an acute chronic obstructive pulmonary disease exacerbation.

Design:
Cross-sectional study of 13,893 patients with chronic obstructive pulmonary disease treated with noninvasive ventilation.

Setting:
A total of 243 U.S. hospitals participating in the Premier Inpatient Database.

Patients:
A total of 13,893 patients admitted between July 2009 and June 2011.

Interventions:
None.

Measurements and Main Results:
Annual hospital volume of noninvasive ventilation was analyzed as a continuous variable, as well as after grouping it in four categories. The median hospital annual volume of noninvasive ventilation use was 627 and varied from 234 admissions in quartile 1 to 1,529 admissions in quartile 4. Noninvasive ventilation failure occurred in 15.2%, and in-hospital mortality was 6.5%. After adjusting for patient characteristics, relative to low-volume hospitals, high-volume hospitals did not have lower noninvasive ventilation failure (odds ratio quartile 4 vs quartile 1, 1.05; 95% CI, 0.65–1.68) or in-hospital mortality (odds ratio quartile 4 vs quartile 1, 0.88; 95% CI, 0.69–1.12). In a hierarchical multivariable analysis with adjustment for patient characteristics where volume was assessed as a continuous variable, hospital volume was not related to outcomes, including noninvasive ventilation failure (p = 0.87), in-hospital mortality (p = 0.88), 30-day readmission for chronic obstructive pulmonary disease (p = 0.83), or hospital length of stay (p = 0.12).

Conclusions:
The results of this large retrospective cohort study suggest that hospitals with higher noninvasive ventilation volume do not achieve better outcomes of patients with chronic obstructive pulmonary disease exacerbation treated with noninvasive ventilation; even hospitals with low noninvasive ventilation volume are able to successfully implement this intervention.
Wound Complications and Perineal Pain After Extralevator Versus Standard Abdominoperineal Excision
Authors: Colov Emilie P. , Klein Mads , Gögenur Ismail 
Published: August 2016

BACKGROUND:
Extralevator abdominoperineal excision was introduced as an alternative to conventional abdominoperineal excision for low rectal cancers. The perineal dissection is more extensive with extralevator abdominoperineal excision and leaves a greater defect.

OBJECTIVE:
The aim of this study was to evaluate, on a national basis, the risk of perineal wound complications, pain, and hernia after conventional and extralevator abdominoperineal excision performed for low rectal cancer.

DESIGN:
This was a retrospective study collecting data from the Danish Colorectal Cancer Group database and from electronic medical files of patients.

SETTINGS:
The study was conducted at Danish surgical departments.

PATIENTS:
A total of 445 patients operated between 2009 and 2012 with extralevator or conventional abdominoperineal excision were included.

MAIN OUTCOME MEASURES:
The main end points of this study were perineal wound complications and pain lasting for >30 days after the operation.

RESULTS:
The 2 groups were demographically similar except for a higher ASA score in the conventional group. In the extralevator group, neoadjuvant chemoradiation was more frequent (71% vs 41%; p < 0.001), T stage was higher (more T3 tumors; 52% vs 38%; p = 0.006), and more tumors were fixed (21% vs 12%; p = 0.02). Perineal wound complications and pain were more frequent after extralevator versus conventional excision (44% vs 25%; p < 0.001 and 38% vs 22%; p < 0.001). After multivariate analyses, neoadjuvant chemoradiation, extralevator excision, and operation early in the study period were found to have a significant influence on the risk of long-term wound complications. Neoadjuvant chemoradiation and wound complications were significant risk factors for long-term perineal pain. Results were similar after subgroup analyses on low tumors only.

LIMITATIONS:
This was a retrospective study. The 2 groups were not completely comparable at baseline.

CONCLUSIONS:
Neoadjuvant chemoradiation, extralevator compared with conventional excision, and operation early in the study period were significant factors for predicting perineal wound complications. Neoadjuvant chemoradiation and wound complications were predictors of long-term perineal pain.
How to Size the Anal Canal Circumference When Implanting a Magnetic Anal Sphincter for Fecal Incontinence. Evolution and Update of a New Surgical Technique
Authors: Kim Mia , Lehur Paul-Antoine 
Published: August 2016

INTRODUCTION:
Magnetic anal sphincter augmentation improves function and quality of life of patients with severe fecal incontinence substantially. Measuring the anal circumference exactly with a sizing tool represents a crucial step of the procedure because it determines the correct size and success of the definite implant.

OBJECTIVE:
This study aims to illustrate the consequent development of 3 different sizing models and the use of the recent sizing tool.

TECHNIQUE:
After dissection of a tunnel around the anal canal through a ventral perineal incision, the sizing tool is inserted by using a specially designed introducer to measure the circumference for the appropriate size of implant. First- and second-generation sizing tools could only approximate the final implant size and impeded standardization. The latest sizing model resembles the actual implant with magnetic beads, it is nonstretchable, and it is closable end-to-end.

RESULTS:
The development of 3 measuring tools has progressively improved the accuracy of estimating the correct size of the definitive implant, and the application of the latest sizer seems easy, comfortable in use, and accurate as experienced in our first cases.

CONCLUSION:
The latest device contributes to standardization of the procedure and therefore facilitates the learning curve for newcomers of the method and could avoid the need for radiological on-table control in the near future.
Semiquantitative Volumetry by Sequential PET/CT May Improve Prediction of Complete Response to Neoadjuvant Chemoradiation in Patients With Distal Rectal Cancer
Authors: dos Anjos Dalton A. , Perez Rodrigo O. , Habr-Gama Angelita , São Julião Guilherme P. , Vailati Bruna B. , Fernandez Laura M. , de Sousa João B. , Buchpiguel Carlos A. 
Published: August 2016

BACKGROUND:
Previous studies using PET/CT imaging have failed to accurately identify complete responders to neoadjuvant chemoradiation among patients with rectal cancer. The use of metabolic parameters alone or imprecise delineation of baseline and residual tumor volumes may have contributed for these disappointing findings.

OBJECTIVE:
The purpose of this study was to determine the accuracy of complete response identification in rectal cancer after neoadjuvant chemoradiation by sequential PET/CT imaging with a decrease in tumor metabolism and volume using optimal tumor volume delineation.

DESIGN:
This was a retrospective comparison of prospectively collected data from a clinical trial (National Clinical Trial 00254683).

SETTINGS:
The study was conducted at a single research center.

PATIENTS:
Ninety patients with cT2-4N0-2M0 distal rectal cancer underwent sequential PET/CT at baseline and 12 weeks after neoadjuvant chemoradiation. Quantitative metabolic analysis (median and maximal standard uptake values), volumetric estimates (metabolic tumor volume), and composite estimates incorporating volume and quantitative data (total lesion glycolysis) were compared for the assessment of response to neoadjuvant chemoradiation using receiver operating characteristic curves. Individual standard uptake value thresholds were used according to response to neoadjuvant chemoradiation to match metabolic activity and optimize volume delineation.

MAIN OUTCOME MEASURES:
The accuracy of complete response identification by multiple volumetric and metabolic parameters using sequential PET/CT imaging was measured.

RESULTS:
Variation in total lesion glycolysis between baseline and 12-week PET/CT scans was associated with the best area under the curve (area under the curve = 0.81 (95% CI, 0.69–0.92)) when compared with standard uptake value or metabolic tumor volume for the identification of a complete responder. Patients with a ≥92% decrease in total lesion glycolysis between baseline and 12-week PET/CT scan had a 90% chance to harbor complete response.

LIMITATIONS:
This study was limited by its lack of interobserver agreement analysis.

CONCLUSIONS:
PET/CT scan using volume and metabolic estimates with individual standard uptake value thresholds for volume determination may provide a useful tool to predict response to neoadjuvant chemoradiation in distal rectal cancer.