bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fever and Hip Pain
Authors: Waseem Muhammad , Kumari Divya , Toledano Talya 
Published: March 2017

Abstract
Hip pain in febrile children always raises concern for septic arthritis. Pyomyositis is a rare cause of hip pain. Because it involves muscles around the joint, it may have a similar presentation as a septic hip. This entity therefore has the potential for posing a diagnostic dilemma when physicians face a limping child with fever. We report a child who presented with fever and hip pain and has pyomyositis of the obturator internus muscle. This case underscores the need to consider the possibility of alternative etiologies in a limping child.
Translating Comparative Effectiveness Research Into Practice: Effects of Interventions on Lifestyle, Medication Adherence, and Self-care for Type 2 Diabetes, Hypertension, and Obesity Among Black, Hispanic, and Asian Residents of Chicago and Houston, 2010 to 2013
Authors: Rashid Jamila R. , Leath Brenda A. , Truman Benedict I. , Atkinson Donna Durant , Gary Lisa C. , Manian Nanmathi 
Published: March 2017

Context:
In the United States, racial/ethnic minorities account for disproportionate disease and death from type 2 diabetes, hypertension, and obesity; however, interventions with measured efficacy in comparative effectiveness research are often not adopted or used widely in those communities.

Objective:
To assess implementation and effects of comparative effectiveness research–proven interventions translated for minority communities.

Design:
Mixed-method assessment with pretest–posttest single-group evaluation design.

Setting:
US Department of Health and Human Services, Office of Minority Health, research contractor, and advisory board; health centers, including a federally qualified community health center in Chicago, Illinois; and public housing facilities for seniors in Houston, Texas.

Participants:
A total of 97 black, Hispanic, and Asian participants with any combination of health care provider–diagnosed type 2 diabetes, hypertension, or obesity.

Interventions:
Virtual training institutes where intervention staff learned cultural competency methods of adapting effective interventions. Health educators delivered the Health Empowerment Lifestyle Program (HELP) in Chicago; community pharmacists delivered the MyRx Medication Adherence Program in Houston.

Main Outcome Measures:
Participation rates, satisfaction with interventions during January to April 2013, and pre- to postintervention changes in knowledge, diet, and clinical outcomes were analyzed through July 2013.

Results:
In Chicago, 38 patients experienced statistically significant reductions in hemoglobin A1c and systolic blood pressure, increased knowledge of hypertension management, and improved dietary behaviors. In Houston, 38 subsidized housing residents had statistically nonsignificant improvements in knowledge of self-management and adherence to medication for diabetes and hypertension but high levels of participation in pharmacist home visits and group education classes.

Conclusion:
Adaptation, adoption, and implementation of HELP and MyRx demonstrated important postintervention changes among racial/ethnic participants in Chicago and Houston. The communities faced similar implementation challenges across settings, targets of change, and cities. Available resources were insufficient to sustain benefits with measurable impact on racial/ethnic disparities beyond the study period. Results suggest the need for implementation studies of longer duration, greater power, and salience to policies and programs that can sustain longterm interventions on a community-wide scale.
Early Evaluation Findings From a Federally Funded Training Program: The Public Health Associate Program
Authors: Sobelson Robyn K. , Young Andrea C. , Wigington Corinne J. , Duncan Heather 
Published: March 2017

Objective:
The Centers for Disease Control and Prevention (CDC) created the Public Health Associate Program (PHAP) to establish a continuous source of public health professionals who can deliver frontline services at the federal, state, tribal, local, and territorial levels. The article describes preliminary evaluation findings for PHAP.

Design:
The evaluation's primary purposes are to assess the quality and effectiveness of PHAP, determine its value and impact, and provide information to continuously improve the program. Because the evaluation is both formative and summative and focuses on aggregate outputs and outcomes of PHAP, the methodology is complex and builds over time as different cohorts cycle into and out of the program. Results presented are outcomes of various Web-based surveys and reporting systems.

Participants:
Four PHAP cohorts, consisting of 579 individuals, participated in 1 or more of the evaluation activities described in this article.

Results:
The majority of participants report satisfaction with their PHAP experiences, and 74% of recent graduates indicate they are continuing their careers or education in public health immediately after program completion. Seventy-eight percent of recent PHAP graduates who accept a job in public health are employed by the federal government. One year post-PHAP, 74% of alumni report that PHAP has been influential in their careers.

Conclusion:
CDC's investment in PHAP has increased the capacity and capabilities of the public health workforce. Results presented are early indicators of program quality, effectiveness, and impact. Today's public health workers are asked to do more with less, in the face of a dynamic array of complex public health challenges. PHAP offers public health agencies assistance in tackling these losses and challenges.
Early Childhood Education to Promote Health Equity: A Community Guide Economic Review
Authors: Ramon Ismaila , Chattopadhyay Sajal K. , Barnett W. Steven , Hahn Robert A. 
Published: March 2017

Context:
A recent Community Guide systematic review found that early childhood education (ECE) programs improve educational, social, and health-related outcomes and advance health equity because many are designed to increase enrollment for high-risk children. This follow-up economic review examines how the economic benefits of center-based ECE programs compare with their costs.

Evidence Acquisition:
Kay and Pennucci from the Washington State Institute for Public Policy, whose meta-analysis formed the basis of the Community Guide effectiveness review, conducted a benefit-cost analysis of ECE programs for low-income children in Washington State. We performed an electronic database search using both effectiveness and economic key words to identify additional cost-benefit studies published through May 2015. Kay and Pennucci also provided us with national-level benefit-cost estimates for state and district and federal Head Start programs.

Evidence Synthesis:
The median benefit-to-cost ratio from 11 estimates of earnings gains, the major benefit driver for 3 types of ECE programs (ie, state and district, federal Head Start, and model programs), was 3.39:1 (interquartile interval [IQI] = 2.48-4.39). The overall median benefit-to-cost ratio from 7 estimates of total benefits, based on all benefit components including earnings gains, was 4.19:1 (IQI = 2.62-8.60), indicating that for every dollar invested in the program, there was a return of $4.19 in total benefits.

Conclusions:
ECE programs promote both equity and economic efficiency. Evidence indicates there is positive social return on investment in ECE irrespective of the type of ECE program. The adoption of a societal perspective is crucial to understand all costs and benefits of ECE programs regardless of who pays for the costs or receives the benefits.
SyMRI of the Brain
Authors: Hagiwara Akifumi , Warntjes Marcel , Hori Masaaki , Andica Christina , Nakazawa Misaki , Kumamaru Kanako Kunishima , Abe Osamu , Aoki Shigeki 
Published: March 2017

Abstract
Conventional magnetic resonance images are usually evaluated using the image signal contrast between tissues and not based on their absolute signal intensities. Quantification of tissue parameters, such as relaxation rates and proton density, would provide an absolute scale; however, these methods have mainly been performed in a research setting. The development of rapid quantification, with scan times in the order of 6 minutes for full head coverage, has provided the prerequisites for clinical use. The aim of this review article was to introduce a specific quantification method and synthesis of contrast-weighted images based on the acquired absolute values, and to present automatic segmentation of brain tissues and measurement of myelin based on the quantitative values, along with application of these techniques to various brain diseases. The entire technique is referred to as “SyMRI” in this review. SyMRI has shown promising results in previous studies when used for multiple sclerosis, brain metastases, Sturge-Weber syndrome, idiopathic normal pressure hydrocephalus, meningitis, and postmortem imaging.
Prenatal Diagnosis of Vesicorectal Fistula
Authors: Correia Patricia , Moreira Marta , Rodrigues Maria , Inocêncio Gonçalo 
Published: March 2017

AbstractAnorectal malformations are a rare condition difficult to diagnose in the prenatal period. It can be suspected if distal bowel appears dilated in the first-trimester ultrasound or if intraluminal echogenic foci are detected during the second-trimester scan. We report a case with these ultrasound signs (dilated sigmoid at the first trimester and intraluminal echogenic calcifications at the second trimester), in which a vesicorectal fistula image was obtained. This is the first published prenatal image of a vesicorectal fistula.
Impact of Surgical Resection of the Primary Tumor on Overall Survival in Patients With Metastatic Pheochromocytoma or Sympathetic Paraganglioma
Authors: Roman-Gonzalez Alejandro , Zhou Shouhao , Ayala-Ramirez Montserrat , Shen Chan , Waguespack Steven G. , Habra Mouhammed A. , Karam Jose A. , Perrier Nancy , Wood Christopher G. , Jimenez Camilo 
Published: March 2017

Objective:
To determine whether primary tumor resection in patients with metastatic pheochromocytoma or paraganglioma (PPG) is associated with longer overall survival (OS).

Background:
Patients with metastatic PPG have poor survival outcomes. The impact of surgical resection of the primary tumor on OS is not known.

Methods:
We retrospectively studied patients with metastatic PPG treated at the University of Texas, MD Anderson Cancer Center from January 2000 through January 2015. Kaplan-Meier analysis with log-rank tests was used to compare OS among patients undergoing primary tumor resection and patients not treated surgically. Propensity score method was applied to adjust for selection bias using demographic, clinical, biochemical, genetic, imaging, and pathologic information.

Results:
A total of 113 patients with metastatic PPG were identified. Eighty-nine (79%) patients had surgery and 24 (21%) patients did not. Median OS was longer in patients who had surgery than in patients who did not [148 months, 95% confidence interval (CI) 112.8–183.2 months vs 36 months, 95% CI 27.2–44.8 months; P < 0.001].
Fifty-three (46%) patients had synchronous metastases; of these patients, those who had surgery had longer OS than those who did not (85 months, 95% CI 64.5–105.4 months vs 36 months, 95% CI 29.7–42.3 months; P < 0.001). Patients who had surgery had a similar ECOG performance status to the ones who did not (P = 0.1798, two sample t test; P = 0.2449, Wilcoxon rank sum test). Univariate and propensity score analysis confirmed that patients treated with surgery had longer OS than those not treated surgically irrespective of age, race, primary tumor size and location, number of metastatic sites, and genetic background (log-rank P < 0.001).
In patients with hormonally active tumors (70.8%), the symptoms of catecholamine excess improved after surgery. However, the tumor burden was a more important determinant of OS than hormonal secretion.

Conclusions:
Primary tumor resection in patients with metastatic PPG appeared to be associated with improved OS. In patients with hormonally active tumors, surgical resection led to better blood pressure control.
A team of heterochromatin factors collaborates with small RNA pathways to combat repetitive elements and germline stress
Authors: McMurchy Alicia N. , Stempor Przemyslaw , Gaarenstroom Tessa , Wysolmerski Brian , Dong Yan , Aussianikava Darya , Appert Alex , Huang Ni , Kolasinska-Zwierz Paulina , Sapetschnig Alexandra , Miska Eric , Ahringer Julie 
Published: March 2017

AbstractRepetitive sequences derived from transposons make up a large fraction of eukaryotic genomes and must be silenced to protect genome integrity. Repetitive elements are often found in heterochromatin; however, the roles and interactions of heterochromatin proteins in repeat regulation are poorly understood. Here we show that a diverse set ofC. elegansheterochromatin proteins act together with the piRNA and nuclear RNAi pathways to silence repetitive elements and prevent genotoxic stress in the germ line. Mutants in genes encoding HPL-2/HP1, LIN-13, LIN-61, LET-418/Mi-2, and H3K9me2 histone methyltransferase MET-2/SETDB1 also show functionally redundant sterility, increased germline apoptosis, DNA repair defects, and interactions with small RNA pathways. Remarkably, fertility of heterochromatin mutants could be partially restored by inhibitingcep-1/p53, endogenous meiotic double strand breaks, or the expression of MIRAGE1 DNA transposons. Functional redundancy among these factors and pathways underlies the importance of safeguarding the genome through multiple means.
Self-reported reasons for voluntary abstinences by adolescent cannabis users
Authors: Marandure Blessing Ngonidzashe , Graham Hermine L. 
Published: March 2017

Purpose
Factors influencing cannabis use have been previously identified mainly using multivariate approaches. However, there is a dearth of information collected from the perspective of the adolescent cannabis user, in particular for voluntary abstinences. The paper aims to discuss these issues.

Design/methodology/approach
In total, 38 cannabis users were identified from a sample of 261 adolescents recruited from schools. They completed open-ended questions identifying reasons for voluntary abstinences. Thematic analysis was used to assess their responses.

Findings
Voluntary abstinences by cannabis users were influenced by both internal and external factors. These were the user’s state of mind, an attempt to quit, negative effects of cannabis, prior to important events, prior to family interactions and peers.

Research limitations/implications
The results show that adolescent cannabis users are flexible in their approach to using cannabis, being able to briefly stop when the situation warrants it. However, the study is limited by a lack of in depth and rich data, limiting the scope of the analysis.

Originality/value
This is the first study to identify reasons for voluntary abstinences from the user’s perspective in adolescent cannabis users.
How can schools help to reduce the harm associated with teenage substance use? Development of a theoretically driven whole-school approach
Authors: Markham Wolfgang A. , Bonell Chris , Fletcher Adam , Aveyard Paul 
Published: March 2017

Purpose
Substance use prevalence varies considerably between schools, but to date, whole school approaches for reducing substance use have only been moderately effective. The purpose of this paper is to develop a novel multifaceted whole-school approach to reduce substance use primarily among teenagers aged 11-14 years.

Design/methodology/approach
The outlined approach is premised on the proposal that schools can reduce the harms associated with substance use by promoting school connectedness and improving the school-related experiences of weakly connected and disconnected students. The aim of this approach is to develop students’ autonomy so that they may act in their real and long-term interests. This may be attained by promoting the realisation of essential human capacities for: practical reasoning – through valued opportunities for cognitive development and affiliation – through valued opportunities for affective development that advance students sense of acceptance within school. Schools may achieve this, it is proposed, by providing outlined forms of appropriate formal support and formal control that are augmented by particular features of school organisation, curriculum and pedagogic practice, which are also described.

Findings
A theoretically driven understanding of a whole school approach for reducing teenage substance use is outlined.

Originality/value
The outlined approach may usefully inform the development of future whole school interventions aiming to reduce problematic substance use among school students. Additional potential benefits include more successful student life trajectories.
A method for evaluating treatment quality using in vivo EPID dosimetry and statistical process control in radiation therapy
Authors: Fuangrod Todsaporn , Greer Peter B. , Simpson John , Zwan Benjamin J. , Middleton Richard H. 
Published: March 2017

Purpose
Due to increasing complexity, modern radiotherapy techniques require comprehensive quality assurance (QA) programmes, that to date generally focus on the pre-treatment stage. The purpose of this paper is to provide a method for an individual patient treatment QA evaluation and identification of a “quality gap” for continuous quality improvement.

Design/methodology/approach
A statistical process control (SPC) was applied to evaluate treatment delivery using in vivo electronic portal imaging device (EPID) dosimetry. A moving range control chart was constructed to monitor the individual patient treatment performance based on a control limit generated from initial data of 90 intensity-modulated radiotherapy (IMRT) and ten volumetric-modulated arc therapy (VMAT) patient deliveries. A process capability index was used to evaluate the continuing treatment quality based on three quality classes: treatment type-specific, treatment linac-specific, and body site-specific.

Findings
The determined control limits were 62.5 and 70.0 per cent of the χ pass-rate for IMRT and VMAT deliveries, respectively. In total, 14 patients were selected for a pilot study the results of which showed that about 1 per cent of all treatments contained errors relating to unexpected anatomical changes between treatment fractions. Both rectum and pelvis cancer treatments demonstrated process capability indices were less than 1, indicating the potential for quality improvement and hence may benefit from further assessment.

Research limitations/implications
The study relied on the application of in vivo EPID dosimetry for patients treated at the specific centre. Sampling patients for generating the control limits were limited to 100 patients. Whilst the quantitative results are specific to the clinical techniques and equipment used, the described method is generally applicable to IMRT and VMAT treatment QA. Whilst more work is required to determine the level of clinical significance, the authors have demonstrated the capability of the method for both treatment specific QA and continuing quality improvement.

Practical implications
The proposed method is a valuable tool for assessing the accuracy of treatment delivery whilst also improving treatment quality and patient safety.

Originality/value
Assessing in vivo EPID dosimetry with SPC can be used to improve the quality of radiation treatment for cancer patients.
Markov chain decision model for urinary incontinence procedures
Authors: Kumar Sameer , Ghildayal Nidhi , Ghildayal Neha 
Published: March 2017

Purpose
Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective.

Design/methodology/approach
This research employs randomized, prospective studies to obtain robust cost and utility data used in the Markov chain decision model for examining which of these surgical interventions is more effective in treating women with stress UI based on two measures: number of quality adjusted life years (QALY) and cost per QALY. Treeage Pro Healthcare software was employed in Markov decision analysis.

Findings
Results showed the Sling procedure is a more effective surgical intervention than the Burch. However, if a utility greater than certain utility value, for which both procedures are equally effective, is assigned to persistent incontinence, the Burch procedure is more effective than the Sling procedure.

Originality/value
This paper demonstrates the efficacy of a Markov chain decision modeling approach to study the comparative effectiveness analysis of available treatments for patients with UI, an important public health issue, widely prevalent among elderly women in developed and developing countries. This research also improves upon other analyses using a Markov chain decision modeling process to analyze various strategies for treating UI.
If your market is a competitive dogfight, think like a cat
Authors: Sherman Leonard 
Published: March 2017

Purpose
The article helps answer one of the most urgent questions facing corporate leaders: how can a company trapped in a competitive market innovate successful new products that are meaningfully different?

Design/methodology/approach
The article explains how to implement three business-strategy frameworks that have emerged, all of which provide useful guidance to entrepreneurs and corporate innovators seeking to identify meaningfully differentiated products and services that deliver a compelling consumer value proposition.

Findings
The three strategy frameworks reviewed in this article provide insightful perspectives on how companies can break away from the pack to create sizeable opportunities for profitable growth, even in industries that are struggling with sluggish demand and slim profit margins.

Practical implications
Be prepared to disrupt your own business when the inevitable onset of Red Ocean market conditions begins to diminish your prospects for continued profitable growth.

Originality/value
A comprehensive look at product and service differentiation strategies that can focus the hunt for breakthrough innovations.