bluuebunny/crossref_metadata_2025 huggingface dataset:
Faculty Development Efforts to Promote Screening, Brief Intervention, and Referral to Treatment (SBIRT) in An Internal Medicine Faculty-Resident Practice
Authors: Stone Alanna , Wamsley Maria , O'Sullivan Patricia , Satterfield Jason , Satre Derek D. , Julian Katherine
Published: November 2016

Background: Screening, brief intervention, and referral to treatment (SBIRT) is a practical means to address substance misuse in primary care. Important barriers to implementing SBIRT include adequacy of training and provider confidence as well as logistical hurdles and time constraints. A faculty development initiative aimed at increasing SBIRT knowledge and treatment of substance use disorders (SUDs) should lead to increased use of SBIRT by faculty and the residents they teach. This study examined how a faculty development program to promote SBIRT influenced faculty practice and resident teaching. Methods: This was a cross-sectional study of faculty exposed to multiple SBIRT educational interventions over a 5-year period in an academic faculty-resident general medicine practice. Participants completed a brief online survey followed by a semistructured interview. Quantitative responses were examined descriptively. Qualitative questions were reviewed to identify key themes. Results: Fifteen of 29 faculty (52%) completed the survey and 13 (45%) completed the interviews regarding faculty development interventions. Faculty thought that SBIRT was an important skill and had confidence in screening for substance use disorders, although confidence in making treatment referrals and prescribing pharmacotherapy were rated lower. Many faculty reported screening more frequently for SUDs after attending faculty development sessions. However, several reported that the training did not improve their SBIRT teaching to residents during clinic precepting sessions. To improve uptake of SBIRT, a majority of faculty recommended electronic health record (EHR) alerts. Conclusions: SBIRT is a highly valued set of skills, and training may enhance rates of screening for substance misuse. However, participants did not report a substantial change in SBIRT teaching as a result of faculty development. In the future, small, targeted faculty development sessions, potentially involving strategies for using the electronic health record (EHR), may be an effective way to enhance primary care SBIRT skills.
Use of Risk Mitigation Practices by Family Nurse Practitioners Prescribing Opioids for the Management of Chronic Nonmalignant Pain
Authors: Chaudhary Sahil , Compton Peggy
Published: November 2016

Background: Ongoing opioid analgesic use in patients suffering from chronic nonmalignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. Methods: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP. Results: One hundred sixty-eight FNPs responded (20% response rate), of whom 51.2% affirmed that they prescribe opioids for CNMP. Of the 86 FNPs who prescribe opioids, 66.7% said that less than 25% of their patients were receiving ongoing opioid therapy. The most frequently prescribed opioids were hydrocodone (77.9%) and oxycodone (58.1%). With respect to RMPs, 50 of the 86 opioid-prescribing FNPs (58.8%) reported using treatment contracts with their CNMP patients. Far fewer (20.9%) used formal screening tools to gauge the risk of opioid abuse and misuse. Most respondents (54.94%) reported using prescription monitoring programs, whereas only 33.0% reported using urine toxicology to monitor opioid use. Of the prescribing FNPs, 15.1% reported using abuse-deterrent opioid formulations. Age was found to be a correlate for prescribing opioids for CNMP, with those under 40 years of age less likely to use urine toxicology than those over 41 (45.2% vs. 4.2%; χ2(6) = 11.90, P = .06). Additionally, respondents who did not use treatment contracts reported significantly fewer years in practice (10.5 years, SD = 6.1) than those who did (13.6 years, SD = 1.54, df = 2.82, P = .02). Conclusions: Although RMPs are recommended for use in all CNMP patients receiving ongoing opioid therapy, FNPs do not consistently implement them. In the midst of the current opioid epidemic, FNPs must be vigilant about using appropriate opioid prescription practices.
Commitment and Capacity for Providing Evidence-Based Tobacco Treatment in Us Drug Treatment Facilities
Authors: Richter Kimber P. , Hunt Jamie J. , Cupertino A. Paula , Gajewski Byron J. , Jiang Yu , Marquis Janet , Friedmann Peter D.
Published: November 2016

Background: Although people with mental illness, including substance use disorders, consume 44% of cigarettes in the United States, few facilities provide tobacco treatment. This study assesses staff- and facility-level drivers of tobacco treatment in substance use treatment. Methods: Surveys were administered to 405 clinic directors selected from a comprehensive inventory of 3800 US outpatient facilities. The main outcome was the validated 7-item Index of Tobacco Treatment Quality. Other measures included the validated Tobacco Treatment Commitment Scale and indicators of facility resources for providing tobacco treatment. Results: Stepwise model selection was used to determine the relationship between capacity/resources and treatment quality. The final model retained 7 items and had good fit (adjusted R2 = 0.43). Four capacities significantly predicted treatment quality. Structural equation modeling (SEM) was used to test the impact of staff commitment on treatment quality; the model had good fit and the relationship was significant (comparative fit index [CFI] = 0.951, root mean square error of approximation [RMSEA] = 0.054). Adding the 7 capacity/resources maintained similar model fit (CFI = 0.922, RMSEA = 0.053). Staff commitment was slightly strengthened in this model, with a rise in parameter estimate from 0.449 to 0.560. All resource/capacity items were also significant predictors of treatment quality; the strongest was receiving training in how to provide tobacco treatment (0.360), followed by dedicated staff time (0.279) and having a policy that requires staff to offer treatment (0.272). Conclusions: Staff commitment to providing tobacco treatment was the strongest predictor of tobacco treatment quality, followed by resources for providing treatment. Interventions to change staff attitudes and improve resources for tobacco treatment have the strongest potential for improving quality of care.
Update of the BIPM comparison BIPM.RI(II)-K1.Co-60 of activity measurements of the radionuclide 60Co to include the 2011 result of the CNEA (Argentina), the 2012 results of the BARC (India) and the NRC (Canada), and the 2014 result of the NIM (China)
Authors: Michotte C , Ratel G , Courte S , Arenillas P , Balpardo C , Joseph L , Anuradha R , Kulkarni D B , Galea R , Moore K , Stroak A , Zhang Ming , Liang Juncheng , Liu Haoran
Published: November 2016

Since 2010, four national metrology institutes (NMI) have each submitted a sample of known activity of 60Co to the International Reference System (SIR) for activity comparison at the Bureau International des Poids et Mesures (BIPM), with comparison identifier BIPM.RI(II)-K1.Co-60. The values of the activity submitted were between about 175 kBq and 1600 kBq. The primary standardization results for the CNEA, Argentina and the BARC, India replace their earlier result of 2003 and 2001, respectively. There are now seventeen results in the BIPM.RI(II)-K1.Co-60 comparison. The key comparison reference value (KCRV) has been updated using the power-moderated weighted mean. The degrees of equivalence between each equivalent activity measured in the SIR and the KCRV have been calculated and the results are given in the form of a table. A graphical presentation is also given.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
The final report for CCM.M-K7: key comparison of 5 kg, 100 g, 10 g, 5 g and 500 mg stainless steel mass standards
Authors: Lee Sungjun , Borys Michael , Abbott Patrick , Becerra Luis Omar , Eltawil Alaaeldin A , Jian Wang , Malengo Andrea , Medina Nieves , Snegov Victor , Wüthrich Christian , Scholz Frank
Published: November 2016

In order to show equivalence in mass standards calibration among National Metrology Institutes (NMIs) of member countries of the "Comité international des poids et mesures" (CIPM), key comparisons (KC) of mass standards have been carried out under the auspices of the "Comité Consultatif pour la Masse et les Grandeurs Apparentées" (CCM). This key comparison of 5 kg, 100 g, 10 g, 5 g and 500 mg stainless steel mass standards was based on the decision of the CCM during the 12th meeting held in 2010 at the Bureau International des Poids et Mesures (BIPM). KRISS (Republic of Korea) and PTB (Germany) acted as pilot laboratory and co-pilot laboratory, respectively. The results were evaluated with the Monte Carlo method using measurement values based on participants' reference standards calculated following the recent BIPM amendments in 2015. Regarding participant results, VNIIM (100 g and 5 g) were not consistent with the key comparison reference values within their expanded uncertainties with the coverage factor, k = 2.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
PanViz: interactive visualization of the structure of functionally annotated pangenomes
Authors: Pedersen Thomas Lin , Nookaew Intawat , Wayne Ussery David , Månsson Maria
Published: November 2016

PanViz is a novel, interactive, visualization tool for pangenome analysis. PanViz allows visualization of changes in gene group (groups of similar genes across genomes) classification as different subsets of pangenomes are selected, as well as comparisons of individual genomes to pangenomes with gene ontology based navigation of gene groups. Furthermore it allows for rich and complex visual querying of gene groups in the pangenome. PanViz visualizations require no external programs and are easily sharable, allowing for rapid pangenome analyses.

Availability and Implementation

PanViz is written entirely in JavaScript and is available on https://github.com/thomasp85/PanViz. A companion R package that facilitates the creation of PanViz visualizations from a range of data formats is released through Bioconductor and is available at https://bioconductor.org/packages/PanVizGenerator.

Supplementary information

Supplementary data are available at Bioinformatics online.
Predicting ecosystem responses to changes in fisheries catch, temperature, and primary productivity with a dynamic Bayesian network model
Authors: Trifonova Neda , Maxwell David , Pinnegar John , Kenny Andrew , Tucker Allan
Published: November 2016

The recent adoption of Bayesian networks (BNs) in ecology provides an opportunity to make advances because complex interactions can be recovered from field data and then used to predict the environmental response to changes in climate and biodiversity. In this study, we use a dynamic BN model with a hidden variable and spatial autocorrelation to explore the future of different fish and zooplankton species, given alternate scenarios, and across spatial scales within the North Sea. For most fish species, we were able to predict a trend of increase or decline in response to change in fisheries catch; however, this varied across the different areas, outlining the importance of trophic interactions and the spatial relationship between neighbouring areas. We were able to predict trends in zooplankton biomass in response to temperature change, with the spatial patterns of these effects varying by species. In contrast, there was high variability in terms of response to productivity changes and consequently knock-on effects on higher level trophic species. Finally, we were able to provide a new data-driven modelling approach that accounts for multispecies associations and interactions and their changes over space and time, which might be beneficial to give strategic advice on potential response of the system to pressure.
Impact of predicted climate change scenarios on a coral reef meiofauna community
Authors: Sarmento Visnu Cunha , Pinheiro Bárbara Ramos , Montes Manuel de Jesus Flores , Santos Paulo Jorge Parreira
Published: November 2016

Changes in marine communities in response to elevated CO2 have been reported but information on how representatives of the benthic lower trophic levels will be impacted remains scarce. A laboratory experiment was conducted to evaluate the impact of different climate change scenarios on a coral reef meiofauna community. Samples of the meiofauna community were collected from the coral reef subtidal zone of Serrambi beach (Ipojuca, Pernambuco, Brazil), using artificial substrate units. The units were exposed to control treatments and to three climate change scenarios, and collected after 15 and 29 d. Important changes in the meiofauna community structure were observed after 15 d of exposure. The major meiofauna groups exhibited divergent responses to the various scenarios. Although polychaetes were negatively affected after 29 d in the most severe scenario (Scenario III), harpacticoid copepods were negatively affected in Scenarios II and III after 15 and 29 d. Harpacticoid nauplii were strongly and negatively affected in all scenarios. In contrast, Nematoda exhibited higher densities in all scenarios. To the best of our knowledge, this community-based study was the first to observe how meiofauna organisms from a coral reef environment react to the synergetic effects of reductions in seawater pH and increased temperature.
Five-year quality of life assessment after carbon ion radiotherapy for prostate cancer
Authors: Maruyama Katsuya , Tsuji Hiroshi , Nomiya Takuma , Katoh Hiroyuki , Ishikawa Hitoshi , Kamada Tadashi , Wakatsuki Masaru , Akakura Koichiro , Shimazaki Jun , Aoyama Hidefumi , Tsujii Hirohiko ,   the Working Group for Genitourinary Tumors
Published: November 2016

The aim of this study was to prospectively assess 5-year health-related quality of life (HRQOL) of patients treated with carbon ion radiotherapy (C-ion RT) for clinically localized prostate cancer. A total of 417 patients received carbon ion radiotherapy at a total dose of 63–66 Gray-equivalents (GyE) in 20 fractions over 5 weeks, and neoadjuvant and adjuvant androgen deprivation therapy (ADT) were administered for intermediate and high-risk patients. A HRQOL assessment was performed at five time points (immediately before the initiation of C-ion RT, immediately after, and at 12, 36 and 60 months after completion of C-ion RT) using Functional Assessment of Cancer Therapy (FACT) questionnaires. FACT-G and FACT-P scores were significantly decreased; however, the absolute change after 60 months was minimal. The transient decreases in the Trial Outcome Index (TOI) score returned to their baseline levels. Use of ADT, presence of adverse events, and biochemical failure were related to lower scores. Scores of subdomains of FACT instruments indicated characteristic changes. The pattern of HRQOL change after C-ion RT was similar to that of other modalities. Further controlled studies focusing on a HRQOL in patients with prostate cancer are warranted.
On similarity of binary black hole gravitational-wave skymaps: to observe or to wait?
Authors: Vitale Salvatore , Essick Reed , Katsavounidis Erik , Klimenko Sergey , Vedovato Gabriele
Published: November 2016

Localization estimates for GW150914, the first binary black hole detected by the LIGO instruments, were shared with partner facilities for electromagnetic follow-up. While the source was a compact binary coalescence (CBC), it was first identified by algorithms that search for unmodelled signals, which produced the skymaps that directed electromagnetic observations. Later on, CBC-specific algorithms produced refined versions, which showed significant differences. In this Letter, we show that those differences were not accidental and that CBC and unmodelled skymaps for binary black holes will frequently be different; we thus provide a way to determine whether to observe electromagnetically as promptly as possible (following a gravitational-wave detection), or to wait until CBC skymaps become available, should they not be available in low latency. We also show that, unsurprisingly, CBC algorithms can yield much smaller searched areas.
Non-linear shrinkage estimation of large-scale structure covariance
Authors: Joachimi Benjamin
Published: November 2016

In many astrophysical settings, covariance matrices of large data sets have to be determined empirically from a finite number of mock realizations. The resulting noise degrades inference and precludes it completely if there are fewer realizations than data points. This work applies a recently proposed non-linear shrinkage estimator of covariance to a realistic example from large-scale structure cosmology. After optimizing its performance for the usage in likelihood expressions, the shrinkage estimator yields subdominant bias and variance comparable to that of the standard estimator with a factor of ∼50 less realizations. This is achieved without any prior information on the properties of the data or the structure of the covariance matrix, at a negligible computational cost.
Upper limits for mass and radius of objects around Proxima Cen from SPHERE/VLT
Authors: Mesa D. , Zurlo A. , Milli J. , Gratton R. , Desidera S. , Langlois M. , Vigan A. , Bonavita M. , Antichi J. , Avenhaus H. , Baruffolo A. , Biller B. , Boccaletti A. , Bruno P. , Cascone E. , Chauvin G. , Claudi R. U. , De Caprio V. , Fantinel D. , Farisato G. , Girard J. , Giro E. , Hagelberg J. , Incorvaia S. , Janson M. , Kral Q. , Lagadec E. , Lagrange A.-M. , Lessio L. , Meyer M. , Peretti S. , Perrot C. , Salasnich B. , Schlieder J. , Schmid H.-M. , Scuderi S. , Sissa E. , Thalmann C. , Turatto M.
Published: November 2016

The recent discovery of an earth-like planet around Proxima Centauri has drawn much attention to this star and its environment. We performed a series of observations of Proxima Centauri using Spectro-Polarimetric High-contrast Exoplanet REsearch (SPHERE), the planet-finder instrument installed at the European Southern Observatory (ESO) Very Large Telescope (VLT) UT3, using its near-infrared modules, InfraRed Dual-band Imager and Spectrograph (IRDIS) and IFS. No planet was detected directly, but we set upper limits on the mass up to 7 au by exploiting the AMES-COND models. Our IFS observations reveal that no planet more massive than ∼6–7 MJup can be present within 1 au. The dual-band imaging camera IRDIS also enables us to probe larger separations than other techniques such as radial velocity or astrometry. We obtained mass limits of the order of 4 MJup at separations of 2 au or larger, representing the most stringent mass limits at separations larger than 5 au available at the moment. We also made an attempt to estimate the radius of possible planets around Proxima using the reflected light. Since the residual noise for the observations is dominated by photon noise and thermal background, longer exposures in good observing conditions could improve the achievable contrast limit further.
Physicochemical and Nutritional Properties of Different Maize Races on Toasted Tortillas
Authors: González‐Amaro Rosa María , Figueroa‐Cárdenas Juan de Dios , Perales Hugo , Velés‐Medina José Juan
Published: November 2016

Biodiversity contributes to nutrient production and, together with processing, is a critical factor in product quality. Physicochemical and nutritional properties of toasted tortillas (totopos) were evaluated in 1) maize samples from Oaxaca communities and 2) maize races of different endosperm texture. Texture profiles show that totopos elaborated from Zapalote Chico maize race showed the best performance (low breaking force) and higher crunchability, similar to commercial totopos. Quality of Zapalote Chico totopos was explained by flotation index (FI) and starch viscosity as well as thermal properties. FI was negatively correlated with texture that may related to end use. Zapalote Chico maize gelatinizes at higher (P < 0.05) pasting temperature (72.8–73.3°C) and it had higher (P > 0.05) peak viscosity (3,093–4,723 cP), suggesting a more organized starch structure. In hybrid and Tuxpeño samples, most of the starch granules (90%) were gelatinized and increased the hardness in totopos. The totopo samples increased the peak at 4.45 Å, a characteristic of type‐V diffraction of amylose‐lipid complexes (resistant starch). A small increase in resistant starch (0.6%) was found in totopos, which has important nutritional benefits for consumers. Our results support the preference of Oaxaca people for the totopos made from Zapalote Chico maize.
Enhancement of Nutritional and Antioxidant Properties of Brown Rice Flour Through Solid‐State Yeast Fermentation
Authors: Ilowefah Muna , Bakar Jamilah , Ghazali Hasanah M. , Muhammad Kharidah
Published: November 2016

This study investigated the effect of solid‐state yeast fermentation on the nutritional and antioxidant properties of brown rice flour (BRF). Three brands of commercial baker's yeast (Eagle, Saf‐levure, and Mauripan) were used to ferment BRF at 25°C for 12 h. There were significant increases in protein, ash, insoluble and soluble fiber, phosphorus, zinc, magnesium, calcium, and iron contents after yeast fermentation. Fermented BRF with Eagle yeast possessed the highest contents of protein, ash, zinc, and calcium. Fermentation of BRF with Eagle yeast was more effective in increasing antioxidant activity and total phenolic contents from 1.01 to 1.54 mmol of Trolox equivalents per gram and from 1.09 to 1.21 mg of gallic acid equivalents per gram, respectively. Yeast fermentation reduced phytic acid content of BRF (124.59 ± 0.48 µg/g), and the Eagle yeast‐fermented sample had the lowest value (36.55 µg/g) compared with the other fermented samples. Fermented flour with Eagle yeast also had the highest α‐amylase activity, because it recorded the lowest stirring number. Solid‐state fermentation with commercial yeast, particularly Eagle yeast, was effective in improving the nutritional and antioxidant properties of underutilized BRF as a food ingredient.
Physical and Functional Characteristics of Broken Rice Kernels Caused by Moisture‐Adsorption Fissuring
Authors: Mukhopadhyay Sangeeta , Siebenmorgen Terry J.
Published: November 2016

Fissuring caused by rapid moisture adsorption generates broken kernels upon milling; brokens are often ground to flour. The recent increase in demand for rice flour has promoted interest in brokens. This study investigated the physical and functional characteristics of brokens resulting from milling lots with various levels of moisture adsorption‐induced fissuring. Two long‐grain (LG) cultivars and one medium‐grain (MG) cultivar were conditioned to five initial moisture contents (IMCs), rewetted, and then reconditioned to 12% moisture content. Brown rice fissure enumeration and milling analyses as well as size distribution and functionality analyses of brokens were conducted. As IMC decreased, the percentage of fissured kernels increased and, consequently, the amount of brokens generated increased. Although the number of fissures/kernel also increased with decreasing IMC, the mass distribution of the resultant brokens was not affected by IMC. Across all IMC levels, the mass percentage of the medium‐sized brokens was greatest for the LG cultivars, whereas that of the large‐sized brokens was greatest for the MG cultivar. Regardless of IMC, peak, setback, and final viscosities were greatest for head rice and decreased significantly with decreasing size of brokens. Thus, brokens of different sizes have different functional properties and, hence, may be fractionated for different end‐use applications.
Pulmonary Signet-Ring Cell Adenocarcinoma Metastatic to the Skin
Authors: Boyd Alan S.
Published: November 2016

Internal malignancies occasionally metastasize to the skin, usually imparting a poor prognosis. In men, pulmonary malignancies are the second most common offending tumor. Roughly, half such lesions are adenocarcinomas. A small subset of pulmonary adenocarcinomas exhibits signet-ring morphology. To date, a cutaneous metastasis arising from a pulmonary signet-ring cell adenocarcinoma has not been reported.
Pathogenesis and heterogeneity of ovarian cancer
Authors: Kroeger Paul T. , Drapkin Ronny
Published: November 2016

Purpose of review

The most common type of ovarian cancer, high-grade serous ovarian carcinoma (HGSOC), was originally thought to develop from the ovarian surface epithelium. However, recent data suggest that the cells that undergo neoplastic transformation and give rise to the majority of HGSOC are from the fallopian tube. This development has impacted both translational research and clinical practice, revealing new opportunities for early detection, prevention, and treatment of ovarian cancer.

Recent findings

Genomic studies indicate that approximately 50% of HGSOC are characterized by mutations in genes involved in the homologous recombination pathway of DNA repair, especiallyBRCA1andBRCA2. Clinical trials have demonstrated successful treatment of homologous recombination-defective cancers with poly-ribose polymerase inhibitors through synthetic lethality. Recently, amplification ofCCNE1was found to be another major factor in HGSOC tumorigenesis, accounting for approximately 20% of all cases. Interestingly, amplification ofCCNE1and mutation of homologous recombination repair genes are mutually exclusive in HGSOC.

The fallopian tube secretory cell is the cell of origin for the majority of ovarian cancers. Although it remains unclear what triggers neoplastic transformation of these cells, certain tumors exhibit loss ofBRCAfunction or amplification ofCCNE1. These alterations represent unique therapeutic opportunities in ovarian cancer.
Natural mineral-rich water ingestion by ovariectomized fructose-fed Sprague-Dawley rats: effects on sirtuin 1 and glucocorticoid signaling pathways
Authors: Das Jugal Kishore , Severo Milton , Pereira Cidália Dionísio , Patrício Emília , Magalhães José , Monteiro Rosário , Neves Delminda , Martins Maria João
Published: November 2016

Objective:

Prevention or induction of metabolic disorders and obesity depend on estrogen signaling and/or exogenous factors, such as mineral content in diet. The protective effects of a Portuguese natural mineral-rich water against the induction of metabolic syndrome in fructose-fed male Sprague-Dawley rats have been reported. The present study was designed to assess the impact of this mineral-rich water on fructose-fed estrogen-deficient female Sprague-Dawley rats.

Methods:

Ovariectomized rats had access to tap (TWO) or mineral-rich (MWO) waters, with and without 10% fructose (10-wk treatment). A sham-operated (tap water supplied) group was included and each of the five groups included six rats. Plasma biochemical and metabolic parameters were evaluated by routine clinical measurements. Western blotting was used to assess hepatic protein expression of sirtuins (Sirt) 1 and 3, phosphorylated AMP-activated protein kinase-α (p-AMPKα), peroxisome proliferator-activated receptor gamma coactivator-1-α (PGC1α), glucocorticoid receptor, and 11beta-hydroxysteroid dehydrogenase type 1 (11βHSD1).

Results:

Ovariectomy increased plasma total cholesterol (46%/P < 0.05), but had no significant effects on hepatic protein expression. Fructose intake by ovariectomized rats increased PGC1α and 11βHSD1 (fructose in tap water [TWFO] vs TWO: 65%/P < 0.05 and 38%/P = 0.05, respectively) as well as glucocorticoid receptor (TWFO and fructose in natural mineral-rich water [MWFO] vs TWO and MWO: 107%/P = 0.05 and 182%/P < 0.05, respectively). Mineral-rich water ingestion exerted an increasing shape on Sirt1 (MWO vs TWO: 76%/P < 0.05; MWFO vs TWFO: 76%/P = 0.06), PGC1α (MWO vs TWO: 77%/P < 0.01), p-AMPKα (MWO vs TWO: 152%/P = 0.01; MWFO vs TWFO: 107%/P = 0.01), and 11βHSD1 (MWO vs TWO: 91%/P = 0.05; MWFO vs TWFO: 47%/P = 0.05).

Conclusions:

Mineral-rich water ingestion may have a prime role on the activation of Sirt1 signaling and the modulation of glucocorticoid signaling in the postmenopause.
Prevalence and correlates of vaginal estrogenization in postmenopausal women in the United States
Authors: Lindau Stacy Tessler , Dude Annie , Gavrilova Natalia , Hoffmann Joscelyn N. , Schumm L. Philip , McClintock Martha K.
Published: November 2016

Objective:

This work aims to establish current population-based vaginal estrogenization norms for postmenopausal US women.

Methods:

Using a US national probability sample of 868 postmenopausal women ages 57 to 85 years (mean age 67.6 ± 0.3 y, 21.6 ± 0.5 y since menopause), we calculated the epithelial maturation value (MV) generated from self-collected vaginal specimens and compared findings with historical clinical data. Linear and logistic regressions were used to describe the relationship between vaginal estrogenization and sociodemographic, physical, gynecologic, and sexual characteristics.

Results:

Among postmenopausal women, mean MV was 46.6 ± 0.8 (SD 17.4, range 2.5-100) and stable across age groups. In every age group, vaginal estrogenization was higher among postmenopausal nonusers of hormone therapy (HT) in the 2005-2006 US cohort than reported for the 1960s Canadian clinical cohort. MV was also higher among women who used postmenopausal HT in the prior 12 months compared with those who did not (55.1 ± 1.2 vs 44.4 ± 0.9, P < 0.001). In multivariate analyses, HT use, obesity and African American race were each independently associated with higher MV. Overall, MV was not associated with sexual activity, but low MV was associated with vaginal dryness during intercourse among sexually active women.

Conclusions:

Compared to 1960s clinical data, current population estimates revealed higher vaginal estrogenization across all age groups and no decline with age. The strongest independent correlates of vaginal estrogenization in postmenopausal US women were current HT use, obesity, and African American race. Postmenopause, half of all women exhibit low vaginal estrogenization.
Primary Fat Grafting to the Pectoralis Muscle during Latissimus Dorsi Breast Reconstruction
Authors: Niddam Jeremy , Vidal Luciano , Hersant Barbara , Meningaud Jean Paul
Published: November 2016

Background:

Latissimus dorsi flap is one of the best options for immediate and delayed breast reconstruction. However, this technique is limited by the tissue volume provided by the flap. To improve breast volume while reducing complications, fat grafting is now very often used in addition to latissimus dorsi flap. To the best of our knowledge, fat grafting was always performed as a second-line surgery, at least a few months after the flap procedure. We aimed to report our experience with an associated breast reconstruction technique combining musculocutaneous latissimus dorsi flap with intrapectoral lipofilling for totally autologous breast reconstruction.

Methods:

Between September 2014 and January 2015, 20 patients underwent this technique for unilateral autologous breast reconstruction (14 delayed and 6 immediate breast reconstructions). A mean harvested fat volume of 278 ml (range: 190–350 ml) and a mean injected fat volume of 228 ml (range: 170–280 ml) were used.

Results:

None of the patients experienced complications, such as flap necrosis, breast skin necrosis, hematomas, or infection. One of the patients developed a seroma, which was treated with 3 drainage punctions. Only 2 patients underwent delayed fat grafting procedure.

Conclusion:

Totally autologous breast reconstruction combining latissimus dorsi flap and intrapectoral fat grafting in the same procedure is a new technique allowing increased breast volume in a single surgery.
Nasal Reshaping with Hyaluronic Acid: An Alternative or Complement to Surgery
Authors: Hedén Per
Published: November 2016

Background:

Rhinoplasty has traditionally been preferred for correction of nasal defects. Long-term clinical experience with hyaluronic acid (HA) injection as an alternative or complement to rhinoplasty is presented.

Methods:

A retrospective review of the author’s clinical experience with HA gel for nasal reshaping from 1997 to 2012 was conducted, with treatments performed during 1998, 2005, and 2012 selected for detailed review.

Results:

More than 250 patients were treated for nasal reshaping with HA since 1997. In addition to being a complement to surgery, HA injection successfully addressed nasal defects that would have been difficult to correct surgically. The effect persisted for >1 year in most patients (>5 y in some patients), with individual variations. No serious complications occurred. When comparing the 3 years reviewed in detail, new indications for nasal reshaping with HA gel became evident over time, which was also reflected by the increase in number of patients treated (1998: n = 2; 2005: n = 22; 2012: n = 51). Of these patients, 55 (73%) received HA injection instead of rhinoplasty, 20 (27%) received HA injection after rhinoplasty, and 5 (7%) underwent rhinoplasty after HA injection. The mean injection volume was 0.4 mL HA gel/treatment. All patients were satisfied with the primary outcome of treatment. Retreatment was performed in 32 patients (43%).

Conclusions:

Injection of HA gel is a valuable tool for nasal reshaping. It can also be used for correction of minor postrhinoplasty defects in appropriate patients.
Examination of Epithelial Mesenchymal Transition in Keloid Tissues and Possibility of Keloid Therapy Target
Authors: Kuwahara Hiroaki , Tosa Mamiko , Egawa Seiko , Murakami Masahiro , Mohammad Ghazizadeh , Ogawa Rei
Published: November 2016

Background:

Keloid is a fibroproliferative skin disorder that is characterized by collagen accumulation and blood vessel proliferation in the reticular layer of the dermis. It is caused by prolonged inflammation after cutaneous injury. Several studies suggested recently that epithelial mesenchymal transition (EMT) is involved in the development of fibrosis. This study assessed whether EMT also participates in keloid development and/or aggravation.

Methods:

Resected keloid (n = 19) and normal skin (n = 13) samples were subjected to immunohistochemical, immunofluorescent, and Western blot analyses of their expression of epidermal (E-cadherin) and mesenchymal (vimentin) proteins.

Results:

Immunohistochemical analysis showed that the keloid tissues had more vimentin-positive cells in the epidermis than the normal tissues. When normal primary keratinocytes were cultured with proinflammatory cytokines, the cobblestone-shaped cells changed to a spindle shape and many vimentin-positive cells were detected. When immortalized HaCaT keratinocytes were cocultured in split-well plates with normal or keloid-derived fibroblasts, they also underwent EMT, as indicated by their greater vimentin expression on Western blot analysis compared with HaCaT cells that were cultured alone.

Conclusions:

EMT was observed in keloid specimens. EMT was induced by inflammatory cytokines and fibroblasts. EMT may be involved in keloid generation and/or aggravation and may have potential as a keloid treatment target.
Infants With Congenital Zika Virus Infection
Authors: Porter Sallie , Mimm Nancy
Published: November 2016

Zika virus infection-associated microcephaly has generated public health and media concern. Unsettling images emerging from Brazil of infants with abnormally small heads have raised concern among women of childbearing age, international travelers, government officials, and health care professionals. The World Health Organization declared the most recent, ongoing Zika virus infection outbreak a “public health emergency of international concern.” The Centers for Disease Control and Prevention is working to understand the impact of Zika virus infection in the United States and elsewhere. Zika virus is a mosquito-transmitted Flavivirus that can also be transmitted through sexual contact. Congenital Zika virus infection is a cause of microcephaly and other serious neurological harm to the fetus. The early intervention professional should understand Zika virus infection including the geographical risk, etiology, epidemiology, and potential developmental impact. Still evolving clinical, policy, and research implications for early intervention professionals need to be based on the context of emerging scientific information. It is important for early intervention professionals to remain attentive, as scientific knowledge concerning the impact of congenital Zika virus infection in infants and families will be evolving for years to come.
Conditioned pain modulation in patients with nonspecific chronic back pain with chronic local pain, chronic widespread pain, and fibromyalgia
Authors: Gerhardt Andreas , Eich Wolfgang , Treede Rolf-Detlef , Tesarz Jonas
Published: November 2016

Findings considering conditioned pain modulation (CPM) in chronic back pain (CBP) are contradictory. This might be because many patients with CBP report pain in further areas of the body, and altered CPM might influence spatial extent of pain rather than CBP per se. Therefore, we compared CPM in patients with CBP with different pain extent. Patients with fibromyalgia syndrome (FMS), for whom CPM impairment is reported most consistently, were measured for comparison. Based on clinical evaluation and pain drawings, patients were categorized into chronic local back pain (CLP; n = 53), chronic widespread back pain (CWP; n = 32), and FMS (n = 92). Conditioned pain modulation was measured by the difference in pressure pain threshold (test stimuli) at the lower back before and after tonic heat pain (conditioning stimulus). We also measured psychosocial variables. Pressure pain threshold was significantly increased in CLP patients after tonic heat pain (P < 0.001) indicating induction of CPM. Conditioned pain modulation in CLP was significantly higher than that in CWP and FMS (P < 0.001), but CPM in CWP and FMS did not differ. Interestingly, a higher number of painful areas (0-10) were associated with lower CPM (r = 0.346, P = 0.001) in CBP but not in FMS (r = −0.013, P = 0.903). Anxiety and depression were more pronounced in FMS than in CLP or CWP (P values <0.01). Our findings suggest that CPM dysfunction is associated with CWP and not with FMS as suggested previously. FMS seems to differ from CWP without FMS by higher psychosocial burden. Moreover, patients with CBP should be stratified into CLP and CWP, and centrally acting treatments targeting endogenous pain inhibition seem to be more indicated the higher the pain extent.
Dental Trauma in a Pediatric Emergency Department Referral Center
Authors: Hall Emily , Hickey Patricia , Nguyen-Tran Thuy , Louie Jeff
Published: November 2016

Objective

The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department.

Methods

We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition.

Results

We identified 108 children with dental and if present, associated oral injuries. The median age was 12.3 years, the most common tooth injured were the primary (25.9%) or permanent (62%) upper central incisors, and the majority of subjects presented in the afternoon (mean time was 3:50 pm, SD ±24 minutes). A large proportion of dental injuries occurred in patients with permanent dentation (62%) and half of all children had more than 1 tooth injury. The majority of children (75%) were evaluated by either pediatric dental, oral surgery, or otolaryngology services, whereas 3.7% of the cases required multiple services. Twenty-five percent of children had an associated jaw fracture. Eighty-three percent of children were discharged home, of those, 49.1% were prescribed opioids, and 38.3% oral antibiotics.

Conclusions

Emergency departments are often relied upon to evaluate and treat simple and complex dental and oral injuries. The ability to use a multidisciplinary team to manage pediatric oral and dental trauma is essential for care.
Publishing Trends in the Field of Pediatric Emergency Medicine From 2004 to 2013
Authors: Rixe Nancy S. , Rixe Jeffrey , Glick Joshua , Lehman Erik , Olympia Robert P.
Published: November 2016

Objective

To identify publishing trends within the field of pediatric emergency medicine between 2004 and 2013.

Methods

We conducted a MEDLINE search of pediatric emergency medicine articles, filtered by clinical trial, published between 2004 and 2013 in ten journals from the fields of pediatrics, emergency medicine, general medicine, and pediatric emergency medicine. Each article was classified by journal type, study design, results (positive or negative/equivocal), age/type of subjects, and major topic (based on the objective of the study). Articles were stratified by publication period (2004–2008 or 2009–2013) to analyze trends.

Results

A total of 464 articles were analyzed. The majority of articles were described as randomized-controlled trials (47%) with negative/equivocal findings (70%). The most common major topics were pain management, asthma, sedation, bronchiolitis, resuscitation, simulation, and ultrasound. Over time, the percentage of articles published in pediatrics and pediatric emergency medicine journals increased (P = 0.0499) and the percentage for all study designs increased except for randomized controlled trials (P = 0.0089). There were no differences between the 2 publication periods when stratified by results, age/type of subjects, and major topic.

Conclusions

By identifying these trends, we hope to encourage researchers to perform studies in the field of pediatric emergency medicine where deficiencies lie and to guide pediatric health care professionals to where published, evidence-based studies can be found in the medical literature.
Assessing Different Partner Notification Methods for Assuring Partner Treatment for Gonorrhea: Looking for the Best Mix of Options
Authors: Fleming Eleanor , Hogben Matthew
Published: November 2016

Context:

Partner notification for gonorrhea is intended to interrupt transmission and to bring people exposed to infection to care. Partner notification may be initiated through public health professionals (disease intervention specialist: DIS referral) or patients (patient referral). In some cases, patients may carry medications or prescriptions for partners (patient-delivered partner therapy: PDPT).

Objective:

To examine how patterns of notifying and treating partners of persons with gonorrhea differ by partner notification approach.

Design:

From published literature (2005-2012), we extracted 10 estimates of patient referral data from 7 studies (3853 patients, 7490 partners) and 5 estimates of PDPT data from 5 studies (1781 patients, 3125 partners). For DIS referral estimates, we obtained 2010-2012 data from 14 program settings (4581 patients interviewed, 8301 partners). For each approach, we calculated treatment cascades based on the proportion of partners who were notified and treated. We also calculated cascades based on partners notified and treated per patient diagnosed.

Results:

Proportions of partners notified and treated were, for patient referral, 56% and 34%; for PDPT, 57% and 46%; for DIS referral, 25% and 22%. Notification and treatment estimates for patient referral and PDPT were significantly higher than for DIS referral, but DIS referral was more efficacious than the other methods in assuring treatment among those notified (all Ps < .001). The notification and treatment ratios per patient seen were, for patient referral, 0.96 and 0.61; for PDPT, 0.90 and 0.73; for DIS referral, 0.45 and 0.40.

Conclusion:

Patient-based methods had higher proportions of partners treated overall, but provider referral had the highest proportion treated among those notified. These data may assist programs to align the most efficacious strategies with the most epidemiologically or clinically important cases while assuring the best scalable standard of care for others.
Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a National Cohort of Gay and Bisexual Men in the United States
Authors: Parsons Jeffrey T. , Rendina H. Jonathon , Lassiter Jonathan M. , Whitfield Thomas H. F. , Starks Tyrel J. , Grov Christian
Published: November 2016

Objectives:

The HIV care cascade provides milestones to track the progress of HIV-positive people from seroconversion through viral suppression. We propose a Motivational pre-exposure prophylaxis (PrEP) Cascade involving 5 stages based on the Transtheoretical Model of Change.

Methods:

We analyzed data from 995 men in One Thousand Strong, a longitudinal study of a national panel of HIV-negative gay and bisexual men in the United States.

Results:

Nearly all (89%) participants were sexually active in the past 3 months and 65% met Centers for Disease Control criteria for PrEP candidacy. Of those identified as appropriate candidates, 53% were Precontemplative (stage 1; unwilling to take or believing they were inappropriate candidates for PrEP) and 23% were in Contemplation (stage 2; willing and self-identified as appropriate candidates). Only 11% were in PrEParation (stage 3; seeing PrEP as accessible and planning to initiate PrEP) and 4% were in PrEP Action (stage 4; prescribed PrEP). Although few of those who were identified as appropriate candidates were on PrEP, nearly all PrEP users (98%) reported adhering to 4 or more doses per week and most (72%) were returning for recommended quarterly medical visits, resulting in 9% of PrEP candidates reaching Maintenance and Adherence (stage 5).

Conclusions:

The large majority of participants were appropriate candidates for PrEP, yet fewer than 1 in 10 were using and adherent to PrEP. These findings highlight the need for interventions tailored to address the unique barriers men face at each stage of the cascade, particularly at the earliest stages where the most dramatic losses were identified.