bluuebunny/crossref_metadata_2025 huggingface dataset:
Which Bay Leaf is in Your Spice Rack? – A Quality Control Study
Authors: Raman Vijayasankar , Bussmann Rainer , Khan Ikhlas
Published: March 2017

The accurate identification of bay leaf in natural products commerce may often be confusing as the name is applied to several different species of aromatic plants. The true “bay leaf”, also known as “bay laurel” or “sweet bay”, is sourced from the tree Laurus nobilis, a native of the Mediterranean region. Nevertheless, the leaves of several other species including Cinnamomum tamala, Litsea glaucescens, Pimenta racemosa, Syzygium polyanthum, and Umbellularia californica are commonly substituted or mistaken for true bay leaves due to their similarity in the leaf morphology, aroma, and flavor. Substitute species are, however, often sold as “bay leaves”. As such, the name “bay leaf” in literature and herbal commerce may refer to any of these botanicals. The odor and flavor of these leaves are, however, not the same as the true bay leaf, and for that reason they should not be used in cooking as a substitute for L. nobilis. Some of the bay leaf substitutes can also cause potential health problems. Therefore, the correct identification of the true bay leaf is important. The present work provides a detailed comparative study of the leaf morphological and anatomical features of L. nobilis and its common surrogates to allow for correct identification.
Clinical Parameters following Multiple Oral Dose Administration of a Standardized Andrographis paniculata Capsule in Healthy Thai Subjects
Authors: Suriyo Tawit , Pholphana Nanthanit , Ungtrakul Teerapat , Rangkadilok Nuchanart , Panomvana Duangchit , Thiantanawat Apinya , Pongpun Wanwisa , Satayavivad Jutamaad
Published: March 2017

Andrographis paniculata has been widely used in Scandinavian and Asian counties for the treatment of the common cold, fever, and noninfectious diarrhea. The present study was carried out to investigate the physiological effects of short-term multiple dose administration of a standardized A. paniculata capsule used for treatment of the common cold and uncomplicated upper respiratory tract infections, including blood pressure, electrocardiogram, blood chemistry, hematological profiles, urinalysis, and blood coagulation in healthy Thai subjects. Twenty healthy subjects (10 males and 10 females) received 12 capsules per day orally of 4.2 g of a standardized A. paniculata crude powder (4 capsules of 1.4 g of A. paniculata, 3 times per day, 8 h intervals) for 3 consecutive days. The results showed that all of the measured clinical parameters were found to be within normal ranges for a healthy person. However, modulation of some parameters was observed after the third day of treatment, for example, inductions of white blood cells and absolute neutrophil count in the blood, a reduction of plasma alkaline phosphatase, and an induction of urine pH. A rapid and transient reduction in blood pressure was observed at 30 min after capsule administration, resulting in a significant reduction of mean systolic blood pressure. There were no serious adverse events observed in the subjects during the treatment period. In conclusion, this study suggests that multiple oral dosing of A. paniculata at the normal therapeutic dose for the common cold and uncomplicated upper respiratory tract infections modulates various clinical parameters within normal ranges for a healthy person.
In vivo inhibition of polyamine oxidase by a spermine analogue, MDL-72527, in tomato exposed to sublethal and lethal salt stress
Authors: Takács Zoltán , Poór Péter , Szepesi Ágnes , Tari Irma
Published: March 2017

The spermine analogue N1,N4-bis-(2,3-butadienyl)-1,4-butanediamine (MDL-72527), an effective inhibitor of polyamine oxidases (PAOs), triggers a systemic response in tomato (Solanum lycopersicum L.) exposed to sublethal (100 mM) and lethal (250 mM) NaCl concentrations. The accumulation of free polyamines (PAs), the terminal oxidation of PAs by diamine oxidases (DAOs) and PAOs, and the production of H2O2 by PA oxidases depends on the intensity of salt stress. Spermidine and spermine content increased significantly under sublethal salt concentrations, but remained low under lethal salt stress. Along with increased expression of the selected SlDAO1 and SlPAO1 genes in the leaves and roots, respectively, DAO and PAO activities and their product, H2O2, increased and initiated cell death by irreversible loss of electrolytes at 250 mM NaCl. MDL-72527 significantly increased spermine, spermidine and/or putrescine contents as a result of reduced activity of PA oxidases; furthermore, it inhibited H2O2 and NO production during salt treatment. These results indicate that PAO contributed to H2O2 and NO production under salt stress, and the terminal activities of DAO and PAO play a role in cell death induction at 250 mM NaCl. However, the inhibition of PAO by MDL-72527 does not increase the salt tolerance of plants, since electrolyte leakage increased significantly in the presence of the inhibitor.
Structure of human IFIT1 with capped RNA reveals adaptable mRNA binding and mechanisms for sensing N1 and N2 ribose 2′-O methylations
Authors: Abbas Yazan M. , Laudenbach Beatrice Theres , Martínez-Montero Saúl , Cencic Regina , Habjan Matthias , Pichlmair Andreas , Damha Masad J. , Pelletier Jerry , Nagar Bhushan
Published: March 2017

Significance

IFIT1 is an antiviral effector of host innate-immunity that selectively recognizes the 5′-end of viral mRNAs, which are often capped to mimic host mRNA, and blocks their translation. Our X-ray structural analysis reveals that the cap and four additional nucleotides are encircled by IFIT1 through a central tunnel in an adaptable manner, which gives it the flexibility required to defend against many different viruses, and to deter their ability to rapidly evolve. Host mRNA, normally ribose methylated at the first and second nucleotides following the cap, avoids IFIT1 recognition through tight complementary interfaces at these positions. This study uncovers the molecular basis for how IFIT1 selectively recognizes viral mRNAs and will help guide development of viral vaccines and mRNA therapeutics.
Shrinking instability of toroidal droplets
Authors: Fragkopoulos Alexandros A. , Pairam Ekapop , Berger Eric , Segre Phil N. , Fernández-Nieves Alberto
Published: March 2017

Significance

Liquid doughnuts or tori exhibit an inherent instability consisting in the shrinking of their “hole.” For sufficiently thick tori, this behavior is the only route for the torus to become spherical and thus minimize the area for a given volume. Of note, this shrinking instability is not completely understood. In this work, we experimentally determine the flow field of toroidal droplets as they shrink and account for our observations by solving the relevant equations of motion in toroidal coordinates. We find that four modes, out of the many possible ones, are needed to successfully account for all of the relevant features in the experiment. These results highlight the rich fluid mechanics that results in the presence of interfaces with nonconstant mean curvature.
Quantifying pigment cover to assess variation in animal colouration
Authors: Siegenthaler Andjin , Mondal Debapriya , Benvenuto Chiara
Published: March 2017

The study of animal colouration addresses fundamental and applied aspects relevant to a wide range of fields, including behavioural ecology, environmental adaptation and visual ecology. Although a variety of methods are available to measure animal colours, only few focus on chromatophores (specialized cells containing pigments) and pigment migration. Here, we illustrate a freely available and user-friendly method to quantify pigment cover (PiC) with high precision and low effort using digital images, where the foreground (i.e. pigments in chromatophores) can be detected and separated from the background. Images of the brown shrimp, Crangon crangon, were used to compare PiC with the traditional Chromatophore Index (CI). Results indicate that PiC outcompetes CI for pigment detection and transparency measures in terms of speed, accuracy and precision. The proposed methodology provides researchers with a useful tool to answer essential physiological, behavioural and evolutionary questions on animal colouration in a wide range of species.
2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis*
Authors: Tunkel Allan R. , Hasbun Rodrigo , Bhimraj Adarsh , Byers Karin , Kaplan Sheldon L. , Scheld W. Michael , van de Beek Diederik , Bleck Thomas P. , Garton Hugh J. L. , Zunt Joseph R.
Published: March 2017

The Infectious Diseases Society of America (IDSA) Standards and Practice Guidelines Committee collaborated with partner organizations to convene a panel of 10 experts on healthcare-associated ventriculitis and meningitis. The panel represented pediatric and adult specialists in the field of infectious diseases and represented other organizations whose members care for patients with healthcare-associated ventriculitis and meningitis (American Academy of Neurology, American Association of Neurological Surgeons, and Neurocritical Care Society). The panel reviewed articles based on literature reviews, review articles and book chapters, evaluated the evidence and drafted recommendations. Questions were reviewed and approved by panel members. Subcategories were included for some questions based on specific populations of patients who may develop healthcare-associated ventriculitis and meningitis after the following procedures or situations: cerebrospinal fluid shunts, cerebrospinal fluid drains, implantation of intrathecal infusion pumps, implantation of deep brain stimulation hardware, and general neurosurgery and head trauma. Recommendations were followed by the strength of the recommendation and the quality of the evidence supporting the recommendation. Many recommendations, however, were based on expert opinion because rigorous clinical data are not available. These guidelines represent a practical and useful approach to assist practicing clinicians in the management of these challenging infections.

Keywords. ventriculitis; meningitis; cerebrospinal fluid shunts; cerebrospinal fluid drains; central nervous system infections.
Draft genome of the Northern snakehead, Channa argus
Authors: Xu Jian , Bian Chao , Chen Kunci , Liu Guiming , Jiang Yanliang , Luo Qing , You Xinxin , Peng Wenzhu , Li Jia , Huang Yu , Yi Yunhai , Dong Chuanju , Deng Hua , Zhang Songhao , Zhang Hanyuan , Shi Qiong , Xu Peng
Published: March 2017

Background

The Northern snakehead (Channa argus), a member of the Channidae family of the Perciformes, is an economically important freshwater fish native to East Asia. In North America, it has become notorious as an intentionally released invasive species. Its ability to breathe air with gills and migrate short distances over land makes it a good model for bimodal breath research. Therefore, recent research has focused on the identification of relevant candidate genes. Here, we performed whole genome sequencing of C. argus to construct its draft genome, aiming to offer useful information for further functional studies and identification of target genes related to its unusual facultative air breathing. Findings: We assembled theC. argus genome with a total of 140.3 Gb of raw reads, which were sequenced using the Illumina HiSeq2000 platform. The final draft genome assembly was approximately 615.3 Mb, with a contig N50 of 81.4 kb and scaffold N50 of 4.5 Mb. The identified repeat sequences account for 18.9% of the whole genome. The 19 877 protein-coding genes were predicted from the genome assembly, with an average of 10.5 exons per gene. Conclusion: We generated a high-quality draft genome of C. argus, which will provide a valuable genetic resource for further biomedical investigations of this economically important teleost fish.
Post-smolt survival of Baltic salmon in context to changing environmental conditions and predators
Authors: Friedland Kevin D. , Dannewitz Johan , Romakkaniemi Atso , Palm Stefan , Pulkkinen Henni , Pakarinen Tapani , Oeberst Rainer
Published: March 2017

The survival of Baltic salmon Salmo salar during the first year at sea (post-smolt stage) has declined since the beginning of the 1990s. In this analysis, we complement previous studies on possible causes of this decline by considering a suite of environmental parameters, potential change in predation pressure, and post-smolt growth. Marine survival estimates were found to be negatively correlated with temperature, indicating that warming conditions have not favoured survival. Survival was also found to be positively correlated with dissolved oxygen levels and regionally related to shifts in salinity. These relationships were further studied in context to the potential predation on post-smolts by one of the main piscivores in the Baltic, Eastern Baltic cod (Gadus morhua callarias). Concomitant with changes in environmental conditions, Baltic cod has changed its latitudinal range, moving northward in the Baltic, possibly in response to warming conditions. These changes lead us to hypothesize that predation pressure on salmon may have increased in recent years as cod has now occupied habitats used by salmon post-smolts during their southward feeding migrations. This predation may have been intensified as a result of anoxic conditions in the central basin by concentrating predation interactions in coastal waters and/or the upper water column typically occupied by salmon post-smolts. Indicators of post-smolt growth were applied to test the alternate hypothesis that mortality is growth-mediated; these indicators lacked a time series trend, which supports the contention that shifting predation pressure rather than feeding opportunities is responsible for the decline in post-smolt survival in Baltic salmon.
Bumped-Kinase Inhibitors for Cryptosporidiosis Therapy
Authors: Hulverson Matthew A. , Vinayak Sumiti , Choi Ryan , Schaefer Deborah A. , Castellanos-Gonzalez Alejandro , Vidadala Rama S. R. , Brooks Carrie F. , Herbert Gillian T. , Betzer Dana P. , Whitman Grant R. , Sparks Hayley N. , Arnold Samuel L. M. , Rivas Kasey L. , Barrett Lynn K. , White A. Clinton , Maly Dustin J. , Riggs Michael W. , Striepen Boris , Van Voorhis Wesley C. , Ojo Kayode K.
Published: March 2017

This study describes iterative experiments to define bumped-kinase inhibitor properties needed for clinical efficacy. For these compounds, pharmacokinetics analysis of clinical cryptosporidiosis in mice show that fecal drug levels greater than parasite inhibitory concentrations correlate best with effective therapeutic outcomes.
What Is CPTED? Reconnecting Theory with Application in the Words of Users and Abusers
Authors: Armitage Rachel , Monchuk Leanne
Published: March 2017

Crime prevention through environmental design (CPTED) represents a multifaceted approach to crime reduction that draws upon theories from environmental criminology, architecture and urban design and requires the commitment of agencies as diverse as police, planners, and housing developers. Its importance as a crime reduction approach has been formalized through strategy, policy, and regulation and its effectiveness has been confirmed in evaluations (see Brown, unpublished data, Pascoe, 1999, Armitage, 2000, Teedon et al., 2009; 2010, Armitage and Monchuk, 2011). Yet there remains a lack of clarity regarding CPTED’s definition, scope, and crucially, the fundamental components that form its definition. Conscious of the need for clarity and consistency, this article presents the findings from in-depth interviews with a sample of 10 incarcerated, adult, male burglars and 10 Designing Out Crime Officers in England and Wales. The method was exploratory and inductive, with participants being encouraged to express their perceptions of housing design features and the association of these features with burglary risk. The findings reveal key similarities between the users and abusers of CPTED and confirm (and elevate) the significance of features such as surveillance. However, other features of design traditionally considered as critical to burglary risk are afforded less importance—raising questions regarding terminology, weighting and redefinition.
Homecare and Healthcare Utilization Errors Post–Neonatal Intensive Care Unit Discharge
Authors: Patel Rupalee , Nudelman Matthew , Olarewaju Adebola , Pooley Sunshine Weiss , Jegatheesan Priya , Song Dongli , Govindaswami Balaji
Published: March 2017

Background:

High-risk infants transitioning from the neonatal intensive care unit (NICU) to home represent a vulnerable population, given their complex care requirements. Little is known about errors during this period.

Purpose:

Identify and describe homecare and healthcare utilization errors in high-risk infants following NICU discharge.

Methods:

This was a prospective observational cohort study of homecare (feeding, medication, and equipment) and healthcare utilization (appointment) errors in infants discharged from a regional NICU between 2011 and 2015. Chi-square test and Wilcoxon rank-sum test were used to compare infant and maternal demographics between infants with and without errors.

Results:

A total of 363 errors were identified in 241 infants during 635 home visits. The median number of visits was 2. No significance was found between infant and maternal demographics in those with or without errors.

Implications of Practice:

High-risk infants have complex care needs and can benefit from regular follow-up services. Home visits provide an opportunity to identify, intervene, and resolve homecare and healthcare utilization errors.

Implications of Research:

Further research is needed to evaluate the prevalence and cause of homecare errors in high-risk infants and how healthcare resources and infant health outcomes are affected by those errors. Preventive measures and mitigating interventions that best address homecare errors require further development and subsequent description.
Dietary Supplementation With Nonfermentable Fiber Alters the Gut Microbiota and Confers Protection in Murine Models of Sepsis
Authors: Morowitz Michael J. , Di Caro Valentina , Pang Diana , Cummings Jessica , Firek Brian , Rogers Matthew B. , Ranganathan Sarangarajan , Clark Robert S. B. , Aneja Rajesh K.
Published: March 2017

Objectives:

Links between microbial alterations and systemic inflammation have been demonstrated in chronic disease, but little is known about these interactions during acute inflammation. This study investigates the effect of dietary supplementation with cellulose, a nonfermentable fiber, on the gut microbiota, inflammatory markers, and survival in two murine models of sepsis.

Design:

Prospective experimental study.

Setting:

University laboratory.

Subjects: Six-week-old male C57BL/6 wild-type mice.

Interventions:

Mice were assigned to low-fiber, normal-fiber, or high-fiber diets with or without antibiotics for 2 weeks and then subjected to sepsis by cecal ligation and puncture or endotoxin injection. Fecal samples were collected for microbiota analyses before and after dietary interventions.

Measurements and Main Results:

Mice that received a high-fiber diet demonstrated increased survival after cecal ligation and puncture relative to mice receiving low-fiber or normal-fiber diets. The survival benefit was associated with decreased serum concentration of pro-inflammatory cytokines, reduced neutrophil infiltration in the lungs, and diminished hepatic inflammation. The high-fiber diet also increased survival after endotoxin injection. Bacterial 16S ribosomal RNA gene sequences from each sample were amplified, sequenced, and analyzed. Fiber supplementation yielded an increase in relative abundance of the genera Akkermansia and Lachnospiraceae, taxa commonly associated with metabolic health. Administration of antibiotics to mice on the high-fiber diet negated the enrichment of Akkermansia species and the survival benefit after cecal ligation and puncture.

Conclusion:

Dietary supplementation with cellulose offers a microbe-mediated survival advantage in murine models of sepsis. Improved understanding of the link between diet, the microbiota, and systemic illness may yield new therapeutic strategies for patients with sepsis.
Application of a Framework to Implement Trauma-Informed Care Throughout a Pediatric Health Care Network
Authors: Weiss Danielle , Kassam-Adams Nancy , Murray Carol , Kohser Kristen L. , Fein Joel A. , Winston Flaura K. , Marsac Meghan L.
Published: March 2017

Introduction:

To evaluate the initial application of a recently published three-step framework for implementing trauma-informed care (TIC) in a pediatric health care network by applying Framework for Spread.

Methods:

In steps 1 and 2 of the framework, we established commitment from the health care network leadership and initial interest in TIC among clinical providers (step 1), set evidence-based training goals and created the associated TIC training content (step 2). In step 3, 440 health care professionals (from 27 health care teams) participated in single-session, 1-hour training that covered the psychological impact of injury- and illness-related trauma, identification of traumatic stress symptoms, and how to respond to children exposed to potentially traumatic events. A concomitant quality improvement project allowed us to assess potential changes in training participants' favorable attitudes toward the integration of TIC and confidence in delivering TIC.

Results:

Compared with pretraining, participants demonstrated increases in attitude toward TIC, t(293) = 5.8, P < .001, Cohen's d = 0.32, and confidence in delivering TIC, t(293) = 20.9, P < .001, Cohen's d = 1.09.

Discussion:

Trainings were effective in achieving proximal goals targeting attitudes and confidence, thereby demonstrating the feasibility and clinical relevance of TIC training when implemented according to the three-step framework. Future research should examine methods of training to reach wide audiences to promote systematic change and evaluate changes in patient outcomes associated with providers' implementation of TIC.
Response of BRAF inhibitor-associated squamous cell lung carcinoma to drug withdrawal
Authors: Blackmon Jonathan T. , Dhawan Ratika , Terry Nina L. , Conry Robert M.
Published: March 2017

Vemurafenib and dabrafenib, two Food and Drug Administration-approved selective BRAF kinase inhibitors (BRAFi), have revolutionized the targeted therapy of cutaneous melanoma. Off-target effects of these drugs paradoxically activate the MAP kinase pathway in BRAF wild-type cells, leading to secondary malignancies. Although cutaneous squamous cell carcinomas are by far the most frequent, emergence of potentially life-threatening secondary tumors from other sites following prolonged therapy is a growing concern. Herein, we provide the first case report of squamous cell lung carcinoma apparently secondary to BRAFi developing in a metastatic melanoma patient on vemurafenib for 23 months. Subsequent BRAFi with dabrafenib for 5 months was accompanied by rapid lung cancer progression with 86% increase in diameter. Withdrawal of BRAFi as the only change in therapy resulted in partial response maintained for more than 8 months. Clinicians should be atuned to the risk of noncutaneous second malignancies induced by BRAFi, particularly in the setting of progression of an isolated lesion after prolonged therapy.
Alzheimer’s disease pathology and the unfolded protein response: prospective pathways and therapeutic targets
Authors: Koss David J. , Platt Bettina
Published: March 2017

Many vital interdependent cellular functions including proteostasis, lipogenesis and Ca2+ homeostasis are executed by the endoplasmic reticulum (ER). Exogenous insults can impair ER performance: this must be rapidly corrected or cell death will ensue. Protective adaptations can boost the functional capacity of the ER and form the basis of the unfolded protein response (UPR). Activated in response to the accumulation of misfolded proteins, the UPR can halt protein translation while increasing protein-handling chaperones and the degradation of erroneous proteins through a conserved three-tier molecular cascade. However, prolonged activation of the UPR can result in the maladaptation of the system, resulting in the activation of inflammatory and apoptotic effectors. Recently, UPR and its involvement in neurodegenerative disease has attracted much interest and numerous potentially ‘drugable’ points of crosstalk are now emerging. Here, we summarize the functions of the ER and UPR, and highlight evidence for its potential role in the pathogenesis of Alzheimer’s disease, before discussing several key targets with therapeutic potential.
The Aesthetic Items Scale: A Tool for the Evaluation of Aesthetic Outcome after Breast Reconstruction
Authors: Dikmans Rieky E.G. , Nene Lauren E.H. , Bouman Mark-Bram , de Vet Henrica C.W. , Mureau Marc A.M. , Buncamper Marlon E. , Winters Hay A.H. , Ritt Marco J.P.F. , Mullender Margriet G.
Published: March 2017

Background:

Valid tools to assess aesthetic outcomes after breast reconstructive surgery are scarce. Previously a professional aesthetic assessment scale was introduced, the Aesthetic Items Scale (AIS). We aim to determine if this method is a valid and reliable tool to assess aesthetic outcome after breast reconstructive surgery.

Methods:

The study population was consenting women who underwent prophylactic mastectomy with subsequent implant-based breast reconstruction. The aesthetic outcome with regard to breast volume, shape, symmetry, scars, and nipple areola complex was rated on a 5-point scale using standardized photographs to give a summed total score. Photographs were evaluated by the patient, 5 plastic surgeons, and 3 mammography nurses. An overall rating of aesthetic outcome on a 1–10 scale was given separately. We determined the intraclass correlation coefficient and assessed interobserver agreement. To assess validity, we calculated the correlation between total score and overall rating of aesthetic outcome.

Results:

Interobserver reliability was highest between plastic surgeons for the subitem and overall scores and ranged between 0.56 and 0.82. The summed score of the AIS correlates strongly with the overall rating in professionals but not in patients.

Conclusions:

The AIS is a valid and reliable method for evaluating aesthetic outcome of breast reconstruction by plastic surgeons. The results indicate that patients judge aesthetic outcome differently, taking into account factors that are not represented in the AIS. Professionals can use this method to evaluate surgical results, but other measurements are needed to map satisfaction of the patient with her breasts.
Follistatin and the Breast Implant Capsule
Authors: Frenkiel Brett A. , Temple-Smith Peter , de Kretser David , Southwick Graeme J.
Published: March 2017

Background:

Breast capsular contracture remains an elusive problem faced by plastic surgeons and is the leading long-term complication after breast implantation. Follistatin (Fst) is a protein with known anti-inflammatory and antifibrotic properties and has the potential to limit the severity of diseases associated with inflammation and fibrosis such as capsular contracture. The aim of this study was to examine the effect of Fst288 on capsular fibrosis around silicone implants in a mouse model.

Methods:

BALB/c mice were implanted subcutaneously with untreated silicone implants (baseline control). In the experimental group, immediately after silicone implant insertion, the implant pocket received either a single injection of 1 µg Fst288 or normal saline (internal control). The animals were killed at 3, 5, 7, 14, 28, and 90 days after surgery, and serum, implants, and the surrounding tissue were removed for histological and immunohistochemical analyses.

Results:

Fst288 treatment resulted in significant decreases in capsule thickness at 28 days (P < 0.05) and 3 months (P < 0.001), decreased collagen production at 14 days (P < 0.05) and 3 months (P < 0.01), decreased angiogenesis at 3 months (P < 0.001), decreased α-smooth muscle actin levels at 3 months (P < 0.05), and a decrease in the number of CD45+ cells at days 5 (P < 0.05) and 7 (P < 0.01), respectively, when compared with control implants.

Conclusions:

A single injection of Fst288 at the time of silicone implant insertion into the mice results in a significant reduction in pericapsular inflammation and capsular fibrosis.
Evaluation of Brazilian Primary Health Care From the Perspective of the Users
Authors: Fausto Márcia Cristina Rodrigues , Bousquat Aylene , Lima Juliana Gagno , Giovanella Ligia , Almeida Patty Fidelis de , Mendonça Maria Helena Magalhães de , Seidl Helena , Silva Andréa Tenório Correia da
Published: March 2017

The objective of this study was to examine the experience of primary care center (PCC) users in Brazil, classified according to the quality of its structure, in relation to the aspects of accessibility, continuity, and acceptability. The source of information was the National Program to Improve Access and Quality of Primary Care in 2013-2014. A total of 109 919 interviewees in 24 055 PCCs comprised the sample. Results show that the structure of a PCC was associated with better indicators of accessibility (oral health and medicines) and continuity of care (patient navigation in the health system). No association was found between indicators of accessibility and the PCC structure.
Primary Care Dentistry in Brazil
Authors: Neves Matheus , Giordani Jessye Melgarejo do Amaral , Ferla Alcindo Antônio , Hugo Fernando Neves
Published: March 2017

This cross-sectional study aimed to evaluate the association between sociodemographic characteristics, health care indicators, work process characteristics, and the performance of preventive dental procedures by oral health care teams (OHCTs) assessed during the first phase of the PMAQ in Brazil. A census of 10 334 primary OHCTs was conducted. The outcome included topical application of fluoride, application of sealants, detection of oral lesions, and monitoring of suspected or confirmed cases of oral cancer. The multilevel Poisson regression model was used to obtain crude and adjusted prevalence ratios. The performance of preventive dental procedures was 29.46% (3044/10 334; 95% confidence interval, 28.57-30.33), which was considered low.
Brazil's National Program for Improving Primary Care Access and Quality (PMAQ)
Authors: Macinko James , Harris Matthew J. , Rocha Marcia Gomes
Published: March 2017

Despite some remarkable achievements, there are several challenges facing Brazil's Family Health Strategy (FHS), including expanding access to primary care and improving its quality. These concerns motivated the development of the National Program for Improving Primary Care Access and Quality (PMAQ). Although voluntary, the program now includes nearly 39 000 FHS teams in the country and has led to a near doubling of the federal investment in primary care in its first 2 rounds. In this article, we introduce the PMAQ and advance several recommendations to ensure that it continues to improve primary care access and quality in Brazil.
Neurobiology of Comorbid Substance Use Disorders and Psychiatric Disorders
Authors: Balhara Yatan Pal Singh , Kuppili Pooja Patnaik , Gupta Rishab
Published: March 2017

Background

“Dual disorder” or “dual diagnosis” refers to the co-occurrence of substance use disorder and psychiatric disorders. Prospective studies have shown that treatment outcomes, such as symptom levels, hospitalization rates, housing stability, and functional status, are worse among the patients with dual disorders as compared with those who have either of these disorders.

Objectives

The current article is aimed at reviewing the current state of evidence on neurobiology of dual disorders. Given the high prevalence of co-occurrence of substance use disorder and psychiatric disorders, it is important to explore the various facets of this association. The current review assimilates the information on neurobiological research on dual disorders and helps the readers gain insights into the current understanding on this theme.

Methods

The electronic database of PubMed was searched for relevant publications.

Results

The studies included in the review belonged to various domains of neurobiology including neuropathology, structural neuroimaging, functional neuroimaging, genetics, neurochemicals/neuroreceptors, and neuroendocrinology. Forty studies were included in the review.

Conclusions

Most of the issues related to the neurobiology of dual disorders remain inadequately studied. However, the current evidence suggests that the individuals with co-occurring disorders are likely to differ from those with either substance use disorders or psychiatric disorders alone on various neurobiological aspects. Hence, it is imperative to systematically study the various neurobiological aspects of dual disorders in the future.
Psychometric Properties of the Fagerström Test for Nicotine Dependence in a Sample of Mexican Smokers
Authors: Moreno-Coutiño Ana , Villalobos-Gallegos Luis
Published: March 2017

Introduction

The Fagerström Test for Nicotine Dependence (FTND) is a widely used six-item questionnaire, often used as a measure of physical dependence on nicotine, although evidence of its validity in Spanish-language studies is scarce.

Aim

The aim of this study was to assess the psychometric properties of FTND in Spanish speakers.

Method

We recruited 136 regular adult smokers to answer the FTND. We assessed the internal consistency of the FTND with a Cronbach’s alpha and convergent and divergent validity with the Pearson product–moment coefficient between variables of external criteria, both measure and nonmeasure related; the FTND items, and the total score. We performed a binary logistic regression model to determine predictive validity of the questionnaire, using the FTND total scores as an independent variable and cessation as the outcome. We performed a confirmatory factor analysis to assess the robustness of a single-factor model.

Results

The internal consistency had a lower coefficient than current standards. The FTND was unable to predict cessation at any assessed time point. The FTND total score showed significant correlation with exhaled carbon monoxide, urinary cotinine, and self-report of cigarettes smoked per day. However, Items 5 (smoke in the first hours) and 6 (smoke if ill) failed to obtain a significant correlation with biological biomarkers.

Discussion

Although the FTND showed an adequate construct validity, the results suggest that its convergent and predictive validity is limited; therefore, it might not be suitable for the Mexican population. More studies in other populations are needed to establish the generalizability of these findings.
Providing Tobacco Treatment in a Community Mental Health Setting
Authors: Okoli Chizimuzo T. C. , Mason Dia A. , Brumley-Shelton Angela , Robertson Heather
Published: March 2017

Objective

Individuals with mental illnesses (MIs) are disproportionately affected by tobacco-related disease burden because of higher tobacco use prevalence and poor tobacco treatment outcomes. This pilot study examines the outcomes of delivering an evidence-based tobacco treatment program (the Cooper–Clayton program) in a community mental health setting.

Design

A prospective nonequivalent group design was used to assess outcomes.

Sample

This study included 47 participants, of which 19 were in a community mental health setting and 28 were from two non-mental-health settings.

Measurements

Information on sociodemographic (gender, age, educational level, and current life stressors) and medical, MI, substance use, and tobacco use and cessation histories were obtained. Program completion and smoking cessation at the end of treatment (verified with expired carbon monoxide monitoring) were assessed.

Intervention

The program consists of combining behavioral counseling with nicotine replacement therapy for 12 weeks.

Results

Participants from the mental health setting were significantly less educated, had greater medical comorbidities, had greater psychiatric and mental health histories, and had greater perceived secondhand tobacco smoke exposure as compared with those from the non-mental-health settings. Thirty-two percent of the participants (6/19) completed the program in the mental health site as compared with 68% (19/28) from the non-mental-health site. None of those from the mental health site achieved cessation as compared with 68% of those from non-mental-health sites.

Conclusions

The differential outcomes of evidence-based tobacco treatment programs in non-mental-health versus mental health settings may suggest the need to modify existing tobacco treatment approaches for those with MIs in community settings.
The prevalence of viral agents in esophageal adenocarcinoma and Barrett’s esophagus: a systematic review
Authors: Kunzmann Andrew T. , Graham Suzanne , McShane Charlene M. , Doyle James , Tommasino Massimo , Johnston Brian , Jamison Jackie , James Jacqueline A. , McManus Damian , Anderson Lesley A.
Published: March 2017

Background and aims

Human papilloma virus (HPV), which may reach the esophagus through orogenital transmission, has been postulated to be associated with esophageal adenocarcinoma (EAC). A systematic review of the literature investigating the prevalence of infectious agents in EAC and Barrett’s esophagus (BE) was carried out.

Methods

Using terms for viruses and EAC, the Medline, Embase, and Web of Science databases were systematically searched for studies published, in any language, until June 2016 that assessed the prevalence of viral agents in EAC or BE. Random-effects meta-analyses of proportions were carried out to calculate the pooled prevalence and 95% confidence intervals (CIs) of infections in EAC and BE.

Results

A total of 30 studies were included. The pooled prevalence of HPV in EAC tumor samples was 13% (n=19 studies, 95% CI: 2–29%) and 26% (n=6 studies, 95% CI: 3–59%) in BE samples. HPV prevalence was higher in EAC tissue than in esophageal tissue from healthy controls (n=5 studies, pooled odds ratio=3.31, 95% CI: 1.15–9.50). The prevalence of Epstein–Barr virus (EBV) in EAC was 6% (n=5, 95% CI: 0–27%). Few studies have assessed other infectious agents. For each of the analyses, considerable between-study variation was observed (I
2=84–96%); however, sensitivity analyses did not show any major sources of heterogeneity.

Conclusion

The prevalence of HPV and EBV in EAC is low compared with other viral-associated cancers, but may have been hampered by small sample sizes and detection methods susceptible to fixation processes. Additional research with adequate sample sizes and high-quality detection methods is required.
Telehealth in Palliative Care
Authors: Head Barbara A. , Schapmire Tara J. , Zheng Yongqiang
Published: March 2017

A systematic review was conducted to explore published quantitative and qualitative research describing patient-reported outcomes of palliative telehealth intervention studies. Multiple databases were searched for articles published between January 2006 and May 2016, which met study criteria. Methodological quality was assessed using Cochrane Collaboration’s tool for assessing risk of bias for quantitative articles. For studies reporting qualitative outcomes, a checklist was used to evaluate trustworthiness of the methodology. Of the 6 studies reporting quantitative outcomes, 3 studies were rated as having moderate study quality, and 3 studies were rated as having low study quality. Of the 6 studies reporting qualitative outcomes, 3 reported 5 different methods for ensuring trustworthiness, whereas 1 article reported 4 methods, 1 reported 3, and 1 article reported 2 methods. Studies were notably diverse in terms of patient population, technology used, outcomes measures, and methodology. Results across studies were also variable. Methodological factors were major limitations. Recruitment problems, participant attrition, and lack of standardized outcomes measures impacted outcome assessment. Overall, research support for positive patient outcomes in palliative telehealth interventions was weak. However, all studies but one found positive results to support the intervention.
Hope for a Miracle
Authors: Blackler Liz
Published: March 2017

Living with a life-threatening illness is challenging. It is not uncommon for patients and caregivers facing medical uncertainties to utilize religious coping as a tool to foster adjustment to changes along an illness trajectory. Religious coping can promote a sense of meaning, emotional well-being, and hope. This article explores requests for aggressive treatment stemming from strongly held religious beliefs and overarching hope for a miracle. A case example highlights the complexities of religious coping, belief in miracles, and requests for life-prolonging treatment at the end of life. The article closes with a discussion of the ethical considerations and strategies for best communicating with and caring for patients who request life-prolonging medical care in advanced illness.
The Role of Hospice and Palliative Care Nurses in Quality Improvement
Authors: Lindley Lisa C. , Herr Keela A. , Norton Sally A.
Published: March 2017

Now more than ever, it is essential for hospice and palliative care nurse leaders to be front and center in the quality improvement (QI) arena. Because nurses are integral to the delivery of hospice and palliative care, they are pivotal in efforts to improve quality. This article sought to provide an in-depth understanding of the leadership role that nurses can play in QI activities from project inception and team formation, to the planning stage. The analysis revealed that hospice and palliative care nurses have a leadership role at the onset of the QI project that includes active team membership as a QI team leader, team member, and/or champion. Nurses also have a leadership role in formulating the project aims and choosing the appropriate project model within their organizations. Finally, hospice and palliative care nurses use their planning skills to develop QI project measures, data collection plan, data analysis plan, and communication/implementation/evaluation plan. The QI project provides opportunities for hospice and palliative care nurse leaders to use their clinical, technical, and administrative knowledge to improve the care of patients and families at the end of life.
RN to BSN Transition
Authors: Phillips Tracy , Titzer Evans Jennifer L.
Published: March 2017

Over 670,000 ADN- and diploma-prepared nurses will need to complete their BSN degrees to meet the Institute of Medicine's recommendation that at least 80% of registered nurses (RNs) be BSN-prepared by year 2020. Understanding motivators, barriers, and the transition experience for RNs to advance their degree will help educators and nurse leaders understand the importance of a partnership to educate and mentor RNs to pursue a BSN degree.
Development and Prospective Validation of Tools to Accurately Identify Neurosurgical and Critical Care Events in Children With Traumatic Brain Injury*
Authors: Bennett Tellen D. , DeWitt Peter E. , Dixon Rebecca R. , Kartchner Cory , Sierra Yamila , Ladell Diane , Srivastava Rajendu , Riva-Cambrin Jay , Kempe Allison , Runyan Desmond K. , Keenan Heather T. , Dean J. Michael
Published: March 2017

Objective:

To develop and validate case definitions (computable phenotypes) to accurately identify neurosurgical and critical care events in children with traumatic brain injury.

Design:

Prospective observational cohort study, May 2013 to September 2015.

Setting:

Two large U.S. children’s hospitals with level 1 Pediatric Trauma Centers.

Patients:

One hundred seventy-four children less than 18 years old admitted to an ICU after traumatic brain injury.

Measurements and Main Results:

Prospective data were linked to database codes for each patient. The outcomes were prospectively identified acute traumatic brain injury, intracranial pressure monitor placement, craniotomy or craniectomy, vascular catheter placement, invasive mechanical ventilation, and new gastrostomy tube or tracheostomy placement. Candidate predictors were database codes present in administrative, billing, or trauma registry data. For each clinical event, we developed and validated penalized regression and Boolean classifiers (models to identify clinical events that take database codes as predictors). We externally validated the best model for each clinical event. The primary model performance measure was accuracy, the percent of test patients correctly classified. The cohort included 174 children who required ICU admission after traumatic brain injury. Simple Boolean classifiers were greater than or equal to 94% accurate for seven of nine clinical diagnoses and events. For central venous catheter placement, no classifier achieved 90% accuracy. Classifier accuracy was dependent on available data fields. Five of nine classifiers were acceptably accurate using only administrative data but three required trauma registry fields and two required billing data.

Conclusions:

In children with traumatic brain injury, computable phenotypes based on simple Boolean classifiers were highly accurate for most neurosurgical and critical care diagnoses and events. The computable phenotypes we developed and validated can be used in any observational study of children with traumatic brain injury and can reasonably be applied in studies of these interventions in other patient populations.
Aerococcus urinae, a cause of cystitis with malodorous urine in a child: clinical and microbiological challenges
Authors: Skalidis Tilemachos , Papaparaskevas Josef , Konstantinou Dimitrios , Kapolou Eleni , Falagas Mathhew E. , Legakis Nicholas
Published: March 2017

Introduction. An infection of the lower urinary tract associated with an extremely unpleasant odour due to Aerococcus urinae in an otherwise healthy 5-year-old boy is described herein.

Case presentation. Interestingly, imaging examination revealed the presence of a bladder diverticulum. Routine microbiological examination based on Gram staining, colony morphology and catalase reactivity suggested that the responsible pathogen could belong either to staphylococci, α-haemolytic streptococci or enterococci, which are more common urine isolates. Of note is that the VITEK 2 automated system could not identify the micro-organism. Susceptibility testing showed full sensitivity to β-lactam antibiotics and resistance to trimethoprim/sulfamethoxazole. The isolate was subjected to 16S rRNA gene sequence analysis because of its unusual characteristics. It was identified as A. urinae and the sequence was deposited in GenBank under the accession number KU207150.

Conclusion.
A. urinae should be considered as a causative agent of urinary-tract infection associated with malodorous urine.
Successful treatment of Listeria monocytogenes prosthetic valve endocarditis using rifampicin and benzylpenicillin in combination with valve replacement
Authors: Hasan Tasnim , Chik William , Chen Sharon , Kok Jen
Published: March 2017

Introduction.
Listeria monocytogenes is an uncommon cause of prosthetic valve endocarditis (PVE). Recommended antimicrobial therapy typically includes intravenous β-lactams with or without synergistic aminoglycosides. In vitro studies have previously identified antagonism when rifampicin has been used in combination with β-lactams. However, in vivo data of rifampicin use are limited despite its enhanced anti-biofilm activity.

Case presentation. A 63-year-old male presented with fever and back pain. L. monocytogenes bacteraemia and bioprosthetic aortic valve endocarditis was confirmed, along with spinal discitis and osteomyelitis. He was successfully treated with benzylpenicillin and rifampicin, in conjunction with valve replacement.

Conclusion. Rifampicin remains an alternate agent to use, when there are contraindications to traditional aminoglycoside therapy. Further data on rifampicin use in L. monocytogenes PVE are awaited.