bluuebunny/crossref_metadata_2025 huggingface dataset:
Real-time measurement of small molecules directly in awake, ambulatory animals
Authors: Arroyo-Currás Netzahualcóyotl , Somerson Jacob , Vieira Philip A. , Ploense Kyle L. , Kippin Tod E. , Plaxco Kevin W.
Published: January 2017

Significance

The ability to monitor arbitrary molecules directly in living subjects as they undergo their daily routines remains one of the “holy grails” of bioanalytical chemistry. Such a technology would, for example, vastly improve our knowledge of physiology, pharmacokinetics, and toxicology by allowing the high-precision measurement of drugs and metabolites under realistic physiological conditions. Real-time molecular measurements would also provide an unparalleled window into health status (e.g., kidney function) and would facilitate “therapeutic drug monitoring,” in which dosing is personalized to the specific metabolism of each individual patient. Finally, the ability to measure molecules in the body in real time would provide unprecedented new routes by which drugs with dangerously narrow therapeutic windows could be safely and efficiently administered.
Exposure to inequality affects support for redistribution
Authors: Sands Melissa L.
Published: January 2017

Significance

As the world’s population grows more urban, encounters between members of different socioeconomic groups occur with greater frequency. I provide real-world experimental evidence that exposure to inequality shapes decision-making. By randomly assigning microenvironments of inequality, this study builds on observational research linking the salience of inequality to antisocial behavior, as well as survey experimental evidence connecting perceived inequality to diminished generosity. Specifically, I show that exposure to socioeconomic inequality in an everyday setting negatively affects willingness to publicly support a redistributive economic policy. This study advances our understanding of how environmental factors, such as exposure to racial and economic outgroups, affect human behavior in consequential ways.
Wnt5a is essential for hippocampal dendritic maintenance and spatial learning and memory in adult mice
Authors: Chen Chih-Ming , Orefice Lauren L. , Chiu Shu-Ling , LeGates Tara A. , Hattar Samer , Huganir Richard L. , Zhao Haiqing , Xu Baoji , Kuruvilla Rejji
Published: January 2017

Significance

The maintenance of neuronal morphology in the adult brain is an understudied area. Here, using tissue-specific deletion in mice, we reveal Wnt5a, a member of the Wnt family of developmental morphogens, as an essential factor for the long-term stability of dendritic architecture in the adult hippocampus. Wnt5a influences synaptic plasticity and related cognitive functions in the mature hippocampus through CaMKII-mediated signaling, Rac1-dependent actin dynamics, and cyclic AMP-responsive element binding-mediated NMDA receptor biosynthesis. In the long-term, Wnt5a-mediated regulation of cytoskeletal signaling and excitatory synaptic transmission is responsible for the maintenance of dendritic arbors and spines in adult CA1 pyramidal neurons. These findings provide insight into the poorly understood structural maintenance mechanisms that exist in the adult brain.
Quality control mechanisms exclude incorrect polymerases from the eukaryotic replication fork
Authors: Schauer Grant D. , O’Donnell Michael E.
Published: January 2017

Significance

DNA replication is a central life process and is performed by numerous proteins that orchestrate their actions to separate the strands of duplex DNA and produce two new copies of the genome for cell division. While the antiparallel architecture of DNA is elegant in its simplicity, replication of DNA still holds many mysteries. For example, many essential replication proteins still have unknown functions. In eukaryotes the two DNA strands are duplicated by different DNA polymerases. The mechanism by which these different polymerases target to their respective strands is understood. This report examines the mechanisms that eject incorrect polymerases when they associate with the wrong strand.
Toxic PR
n
poly-dipeptides encoded by the
C9orf72
repeat expansion block nuclear import and export
Authors: Shi Kevin Y. , Mori Eiichiro , Nizami Zehra F. , Lin Yi , Kato Masato , Xiang Siheng , Wu Leeju C. , Ding Ming , Yu Yonghao , Gall Joseph G. , McKnight Steven L.
Published: January 2017

Significance

A hexanucleotide repeat expansion in the first intron of the
C9orf72
gene represents the most prominent form of heritable amyotrophic lateral sclerosis. Bidirectional transcription and ATG-independent translation of the expanded (GGGGCC)
n
repeat specifies the production of toxic glycine:arginine (GR
n
) and proline:arginine (PR
n
) poly-dipeptides. The present study provides evidence that the PR
n
poly-dipeptide binds directly to the central channel of nuclear pores, causing inhibition of both the import and export of macromolecules to and from the nucleus. Nuclear pore binding is shown to be mediated via direct interaction between the toxic PR
n
poly-dipeptide and polymeric forms of nuclear pore proteins enriched in phenylalanine:glycine repeats.
Strength and toughness of clean nanostructured bainite
Authors: Peet M. J. , Fielding L. C. D. , Hamedany A. A. , Rawson M. , Hill P. , Bhadeshia H. K. D. H.
Published: January 2017

A nanostructured steel has been produced using a clean steel-making technique. The mechanical properties have been comprehensively characterised. The maximum strength of the material recorded was 2.2 GPa at yield, with an ultimate tensile strength of 2.5 GPa, accompanied by a Charpy impact energy of 5 J, achieved by heat treatment to refine the prior austenite grain size from 145 to 20 µm. This increased the strength by 40% and the Charpy V-notch energy more than doubled. In terms of resistance of the hardness to tempering, the behaviour observed was similar to previous alloys. Despite reducing the hardness and strength, tempering was observed to reduce the plane-strain fracture toughness.
ZODIACAL EXOPLANETS IN TIME (ZEIT). IV. SEVEN TRANSITING PLANETS IN THE PRAESEPE CLUSTER
Authors: Mann Andrew W. , Gaidos Eric , Vanderburg Andrew , Rizzuto Aaron C. , Ansdell Megan , Medina Jennifer Vanessa , Mace Gregory N. , Kraus Adam L. , Sokal Kimberly R.
Published: January 2017

Open clusters and young stellar associations are attractive sites to search for planets and to test theories of planet formation, migration, and evolution. We present our search for, and characterization of, transiting planets in the 800 Myr old Praesepe (Beehive, M44) Cluster from K2 light curves. We identify seven planet candidates, six of which we statistically validate to be real planets, the last of which requires more data. For each host star, we obtain high-resolution NIR spectra to measure its projected rotational broadening and radial velocity, the latter of which we use to confirm cluster membership. We combine low-resolution spectra with the known cluster distance and metallicity to provide precise temperatures, masses, radii, and luminosities for the host stars. Combining our measurements of rotational broadening, rotation periods, and our derived stellar radii, we show that all planetary orbits are consistent with alignment to their host star’s rotation. We fit the K2 light curves, including priors on stellar density to put constraints on the planetary eccentricities, all of which are consistent with zero. The difference between the number of planets found in Praesepe and Hyades (8 planets,

Myr) and a similar data set for Pleiades (0 planets, ≃125 Myr) suggests a trend with age, but may be due to incompleteness of current search pipelines for younger, faster-rotating stars. We see increasing evidence that some planets continue to lose atmosphere past 800 Myr, as now two planets at this age have radii significantly larger than their older counterparts from Kepler.
KEPLER TRANSIT DEPTHS CONTAMINATED BY A PHANTOM STAR
Authors: Dalba Paul A. , Muirhead Philip S. , Croll Bryce , Kempton Eliza M.-R.
Published: January 2017

We present ground-based observations from the Discovery Channel Telescope (DCT) of three transits of Kepler-445c—a supposed super-Earth exoplanet with properties resembling GJ 1214b—and demonstrate that the transit depth is ∼50% shallower than the depth previously inferred from Kepler spacecraft data. The resulting decrease in planetary radius significantly alters the interpretation of the exoplanet’s bulk composition. Despite the faintness of the M4 dwarf host star, our ground-based photometry clearly recovers each transit and achieves repeatable 1σ precision of ∼0.2% (2 millimags). The transit parameters estimated from the DCT data are discrepant with those inferred from the Kepler data to at least 17σ confidence. This inconsistency is due to a subtle miscalculation of the stellar crowding metric during the Kepler pre-search data conditioning (PDC). The crowding metric, or CROWDSAP, is contaminated by a non-existent phantom star originating in the USNO-B1 catalog and inherited by the Kepler Input Catalog (KIC). Phantom stars in the KIC are likely rare, but they have the potential to affect statistical studies of Kepler targets that use the PDC transit depths for a large number of exoplanets where an individual follow-up observation of each is not possible. The miscalculation of Kepler-445c’s transit depth emphasizes the importance of stellar crowding in the Kepler data, and provides a cautionary tale for the analysis of data from the Transiting Exoplanet Survey Satellite, which will have even larger pixels than Kepler.
Geographic Expansion of Lyme Disease in Michigan, 2000–2014
Authors: Lantos Paul M. , Tsao Jean , Nigrovic Lise E. , Auwaerter Paul G. , Fowler Vance G. , Ruffin Felicia , Foster Erik , Hickling Graham
Published: January 2017

Background

Most Lyme disease cases in the Midwestern United States are reported in Minnesota and Wisconsin. In recent years, however, a widening geographic extent of Lyme disease has been noted with evidence of expansion eastwards into Michigan and neighboring states with historically low incidence rates.

Methods

We collected confirmed and probable cases of Lyme disease from 2000 through 2014 from the Michigan Department of Health and Human Services, entering them in a geographic information system. We performed spatial focal cluster analyses to characterize Lyme disease expansion. We compared the distribution of human cases with recent Ixodes scapularis tick distribution studies.

Results

Lyme disease cases in both the Upper and Lower Peninsulas of Michigan expanded more than 5-fold over the study period. Although increases were seen throughout the Upper Peninsula, the Lower Peninsula particularly expanded along the Indiana border north along the eastern shore of Lake Michigan. Human cases corresponded to a simultaneous expansion in established I scapularis tick populations.

Conclusions

The geographic distribution of Lyme disease cases significantly expanded in Michigan between 2000 and 2014, particularly northward along the Lake Michigan shore. If such dynamic trends continue, Michigan—and possibly neighboring areas of Indiana, Ohio, and Ontario, Canada—can expect a continued increase in Lyme disease cases.
Hospitalizations for Respiratory Syncytial Virus Among Adults in the United States, 1997–2012
Authors: Pastula Susan T. , Hackett Judith , Coalson Jenna , Jiang Xiaohui , Villafana Tonya , Ambrose Christopher , Fryzek Jon
Published: January 2017

Background

Respiratory syncytial virus (RSV) is an established cause of serious lower respiratory disease in children, but the burden in adults is less well studied.

Methods

We conducted a retrospective study of hospitalizations among adults ≥20 years from the 1997–2012 National Inpatient Sample. Trends in RSV admissions were described relative to unspecified viral pneumonia admissions. Hospitalization severity indicators were compared among immunocompromised RSV, non-immunocompromised RSV, and influenza admissions.

Results

An estimated 28237 adult RSV hospitalizations occurred, compared with 652818 influenza hospitalizations; 34% were immunocompromised individuals. Respiratory syncytial virus and influenza patients had similar age, gender, and race distributions, but RSV was more often diagnosed in urban teaching hospitals (73.0% for RSV vs 34.6% for influenza) and large hospitals (71.9% vs 56.4%). Respiratory syncytial virus hospitalization rates increased from 1997 to 2012, particularly for those ≥60, increasing from 0.5 to 4.6 per 100000, whereas unspecified pneumonia admission rates decreased significantly (P < .001). Immunocompromised patients with RSV hospitalization had significantly higher inpatient mortality (P = .013), use of mechanical ventilation (P = .016), mean length of stay (LOS) (P < .001), and mean cost (P < .001) than non-immunocompromised RSV hospitalizations. Overall, RSV hospitalizations were more severe than influenza hospitalizations (6.2% mortality for RSV vs 3.0% for influenza, 16.7% vs 7.2% mechanical ventilation, mean LOS of 6.0 vs 3.6 days, and mean cost of $38828 vs $14519).

Conclusions

Respiratory syncytial virus hospitalizations in adults are increasing, likely due to increasing recognition and diagnosis. The burden of RSV in adults deserves attention. Although there are fewer hospitalizations than influenza, those that are diagnosed are on average more severe.
Diagnosis in France of a Non-Toxigenic tox Gene-Bearing Strain of Corynebacterium diphtheriae in a Young Male Back From Senegal
Authors: Billard-Pomares Typhaine , Rouyer Cécile , Walewski Violaine , Badell-Ocando Edgar , Dumas Marc , Zumelzu Coralie , Jaureguy Françoise , Brisse Sylvain , Caux Frédéric , Bouchaud Olivier , Carbonnelle Etienne
Published: January 2017

Cutaneous diphtheria is uncommon in Europe. In this study, we report a case of imported cutaneous infection due to a non-toxigenic but tox gene-bearing (NTTB) strain of Corynebacterium diphtheriae. The NTTB strains are recognized as emerging pathogens across Europe, and physicians and bacteriologists should be aware of the circulation of these strains.
Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses
Authors: Worrell Mary Claire , Kramer Michael , Yamin Aliya , Ray Susan M. , Goswami Neela D.
Published: January 2017

Background

Tuberculosis (TB) causes significant morbidity and mortality in US cities, particularly in poor, transient populations. During a TB outbreak in Fulton County, Atlanta, GA, we aimed to determine whether local maps created from multiple locations of personal activity per case would differ significantly from traditional maps created from single residential address.

Methods

Data were abstracted for patients with TB disease diagnosed in 2008–2014 and receiving care at the Fulton County Health Department. Clinical and activity location data were abstracted from charts. Kernel density methods, activity space analysis, and overlay with homeless shelter locations were used to characterize case spatial distribution when using single versus multiple addresses.

Results

Data were collected for 198 TB cases, with over 30% homeless US-born cases included. Greater spatial dispersion of cases was found when utilizing multiple versus single addresses per case. Activity spaces of homeless and isoniazid (INH)-resistant cases were more spatially congruent with one another than non-homeless and INH-susceptible cases (P < .0001 and P < .0001, respectively).

Conclusions

Innovative spatial methods allowed us to more comprehensively capture the geography of TB-infected homeless persons, who made up a large portion of the Fulton County outbreak. We demonstrate how activity space analysis, prominent in exposure science and chronic disease, supports that routine capture of multiple location TB data may facilitate spatially different public health interventions than traditional surveillance maps.
Risk Factors and Clinical Outcomes Associated with Perioperative Transfusion-associated Circulatory Overload
Authors: Clifford Leanne , Jia Qing , Subramanian Arun , Yadav Hemang , Schroeder Darrell R. , Kor Daryl J.
Published: January 2017

Background

Transfusion-associated circulatory overload remains underappreciated in the perioperative environment. The authors aimed to characterize risk factors for perioperative transfusion-associated circulatory overload and better understand its impact on patient-important outcomes.

Methods

In this case–control study, 163 adults undergoing noncardiac surgery who developed perioperative transfusion-associated circulatory overload were matched with 726 transfused controls who did not develop respiratory complications. Univariate and multivariable logistic regression analyses were used to evaluate potential risk factors for transfusion-associated circulatory overload. The need for postoperative mechanical ventilation, lengths of intensive care unit and hospital stay, and mortality were compared.

Results

For this cohort, the mean age was 71 yr and 56% were men. Multivariable analysis revealed the following independent predictors of transfusion-associated circulatory overload: emergency surgery, chronic kidney disease, left ventricular dysfunction, previous β-adrenergic receptor antagonist use, isolated fresh frozen plasma transfusion (vs. isolated erythrocyte transfusion), mixed product transfusion (vs. isolated erythrocyte transfusion), and increasing intraoperative fluid administration. Patients who developed transfusion-associated circulatory overload were more likely to require postoperative mechanical ventilation (73 vs. 33%; P < 0.001) and experienced prolonged intensive care unit (11.1 vs. 6.5 days; P < 0.001) and hospital lengths of stay (19.9 vs. 9.6 days; P < 0.001). Survival was significantly reduced (P < 0.001) in transfusion recipients who developed transfusion-associated circulatory overload (1-yr survival 72 vs. 84%).

Conclusions

Perioperative transfusion-associated circulatory overload was associated with a protracted hospital course and increased mortality. Efforts to minimize the incidence of transfusion-associated circulatory overload should focus on the judicious use of intraoperative blood transfusions and nonsanguineous fluid therapies, particularly in patients with chronic kidney disease, left ventricular dysfunction, chronic β-blocker therapy, and those requiring emergency surgery.
Epidural Labor Analgesia and Maternal Fever
Authors: SHARPE EMILY E. , ARENDT KATHERINE W.
Published: January 2017

Women receiving an epidural for labor analgesia are at increased risk for intrapartum fever. This relationship has been supported by observational, before and after, and randomized controlled trials. The etiology is not well understood but is likely a result of noninfectious inflammation as studies have found women with fever have higher levels of inflammatory markers. Maternal pyrexia may change obstetric management and women are more likely to receive antibiotics or undergo cesarean delivery. Maternal pyrexia is associated with adverse neonatal outcomes. With these consequences, understanding and preventing maternal fever is imperative.
RETINAL DETACHMENT ASSOCIATED WITH PERIPAPILLARY STAPHYLOMA IMAGED WITH SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY
Authors: Kunita Daisuke , Inoue Makoto , Koto Takashi , Hirakata Akito
Published: January 2017

Purpose:

To examine a rhegmatogenous retinal detachment (RRD) associated with a peripapillary staphyloma with swept source optical coherence tomography (SS-OCT) before and after vitrectomy and circumferential photocoagulation.

Methods:

The SS-OCT images including the montage images of two patients with a RRD associated with peripapillary staphylomas were analyzed. A 34-year-old woman (Case 1) and a 70-year-old woman (Case 2) both noticed temporal visual field defects in their left eyes. Ophthalmoscopy showed a retinal detachment in the nasal quadrant without any peripheral breaks in both patients. The best-corrected visual acuity was 20/20 with -8.5 diopters in Case 1 and 20/25 with -7.0 diopters and moderate cataract in Case 2. SS-OT was used to follow the clinical course of the RRD.

Results:

Preoperatively, retinal tears were detected nasal to the optic disk within the excavated staphyloma in the SS-OCT images. A posterior vitreous detachment was not present in Case 1 but was present in Case 2. The glial tissue at the edge of the excavated staphyloma was removed from both eyes, and the subretinal fluid was drained internally through the retinal breaks. Hemicircumferential photocoagulation was performed at the nasal edge of the staphyloma, and the retina was reattached in both eyes. Postoperative SS-OCT montage images showed retinal reattachment but a detachment was still present within the staphyloma.

Conclusion:

Vitreous surgery was effective for an RRD associated with a peripapillary staphyloma. Examinations by SS-OCT can follow the changes in the RRD and the excavated lesion of a peripapillary staphyloma.
Retinal Oximetry in Subjects With Glaucomatous Hemifield Asymmetry
Authors: Yap Zhu Li , Ong Charles , Lee Yi Fang , Tsai Andrew , Cheng Clarissa , Nongpiur Monisha E. , Perera Shamira A.
Published: January 2017

Purpose:

Although some studies suggest a strong link between retinal vessel oxygenation and damage to the retinal nerve fiber layer (RNFL) seen in glaucoma, it has yet to be conclusively proven. This study compares intraocular retinal oximetry in glaucomatous eyes displaying asymmetrically affected hemifields across different subgroups of glaucoma, namely primary angle closure glaucoma (PACG), primary open-angle glaucoma (POAG), and normal tension glaucoma (NTG).

Methods:

In this prospective cross-sectional study, 99 patients (PACG, n=28; POAG, n=37; NTG, n=34) underwent retinal oxygenation and vessel caliber measurements using the Oxymap T1 Retinal Oximeter, Cirrus optical coherence tomography, and Humphrey visual field testing. For the comparison between different subtypes of glaucoma, an analysis of variance with Bonferroni method was performed. Intraeye differences were compared with a paired t test. Determination of the more affected and less affected hemifield was made using the Humphrey visual field pattern deviation plot.

Results:

Considering the mean deviation and Advanced Glaucoma Interventional Study score, the visual field defects were milder in NTG as compared with POAG and PACG (P<0.05).

Arteriole diameter was smaller in the more affected hemifield compared with the less affected hemifield in patients with PACG (109.30±18.07 vs. 120.57±17.92; P=0.023) and NTG (109.36±13.79 vs. 117.46±17.72; P=0.04). The more affected hemifield had a significantly thinner RNFL than the less affected hemifield in patients across all 3 groups, though this was only significant in PACG (P=0.02) and NTG patients (P<0.01). In all 3 groups, although the less affected hemifield tended to have a marginally higher arteriole and venule oxygen saturation than the more affected hemifield, no statistical significance was reached. There were no significant differences in arteriovenous difference between the more and less affected hemifield in all 3 groups.

Conclusions:

In our study, localized visual field losses were not associated with changes in retinal oximetry but were associated with narrower retinal arteriolar diameters in PACG and NTG. The RNFL was thinner in the more affected hemifield in these 2 groups but this was not so marked in the POAG sample, possibly limiting our ability to find a difference in arteriolar diameter there.
Baby Shampoo Versus Povidone-Iodine or Isopropyl Alcohol in Reducing Eyelid Skin Bacterial Load
Authors: Garcia Giancarlo A. , Nguyen Christine V. , Yonkers Marc A. , Tao Jeremiah P.
Published: January 2017

Purpose:

Baby shampoo is used as an alternative surgical skin preparation, but the evidence supporting its use is scarce with no descriptions of efficacy in the periocular region. The authors compare the efficacy of baby shampoo, povidone-iodine (PI, Betadine) and isopropyl alcohol (IA) in reducing eyelid skin bacterial load.

Methods:

Prospective, randomized, comparative, and interventional trial. Bacterial load on adult, human eyelid skin was quantitated before and after cleansing with 1) dilute baby shampoo, 2) 10% PI, or 3) 70% IA. Paired skin swabs were collected from a 1 cm2 area of the upper eyelid of subjects before and after a standardized surgical scrub technique. Samples were cultured on 5% sheep blood agar for 24 hours. The number of colony forming units (CFU) was assessed and bacterial load per square centimeter of eyelid skin was quantified.

Results:

Baseline and postcleansing samples were assessed from 42 eyelids of 42 subjects (n = 14 for each of baby shampoo, PI, and IA). Before cleansing, similar amounts of bacterial flora were grown from all specimens (median log CFU/cm2 = 2.04 before baby shampoo, 2.01 before PI, 2.11 before IA; p > 0.05). All 3 cleansing agents significantly reduced the bacterial load (p < 0.01 for each). There was no statistically significant difference in postcleansing bacterial load between the 3 cleansing agents (median log CFU/cm2 = 0.48 after baby shampoo, 0.39 after PI, 0.59 after IA; p > 0.05). Change from baseline in bacterial load was statistically similar for all 3 agents (median reduction in log CFU/cm2 = 1.28 with baby shampoo, 1.57 with PI, 1.40 with IA; p > 0.05). These corresponded to bacterial load reductions of 96.3%, 96.6%, and 98.4% for baby shampoo, PI, and IA, respectively.

Conclusions:

Baby shampoo achieved comparable diminution in eyelid skin bacterial load to PI or IA. These data suggest baby shampoo may be an effective preoperative cleansing agent.
Short article: Noninvasive assessment of portal hypertension and detection of esophageal varices in cirrhosis: state-of-the-art
Authors: de Oliveira Ana C.
Published: January 2017

Portal hypertension (PHT) is a major consequence of any chronic liver disease and it is the main cause of complications in patients with cirrhosis. Measurement of hepatic vein pressure gradient is considered the gold standard for PHT assessment, together with its diagnosis and prognosis relevance. Even though hepatic vein pressure gradient measurement is a safe procedure, it is still considered an invasive technique and not widely available. There is thus a need for noninvasive methods that can predict the progression of PHT as well as the presence and the risk of complications related to esophageal varices. This review aimed to discuss the noninvasive markers used in the assessment of PHT and detection of high-risk esophageal varices in patients with liver cirrhosis. We focus on the main biomarkers, particularly those used in the routine assessment of chronic liver disease, and the physical methods that use tissue elastography as a diagnosis tool.
Short article: Impact of genetic variation in the vasopressin 1a receptor on the development of organ failure in patients admitted for acute decompensation of liver cirrhosis
Authors: Kerbert Annarein J.C. , Schaapman Jelte J. , van der Reijden Johan J. , Amorós Navarro Àlex , McCormick Aiden , van Hoek Bart , Arroyo Vicente , Ginès Pere , Jalan Rajiv , Vargas Victor , Stauber Rudolf , Verspaget Hein W. , Coenraad Minneke J.
Published: January 2017

Background

Vasopressin receptor-mediated vasoconstriction is considered to be involved in the pathogenesis of organ failure in acute-on-chronic liver failure (ACLF).

Patients and methods

We studied the association between six single nucleotide polymorphisms (SNPs) of the vasopressin 1a receptor gene and the development of organ failure in 826 patients admitted for acute decompensation of liver cirrhosis (n=641) or ACLF (n=185).

Results

No associations were found for SNPs with the presence of circulatory or renal failure. A C>T mutation in SNP rs7308855 and a T>A mutation in SNP rs7298346 showed an association with the presence of coagulation failure in the entire population (n=61, P=0.024 and 0.060, respectively) and in the subgroup of patients with ACLF (n=44, P=0.081 and 0.056, respectively).

Conclusion

Genetic variation in the vasopressin 1a receptor was found not to be associated with circulatory or renal failure, but with the presence of coagulation failure in patients with acute decompensation of liver cirrhosis and ACLF.
Electronic Health Record Data Versus the National Health and Nutrition Examination Survey (NHANES)
Authors: Funk Luke M. , Shan Ying , Voils Corrine I. , Kloke John , Hanrahan Lawrence P.
Published: January 2017

Background:

Estimating population-level obesity rates is important for informing policy and targeting treatment. The current gold standard for obesity measurement in the United States—the National Health and Nutrition Examination Survey (NHANES)—samples <0.1% of the population and does not target state-level or health system-level measurement.

Objective:

To assess the feasibility of using body mass index (BMI) data from the electronic health record (EHR) to assess rates of overweight and obesity and compare these rates to national NHANES estimates.

Research Design:

Using outpatient data from 42 clinics, we studied 388,762 patients in a large health system with at least 1 primary care visit in 2011–2012.

Measures:

We compared crude and adjusted overweight and obesity rates by age category and ethnicity (white, black, Hispanic, Other) between EHR and NHANES participants. Adjusted overweight (BMI≥25) and obesity rates were calculated by a 2-step process. Step 1 accounted for missing BMI data using inverse probability weighting, whereas step 2 included a poststratification correction to adjust the EHR population to a nationally representative sample.

Results:

Adjusted rates of obesity (BMI≥30) for EHR patients were 37.3% [95% confidence interval (95% CI), 37.1–37.5] compared with 35.1% (95% CI, 32.3–38.1) for NHANES patients. Among the 16 different obesity class, ethnicity, and sex strata that were compared between EHR and NHANES patients, 14 (87.5%) contained similar obesity estimates (ie, overlapping 95% CIs).

Conclusions:

EHRs may be an ideal tool for identifying and targeting patients with obesity for implementation of public health and/or individual level interventions.
Honoring Patient Requests
Authors: Wirpsa M. Jeanne , Elpern Ellen H.
Published: January 2017

Hospitals seeking to support advance care planning and the execution of advance directives face challenges in matching patient readiness with the availability of knowledgeable personnel and resources. A volunteer-based advance directive team represents an innovative approach to providing personalized, timely, and accurate information about advance directives and assisting patients with their completion.
Advanced Practice Providers’ Perceptions of Patient Workload
Authors: Kapu April N. , McComiskey Carmel A. , Buckler Lacey , Derkazarian Jennifer , Goda Tammy , Lofgren Maria A. , McIlvennan Colleen K. , Raaum Julie , Selig Patricia M. , Sicoutris Corinna , Todd Barbara , Turner Vicki , Card Elizabeth , Wells Nancy
Published: January 2017

OBJECTIVE:

This study examines data collected from a survey of advanced practice providers’ (APPs’) perceptions of reasonable versus actual APP-to-patient ratios and other factors that affect workload burden in both inpatient and outpatient clinical settings.

BACKGROUND:

Advanced practice providers provide accessible, cost-effective, and quality care in a growing number of specialty practices across multiple patient care settings. They are caring for higher volumes of patients and assuming more responsibilities while continuing to navigate highly complex healthcare systems. Limited evidence or benchmark data exist that would assist in determining optimal workload and staffing models that include APPs.

METHODS:

A group of advanced practice leaders developed and distributed a 43-question survey of workload factors to a highly diverse APP workforce.

RESULTS:

There were 1466 APPs across 37 areas of practice who responded to the survey distributed in 14 separate organizations. The perceived reasonable workload was lower than the actual workload for 22 specialty practice areas. The analysis included years of experience as an APP, work hours, on-call commitment, nonclinical responsibilities, and time spent in documentation, direct patient care, and performing procedures.

CONCLUSIONS:

There is a consensus among APPs, within their practice area, about what constitutes a reasonable patient assignment, despite the variability in APP experience, organizational culture, processes, and patient acuity.
Impact of Standardized New Medication Education Program on Postdischarge Patients’ Knowledge and Satisfaction
Authors: Jones Tammie R. , Coke Lola
Published: January 2017

This study, implemented on 2 medical-surgical units, evaluated the impact of a standardized, evidence-based new medication education program. Outcomes evaluated included patient postdischarge knowledge of new medication purpose and side effects, patient satisfaction with new medication, and Medicare reimbursement earn-back potential. As a result, knowledge scores for new medication purpose and side effects were high post intervention. Patient satisfaction with new medication education increased. Value-based purchasing reimbursement earn-back potential improved.
Nursing Peer Review Perceptions and Practices
Authors: Whitney Kevin , Haag-Heitman Barbara , Chisholm Margery , Gale Sharon
Published: January 2017

OBJECTIVE:

This study sought to understand chief nurse executive perceptions of nursing peer review (NPR) and current NPR practices in their organizations to provide insights and recommendations for the path forward to a robust NPR approach nationally.

BACKGROUND:

Nursing peer review is a key component of professional nursing practice focused on self-regulation and improving quality and safety. Despite its known benefits, NPR is not broadly disseminated, and how it is currently used and perceived is not well understood.

METHODS:

A causal-comparison study design was used. A 25-question, Web-based survey was administered to collect data variables.

RESULTS:

Chief nurse executives perceived NPR as important in improving quality and safety; however, its prevalence was low. Chief nurse executives also reported NPR practices not aligned with the American Nurses Association (ANA) NPR guidelines.

CONCLUSIONS:

Results suggest that knowledge gaps exist regarding NPR’s purpose, outcomes, and alignment with the ANA peer review guidelines. Interventions are needed to address these gaps to further advance NPR adoption nationally.
Partnering With Patients to Improve Care
Authors: Cunningham Regina , Walton Mary K.
Published: January 2017

Increasingly, healthcare organizations are adopting patient and family advisory councils as a key strategy to create a culture grounded in patient- and family-centered principles and improve the patient experience. In the 1st of a 3-part series, the chief nurse executive and the director of patient- and family-centered care at a Magnet®-designated academic medical center discuss how a stronger patient voice can lead to better care and improved clinical outcomes. The authors examine ways in which the Magnet culture helped drive change and offer tips to establish a successful patient and family advisory council.
A Leadership Education and Development Program for Clinical Nurses
Authors: Fitzpatrick Joyce J. , Modic Mary Beth , Van Dyk Jennifer , Hancock K. Kelly
Published: January 2017

OBJECTIVE:

The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders.

BACKGROUND:

The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management.

METHODS:

A quantitative, longitudinal, survey design was used with 2 cohorts. The program consisted of six 4-hour sessions for 3 to 6 months. Leadership practices were measured before program implementation, at the end of the program, and 3 months after program completion.

RESULTS:

There were significant increases in leadership practices sustained 3 months after program completion. A range of other outcome measures was included.

CONCLUSIONS:

There is a need for additional leadership development programs for clinical nurses.
A Pilot Study
Authors: Fountain Donna M. , Thomas-Hawkins Charlotte
Published: January 2017

OBJECTIVE:

The aim of this study was to test the reliability and validity of the Psychological Conditions Scale (PCS), a measure of drivers of engagement in hospital-based nurses.

BACKGROUND:

Research suggests drivers of engagement are positive links to patient, employee, and hospital outcomes. Although this scale has been used in other occupations, it has not been tested in nursing.

METHODS:

A cross-sectional, methodological study using a convenience sample of 200 nurses in a large Magnet® hospital in New Jersey.

RESULTS:

Cronbach’s α’s ranged from .64 to .95. Principal components exploratory factor analysis with oblique rotation revealed that 13 items loaded unambiguously in 3 domains and explained 76% of the variance. Mean PCS scores ranged from 3.62 to 4.68 on a 5-point Likert scale.

CONCLUSIONS:

The scale is an adequate measure of drivers of engagement in hospital-based nurses. Leadership efforts to promote the facilitators of engagement are recommended.
Satisfaction Data Collected by E-mail and Smartphone for Emergency Department Patients
Authors: Strickler Jeffery C. , Lopiano Kenneth K.
Published: January 2017

OBJECTIVE:

This study profiles an innovative approach to capture patient satisfaction data from emergency department (ED) patients by implementing an electronic survey method. This study compares responders to nonresponders.

BACKGROUND:

Our hypothesis is that the cohort of survey respondents will be similar to nonresponders in terms of the key characteristics of age, gender, race, ethnicity, ED disposition, and payor status.

METHODS:

This study is a cross-sectional design using secondary data from the database and provides an opportunity for univariate analysis of the key characteristics for each group. The data elements will be abstracted from the database and compared with the same key characteristics from a similar sample from the database on nonresponders to the ED satisfaction survey.

FINDINGS:

Age showed a statistically significant difference between responders and nonresponders. Comparison by disposition status showed no substantial difference between responders and nonresponders. Gender distribution showed a greater number of female than male responders. Race distribution showed a greater number and response by white and Asian patients as compared with African Americans. A review of ethnicity showed fewer Hispanics responded. An evaluation by payor classification showed greater number and response rate by those with a commercial or Workers Comp payor source. The response rate by Medicare recipients was stronger than expected; however, the response rate by Medicaid recipients and self-pay could be a concern for underrepresentation by lower socioeconomic groups. Finally, the evaluation of the method of notification showed that notification by both e-mail and text substantially improved response rates.

CONCLUSION:

The evaluation of key characteristics showed no difference related to disposition, but differences related to age, gender, race, ethnicity, and payor classification. These results point to a potential concern for underrepresentation by lower socioeconomic groups. The results showed that notification by both e-mail and text substantially improved response rates.
Philanthropic Donor Perspectives on Supporting Nursing Excellence in a Community Hospital
Authors: Fickley Sharon K. , Mishler Ray R. , Black Amelia S. , DeGuzman Pam B.
Published: January 2017

OBJECTIVE:

The purpose of this research is to explore donors’ perspectives on support of nursing excellence in a community hospital.

BACKGROUND:

Philanthropic support is rapidly becoming critical to support nursing excellence in hospitals, including continuing education, nursing research, and professional development. However, no research has examined the experience of private donors who support nursing programs in community hospitals.

METHODS:

Structured interviews were conducted with individuals with a history of providing significant financial support (gifts >$50 000) targeted specifically for nursing in a 176- bed community hospital in the southeastern United States. Analysis was performed using descriptive content analysis.

RESULTS:

Four themes emerged that centered around making a difference, helping nurses meet new challenges, an existing foundation of service, and valuing excellent nursing care received.

CONCLUSIONS:

This research provides specific information that nursing administrators can use when seeking philanthropic gifts to support nursing excellence programs in US community hospitals.
Tapping Magnet®’s Culture of Innovation to Improve the Patient Experience
Authors: Rainer Jennifer
Published: January 2017

As incentives grow for healthcare organizations to improve the patient experience, an increasing number choose to add consumers directly into their leadership structures. In this final installment about the value of patient and family advisory councils, the senior director of quality at a large, Magnet®-recognized Texas hospital explains how tapping into a well-established Magnet culture helped the organization adopt innovative approaches that produced positive change. Based on an interview with the author, she notes that seeing basic issues through patients’ eyes challenged long-held beliefs and led to improvements in a wide variety of areas. A discussion of the next frontier for patient and family advisory councils focuses on the small but growing number of hospitals that bring community members to the table to openly share, dissect, and improve issues of quality and safety.
Changes in the Distribution of Sex Partners in the United States: 2002 to 2011–2013
Authors: Harper Christopher R. , Dittus Patricia J. , Leichliter Jami S. , Aral Sevgi O.
Published: January 2017

Objective

The purpose of the current analysis is to examine subgroup differences in the distribution of opposite-sex sex partners in the United States across an approximate 10-year period to identify patterns that may inform sexually transmitted infection research and prevention.

Methods

Data were drawn from the 2002 and 2011–2013 National Survey of Family Growth, a US probability-based household survey focusing on sexual and reproductive health. The measures included in this analysis were lifetime opposite-sex sex partners and opposite-sex sex partners in the past year. Analyses were conducted separately for men and women. All analyses were conducted in R and R-studio with the “survey” package, focusing on medians, the 80th, and 95th quartile.

Results

In 2002, there were significant differences between men and women in median number of lifetime sex partners with men reporting more lifetime partners. However, in the 2011–2013 data, these differences are no longer significant. Still, the findings suggest that the top 20% and top 5% of men are reporting significantly more lifetime partners than their female counterparts. In comparison, partners in the past year remain relatively unchanged for both men and women.

Conclusions

These findings suggest that there were important changes in the distribution of sex partners between 2002 and 2011–2013 that have implications for sexually transmitted infection prevention. Median lifetime partners are no longer different for women and men: however, the distribution of lifetime partners among men is becoming even more skewed.
The Human Immunodeficiency Virus Endemic: Maintaining Disease Transmission in At-Risk Urban Areas
Authors: Rothenberg Richard B. , Dai Dajun , Adams Mary Anne , Heath John Wesley
Published: January 2017

Objectives

A study of network relationships, geographic contiguity, and risk behavior was designed to test the hypothesis that all 3 are required to maintain endemicity of human immunodeficiency virus (HIV) in at-risk urban communities. Specifically, a highly interactive network, close geographic proximity, and compound risk (multiple high-risk activities with multiple partners) would be required.

Methods

We enrolled 927 participants from two contiguous geographic areas in Atlanta, GA: a higher-risk area and lower-risk area, as measured by history of HIV reporting. We began by enrolling 30 “seeds” (15 in each area) who were comparable in their demographic and behavioral characteristics, and constructed 30 networks using a chain-link design. We assessed each individual's geographic range; measured the network characteristics of those in the higher and lower-risk areas; and measured compound risk as the presence of two or more (of 6) major risks for HIV.

Results

Among participants in the higher-risk area, the frequency of compound risk was 15%, compared with 5% in the lower-risk area. Geographic cohesion in the higher-risk group was substantially higher than that in the lower-risk group, based on comparison of geographic distance and social distance, and on the extent of overlap of personal geographic range. The networks in the 2 areas were similar: both areas show highly interactive networks with similar degree distributions, and most measures of network attributes were virtually the same.

Conclusions

Our original hypothesis was supported in part. The higher and lower-risk groups differed appreciably with regard to risk and geographic cohesion, but were substantially the same with regard to network properties. These results suggest that a “minimum” network configuration may be required for maintenance of endemic transmission, but a particular prevalence level may be determined by factors related to risk, geography, and possibly other factors.
Evaluation of the Condom Barriers Scale for Young Black Men Who Have Sex With Men: Reliability and Validity of 3 Subscales
Authors: Crosby Richard A. , Sanders Stephanie A. , Graham Cynthia A. , Milhausen Robin , Yarber William L. , Mena Leandro
Published: January 2017

Background

Reliable and valid scale measures of barriers to condom use are not available for young black men who have sex with men (YBMSM). The purpose of this study was to evaluate the Condom Barriers Scales for application with YBMSM.

Methods

A clinic-based sample of 600 YBMSM completed a computer-assisted self-interview. The primary measure was a 14-item abbreviated version of the Condom Barriers Scale. Reliability and criterion validity were assessed.

Results

All 3 subscales were reliable: partner-related barriers (Cronbach α=0.73), sensation-related barriers (α=0.70), and motivation-related barriers (α =0.81). A complete absence of barriers was common: 47.0% (partner-related), 30.7% (sensation-related), and 46.5% (motivation-related). Dichotomized subscales were significantly associated with reporting any condomless insertive anal sex (all Ps < 0.001) and any condomless receptive anal sex (all Ps < 0.001). The subscales were significantly associated with these measures of condomless sex preserved at a continuous level (all Ps <0.001, except for sensation barriers associated with condomless receptive anal sex = 0.03). Further, the subscales were significantly associated with reporting any condom use problems (all Ps <0.001) and a measure of condomless oral sex (all Ps <0.001, except for partner-related barriers=0.31). Finally, the sensation-related barriers subscale was significantly associated with testing positive for Chlamydia and/or gonorrhea (P=0.049).

Conclusions

The 3 identified subscales yielded adequate reliability and strong evidence of validity, thereby suggesting the utility of these brief measures for use in observational and experimental research with YBMSM.