bluuebunny/crossref_metadata_2025 huggingface dataset:
Targeting of the respiratory chain by toxicants: beyond the toxicities to mitochondrial morphology
Authors: Zhou P. K. , Huang R. X.
Published: September 2018

The mitochondrion is an important subcellular target of environmental toxicants. With environmental stress, a series of toxic effects on mitochondria are induced, which originate from the dynamic changes of mitochondrial fusion and fission, structure/membrane damage, and respiratory chain dysfunction. The toxic effects of various toxicants on mitochondrial morphology and intact membranes, and their determination of cell fate, have already been broadly studied and reported on. However, their effects on the integrity and function of the mitochondrial respiratory chain (RC) remain incompletely understood. Recently, Fan et al. and Yu et al. approached this topic by closely examining the mitochondrial toxicities, including the effect on the respiratory chain, induced by organic arsenical chemical 2-methoxy-4-(((4-(oxoarsanyl)phenyl)imino)methyl)phenol and thiourea gold(i) complexes (AuTuCl). Obviously, toxicant-induced dysfunction of the respiratory chain can hinder ATP production, and may elevate ROS generation. The increased ROS can further damage mtDNA, and consequently leads to inactivation of some RC protein-encoding mtDNA, generating a vicious circle of amplifying mitochondrial damage. We hope that these studies focused on RC structure and activity will broaden our view of mitochondrial toxicology and draw forth more profound mechanistic studies on the respiratory chain toxicity of environmental toxicants and their application in risk assessment.
Modifying Food Textures: Practices and Beliefs of Staff Involved in Nutrition Care
Authors: Garcia Jane Mertz , Chambers Edgar , Russell Emily Groves , Katt Abilene
Published: September 2018

Purpose

Modifying food texture is an important part of dysphagia management, yet less is known about the day-to-day practices that might impact the nutritional well-being of patients. This study surveyed staff involved in the service delivery of texture-modified foods with the objectives to gain information about roles and responsibilities, instruction and knowledge about modifying foods, and beliefs about the use of texture-modified foods in nutrition care.

Method

We created a 21-item survey about texture-modified foods. Recruitment efforts focused on both professional and frontline staff involved in service delivery. Practice groups and organizations provided the means of recruiting professionals from different disciplines. Because frontline staff (e.g., certified nursing assistants, cooks) do not have similar membership groups, we recruited them through direct contacts with health care agencies.

Results

A total of 175 individuals completed the survey. Respondents included 107 professionals (primarily certified dietary managers, registered dietitians, speech-language pathologists) and 68 frontline staff (mostly certified nursing assistants/home health aides). Although the frontline and professional staff showed generally similar patterns of opinions and beliefs about modified food textures, differences emerged in reported experiences, roles, and responsibilities in service delivery.

Conclusions

Survey respondents conveyed generally positive attitudes and opinions about the use of texture-modified foods, and respondents perceived them to be easy to execute and beneficial to the nutritional well-being of patients. Survey findings clearly highlight the contributions of frontline staff in the service delivery of modified food textures. Consideration must be given to continued reliance on informal, limited instruction about texture-modified foods and possible implications for safe nutrition care. Both professional and frontline staff convey a willingness to customize or alter food textures and the belief that patients should be able to choose the level of texture modification that they want to eat.
Effectiveness of a Preexternship Hospital Orientation Program for Graduate Students in Speech-Language Pathology
Authors: Warner Heather , Karlberg Amy , Purdy Mary
Published: September 2018

Purpose

A preexternship hospital orientation program was developed in response to clinical externship supervisors providing feedback that students were not well prepared when entering the medical setting for the 1st time. This program aimed to introduce students to different medical settings where they could observe patients with a range of communication and swallowing disorders and their interactions with a speech-language pathologist.

Method

Students shadowed speech-language pathologists for a half-day at 4 different medical locations throughout the program. Forty-two students filled out pre- and postorientation surveys detailing their experiences and learning outcomes.

Results

An analysis of pre–post surveys indicates that students perceived a gain in working knowledge of several key areas, including assessment protocols, job demands, documentation, and interprofessional collaboration. Students also reported that the experience allowed them to make an informed choice regarding the type of externship or job they wished to pursue in the future.

Conclusion

Students reported favorable outcomes as a result of this observational experience. Clinical exposure programs should be considered as a modality for learning for speech-language pathology students.
Frequency domain soil parameters inversion of horizontally multilayered earth model with considering high‐frequency field
Authors: Li Zhong‐Xin , Rao Shao‐Wei
Published: September 2018

A method to estimate soil parameters of horizontally multilayered earth model in frequency domain is developed with considering high‐frequency field. The theoretical formula of complex apparent resistivity with considering high‐frequency field is derived from Green's function. To avoid time‐consuming numerical integration, complex image method is introduced to solve Sommerfeld integral. Simulated annealing algorithm is applied to optimise soil parameters. The accuracy of this method is confirmed by interpreting field data under the DC field. As the inversion results of this method are different from other literature's results in a four‐layer model, the posterior analysis is made. Then this method is applied to the inversion of frequency domain soil parameters under both quasi‐static field and high‐frequency field. The differences of complex apparent resistivity distribution between quasi‐static field and high‐frequency field are compared at different frequencies.
Development of combined Runge–Kutta Broyden's load flow approach for well‐ and ill‐conditioned power systems
Authors: Tostado‐Véliz Marcos , Kamel Salah , Jurado Francisco
Published: September 2018

Load flow (LF) is an extensively used tool in planning and operation of power systems. Formulation of LF problem can be assimilated as a set of autonomous ordinary differential equations, therefore, many numeric methods can be used to solve this problem. However, LF methods often need to compute one or more Jacobian matrix inversions in each iteration. Owing to this fact, these methods might not be computationally efficient. In this study, the authors propose combined Runge–Kutta Broyden's LF (RK4B) method in order to reduce the required Jacobian matrix inversion to only one in the first iteration. In this proposed method, Broyden's approach is employed in fourth‐order Runge–Kutta method. In addition, two modifications of the proposed method are presented to reduce the number of iterations and improve the computational performance. The proposed method and the two modifications are validated using several well‐ and ill‐conditioned cases. Results show that the combined approach has better computational performance than the classical multistage numeric methods, besides it preserves the robustness features of fourth‐order Runge–Kutta method.
Data clustering based probabilistic optimal power flow in power systems
Authors: Galvani Sadjad , Choogan Mahmoud
Published: September 2018

Ever increasing use of renewable energies beside other uncertain parameters in power systems makes it necessary to evaluate power system issues, probabilistically. One of the important studies in power systems operating is optimal power flow (OPF), which should be considered as probabilistic OPF (POPF). However, the Monte Carlo simulation (MCS) method can be efficiently used for handling any type of uncertainty but this method suffers from large calculation requirements and cannot be implemented in various studies. Especially, in evolutionary based optimization problems the use of MCS method is completely restricted. Data clustering is an alternative method which keeps the accuracy of the MCS method and requires very less calculation burden. In this study, data clustering is used for probabilistic assessment of power system in POPF problem. The proposed method is very fast, accurate and can easily handle any type of correlation between stochastic input variables. The correlated input variables are generated by the Cholesky decomposition method. The Genetic Algorithm (GA) is used as optimization tool. In order to demonstrate and validate the performance of the proposed method, IEEE 30‐ and 118‐bus standard test systems are studied and the results are compared with a modified version of the two‐point estimate method.
IVH-Prävention bei ELBW-Frühgeborenen in zwei Perinatalzentren
Authors: Cipowicz Clara , Schmid Manuel , Hummler Helmut , Thome Ulrich
Published: September 2018

Hintergrund Im Rahmen eines Projekts zur konsequenten Vermeidung zahlreicher bekannter Risikoindikatoren sank die Inzidenz von intraventrikulären Hämorrhagien (IVH) am Ulmer Perinatalzentrum. Ein Vergleich mit dem Leipziger Zentrum sollte Hinweise liefern, an welchen Stellen es an beiden Zentren noch Verbesserungsmöglichkeiten gibt.

Methoden Eine retrospektive Datenerhebung wurde für 189 Leipziger und 89 Ulmer Frühgeborene mit einem Geburtsgewicht von unter 1000 g durchgeführt. Für diese Daten wurde ein Vergleich zwischen den beiden Zentren durchgeführt.

Ergebnisse Eine IVH aller Schweregrade wurde in Leipzig (56/197, 28,4%) häufiger (p=0,01) als in Ulm (13/89, 14,6%) gefunden. Der Unterschied betraf nur die leichten IVH Grade 1–2; die Inzidenz der schweren IVH (Grad 3–4) unterschied sich nicht zwischen den beiden Zentren (p=0,59, Leipzig 12/197, 6,1%; Ulm 4/89, 4,5%). Weiterhin zeigte sich bei einzelnen IVH-Risikoindikatoren eine unterschiedliche Verteilung zwischen den beiden Zentren. So trat eine postnatale Hypokapnie in Leipzig (42/197, 21,3%) häufiger auf (p<0,01) als in Ulm (3/86, 3,5%). Auch eine postnatale Hypothermie ereignete sich häufiger (p<0,01) in Leipzig (53/197, 26,9%) als in Ulm (10/89, 11,2%). In Ulm wurde hingegen eine rasche postnatale Surfactantapplikation seltener (p<0,01) durchgeführt (32/60, 53,3%) als in Leipzig (136/158, 86,1%) und Bikarbonat wurde in Ulm häufiger gegeben (48/89, 46,1% gegenüber 183/197, 7,1%, p<0,01).

Schlussfolgerung Potenziell vermeidbare Risikofaktoren traten in beiden Zentren in unterschiedlicher Häufigkeit auf. Diese Ergebnisse ermöglichen es beiden Zentren, die jeweils mit erhöhte Häufigkeit aufgetretenen Risikofaktoren gezielt zu vermeiden und so die IVH-Rate weiter abzusenken.
Glans Ischemia after Circumcision in a 16-Year-Old Boy: Full Recovery after Angiography with Local Spasmolysis, Systemic Vasodilatation, and Anticoagulation
Authors: Gnatzy Richard , Fuchs Jochen , Siekmeyer Manuela , Beeskow Anne , Gosemann Jan-Hendrik , Lacher Martin
Published: September 2018

Circumcision is one of the most frequent procedures performed by pediatric surgeons. A dorsal penile nerve block (DPNB) is commonly used for perioperative analgesia. We report the case of a 16-year-old boy with ischemia of the glans who presented on the first postoperative day after circumcision under DPNB (0.25% bupivacaine) at an outside hospital. The patient underwent immediate angiography under sedation. An intra-arterial spasmolysis was performed with alprostadil and nitroglycerine and a sufficient perfusion of the glans penis was confirmed. Subsequently, systemic sildenafil, arginine, and heparin were given. Following this 3-day medical treatment, ischemia resolved completely. Our case emphasizes the role of invasive angiography in the diagnostic workup and the therapeutic possibilities of local spasmolysis, systemic vasodilatation, and anticoagulation.
Pulmonary Metastasectomy of Sarcoma: Is the Ratio of Surgical Margin to Nodule Size a Prognostic Factor?
Authors: Özdil Ali , Tekneci Ahmet Kayahan , Dökümcü Zafer , Divarcı Emre , Keçeci Burçin , Sezak Murat , Çakan Alpaslan , Çağırıcı Ufuk
Published: September 2018

Background Main prognostic factors of improved survival after pulmonary metastasectomy (PM) for osteogenic and soft tissue sarcomas are suggested as histological type, number and size of pulmonary nodules, and disease-free interval (DFI).

Methods Sixty-nine patients who underwent PM between January 1999 and December 2017 were evaluated retrospectively. Relations between parameters and prognostic risk factors for overall survival (OS) and disease-free survival (DFS) were evaluated.

Results Osteosarcoma was the most common histologic type (36.2%) and 21 of 25 cases were seen under the age 20 years (p < 0.001). Comparison of patient groups including osteosarcoma and nonosteosarcoma patients showed significant difference according to age (p < 0.001), nodule size (p = 0.033), ratio of surgical margin to nodule size (p = 0.007), and DFI (p = 0.039). Univariate analysis showed that the number of nodules (p = 0.008), ratio of surgical margin to nodule size (p = 0.001), and localization of nodule (p = 0.039) were significant factors associated with DFS. Also, nodule size (p = 0.042), number of nodules (p = 0.003), ratio of surgical margin to nodule size (p < 0.001), and laterality (p = 0.027) were significant prognostic factors associated with OS. Cut-off values of ratio of surgical margin to nodule size for DFS and OS were calculated as 0.94. Logistic regression analysis determined the ratio of surgical margin to nodule size as the common significant risk factor for DFS and OS.

Conclusions Our study showed that the ratio of surgical margin to nodule size ≥ 1 should be taken as a common risk factor for DFS and OS. Therefore, resection of nodules with the possible widest surgical margin is an important point of PM.
Genetics And Periodontium: A Review
Authors: Singh Baljeet , Garg Avnika , Nayyar Nandini , Sharma Alka
Published: September 2018

Periodontal disease may be regarded as a range of different diseases for which certain individuals are at relatively high risk. Epidemiological and molecular studies of the oral microbial flora suggest, that although microbial factors are required for periodontal disease, they alone do not predict the presence or severity of periodontitis. So in high-risk patient groups, host factors appear to play an important role in susceptibility to periodontitis. In recent years elements of host susceptibility, such as immune response and systemic disease state, and other non-microbial environmental factors, such as smoking, have been shown to be important contributors to the disease expression. Thus, periodontitis represents a lifelong account of interactions between our genome, our behavior, and our environment.
Polymerase Chain Reaction: A Powerful Diagnostic and Research Tool
Authors: Jain Kanu , Mehendiratta Monica , Jindal Deepti , Bansal Mohit
Published: September 2018

To fully understand cellular processes, scientists often examine events at the level of nucleic acids and protein molecules. These studies are complicated by the fact that cells have miniscule amounts of molecules of interest which are too small to be seen. So we require molecular tools to visualize these molecules. Polymerase chain reaction is one such technique widely used in molecular biology and produce quantities that are sufficient to study and visualize. With the advancement in this technique, it has revolutionized the field of research and diagnosis. In this article, we present a review on the principle, basic technique, applications, limitations and recent advances of Polymerase Chain Reaction.
A Study to Evaluate Life Span of Crowns & Fixed Partial Dentures and Various Reasons of their Failures
Authors: Singh Gursharan , Madan Nishtha , Kumar Mandeep , Walia Cherry , Singh Opinder
Published: September 2018

Most patients are concerned about the anticipated length of service and reasons of replacement of fixed dental prostheses (FPDs). This study tried to find out relationship among various factors causing failures in fixed dental prostheses. Patients treated with fixed dental prostheses were examined clinically and radiographically. A group of 106 patients were evaluated for unsatisfactory restorations. These groups of patients produced records of initial treatment to ascertain the length of service of restoration. The mean survival period of fixed dental prostheses was 7.5 years. This investigation helped find causes for failures and survival period of various FPDs. Among the reasons of failures, caries was the most frequently observed (24.2%), followed by defective margin (18.2%), unsatisfactory esthetics (15.2%), retention problem (11.7%), periodontal disease (8.8%), fractured tooth (10.6%), periapical lesion (5.8%), porcelain fracture (4.2%) and others (1.3%). Causes of failures were also grouped into two groups (Mechanical & Oral diseases) for comparison. The Mechanical group showed higher failure percentage (59.9%) as compared to Oral diseases group (38.8%).
A New Geometric Intersection Point (Ms) to Determine the Spatial Position of Maxillary Sinus
Authors: Singh Sarabjeet , Gautam Mukti , Kashyap Rita , Sandhu Gurinderpal , Singla Divya
Published: September 2018

Introduction: Cephalometeric landmark detection, is a knowledge intensive activity to identify on standardized lateral x-rays of the skull, to perform measurements needed for medical diagnosis, treatment planning and evaluation. For computation of analysis of steps and for determination of underlying structures, provided landmarks should be correctly localized. Due to the complexity of human anatomy sensed in a cephalometric x-ray, the landmarks are localized and constructed. Maxillary sinus has an important role to play in the formation of facial contours. Objective: Our aim is to check the validity of new geometric intersection point Ms, evaluating cephalometerically the spatial position of maxillary sinus and to find any correlation between the spatial position of maxillary sinus and sagittal dysplasias. Study design: A single-institution prospective analysis. Subjects and methods: A total of 20 lateral cephalograms were used, of both sexes, ranging in age from 18-25 years. These radiographs were from subjects, classified into class I and class II on the bases of ANB and Ao-Bo. Maxillary sinus was carefully analyzed and measured in linear dimensions of length and width and its spatial position was calculated by using a new geometric intersection point Ms, created by the intersection of the linear measurements, in relation to the anterior cranial base. The spatial position of maxillary sinus was calculated from the position of the intersection point Ms. The length and height of maxillary sinus was measured and compared in both the groups. Results: The mean of maxillary sinus length (MSL) and height (MSH) was 43.2 ± SD 3.2mm and 41.2 ± SD 3.8mm, respectively for classI (p value=0.595) and 44.2 ± SD 4.9mm and 43.0 ± SD 3.4mm, respectively for class II (p value=0.283). The intersection point Ms depicting centre of maxillary sinus from x-axis (Ms-Msx) was same for both the groups. Mean for Ms-Msy, was 37.3 ± SD 5.7 for class I and 37.8 ± SD 1.9 for class II (p value=0.796). No statistical significance was found among the results in both the groups. Conclusion: The length and height of maxillary sinus was calculated and the centre of maxillary sinus was calculated by the intersection of the two. This new point can contribute in calculating the spatial position of sinus and be an effective measure to study the convexity and concavity of the midface. In the present study, the length and height of the sinus did not alter with the increased or decreased ANB and Ao-Bo. There was no significant spatial position change of maxillary sinus with variation in ANB and Ao-Bo (sagittal). Regarding vertical parameters, Ms may have significant correlation with the various malocclusions.
Microleakage Evaluation of Nano Ceramics and Nano Composite Resins Using Self Etch Adhesive in Class V Cavities Using Single Increment Technique
Authors: Singh S. Vijay , Gupta Saurabh , Jain Pragya , Munjal Vaibhav
Published: September 2018

Micro leakage plays an important role in the success of composite restoration, this have led to researcher to find newer composite restorative material with present study it was observed that Self-etch adhesive systems and single increment technique are advantageous in that it reduces the application time and technique related sensitivity.
Endodontic Treatment with MTA in a Tooth with Open Apex-A Case Report
Authors: Singla Ruchi , Bhushan Jagat ,   Vandana
Published: September 2018

This case report describes the treatment of a tooth with necrotic pulp and open apex (maxillary left central incisor). In this conventional multiple-visit apexification with calcium hydroxide was replaced with a simple two step apical barrier techinique using MTA. The treatment involved mild debridement of the dentinal walls with K files and repeated irrigation with sodium hypochlorite solution, followed by calcium hydroxide dressing for 1 week and lastly creating an apical plug with MTA. The objective of the treatment was to provide an apical stop for the root canal filling material.
Conventional Complete Denture for a Patient with Malunited Fracture of Mandible: A Case Report
Authors: Sharma Monica , Lal Jagmohan , Kaur Ravneet , Kumar Mandeep , Sharma Bhavna
Published: September 2018

A patient with malunited fracture of mandible require preprosthic reconstructive surgery followed by implant-assisted overdentures. In this case report, conventional complete dentures were fabricated for the patient as he refused any invasive treatment. The fabrication procedure of the denture was carefully modified according to anatomical and functional situation of the patient to achieve adequate retention and stability. Complete dentures thus fabricated provided comfort and sufficient function to the patient.
Surgical Management of Horizontal Root Fracture with Platelet Rich Fibrin (PRF) Placement: Case Report of Two Cases
Authors: Bansal Parul , Kanyal Kalpana , Nikhil Vineeta
Published: September 2018

Radicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5 - 7% of the cases. Horizontal root fractures can be managed endodontically or combined endodontic and surgical approach. Treatment varies according to the displacement and vitality of the fragments. This paper presents a case report of two cases of horizontal root fracture, present between the middle and apical third of central incisors, which were managed by combined endodontic and surgical approach, while in second case it was followed by PRF placement to facilitate osteoinduction and periodontal tissue regeneration.
A glucosyltransferase specific for 4-hydroxy-2,5-dimethyl-3(2H)-furanone in strawberry
Authors: Yamada Aki , Ishiuchi Kan’ichiro , Makino Toshiaki , Mizukami Hajime , Terasaka Kazuyoshi
Published: September 2018

4-Hydroxy-2,5-dimethyl-3(2H)-furanone (HDMF) is a key aroma compound in Fragaria × ananassa (strawberry). A considerable amount of HDMF is converted into HDMF β-D-glucoside and accumulated in mature strawberry fruits. Here we isolated a novel UDP-glucose: HDMF glucosyltransferase, UGT85K16 from Fragaria × ananassa. UGT85K16 preferentially glucosylated the hydroxyl group of HDMF and its structural analogs. Although UGT85K16 also catalyzed the glucosylation of vanillin, its affinity and efficiency toward HDMF was higher. The expression of UGT85K16 mRNA correlated with the accumulation of HDMF and its glucoside in Fragaria × ananassa plants. These results suggest that UGT85K16 might be UDP-glucose: HDMF glucosyltransferase in strawberries.

Abbreviations: DMMF: 2,5-dimethyl-4-methoxy-3(2H)-furanone; EHMF: 2(5)-ethyl-4-hydroxy-5(2)-methyl-3(2H)-furanone; GBV: glycosidically bound volatile; HDMF: 4-hydroxy-2,5-dimethyl-3(2H)-furanone; HMF: 4-hydroxy-5-methyl-3(2H)-furanone; HMMF: 4-hydroxy-5-methyl-2-methylene-3(2H)-furanone; PSPG: Plant secondary product glycosyltransferase; RT-PCR: reverse transcription-PCR; OMT: O-methyltransferase; UGT: UDP-glycosyltransferase
Unstructured brainstorming is not enough: structured brainstorming based on four verification and validation questions yields better hazard identification in healthcare
Authors: Kobo-Greenhut Ayala , Reuveni Haim , Ben Shlomo Izhar , Megnezi Racheli
Published: September 2018

Objectives

(1) To introduce the Methodical Hazard Identification Checklist (MHIC) for structured brainstorming and the four V&V categories on which it is based, and (2) to compare its efficacy with that of brainstorming (BS) in identifying hazards in healthcare.

Design

Comparative analysis of MHIC and team BS results.

Setting

Baruch Padeh Medical Center, Poriya, Israel.

Study participants

Quality engineering students, facilitators, validation teams and hospital staff who were familiar with the specific processes.

Intervention(s)

The number of hazards identified by team BS were compared with those deduced by applying the four V&V hazard categories to each step (the MHIC) of 10 medical and 12 administrative processes.

Main Outcome Measure(s)

The total number of hazards (1) identified by BS, (2) identified by MHIC, (3) validated by the validation team and (4) hazards identified by both methods that the validation team deemed unreasonable.

Results

MHIC was significantly more successful than BS in identifying all hazards for the 22 processes (P < 0.0001). The estimated probabilities of success for BS for administrative and medical processes were 0.4444, 95%CI = [0.3506, 0.5424] and 0.3080, 95%CI = [0.2199, 0.4127], respectively. The estimated probabilities of success for MHIC for administrative and medical processes were 0.9885, 95%CI = [0.9638, 0.9964] and 0.9911, 95%CI = [0.9635, 0.9979], respectively.

Conclusions

Compared to traditional BS, MHIC performs much better in identifying prospective hazards in the healthcare system. We applied MHIC methodology to administrative and medical processes and believe it can also be used in other industries that require hazard identification.
Something for Every Nurse
Authors: Kennedy Maureen Shawn
Published: September 2018

Articles on workplace violence, nursing and the media, and other noteworthy topics.
Fraught Times for Women's Health
Authors: Sofer Dalia
Published: September 2018

Access to reproductive health services is increasingly limited.
‘Age-Friendly’ Health Systems for Older Adults
Authors: Mechcatie Elizabeth
Published: September 2018

Organizations partner to promote a new model of care.
An Alternative to Assisted Living and Nursing Homes for Adults: Foster Care
Authors: Pfeifer Gail M.
Published: September 2018

Foster care programs offer home-like care settings.
First Approval of a Drug Derived from Marijuana
Authors: Aschenbrenner Diane S.
Published: September 2018

Two rare, severe seizure disorders, Lennox–Gastaut syndrome and Dravet syndrome, can now be treated with cannabidiol (Epidiolex), the first approved drug derived from marijuana.

Cannabidiol does not contain the psychoactive component of marijuana and does not lead to physical dependence.

Common adverse effects include somnolence, elevated liver enzyme levels, insomnia, sleep disorder, poor-quality sleep, and infections.
Patient Education on Generic Drugs
Authors: Aschenbrenner Diane S.
Published: September 2018

The Food and Drug Administration has online teaching resources available to help health care providers teach their patients about generic drugs.
Cardiovascular Risk of Celecoxib no Worse Than That of Ibuprofen or Naproxen
Authors: Aschenbrenner Diane S.
Published: September 2018

Data from a long-term prospective, randomized trial comparing the cardiovascular safety of celecoxib with that of ibuprofen and naproxen have shown that celecoxib carries no greater risk of clot-related cardiovascular events.

The dosage studied was low, 100 mg twice a day, and the safety of higher dosages has not yet been studied.
Antioxidant Supplements to Prevent Age-Related Macular Degeneration
Authors: Govind Natalie
Published: September 2018

Editor's note: This is a summary of a nursing care–related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.
Original Research: Journalists’ Experiences with Using Nurses as Sources in Health News Stories
Authors: Mason Diana J. , Glickstein Barbara , Westphaln Kristi
Published: September 2018

Purpose: In a 2018 replication of a 1997 study, the Woodhull Study on Nursing and the Media, nurses were identified as sources in only 2% of health news stories in the same print publications investigated in the earlier study, showing no improvement in 20 years. We sought to interview health journalists across a spectrum of media to better understand their perceptions of the barriers and facilitators to using nurses as sources in news stories.

Methods: This qualitative study employed a snowball sampling technique to obtain a sample of 10 health journalists. One-to-one semistructured telephone interviews using open-ended questions were conducted and recorded, and thematic analysis was performed on the transcripts.

Results: Analysis of the transcripts revealed an overarching theme of biases about women, nurses, and positions of authority in health care among journalists, newsrooms, and public relations staff in health care organizations and universities that impeded journalists’ use of diverse sources in health reporting. Subthemes were that 1) when used as sources, nurses can enrich a story; 2) health journalists don't understand the range of nurses’ roles, work, and education; 3) health journalists don't know how to find nurses to interview for news stories and have little time to do so; 4) communications staff of health care organizations and universities aren't offering nurses as sources; 5) editorial biases, policies, and processes can get in the way of journalists using nurses as sources; and 6) nurses and the nursing profession aren't strategic about engaging journalists.

Conclusions: Because nurses as sources can enhance the quality of health news, health journalists should become more aware of their biases and strive to include more nurses, as well as more women and people of color overall, in their stories. Nurses and nursing organizations can do more to reach out to journalists and public relations staff to raise awareness of nurses’ expertise.
Workplace Violence
Authors: Brous Edie
Published: September 2018

How it affects health care, which providers are most affected, and what management and staff can do about it.
Study Finds Increased Venous Thromboembolism Risk in Transfeminine Patients
Authors: Mechcatie Elizabeth , Rosenberg Karen
Published: September 2018

According to this study:

Transfeminine individuals had higher rates of venous thromboembolism and ischemic stroke than cisgender men and women (those whose gender identity is consistent with their sex designation at birth).

The study findings suggest a need for long-term monitoring of vascular adverse effects of estrogen therapy in this population.
A One-Dose-Fits-All Approach to Aspirin Therapy is Suboptimal
Authors: Mechcatie Elizabeth , Rosenberg Karen
Published: September 2018

According to this study:

The clinical effectiveness of low-dose aspirin therapy for the prevention of cardiovascular events depends on body size, diminishing as body size increases.

A tailored dosing strategy is called for.
Nursing Notes are Predictive of Outcomes in ICU Patients
Authors: Mechcatie Elizabeth , Rosenberg Karen
Published: September 2018

According to this study:

The amount and tone of “sentiments” recorded in nursing notes is a significant predictor of 30-day mortality in ICU patients.

Adding it to known predictors of death in ICU patients could improve such prediction.
Literature Review Documents Medicaid Expansion Benefits Under the ACA
Authors: Mechcatie Elizabeth , Rosenberg Karen
Published: September 2018

According to this study:

Peer-reviewed studies provide evidence that Medicaid expansion under the Affordable Care Act has resulted in improvements in access to care and quality of care.

Across all categories, the authors found either significant positive effects of Medicaid expansion or positive but not significant effects, but virtually no negative effects.
Birthing by the Numbers
Authors: Robinson-Lane Sheria G.
Published: September 2018

A pregnant nursing professor well versed in health disparities takes a path less traveled.
Substance Use Disorder Assessment, Diagnosis, and Management for Patients Hospitalized With Severe Infections Due to Injection Drug Use
Authors: Jicha Crystal , Saxon David , Lofwall Michelle R. , Fanucchi Laura C.
Published: September 2018

Objectives:

Persons with injection drug use (IDU) have high healthcare utilization. Consequently, healthcare providers have opportunities to identify and treat underlying substance use disorders (SUD) that drive these hospitalizations. The study purpose was to characterize current SUD evaluation and treatment practices by primary and consulting services during hospitalization for severe infections related to IDU.

Methods:

This study is a retrospective chart review of inpatient admissions to an academic medical center. The 2 inclusion criteria were documentation of IDU in clinical notes and the presence of an infection likely related to IDU. Demographic and clinical data were extracted from electronic medical records.

Results:

A total of 108 inpatient admissions met inclusion criteria and were included in the study. The most common infections related to IDU were endocarditis (n = 65, 60.2%) and osteomyelitis (n = 27, 25.0%). The primary team explicitly documented substance use in the H&P and progress notes in 103 (95.4%) hospitalizations and in 84 (77.8%) at discharge. Opioid use disorder was coded by International Classification of Diseases, Ninth Revision in 62 (57.4%). The most frequent intervention was screening, brief intervention, and referral to treatment in 99 (91.7%) episodes. The vast majority of patients did not have specific plans or recommendations for SUD treatment upon discharge.

Conclusions:

Though more than half of the patients in this study had opioid use disorder, pharmacotherapy for opioid use disorder was typically not provided, and screening, brief intervention, and referral to treatment (SBIRT) was the most common intervention. There are significant gaps in the clinical assessment, diagnosis, and management of SUD in persons hospitalized with life-threatening complications of IDU, leaving many opportunities to improve care for this complex patient population.
Is the National Institute on Alcohol Abuse and Alcoholism Screening Guide Useful for Identifying Adolescents at Risk for Later Cigarette Smoking? A Prospective Study in Primary Care Clinics
Authors: Shadel William G. , Seelam Rachana , Parast Layla , Meredith Lisa S. , D’Amico Elizabeth J.
Published: September 2018

Objectives:

This paper evaluated whether a 2-item assessment of alcohol use risk, developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA SG), prospectively predicted smoking status among a sample of adolescents visiting their primary care physician.

Methods:

We analyzed a sample of 651 adolescents (57.80% female; 56.53% Hispanic, 22.73% African American, 14.44% White, 6.30% other) who completed the NIAAA SG at a baseline appointment and were assessed for future smoking risk. We obtained prospective data on smoking status using data from the 6-month post-baseline follow-up assessment.

Results:

Logistic regression analyses revealed that adolescents who were identified as at risk by the NIAAA SG were more likely to report smoking within 6 months. However, the association between the NIAAA SG and future smoking status became non-significant after controlling for future smoking risk measured at baseline.

Conclusions:

Questions that ask about past smoking and future smoking intentions are best used to screen adolescents in primary care for smoking risk.
Impact of a Nurse Intervention to Improve Sleep Quality in Intensive Care Units
Authors: Díaz-Alonso Julián , Smith-Plaza Andrea M. , Suárez-Mier Belén , Lana Alberto
Published: September 2018

Background

Patients of adult intensive care units (ICUs) often suffer from a lack of sleep. Reducing anxiety by promoting adaptation to the ICU prior to admission may be an appropriate way to increase sleep quality.

Objective

The aim of this study was to evaluate the impact on sleep quality of a brief nurse intervention.

Methods

This was a pilot randomized controlled trial in Spain. Forty patients admitted in hospital for valve cardiac surgery were randomly allocated to (1) control group (n = 20), receiving usual care, and to (2) experimental group (EG, n = 20), receiving a nurse intervention the day before surgery and admission in the ICU. The intervention was based on Roy Adaptation Model. A trained nurse anticipated the stressful stimulus to patients in order to develop functional adaptive behaviors. A set of photographs and videos was used to illustrate the environment and assistance in the ICU. Sleep quality in the ICU was measured with the Richards-Campbell Sleep Questionnaire and usual sleep quality with the Pittsburgh Sleep Quality Index.

Results

After the intervention, sleep quality was lower in the EG compared with the control group (−4 points in Richards-Campbell Sleep Questionnaire, P = .69). Adjustment for main confounders led this reduction to −1.9 points (P = .87) among patients in EG. Stratified analyses shown a positive impact for people who usually slept well (+5.2 points, P = .77), but negative for those who had previous poor sleep quality (−20.0 points, P = .24).

Conclusion

A nurse intervention prior to ICU admission did not increase patients’ sleep quality. In addition, the intervention could have incremented anxiety over the patients who used to sleep poorly at their homes.
Relation Between Infant Microbiota and Autism?
Authors: Axelsson Paul Bryde , Clausen Tine Dalsgaard , Petersen Anne Helby , Hageman Ida , Pinborg Anja , Kessing Lars Vedel , Bergholt Thomas , Rasmussen Steen Christian , Keiding Niels , Løkkegaard Ellen Christine Leth
Published: September 2018

Background:

Hypotheses concerning adverse effects of changes in microbiota have received much recent attention, but unobserved confounding makes them difficult to test. We investigated whether surrogate markers for potential adverse microbiota change in infancy affected autism risk, addressing unobserved confounding using a sibling study design.

Methods:

This is a population-based, prospective cohort study including all singleton live births in Denmark from 1997 to 2010. The exposure variables were cesarean delivery and antibiotic use in the first 2 years of life. The outcome was a subsequent autism diagnosis. We used the between- and within-sibling model and compared it with sibling-stratified Cox models and simpler standard Cox models that ignored sibship.

Results:

Of our study population including 671,606 children, who were followed for up to 15 years (7,341,133 person-years), 72% received antibiotics, 17.5% were delivered by cesarean, and 1.2% (8,267) developed autism. The standard Cox models predicted that both cesarean (compared with vaginal) delivery and antibiotics increased the risk of autism. In the sibling-stratified Cox model, only broader spectrum antibiotics were associated with increased risk of autism: hazard ratio (HR) = 1.16 (95% confidence interval = 1.01, 1.36). The between–within model estimated no exposure effects: intrapartum cesarean HR = 1.06 (0.89, 1.26); prelabor cesarean HR = 0.97 (0.83, 1.15); exclusively penicillin HR = 1.05 (0.93, 1.18); and broader spectrum antibiotics HR = 1.05 (0.95, 1.16).

Conclusions:

The between–within model rendered more precise estimates than sibling-stratified Cox models, and we believe that it also provided more valid estimates. Results from these preferred models do not support a causal relation between antibiotic treatment during infancy, cesarean delivery, and autism. See video abstract at, http://links.lww.com/EDE/B432.
Geometric Properties of Donor Corneas After Mechanical Trephination in Deep Anterior Lamellar Keratoplasty
Authors: Feizi Sepehr , Masoudi Ali , Rahimi Behrouz , Karimian Farid , Javadi Mohammad Ali
Published: September 2018

Purpose:

To evaluate the geometry of donor corneal buttons after mechanical trephination and to determine whether there were any possible variables that could influence the accuracy of cutting corneal buttons in deep anterior lamellar keratoplasty.

Methods:

This cross-sectional study included 85 sclerocorneal buttons that were transplanted during deep anterior lamellar keratoplasty. Donor corneas were punched from the posterior surface. Photographs that most clearly represented the entire edges of the donor corneas were taken from the punched corneas and systematically analyzed using ImageJ software. The univariate analyses were used to investigate the influence of potential variables on the precision and roundness of the donor cut.

Results:

The epithelial side of the grafts was significantly larger than the posterior side in diameter, perimeter, and area. The perimeter and area of the donor posterior surface and the trephine used for punching the grafts were the same, whereas the epithelial side had a significantly larger perimeter and area than those of the trephine. Graft roundness varied from 0.78 to 1.0 at the epithelial side and from 0.77 to 1.0 at the posterior side. The roundness of the scleral spur, which represented the shape of the donor cornea, was identified as the main predictor of the roundness of the donor cut (P < 0.001).

Conclusions:

The donor buttons after mechanical trephination from the posterior surface may not be circular and of the intended diameter; the epithelial surface dimensions were significantly larger than the posterior surface and trephine dimensions. The roundness of the punched graft was primarily affected by the roundness of the cornea before trephination.
The Relationship Among Health Beliefs, Depressive Symptoms, Medication Adherence, and Social Support in African Americans With Hypertension
Authors: Spikes Telisa , Higgins Melinda , Quyyumi Arshed , Reilly Carolyn , Pemu Pricilla , Dunbar Sandra
Published: September 2018

Background:

African Americans are disproportionately affected by hypertension and have lower medication adherence when compared to other racial groups. Antecedent factors such as beliefs surrounding hypertension, the presence or absence of social support, and depressive symptoms have not been extensively studied collectively in relation to hypertension medication adherence in African Americans.

Objective:

To determine the associations among demographic and clinical factors, depressive symptoms, hypertension beliefs, and social support with blood pressure medication adherence in middle-aged African American adults with a diagnosis of hypertension.

Methods:

A cross-sectional study of (N = 120) African Americans (mean age, 49 years; 22.5% men) with a current diagnosis of metabolic syndrome, including hypertension, who reported having and taking a prescribed blood pressure–lowering medication were included. Descriptive statistics, bivariate correlation analysis, and logistic regression using odds ratio were used to examine the effects of high blood pressure beliefs, social support, and depression on medication adherence.

Results:

A small but significant relationship was found between medication adherence and number of comorbidities (r = 0.19, P = .04). In a multivariate regression model, after controlling for gender, comorbidities remained associated with medication adherence (β = 0. 77, P = .04). Depressive symptoms, high blood pressure beliefs, and social support did not have a significant relationship with medication adherence.

Conclusions:

Multiple comorbidities may have a positive impact upon medication adherence. Further study is needed in a larger sample of African Americans who have a diagnosis of hypertension in addition to other comorbidities requiring medication management.
Experiences of Undergoing Enhanced External Counterpulsation in Patients With Refractory Angina Pectoris
Authors: Wu Eline , Broström Anders , Mårtensson Jan
Published: September 2018

Background:

Enhanced external counterpulsation (EECP) is a noninvasive treatment recommended for patients with refractory angina pectoris (RAP), which generally includes 35 one-hour sessions over 7 weeks. No study has described how patients experience the time before, during, and between sessions, as well as the time after EECP treatment.

Objective:

The aim of this study was to describe how patients with RAP experience EECP treatment.

Methods:

Semistructured interviews took place with 15 strategically selected patients (11 men, 58–91 years old) who had finished 7 weeks of EECP at the 2 existing EECP clinics in Sweden. Data were analyzed using inductive qualitative content analysis.

Results:

The results were divided into 4 content areas, each comprising 3 categories: (1) experiences before EECP was initiated comprised uncharted territory, being given a new opportunity, and gain insight; (2) experiences during EECP sessions comprised physical discomfort, need of distraction, and sense of security; (3) experiences between EECP sessions comprised physical changes, socializing, and coordinating everyday life; and (4) experiences after 1 course of EECP treatment comprised improved physical well-being, improved mental well-being, and maintaining angina in check.

Conclusions:

Enhanced external counterpulsation was perceived as an unknown treatment option among these patients with RAP. Nurses should emphasize education before and during treatment based on individualized care needs to improve knowledge and treatment experience, as well as prevent discomfort. There is a great need to increase the awareness of EECP among healthcare professionals because it can improve the life situation for patients with RAP.