bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing an Epidemic
Authors: Sullivan Matthew C. , Strainge Lauren , Blackmon Jaime E. , Cruess Stacy E. , Wheeler David , Cruess Dean G. 
Published: March 2020

Abstract

Background
Inpatient psychiatric hospitals provide an important point of care for assessing and stabilizing substance use and for facilitating linkage to appropriate treatment. Toxicology screening provides a key measure of substance use yet may miss many cases of substance use because of variable windows of detection and the limited scope of substances assessed. This study assesses the utility of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Substance Use screener as a supplemental tool for identifying substance use by self-report within an inpatient psychiatric hospital setting.

Methods
From a larger sample of 97 adult psychiatric inpatients, 60 who underwent drug toxicology testing and completed the DSM-5 screener were assessed. We examined the sensitivity and specificity of the self-report screener in comparison with drug toxicology test results collected by chart review.

Results
Sensitivity of the DSM-5 screener varied across substances assessed: The self-report measure identified 100% of individuals who tested positive for opioid use, 83% who tested positive for cannabis use, 50% who tested positive for cocaine use, and 37% who tested positive for benzodiazepine use. The self-report measure also identified 27 instances among 60 participants in which substance use identified by self-report was not detected by toxicology testing.

Conclusion
The brief and easily administered DSM-5 Level 2 Substance Use screener shows promise for improving identification of substance use in an inpatient psychiatric hospital setting. This measure may also provide psychiatric inpatient nursing staff with a means of working collaboratively with patients to assess substance use and coordinate appropriate treatment plans.
The 21st Century Opioid Addiction
Authors: Kidd Kirsten , Weinberg Tina , Caboral-Stevens Meriam 
Published: March 2020

Abstract

Introduction
Opioid addiction is a mounting problem and concern in all parts of the world. Drug overdose related to opioid addiction was the leading cause of accidental death in the United States in 2015; this extends to people across all ages, races, genders, and socioeconomic statuses. It is estimated that 21 million Americans aged 12 years or older has one form of substance use disorder, of which 2 million involves the use of prescription pain relievers. The cost of opioid misuse is estimated to be $78.5B based on 2013 data. This amount has exponentially increased more than $20 billion per year compared with 6 years ago.

Purpose
We conducted a concept analysis of opioid addiction in the 21st century and present its implications for nursing.

Methods
Walker and Avant's eight steps for analyzing a concept were utilized.

Results
Uses of opioid addiction from the perspectives of healthcare, sociology, law, and economics are presented. Defining attributes of opioid addiction based on review of the literature include physical dependence to opioids, psychological craving for opioids, habitual use, and lack of self-control. Antecedents, consequences, and empirical referents are also identified. Model, related, and contrary cases are developed.

Conclusion
This concept analysis article enhances understanding of the current opioid addiction crisis that is affecting the country.

Implications to Nursing
Nurses are in a position to play critical roles in the fight against opioid addiction. Nursing opportunities exist starting from the bedside and can reach up to the White House.
Radiation exposure awareness from patients undergoing nuclear medicine diagnostic 99mTc-MDP bone scans and 2-deoxy-2-(18F) fluoro-D-glucose PET/computed tomography scans
Authors: Ribeiro Ana S.F. , Husson Olga , Drey Nicholas , Murray Iain , May Katherine , Thurston Jim , Oyen Wim J.G. 
Published: March 2020

Introduction
Medical imaging is on average the largest source of artificial radiation exposure worldwide. This study seeks to understand patient’s awareness of radiation exposure derived from nuclear medicine diagnostic scans and assess if current information provided by leaflets is adequate.

Methods
Single-centre cross-sectional questionnaire study applied to bone scan and FDG PET/computed tomography patients, at a nuclear medicine and PET/computed tomography department over a 15-week period in 2018. Questionnaires on dose comparators were designed in collaboration with patients, public, and experts in radiation exposure. Qualitative data were analysed using thematic analysis and quantitative data using SPSS (V. 24).

Results
A total of 102 questionnaires were completed (bone scan = 50; FDG PET/computed tomography = 52). Across both groups, 33/102 (32.4%) patients reported having a reasonable understanding of nuclear medicine and 21/102 (20.6%) reported a reasonable knowledge of ionising radiations. When asked to compare the exposure dose of respective scans with common comparators 8/50 (16%) of bone scan patients and 11/52 (21.2%) FDG PET/computed tomography answered correctly. On leaflet information, 15/85 (17.6%) patients reported the leaflets do not provide enough information on radiation exposure and of these 10/15 (66.7%) commented the leaflets should incorporate more information on radiation exposure dose.

Conclusion
More observational and qualitative studies in collaboration with patients are warranted to evaluate patients’ understanding and preferences in communication of radiation exposure from nuclear medicine imaging. This will ensure communication tools and guidelines developed to comply with ionising radiation (medical exposure) regulation 2017 are according to patients needs and preferences.
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on Entrustable Professional Activities
Authors: Sauer Cary G. , Robson Jacob , Turmelle Yumirle P. , Cerezo Carolina S. , Loomes Kathleen M. , Huang Jeannie S. , Quiros‐Tejeira Ruben E. , Benkov Keith J. , Narkewicz Michael R. , Leichtner Alan , Weinstein Toba 
Published: March 2020

ABSTRACTQuality training in pediatric gastroenterology, hepatology, and nutrition is essential for the future of our specialty from advancing the science through research to providing clinical care for children with gastrointestinal, hepatic and nutritional disorders. As educational theory has developed, both the American Board of Pediatrics (ABP) and the Accreditation Council for Graduate Medical Education (ACGME) have commissioned projects to better define training including core competencies, and milestones with the goal of competency‐based assessment. Seeking to provide a clinical context for these competencies and milestones, the ABP commissioned a project for each pediatric subspecialty to develop entrustable professional activities (EPA) while at the same time developing EPAs that are common to all pediatric subspecialties. North American Society for Pediatric Gastroenterology, Hepatology, Nutrition (NASPGHAN) commissioned an EPA Task Force to develop the pediatric gastroenterology, hepatology and nutrition EPAs. This document serves as an introduction to EPAs, including their historical background, underlying educational theory, and the process used to develop the pediatric gastroenterology, hepatology and nutrition EPAs in the United States of America.
Extragenital Gonorrhea and Chlamydia Positivity and the Potential for Missed Extragenital Gonorrhea With Concurrent Urethral Chlamydia Among Men Who Have Sex With Men Attending Sexually Transmitted Disease Clinics—Sexually Transmitted Disease Surveillance Network, 2015–2019
Authors: Abara Winston E. , Llata Eloisa L. , Schumacher Christina , Carlos-Henderson Juli , Peralta Angela M. , Huspeni Dawn , Kerani Roxanne P. , Elder Heather , Toevs Kim , Pathela Preeti , Asbel Lenore , Nguyen Trang Q. , Bernstein Kyle T. , Torrone Elizabeth A. , Kirkcaldy Robert D. 
Published: March 2020

Background
Extragenital gonorrhea (GC) and chlamydia (CT) are usually asymptomatic and only detected through screening. Ceftriaxone plus azithromycin is the recommended GC treatment; monotherapy (azithromycin or doxycycline) is recommended for CT. In urethral CT-positive/urethral GC-negative persons who are not screened extragenitally, CT monotherapy can lead to GC undertreatment and may foster the development of gonococcal antimicrobial resistance. We assessed urethral and extragenital GC and CT positivity among men who have sex with men (MSM) attending sexually transmitted disease clinics.

Methods
We included visit data for MSM tested for GC and CT at 30 sexually transmitted disease clinics in 10 jurisdictions during January 1, 2015, and June 30, 2019. Using an inverse-variance random effects model to account for heterogeneity between jurisdictions, we calculated weighted test visit positivity estimates and 95% confidence intervals (CI) for GC and CT at urethral and extragenital sites, and extragenital GC among urethral CT-positive/GC-negative test visits.

Results
Of 139,718 GC and CT test visits, we calculated overall positivity (GC, 16.7% [95% CI, 14.4–19.1]; CT, 13.3% [95% CI, 12.7–13.9]); urethral positivity (GC, 7.5% [95% CI, 5.7–9.3]; CT, 5.2% [95% CI, 4.6–5.8]); rectal positivity (GC, 11.8% [95% CI, 10.4–13.2]; CT, 12.6% [95% CI, 11.8–13.4]); and pharyngeal positivity (GC, 9.1% [95% CI, 7.9–10.3]; CT, 1.8% [95% CI, 1.6–2.0]). Of 4566 urethral CT-positive/GC-negative test visits with extragenital testing, extragenital GC positivity was 12.5% (95% CI, 10.9–14.1).

Conclusions
Extragenital GC and CT were common among MSM. Without extragenital screening of MSM with urethral CT, extragenital GC would have been undetected and undertreated in approximately 13% of these men. Undertreatment could potentially select for antimicrobial resistance. These findings underscore the importance of extragenital screening in MSM.
A Multimetric Health Literacy Analysis of Autologous Versus Implant-Based Breast Reconstruction
Authors: Chen Daniel H. , Johnson Anna Rose , Ayyala Haripriya , Lee Edward S. , Lee Bernard T. , Tran Bao Ngoc N. 
Published: March 2020

Background
Over the past decade, the demand for breast reconstruction has mirrored the rising incidence of breast cancer. Common postoncologic surgical options include autologous and implant-based reconstruction. Patient-directed health information for breast reconstruction can play a critical role in the decision-making process. This study comparatively evaluates the top online resources for autologous versus implant-based reconstruction using a multimetric health literacy analysis.

Methods
The top 10 websites for autologous and implant-based reconstruction were identified using a Google search. A total of 20 unique links were appraised by 2 independent raters for understandability and actionability using the Patient Education Materials Assessment Tool and cultural sensitivity using the Cultural Sensitivity Assessment Tool. A Cohen κ for interrater reliability was calculated. Mean reading grade level and word complexity were also determined.

Results
Websites for both autologous and implant-based modalities exceeded the recommended sixth- to eighth-grade reading level (12.4 and 12.1, respectively; P = 0.65). Mean understandability scores for each modality were low (60.5 and 62.5, P = 0.65). Autologous-based resources had a lower mean actionability score compared with implant-based materials (19.5 and 24, respectively; P = 0.04). Both reconstructive modalities met the threshold for acceptability for cultural sensitivity (2.79 and 2.58, P = 0.09).

Conclusions
Our study revealed a chasm between the health literacy needs of the average adult and the quality of both implant-based and autologous breast reconstruction resources. Materials for both modalities were often too complex and failed to include tools to facilitate active decision making, particularly for autologous-based reconstruction. Strategies to improve materials should be patient centered and include simplification of reading grade level, incorporation of clear visual aids, and inclusion of procedural risks to promote patient comprehension, participation, and ultimately health outcomes.
Noncultured Minimally Processed Adipose-Derived Stem Cells Improve Radiated Fracture Healing
Authors: Lynn Jeremy V. , Ranganathan Kavitha , Urlaub Kevin M. , Luby Alexandra O. , Stephan Chris J. , Donneys Alexis , Nelson Noah S. , Buchman Steven R. 
Published: March 2020

Abstract
Adipose-derived stem cells mitigate deleterious effects of radiation on bone and enhance radiated fracture healing by replacing damaged cells and stimulating angiogenesis. However, adipose-derived stem cell harvest and delivery techniques must be refined to comply with the US Food and Drug Administration restrictions on implantation of cultured cells into human subjects prior to clinical translation. The purpose of this study is to demonstrate the preservation of efficacy of adipose-derived stem cells to remediate the injurious effects of radiation on fracture healing utilizing a novel harvest and delivery technique that avoids the need for cell culture. Forty-four Lewis rats were divided into 4 groups: fracture control (Fx), radiated fracture control (XFx), radiated fracture treated with cultured adipose-derived stem cells (ASC), and radiated fracture treated with noncultured minimally processed adipose-derived stem cells (MP-ASC). Excluding the Fx group, all rats received a fractionated human-equivalent dose of radiation. All groups underwent mandibular osteotomy with external fixation. Following sacrifice on postoperative day 40, union rate, mineralization, and biomechanical strength were compared between groups at P < 0.05 significance. Compared with Fx controls, the XFx group demonstrated decreased union rate (100% vs 20%), bone volume fraction (P = 0.003), and ultimate load (P < 0.001). Compared with XFx controls, the MP-ASC group tripled the union rate (20% vs 60%) and demonstrated statistically significant increases in both bone volume fraction (P = 0.005) and ultimate load (P = 0.025). Compared with the MP-ASC group, the ASC group showed increased union rate (60% vs 100%) and no significant difference in bone volume fraction (P = 0.936) and ultimate load (P = 0.202). Noncultured minimally processed adipose-derived stem cells demonstrate the capacity to improve irradiated fracture healing without the need for cell proliferation in culture. Further refinement of the cell harvest and delivery techniques demonstrated in this report will enhance the ability of noncultured minimally processed adipose-derived stem cells to improve union rate and bone quality, thereby optimizing clinical translation.
Effectiveness of Pharmacological Interventions for Symptoms of Behavioral Variant Frontotemporal Dementia: A Systematic Review
Authors: Trieu Calvin , Gossink Flora , Stek Max L. , Scheltens Philip , Pijnenburg Yolande A.L. , Dols Annemieke 
Published: March 2020

Background:
Clinical guidance on the symptomatic treatment of behavioral variant frontotemporal dementia (bvFTD) is limited.

Objective:
To provide a systematic review of pharmacological interventions for symptomatic treatment of bvFTD, based on the International bvFTD Criteria Consortium clinical diagnostic criteria: apathy, disinhibition, lack of empathy or sympathy, hyperorality, stereotypical behavior, and executive dysfunction.

Methods:
We systematically searched the PubMed, Embase, and PsycINFO databases for reports on pharmacological interventions for individuals with bvFTD, published between 1970 and 2018, using key indicators and relevant terms. Studies were included if the efficacy of the intervention in alleviating bvFTD symptoms was provided as an outcome. Due to the high prevalence of depressive symptoms in individuals with bvFTD, we also evaluated the effect of the interventions on depression.

Results:
We included 23 studies—11 randomized controlled trials, eight open-label studies, one proof-of-concept study, and three case series—reporting on a total of 573 individuals. Of the 23 studies, 16 used pharmacological interventions that improved bvFTD symptoms. Based on the Neuropsychiatric Inventory, trazodone had the greatest significant reductive effect on the symptoms of bvFTD. Overall, citalopram, rivastigmine, paroxetine, and trazodone all reduced multiple symptoms, including disinhibition, hyperorality, and depression.

Conclusions:
This review provides an overview of the pharmacological interventions that can be used to treat the main bvFTD symptoms as well as a guideline for managing bvFTD. More research is needed to investigate the efficacy of pharmacological interventions for bvFTD through use of a validated outcome and a focus on the specific behavioral problems associated with bvFTD.
Executive Dysfunction Related to Binge Drinking in Ischemic Stroke
Authors: Laari Siiri P.K. , Kauranen Tatu V. , Turunen Katri E.A. , Mustanoja Satu M. , Tatlisumak Turgut , Poutiainen Erja T. 
Published: March 2020

Background:
Recent evidence has shown that cognitive dysfunction is associated with a history of binge drinking in adolescents who do not have an alcohol use disorder. Most previous studies with adults, however, have failed to show a link between cognitive dysfunction and subdiagnostic binge drinking, nor have any studies investigated the additive cognitive effect of binge drinking to ischemic stroke.

Objective:
To examine whether a pattern of cognitive dysfunction, especially executive and memory dysfunction, in patients with a first-ever ischemic stroke is associated with a history of subdiagnostic binge drinking.

Methods:
We studied 206 first-ever ischemic stroke patients (18–65 years) and 50 healthy, demographically comparable adults—both groups with no alcohol use disorder. After exclusion by matching, 189 patients and 39 healthy participants were included in our study (228 participants). The binge-drinking group included 76 participants; the non–binge-drinking group included 152. A multivariate analysis of covariance was used to compare nine cognitive functions between the two groups, with age, education, and stroke severity used as covariates.

Results:
Binge drinking had a significant negative effect on executive functions (P<0.001). The non–binge-drinking group outperformed the binge-drinking group on the Stroop Test (P=0.001), Trail Making Test (P=0.002), and a phonemic fluency test (P=0.005). The Binge×Stroke Severity interaction (P=0.037) indicated that a history of binge drinking increased the negative effect of stroke on executive functions.

Conclusions:
Subdiagnostic binge drinking may exacerbate the adverse effects of ischemic stroke on executive dysfunction.
The Impairment of Number Transcoding Abilities in Individuals with Amnestic Mild Cognitive Impairment and Alzheimer Disease: Associations With Attentional and Executive Functions
Authors: Macoir Joël , Lafay Anne , Hudon Carol 
Published: March 2020

Background:
Studies have shown that number transcoding abilities (ie, translating numbers from one numerical code to another) are affected early in the development of Alzheimer disease (AD). However, no study has extensively explored how these abilities are affected in individuals with mild cognitive impairment (MCI).

Objective:
To determine the contribution that number transcoding tasks make to the identification of MCI, and to pinpoint the cognitive correlates of performance in these tasks.

Methods:
We compared the performance of 20 individuals with the amnestic subtype of MCI, eight individuals with AD, and 20 healthy controls on three number transcoding tasks.

Results:
The results confirmed the presence of number transcoding impairment in the individuals with AD. The individuals with MCI were found to be impaired in two of the transcoding tasks; these individuals produced perseverations of the input code—the most noteworthy error type in individuals with AD. In addition, the relationship between impairment in attentional and executive functions and impairment in number transcoding was supported by the correlational analyses.

Conclusions:
This study confirmed that number transcoding abilities are impaired in individuals with MCI, although less severely than in individuals with AD. Our results provide evidence for the clinical value of including number transcoding tasks in the assessment of cognitive deficits associated with pathological aging.
Epidemiological Trends of Coronavirus Disease 2019 in China
Authors: Chen Bilin , Zhong Huanhuan , Ni Yueyan , Liu Lulu , Zhong Jinjin , Su Xin 
Published: March 2020

ABSTRACTBackgroundThe Coronavirus Disease 2019 (COVID-19) epidemic broke out in Wuhan, China, and it spread rapidly. Since January 23, 2020, China has launched a series of unusual and strict measures, including the lockdown of Wuhan city to contain this highly contagious disease. We collected the epidemiological data to analyze the trend of this epidemic in China.MethodsWe closely tracked the Chinese and global official websites to collect the epidemiological information about COVID-19. The number of total and daily new confirmed cases of COVID-19 in China was presented to illustrate the trend of this epidemic.ResultsOn January 23, 2020, 835 confirmed COVID-19 cases were reported in China. On February 6, 2020, there were 31211 cases. By February 20, 2020, the number reached as high as 75,993. Most cases were distributed in and around Wuhan, Hubei province. Since January 23, 2020, the number of daily new cases in China except Hubei province reached a peak of 890 on the eleventh day and then it declined to a low level of 34 within two full-length incubation periods (28 days), and the number of daily new cases in Hubei also started to decrease on the twelfth day, from 3156 on February 4, 2020 to 955 on February 15, 2020.ConclusionThe COVID-19 epidemic has been primarily contained in China. The battle against this epidemic in China has provided valuable experiences for the rest of the world. Strict measures need to be taken as earlier as possible to prevent its spread.
Epigenomics and Transcriptomics of Systemic Sclerosis CD4+ T cells reveal Long Range Dysregulation of Key Inflammatory Pathways mediated by disease-associated Susceptibility Loci
Authors: Li Tianlu , Ortiz Lourdes , Andrés-León Eduardo , Ciudad Laura , Javierre Biola M. , López-Isac Elena , Guillén-Del-Castillo Alfredo , Simeón-Aznar Carmen Pilar , Ballestar Esteban , Martin Javier 
Published: March 2020

ABSTRACTSystem sclerosis (SSc) is a genetically complex autoimmune disease mediated by the interplay between genetic and epigenetic factors in a multitude of immune cells, with CD4+ T lymphocytes as one of the principle drivers of pathogenesis. In this study, we obtained DNA methylation and expression profiles of CD4+ T cells from 48 SSc patients and 16 healthy controls. Consequently, we identified 9112 and 3929 differentially methylated CpGs positions (DMPs) and differentially expressed genes (DEGs) respectively. These DMPs and DEGs are enriched in functional categories related to inflammation and T cell biology. Furthermore, correlation analysis identified 17,500 possible DMP-DEG interaction pairs within a window of 5 Mb, and utilizing promoter capture Hi-C data, we confirmed that 212 CD4+ T cel specific pairs of DMP-DEG physically interact involving CTCF. Finally, utilizing SSc GWAS data, we identified four important SSc-associated susceptibility loci, TNIP1 (rs3792783), GSDMB (rs9303277), IL12RB1 (rs2305743) and CSK (rs1378942), that physically interact with DMP-DEG pairs cg17239269-ANXA6, cg19458020-CCR7, cg10808810-JUND and cg11062629-ULK3 respectively. Overall, our study reveals a solid link between genetic, epigenetic and transcriptional deregulation in CD4+ T cells of SSc patients, providing a novel integrated view of SSc pathogenic determinants.