bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep disturbance underlies the co-occurrence of trauma and pediatric chronic pain: a longitudinal examination
Authors: Pavlova Maria , Kopala-Sibley Daniel C. , Nania Cara , Mychasiuk Richelle , Christensen Jennaya , McPeak Allison , Tomfohr-Madsen Lianne , Katz Joel , Palermo Tonya M. , Noel Melanie 
Published: February 2020

Abstract
Epidemiological and cross-sectional studies have shown that post-traumatic stress disorder symptoms (PTSS) are common and impairing in youth with chronic pain. Yet, the co-occurrence of PTSS and pediatric chronic pain has not been examined longitudinally, which has limited understanding of theoretically proposed mechanisms (eg, sleep disturbance) underlying the PTSS-pain relationship over time. This longitudinal study aimed to fill this gap. Participants included 138 youth (Mage = 14.29, 75% girls) referred to a tertiary-level outpatient chronic pain program and one of their parents. At baseline, youth reported their pain intensity and interference, PTSS, and subjective sleep disturbances (ie, sleep quality and insomnia). Youth and parents completed semistructured diagnostic interviews to determine the child's post-traumatic stress disorder diagnostic status, and youth completed an objective assessment of sleep patterns for 7 days using actigraphy. At 3-month follow-up, youth once again completed the diagnostic interview and reported their pain intensity, pain interference, and PTSS. Partially latent cross-lagged structural equation panel models revealed that, controlling for pain intensity, pain interference and PTSS co-occurred at baseline, but not at follow-up (while controlling for baseline levels). Higher levels of baseline PTSS were predictive of increases in pain interference at follow-up. Furthermore, subjective sleep disturbances mediated the relationship between baseline PTSS and follow-up pain interference. These findings lend support to conceptual models of PTSS–pain co-occurrence and highlight a critical need to assess and address trauma and sleep disturbances in youth with chronic pain.
Morphine produces potent antinociception, sedation, and hypothermia in humanized mice expressing human mu-opioid receptor splice variants
Authors: Huang Yi-Han , Wu Yu-Wei , Chuang Jian-Ying , Chang Yung-Chiao , Chang Hsiao-Fu , Tao Pao-Luh , Loh Horace H. , Yeh Shiu-Hwa 
Published: February 2020

Abstract
Morphine is a strong painkiller acting through mu-opioid receptor (MOR). Full-length 7-transmembrane (TM) variants of MOR share similar amino acid sequences of TM domains in rodents and humans; however, interspecies differences in N- and C-terminal amino acid sequences of MOR splice variants dramatically affect the downstream signaling. Thus, it is essential to develop a mouse model that expresses human MOR splice variants for opioid pharmacological studies. We generated 2 lines of fully humanized MOR mice (hMOR+; mMOR−/− mice), line #1 and #2. The novel murine model having human OPRM1 genes and human-specific variants was examined by reverse-transcription polymerase chain reaction and the MinION nanopore sequencing. The differences in the regional distribution of MOR between wild-type and humanized MOR mice brains were detected by RNAscope and radioligand binding assay. hMOR+; mMOR−/− mice were characterized in vivo using a tail-flick, charcoal meal, open field, tail suspension, naloxone precipitation tests, and rectal temperature measurement. The data indicated that wild-type and humanized MOR mice exhibited different pharmacology of morphine, including antinociception, tolerance, sedation, and withdrawal syndromes, suggesting the presence of species difference between mouse and human MORs. Therefore, hMOR+; mMOR−/− mice could serve as a novel mouse model for pharmacogenetic studies of opioids.
Development of the Implantable Cardioverter Defibrillator Body Image Concerns Questionnaire
Authors: Frydensberg Vivi Skibdal , Strömberg Anna , Johansen Jens Brock , Pedersen Susanne S. 
Published: February 2020

Background
The implantable cardioverter defibrillator (ICD) is the first-line treatment for the prevention of sudden cardiac death. Although most ICD recipients adapt well to living with the device, some struggle with ICD-related body image concerns (BICs). Because of lack of standardized questionnaires to assess BICs, we do not know the prevalence.

Objective
The aim of this study was to develop a questionnaire that assesses self-reported ICD-related BICs.

Methods
Using a sequential, qualitative multimethod approach, we developed the ICD-BIC questionnaire (ICD-BICQ) based on (1) themes from a scoping review on BICs in ICD recipients, (2) cognitive interviews with ICD recipients to evaluate the validity of items and to ascertain whether items were missing, and (3) input from healthcare professionals. A conceptual framework was created containing 4 general dimensions: (1) assessment, (2) behavior, (3) body perception, and (4) emotions.

Results
Implantable cardioverter defibrillator recipients (n = 8, 2 women and 6 men; age, 40–78 years), 2 specialists in questionnaire development, and healthcare professionals specialized in ICD treatment evaluated the questionnaire. After no new items or new dimensions emerged from the cognitive interviews, the final version 7 of the ICD-BICQ consisted of 39 items tapping into (1) assessment (n = 2), (2) behavior (n = 13), (3) body perception (n = 16), and emotions (n = 8). Items were assessed on a 5-point Likert-type scale.

Conclusion
Using patient and healthcare professionals' involvement, we developed the 39-item ICD-BICQ to measure the prevalence of BICs in ICD recipients. The factor structure, construct validity, psychometric properties, and a clinically relevant cutoff for the ICD-BICQ will be evaluated in a quantitative study of ICD recipients.
Partnering with parents to remove barriers and improve influenza immunization rates for young children
Authors: Bauer Katherine E. , Agruss Janyce Cagan , Mayefsky Jay H. 
Published: February 2020

ABSTRACT

Background:
Despite the ongoing public health initiatives to increase pediatric influenza immunization rates to 80%, only a few US health centers have been able to meet this goal. The suboptimal immunity to influenza poses individual and societal risks for vaccine-preventable cases of influenza and its complications.

Local problem:
At a diverse, urban, family health center, its influenza immunization rate of 44% represented the lowest uptake rate compared with all other early childhood vaccines, increasing the risk of morbidity and mortality in young children, including hospitalization and death.

Methods:
To identify key barriers to influenza immunization, the investigators interviewed parents of children aged 6 through 24 months at this urban family health center via randomized sampling using an open-ended telephone survey.

Interventions:
Based on the concerns parents expressed through the survey, a program was designed and implemented that included reminder calls, parent education, proactive appointment scheduling, and social media reminders.

Results:
After implementing a parent-driven quality-improvement program for 6 months during influenza season, the health center's pediatric influenza immunization rates rose to 57% compared with 44% during the year before.

Conclusions:
Childhood immunization is a critical priority to protect the health and wellness of children. Increasing parent engagement in discussions about increasing immunization rates not only promotes awareness surrounding vaccines but also allows primary care providers to learn from parents to create a patient-centered immunization program. Programs that specifically target immunization efforts toward parental concerns have the potential for increased vaccine acceptance and improved health outcomes.
Focus group testing of a mobile app for pharmacogenetic-guided dosing
Authors: Dodson Crystal Heath , Baker Elizabeth 
Published: February 2020

ABSTRACT

Background:
A common barrier to implementation of precision medicine is the lack of use of published clinical practice guidelines. Consequently, a user-friendly mechanism to easily adopt these guidelines is imperative.

Purpose:
The purpose of this study was to evaluate the perceptions of a prototype of a clinical decision support tool through a mobile application for pharmacogenetics.

Methodological orientation:
A case study on a patient requiring pharmacogenetic testing was provided to the participants. The participants were given up to 30 minutes to identify the correct dosing in the clinical decision support tool based on clinical evidence-based guidelines. Immediately after the utilization of the mobile app, focus group interviews were conducted to identify the perceptions of the tool, obstacles associated with the tool, and suggestions for improvement of the tool.

Sample:
Focus group interviews with 23 nurse practitioners and nurse practitioner students were conducted. Field notes and audio recordings were taken.

Conclusions:
Specific feedback for improvement in the font and size of text, color contrast, use of drug calculator, automatic input, and desire for further development of education portal were found within the data. The findings revealed useful feedback to adjust the prototype to improve the ease of use among nurse practitioners.

Implications for practice:
The revision of this mobile app will improve user friendliness to increase applicability within health care. The mobile app can be used for future research to identify improvements in patient outcomes after implementing this tool.
Correlation of plasma soluble suppression of tumorigenicity-2 level with the severity and stability of coronary atherosclerosis
Authors: Zhang Ying , Fan Zixu , Liu Hua , Ma Jianwei , Zhang Min 
Published: February 2020

Background
Soluble growth stimulation expressed gene 2 (sST2) is the receptor of interleukin (IL)-33. We hypothesized the IL-33/ST2 pathway may be closely related to the progression of coronary atherosclerotic lesions.

Methods
We analyzed 262 patients, including 63 with stable angina pectoris (SAP), 97 with acute coronary syndrome (ACS), and 102 control subjects. Plasma sST2 levels were determined using ELISA. Gensini scores were calculated. Patients with ACS and SAP were further divided according to the complexity of atherosclerotic lesions (simple/complex). Statistical analysis was performed on all data.

Results
The plasma sST2 levels were significantly higher in patients with coronary artery disease (CAD) than in the control group, and were significantly higher in ACS patients with complex lesions than in those with simple lesions. There were no correlations between plasma sST2 level and both the number of culprit vessels and Gensini score. Multivariate stepwise regression analysis revealed that angiographically detected complex lesions were independently correlated with plasma sST2 level. Logistic regression analyses showed that sST2 was an independent factor of both CAD and the lesion type (simple/complex) of ACS. For the diagnosis of ACS and complex lesions, the area under the receiver operating characteristic curve of sST2 was 0.651.

Conclusions
The plasma sST2 level was not correlated with the stenosis severity of coronary atherosclerosis. A relationship between the plasma sST2 level and the morphology of complex lesions was found for the first time, especially in ACS patients. It may be a new marker for assessing the stability and complexity of atherosclerotic plaques.
Teaching Father-Infant Massage during Postpartum Hospitalization
Authors: Suchy Carol , Morgan Gloria , Duncan Susan , Villar Susan , Fox Frieda , Rutledge Dana N. 
Published: February 2020

Abstract

Purpose:
The purpose of this study was to evaluate acceptability and impact of infant massage video instruction on fathers' behaviors in early postpartum.

Methods:
A randomized crossover design was used. Participants were fathers of healthy term infants born at a Magnet hospital in Southern California. Measures included a demographic survey, Father-to-Infant Bonding Scale, Father-Infant Observation Scale, and postdischarge phone interview. Study nurses observed father–infant interactions for 5 minutes. Fathers were randomized to one of two groups: fathers in group 1 saw the massage video before they were observed with their infants and fathers in group 2 saw the video after. Fathers completed the Bonding Scale at baseline in person and again within a week of discharge by phone. Statistics were descriptive and comparative. Responses to interview questions were categorized and described.

Results:
Ninety-eight fathers aged 18 to 44 years participated. Over half of fathers identified as Hispanic and the majority spoke English at home. Most fathers had positive responses to infants on individual Bonding Scale items. Fathers differed significantly in observed interactions with infants depending upon timing of massage instruction; fathers observed immediately after the video had more total interactions, specifically fingertip touching. Poststudy evaluations were predominantly positive.

Clinical Implications:
We found a brief infant massage instruction offered by video was well accepted by fathers and increased observed father–infant interactions.
A Qualitative Reexamination of the Key Features of Burnout
Authors: Tavella Gabriela , Parker Gordon 
Published: February 2020

Abstract
Burnout is generally defined as a triad of emotional exhaustion, lack of empathy, and reduced professional accomplishment constructs. We sought to determine in an exploratory, qualitative study whether these three constructs adequately represent burnout. Participants who self-identified as experiencing burnout completed a questionnaire that asked about their experiences of the condition. A qualitative thematic analysis was undertaken to determine the primary symptom constructs nominated by participants. The thematic analysis resulted in 12 symptom clusters or “themes” being identified as putative burnout features, with several of these themes overlapping with features identified in our independent quantitative analysis. Although we found emotional exhaustion, lack of empathy, and reduced professional accomplishment to be commonly nominated symptoms of burnout, the distinctive presence of several additional themes suggests that the burnout syndrome comprises a broader set of symptom constructs than those currently accepted as the defining features of the condition.
Opioid Use in Fibromyalgia Continues Despite Guidelines That Do Not Support Its Efficacy or Risk
Authors: Bruce Barbara K. , Allman Madeleine E. , Rivera Fernando A. , Abril Andy , Gehin Jessica M. , Oliphant Loretta M. , Nordan Lisa M. , White Launia J. , Martinez Dayana , Niazi Shehzad K. 
Published: February 2020

Background/Objective
The aim of this cross-sectional study is to determine the prevalence of opioid use in a large sample of fibromyalgia (FM) patients and examine the factors associated with opioid prescription/use despite multiple clinical guidelines that do not recommend opioid use in this population.

Methods
Data were collected from a convenience sample of 698 patients admitted from August 2017 to May 2019 into an intensive 2-day Fibromyalgia Treatment Program at a tertiary medical center in the United States after FM diagnosis. Patients were administered the Fibromyalgia Impact Questionnaire–Revised, the Center for Epidemiologic Study of Depression Scale, and the Pain Catastrophizing Scale upon admission to the program. Demographic information and opioid use were self-reported. Logistic regression analysis was utilized to determine associations between patient-related variables and opioid use in this prospective study.

Results
Of 698 patients, 27.1% (n = 189) were taking opioids at intake. Extended duration of symptoms (>3 years), increased age, higher degree of functional impairment, and increased pain catastrophizing were significantly associated with opioid use.

Conclusions
Opioids are not recommended for the treatment of FM under current guidelines. Greater burden of illness appeared to be associated with the prescription and use of opioids in this population. These findings suggest that some providers may not be aware of current recommendations that have been found to be effective in the management of FM that are contained in guidelines. Alternative approaches to the management of FM that do not involve opioids are reviewed in an effort to improve care.
Evidence-Based Approach to Nerve Gap Repair in the Upper Extremity
Authors: Huayllani Maria T. , Boczar Daniel , Forte Antonio J. , Rinker Brian 
Published: February 2020

Abstract
The upper extremity is the most common site for nerve injuries. In most cases, direct repair can be performed, but when a critical gap occurs, special techniques must be used to enhance nerve regeneration and allow recovery of sensory and motor functions. These techniques include the use of autografts, processed nerve allografts, and conduits. However, surprisingly few studies have compared outcomes from the different methods of nerve gap repair in a rigorous fashion. There is a lack of evidence-based guidelines for the management of digital and motor and mixed nerve injuries with a nerve gap. The purpose of this study is to perform a comprehensive literature review and propose a rational algorithm for management of nerve injuries with a critical gap.
Design Thinking–Informed Simulation
Authors: Petrosoniak Andrew , Hicks Christopher , Barratt Lee , Gascon Dominic , Kokoski Candis , Campbell Doug , White Kari , Bandiera Glen , Lum-Kwong Margaret Moy , Nemoy Lori , Brydges Ryan 
Published: February 2020

Introduction
Designing new healthcare facilities is complex and transitions to new clinical environments carry high risks, as unanticipated problems may arise resulting in inefficient care and patient harm. Design thinking, a human-centered design method, represents a unique framework to support the planning, testing, and evaluation of new clinical spaces throughout all phases of construction. Healthcare simulation has been used to test new clinical spaces, yet most report using simulation only in the late design stages. Moreover, healthcare design models have potentially underused human factors approaches calling for human-centered design. We applied a multimodal simulation-based approach underpinned by the principles of design thinking throughout the planning and construction stages of a newly renovated academic emergency department.

Methods
A multidisciplinary team developed and integrated 3 simulation strategies (table-top, mock-up, and in situ simulation) into the 5-step process of design thinking. Through end-user engagement, we identified potential challenges, prototyped solutions through table-top and mock-up simulations, and iteratively tested these solutions through in situ simulation within the actual clinical space.

Results
The team used end-user engagement and feedback to brainstorm and implement effective solutions to problems encountered before opening the new emergency department. The iterative steps and targeted use of simulation resulted in redesigning departmental processes and actual clinical space while mitigating anticipated safety threats and departmental deficiencies.

Conclusions
Design thinking coupled with multimodal simulation across all phases of construction enhanced the design and testing of new clinical infrastructure. Applying this approach early, thoroughly, and efficiently will help healthcare organizations plan changes to clinical spaces.
Teprotumumab in Thyroid-Associated Ophthalmopathy: Rationale for Therapeutic Insulin-Like Growth Factor–I Receptor Inhibition
Authors: Smith Terry J. 
Published: February 2020

Abstract:Thyroid-associated ophthalmopathy (TAO) is an autoimmune component of Graves' disease for which no currently available medical therapy provides reliable and safe benefit. Based on insights generated experimentally over the past several decades, the insulin-like growth factor–I receptor (IGF-IR) has been implicated in the pathogenesis of TAO. Furthermore, an IGF-IR inhibitor, teprotumumab, has emerged from 2 clinical trials as a promising treatment for active, moderate to severe TAO. This brief review intends to provide an overview of the rationale underlying the development of teprotumumab for this disease. It is possible that teprotumumab will soon take its place in our therapeutic armamentarium for active TAO.
Crossroads between transposons and gene regulation
Authors: Branco Miguel R. , Chuong Edward B. 
Published: February 2020

Transposons are mobile genetic elements that have made a large contribution to genome evolution in a largely species-specific manner. A wide variety of different transposons have invaded genomes throughout evolution, acting in a first instance as ‘selfish’ elements, whose success was determined by their ability to self-replicate and expand within the host genome. However, their coevolution with the host has created many crossroads between transposons and the regulation of host gene expression. Transposons are an abundant source of transcriptional modulatory elements, such as gene promoters and enhancers, splicing and termination sites, and regulatory non-coding RNAs. Moreover, transposons have driven the evolution of host defence mechanisms that have been repurposed for gene regulation. However, dissecting the potential functional roles of transposons remains challenging owing to their evolutionary path, as well as their repetitive nature, which requires the development of specialized analytical tools. In this special issue, we present a collection of articles that lay out current paradigms in the field and discuss a vision for future research.
This article is part of a discussion meeting issue ‘Crossroads between transposons and gene regulation’.
EFFECT OF VISUAL-CUEING ON TWO-LEGGED HOPPING VARIABILITY IN CHILDREN WITH AUTISM SPECTRUM DISORDER: A PILOT STUDY
Authors: Lidstone Daniel E. , Dufek Janet S. 
Published: February 2020

ABSTRACTBackgroundMotor deficits in children with Autism Spectrum Disorder (ASD) are highly prevalent. High variability of motor output is commonly reported in children with ASD. Visual cueing using an exergame may be an effective intervention to reduce motor variability in children with ASD.AimTo examine the effect of visual cueing on two-legged hopping variability in children with ASD.MethodsFour children with ASD and six age-matched TD controls performed three 20-s hopping trials with no visual cueing (no cue = NC) and with a 2 Hz visual cue (visual cue = VC). Three-dimensional kinematic data of the sacrum marker and ground reaction force were collected during each hopping trial. Variability was determined using the intra-trial coefficient of variation (CoV) of hopping frequency, hop height, and negative sacral displacementResultsA marginally significant interaction between GROUP (ASD/TD) and CUE type (NC/VC) was observed for hopping frequency variability (p= 0.06) indicating greater impairment in the ASD group vs. TD group with visual vs. no-cueing. The main effect of group showed a statistically significant difference in hopping frequency (p= 0.037), hopping frequency variability (p= 0.008), and negative sacrum displacement variability (p= 0.04).ConclusionThis pilot study confirmed high motor variability in the amplitude and frequency of repetitive movements in children with ASD. However, visual cueing was ineffective at reducing the variability of motor output in children with autism.