bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence‐based medicine's curious path: From clinical epidemiology to patient‐centered care through decision analysis
Authors: Falzer Paul R. 
Published: August 2020

AbstractEvidence‐based medicine (EBM), one of the most important movements in health care, has been a lightning rod for controversy. Conflicts about the meaning and value of EBM are owing in part to lack of clarity about basic questions regarding its development, the importance of expertise and intuition, and the role of evidence in clinical decision making. These issues have persisted in part because of unclarity at the outset, but also because of how EBM evolved, why it was introduced when it was, and how it was modified following its introduction. This paper traces the evolution of EBM from clinical epidemiology (CE) and the internal dispute that precipitated the developers to establish EBM as a distinct approach to clinical practice. The paper proposes that health care industrialization also had a significant role in EBM's emergence and that industrialization influenced the decision to merge EBM with the method of normative decision making known as decision analysis (DA). The paper discusses the impact of this merger, in particular how it led to EBM's identification with managed care and has added momentum to the effort at forging a connection between a normative decision model and clinical judgement. This effort would turn clinical decision making into a conduit for bringing administrative rules and regulations into the consulting room and would result in expertise becoming a surplus skill. The paper closes by discussing a challenge yet unmet by EBM's advocates and critics—to chronicle the dangers that EBM in the framework of DA during the current era of industrialization poses to health and health care, and discover ways of unhinging the relationship between model and judgement.
Dissemination of Prenatal Drinking Guidelines: A Preliminary Study Examining Personal Alcohol Use Among Midwives in a Southwestern US State
Authors: Olusanya Olufunto A. , Barry Adam E. 
Published: August 2020

IntroductionThe constellation of birth defects seen in fetuses exposed to alcohol in utero have been described as fetal alcohol spectrum disorders. Evidence suggests that health care providers’ communication practices regarding prenatal alcohol use could have beneficial outcomes. There is a paucity of investigations, however, that have examined the health professionals’ personal alcohol use and prenatal alcohol recommendations they provide.MethodsThis study sought to examine and compare midwives’ personal alcohol use and communication practices regarding prenatal alcohol consumption. Certified nurse‐midwives (CNMs) and certified professional midwives (CPMs) in a southwestern US state participated. Inclusion criteria included training in prenatal care, labor, birth, and membership in a midwife professional organization. Personal drinking behaviors were assessed with Alcohol Use Disorder Identification Test—Consumption (AUDIT‐C).ResultsAll midwives (N = 61; 100%) reported they typically screened a patient for alcohol use during an initial prenatal visit. However, 5 (8.2%) respondents opted for recommendations that advised patients to drink once in a while. Similarly, 4 (6.6%) midwives counseled no more than one drink per day. In the cohort of participants (n = 40) with AUDIT‐C scores, 25 (62.5%) engaged in nonrisky drinking (AUDIT‐C scores <3). Most respondents (n = 39 of 40; 97.5%) typically consumed 1 to 2 standard drinks on the day they drank. There was no statistically significant difference in mean overall AUDIT‐C scores between CNMs and CPMs (P = .42). When examining midwives’ (1) responses on the AUDIT‐C questionnaire, (2) nonrisky or risky drinking behaviors, and 3) communication practices regarding prenatal alcohol use, Fisher's exact test showed no statistically significant differences between CNMs and CPMs.DiscussionResults of this study highlight the importance of advocating healthy lifestyles among health care professionals while also promoting communication practices that align with national alcohol guidelines. Future investigations that examine associations between health care professionals’ personal alcohol use and type or effectiveness of services offered to patients may be beneficial.
Why healthcare market needs government intervention to improve access to essential medicines and healthcare efficiency: a scoping review from pharmaceutical price regulation perspective
Authors: Mensa Sorato Mende , Davari Majid , Abdollahi Asl Akbar , Soleymani Fatemeh , Kebriaeezadeh Abbas 
Published: August 2020

AbstractBackgroundAccess to quality essential medicines at affordable price to patients in the healthcare market is one of the main goals of universal health coverage and health-related sustainable development goals. Healthcare market is imperfect, and the government cannot ensure access to essential medicines if the market is left to operate under invisible hand control. This scoping review was conducted with intention to provide the clear picture on impact of pharmaceutical price regulation on access to essential medicines, drug innovation and launching.MethodsWe searched articles written in the English language since January 2000 from PubMed, Embase, Scopus, Ovid/Medline and Google scholar with systematic search query.ResultsAccess to essential medicines, which is defined in terms of availability, affordability, accessibility, acceptability and quality of drugs, can be improved by pharmaceutical price regulation. Countries can use different price regulation strategies based on their healthcare objectives and priority healthcare needs. Country-specific pharmaceutical price regulation could not significantly affect drug innovation and launching. However, supportive strategies such as open public funding for drug innovation research, providing innovation awards and strong patent rights can counterbalance the effect of price regulation on innovation and drug development research in developed countries.ConclusionRegulating pharmaceutical pricing system is one of the key strategies to ensure access to essential medicines. Countries that have implemented pharmaceutical price regulation system (Germany, the UK, Canada and Iran) have achieved better access to essential medicines. However, the US and Ethiopian health systems that are unregulated concerning pharmaceutical pricing had a great challenge of affordability of essential medicines. Therefore, setting country-specific pharmaceutical price regulation system along with additional strategies to improve drug innovation is critical to ensure access to essential medicines.
Addiction science and the perception of freewill
Authors: Monterosso John R. , Schwartz Barry 
Published: August 2020

ABSTRACTDo people think individuals with Substance Use Disorder (SUD) have freewill? How does addiction science inform views on the issue? We distinguish between two senses of freewill: 1) libertarian freewill, in which freedom turns on a particular metaphysical conception of action (sometimes operationalized as “could have done otherwise”), and 2) compatibilist freewill, in which freedom depends on the relation between the actor's psychology and her actions (e.g., “was the act what she wanted to do?”). We argue that, in different ways, scientific accounts can impact conceived freewill by linking addictive behavior to mechanisms that observers view as peripheral to the actor (motivation modularity). While a variety of impacts on conceived compatibilist freewill are plausible, we argue that contemporary addiction science has no direct bearing on conceived libertarian freewill. Addiction science may, however, indirectly impact conceived libertarian freewill by priming an explanatory framework in which intention is superfluous (especially materialism).
Anxiety and depression among patients admitted to intensive care
Authors: Shdaifat Sajeda Aref , Al Qadire Mohammad 
Published: August 2020

AbstractBackgroundCritically ill patients in intensive care units frequently experience high levels of anxiety and depression. These symptoms affect the patient's treatment plan and response to treatment.Aims and objectivesTo identify the prevalence of anxiety and depression among patients admitted to intensive care units in Jordan and their correlation with quality of life.DesignA descriptive cross‐sectional survey design was used.MethodsThe sample for this study consisted of 108 patients admitted to intensive care units in seven governmental hospitals in Jordan. Three instruments were used to collect the data: the demographic data sheet, Hospital Anxiety and Depression Scale, and the World Health Organization Quality of Life tool.ResultsMore than half of the participants were female (56.5%), and the mean age was 44.6 years (SD 18.2); 84.3% had anxiety with a mean total score of 12.1 (SD 4.3), and 79.6% of the patients had depression with a mean total score of 11.5 (SD 4.5). A significant negative correlation was found between the mean total anxiety score (r = −0.541, P < .001), depression (r = −0.616, P < .001), and the mean total quality of life score.ConclusionsManagement programmes for anxiety and depression are highly recommended for intensive care units patients. Such programmes should focus on teaching health care providers correct assessment and management techniques. In addition, developing and implementing a psychiatric consultation support system for these patients might contribute to better management of anxiety and depression.Relevance to Clinical PracticeThis study reveals high prevalence of anxiety and depression among critically ill patient in ICUs. So, regular assessment of anxiety and depression should be conducted by healthcare provider. This requires using a valid and reliable assessment tool. Early correct assessment would result in optimal management for anxiety and depression through patient referral to psychiatric care and the use of pharmacological and non‐pharmacological interventions.Guidelines to assess and manage anxiety and depression should be adapted and implemented into clinical practice within the intensive care units.Regular psychiatric consultation for patients admitted to ICU might be helpful in detecting and managing anxiety and depression symptoms.
Global differences in atopic dermatitis
Authors: Suaini Noor H. A. , Tan Cheryl P. T. , Loo Evelyn X. L. , Tham Elizabeth Huiwen 
Published: August 2020

AbstractAtopic dermatitis (AD) is a chronic inflammatory skin disorder, with a highly variable prevalence worldwide. Recent evidence, however, has shown an increase in prevalence in the Asia Pacific region. Nevertheless, most of the published literature has focused mainly on Western populations, and only few clinical trials have included subgroups of other ethnic populations. Reasons for the observed ethnic and geographical differences in AD are not well established. This calls into question the need for a better understanding of AD pathogenesis and inter‐ethnic differences in clinical and immuno‐phenotypes. These differences may reflect inherent variability in disease mechanisms between populations, which in turn may impact upon treatment responses such as biologics that are currently tailored mainly to a specific immuno‐phenotype (T‐helper type 2 dominant). In this article, we reviewed existing literature on the prevalence of AD globally, highlighting differences, if any, in the clinical and immuno‐phenotypes of AD between different ethnicities. We discussed genetic and environmental factors that affect AD in different populations and therapeutic considerations. Our review highlights AD as a disease with ethnic‐dependent clinical and immunological heterogeneity and calls for greater inclusion of ethnic diversity in future research in order to develop targeted treatments.
Steroid‐refractory acute graft‐versus‐host disease graded III‐IV in pediatric patients. A mono‐institutional experience with a long‐term follow‐up
Authors: Berger Massimo , Pessolano Rosanna , Carraro Francesca , Saglio Francesco , Vassallo Elena , Fagioli Franca 
Published: August 2020

AbstractaGvHD remains a major obstacle to successful HSCT. We report our experience on steroid‐refractory aGvHD III and IV from 1989 to 2017. Ninety patients with aGvHD III or IV were stratified according to the HSCT year: 1989‐1998, 1999‐2007, and 2008‐2017 and to aGvHD extension (GvHD III vs IV) and finally the probability of OS, RI, and TRM was calculated accordingly. aGvHD III patients had a substantial improvement over time: day 100 OS raised from 64% (95% CI 39‐89) in the first cohort to 100% in the latest (P = .022), and it was mainly due to a reduction of TRM (it was 28% [95% CI 12‐65] in the first cohort to 0% in the latest (P = .01). The aGvHD IV patients did not present a significant improvement. Day 100 OS was 42% (95% CI 16‐68) in the first group and 54% (95% CI 25‐83) in the year 2008‐2017 (P = NS), and the day‐100 TRM was very similar (it was 57% [95% CI 36‐90] in the first cohort and 45% [95% CI 23‐89] in the latest (P = NS). We report significant improvements in OS and TRM in patients diagnosed with grade III aGvHD. Patients with the most severe aGvHD appear to have no or fewer benefits on long‐term outcomes.
Bartonella henselae infection in the pediatric solid organ transplant recipient
Authors: Lopez Santiago Manuel Cayetano , Davis Amy , Zinn Matthew , Feingold Brian , Green Michael , Michaels Marian G. 
Published: August 2020

AbstractBartonella henselae infection can cause a wide spectrum of diseases in both the immunocompetent and immunocompromised host with BA a severe form relegated to immunocompromised hosts, including solid organ transplant population. There are established criteria for diagnosis of Bartonella infection based on clinical presentation, serologic testing, imaging studies and, when indicated, tissue sampling for histopathological evaluation, particularly for BA. However, treatment recommendations for BA are inconclusive. Furthermore, there are no studies in the pediatric solid organ transplant population for antimicrobial therapy during BA secondary to Bartonella henselae infection. A case of BA following heart transplant is presented along with a literature review of clinical presentation; diagnosis and therapy for BA in the pediatric solid organ transplant population.
Contemporary practices for mechanical oral hygiene to prevent periodontal disease
Authors: Sälzer Sonja , Graetz Christian , Dörfer Christof E. , Slot Dagmar E. , Van der Weijden Fridus A. 
Published: August 2020

AbstractIt is well established that dental plaque on teeth leads to gingivitis and periodontitis, and that several mechanical and chemical methods of plaque control can prevent gingivitis. The aim of the current review is to summarize and synthesize the available scientific evidence supporting practices for mechanical oral hygiene to prevent periodontal diseases. Evidence for contemporary practices of mechanical oral hygiene to prevent periodontal disease relies on studies of gingivitis patients. General recommendations concerning the ideal oral hygiene devices and procedures are still inconclusive. However, toothbrushing and interdental cleaning remain the mainstays of prevention of periodontal diseases. The primary approach requires individually tailored instruction for implementation of a systematic oral hygiene regimen.
Interventions to prevent periodontal disease in tobacco‐, alcohol‐, and drug‐dependent individuals
Authors: Kumar Purnima S. 
Published: August 2020

AbstractSubstance abuse affects more than one sixth of the world's population. More importantly, the nature of the abuse and the type of addictive substances available to individuals is increasing exponentially. All substances with abusive potential impact both the human immuno‐inflammatory system and oral microbial communities, and therefore play a critical role in the etiopathogenesis of periodontal diseases. Evidence strongly supports the efficacy of professionally delivered cessation counseling. Dentists, dental therapists, and hygienists are ideally placed to deliver this therapy, and to spearhead efforts to provide behavioral and pharmacologic support for cessation. The purpose of this review is to examine the biologic mechanisms underlying their role in disease causation, to understand the pharmacologic and behavioral basis for their habituation, and to investigate the efficacy of population‐based and personalized interventions in prevention of periodontal disease.
Life‐threatening pathogens in severe/progressive periodontitis: Focal infection risk, future periodontal practice, role of the Periodontology 2000
Authors: Slots Jørgen 
Published: August 2020

AbstractSevere/progressive periodontitis is associated with cardiovascular disease, cancer, Alzheimer’s disease, and dozens of other serious diseases. Herpesviruses are implicated in severe periodontitis and in specific subsets of each of the above systemic diseases. That both periodontitis and herpesviruses are linked to the same nonoral diseases is consistent with a systemic pathogenic role of periodontal herpesviruses. Effective control of periodontitis‐related systemic diseases requires collaboration between dentistry and medicine. Periodontology has emerged as an important preventive medical discipline, and periodontal teaching and practice need to adjust accordingly.
The More Who Die, the Less We Care: Evidence from Natural Language Analysis of Online News Articles and Social Media Posts
Authors: Bhatia Sudeep , Walasek Lukasz , Slovic Paul , Kunreuther Howard 
Published: August 2020

AbstractConsiderable amount of laboratory and survey‐based research finds that people show disproportional compassionate and affective response to the scope of human mortality risk. According to research on “psychic numbing,” it is often the case that the more who die, the less we care. In the present article, we examine the extent of this phenomenon in verbal behavior, using large corpora of natural language to quantify the affective reactions to loss of life. We analyze valence, arousal, and specific emotional content of over 100,000 mentions of death in news articles and social media posts, and find that language shows an increase in valence (i.e., decreased negative affect) and a decrease in arousal when describing mortality of larger numbers of people. These patterns are most clearly reflected in specific emotions of joy and (in a reverse fashion) of fear and anger. Our results showcase a novel methodology for studying affective decision making, and highlight the robustness and real‐world relevance of psychic numbing. They also offer new insights regarding the psychological underpinnings of psychic numbing, as well as possible interventions for reducing psychic numbing and overcoming social and psychological barriers to action in the face of the world's most serious threats.
The thin red line between species – genomic differentiation of Gymnosoma Meigen, a taxonomically challenging genus of parasitoid flies (Diptera: Tachinidae)
Authors: Lee Kyung Min , Zeegers Theo , Mutanen Marko , Pohjoismäki Jaakko 
Published: August 2020

AbstractIn traditional taxonomy, species are differentiated using morphological arguments, which can be subjective and cause confusion particularly when the initial species descriptions have been inadequate. The development of DNA‐based methods has provided more objective tools to recognize and quantify species differences, as well as enabled the detection of cryptic that is morphologically indistinguishable, species. Conversely, we show here that large‐scale, genome‐wide analysis of 11 427 loci and 65 825 SNPs is mostly unable to differentiate between many of the currently valid Palearctic species of bug‐killing parasitoid flies in the genus Gymnosoma Meigen (Diptera: Tachinidae), despite the proposed morphological differences. We conclude that alongside a few well‐defined taxa with discrete morphological features and unique DNA barcodes, Palearctic Gymnosoma is likely to contain a single, highly variable and geographically widespread species.
Using real data for statistics education in an open‐source learning environment
Authors: Jonsdottir Anna H. , Lentin Jamie , Calian Violeta , Hafsteinsson Eggert K. , Stefansson Gunnar 
Published: August 2020

AbstractThe tutor‐web is an open‐source learning environment designed to be used for teaching mathematics and statistics. The system offers thousands of exercises at high school and university level, and has been used for a decade to teach introductory statistics courses with good results. A new component has recently been added to the tutor‐web so that students can enter their own data or get real data from several data sources for practicing and learning new concepts.
Disseminated histoplasmosis with ocular adnexal involvement in seven cats
Authors: Ewald Margaret M. , Rankin Amy J. , Meekins Jessica M. , McCool Emily S. 
Published: August 2020

AbstractObjectiveTo describe the clinical features, diagnosis, and treatment of disseminated histoplasmosis with conjunctival and/or nictitating membrane involvement in cats.ProcedureMedical records from seven cats with naturally acquired disseminated histoplasmosis and conjunctival and/or nictitating membrane lesions were reviewed for signalment, clinical findings, diagnostic results, treatment, and outcome.ResultsBreeds included domestic shorthair (n = 5), Maine Coon (n = 1), and Siamese mix (n = 1) with four spayed females and three castrated males. Conjunctival abnormalities were identified in four cats, and nictitating membrane lesions were identified in four cats; one cat had both a conjunctival and nictitating membrane lesion. Cytologic evaluation of lesions identified Histoplasma capsulatum organisms in two of four cases sampled, and histopathologic evaluation identified H capsulatum in both cases in which a sample was submitted. Histoplasmosis antigen testing was positive in three of four submitted samples. Initial treatment for all cats included fluconazole (median dose: 26 mg/kg/d). Median duration of follow‐up was 11 months (range: 1‐108 months; n = 4). Resolution of ocular adnexal lesions was achieved in three cats. Two cats had relapse of disease, one of which was subsequently euthanized. One cat with concurrent feline immunodeficiency virus (FIV) infection died one month after diagnosis of histoplasmosis.ConclusionsHistoplasmosis should be a differential diagnosis for ocular adnexal inflammatory lesions in cats.