bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Single-Center Experience and Literature Review of Management Strategies for Clostridium difficile Infection in Hematopoietic Stem Cell Transplant Patients
Authors: Majeed Aneela , Larriva Marti M. , Iftikhar Ahmad , Mushtaq Adeela , Campbell Patrick , Malik Mustafa Nadeem , Rafae Abdul , Zar Muhammad Abu , Kamal Ahmad , Lakhani Midhat , Khalid Nageena Rani , Zangeneh Tirdad T. , Anwer Faiz 
Published: November 2019

IntroductionThe aim of our study is to evaluate risk factors associated with the development ofClostridium difficileinfection (CDI) in hematopoietic stem cell transplant (HSCT) patients, determine its incidence, and report outcomes of CDI in our patient population.MethodsWe performed a retrospective review of medical records of adult HSCT recipients diagnosed between 2013 and 2016 at our center. Logistic regression models were used to determine the relationship between risk factors and the odds of CDI.ResultsThe overall incidence of CDI in HSCT patients was 9.4%. The incidence of CDI was higher in allogeneic HSCT (20%) versus autologous HSCT (4.8%). No statistically significant differences in age, sex, cancer type, and transplant type were found between those who developed CDI and those who did not. However, patients with CDI had a longer length of stay (25 days) and used more antibiotics (30 days prior to and during admission for HSCT) than non-CDI patients (19 days). Only 2 of 17 patients (11.8%) with CDI experienced recurrence among 180 patients after HSCT. No patient suffered from toxic megacolon or ileus, and no patient underwent colectomy. There was no mortality associated with CDI at our center.ConclusionsClostridium difficileinfection has an incidence rate of 9.4% in HSCT recipients. Established risk factors including age, sex, cancer type, and transplant type were not identified as risk factors in our population. However, longer LOS and use of more than 4 lines of antibiotics were observed among those with CDI compared with those without CDI.
A functional polymorphism in the ATP-Binding Cassette B1 transporter predicts pharmacologic response to combination of nortriptyline and morphine in neuropathic pain patients
Authors: Benavides Rodrigo , Vsevolozhskaya Olga , Cattaneo Stefano , Zaykin Dmitri , Brenton Ashley , Parisien Marc , Verma Vivek , Khoury Samar , Gilron Ian , Diatchenko Luda 
Published: November 2019

AbstractMany genetic markers have been associated with variations in treatment response to analgesics, but none have been assessed in the context of combination therapies. In this study, the treatment effects of nortriptyline and morphine were tested for an association with genetic markers relevant to pain pathways. Treatment effects were determined for single and combination therapies. A total of 24 functional single nucleotide polymorphisms were tested within the gene loci of mu-opioid receptor (OPRM1) gene locus, ATP-Binding Cassette B1 Transporter (ABCB1), Cytochrome P450 gene family (CYP2C19andCYP2D6), catecholamine inactivator Catechol-O-Methyl Transferase (COMT), and serotonin receptor 2A (HTR2A). Genotyping was performed in a population of neuropathic pain patients who previously participated in a clinical trial. For monotherapy, neither nortriptyline nor morphine responses were associated with single nucleotide polymorphisms. However, for nortriptyline + morphine combination therapy, the single nucleotide polymorphism rs1045642 within the drug efflux pump ABCB1 transporter significantly predicted analgesic response. The presence of the C allele accounted for 51% of pain variance in this subgroup in response to combination treatment. The T-allele homozygotes demonstrated only 20% improvement in pain scores, whereas the C-allele homozygotes 88%. There was no significant contribution of rs1045642 to the medication side effects under all treatment conditions. The UK Biobank data set was then used to validate this genetic association. Here, patients receiving similar combination therapy (opioid + tricyclic antidepressant) carrying the C allele of rs1045642 displayed 33% fewer body pain sites than patients without that allele, suggesting better pain control. In all, our results show a robust effect of the rs1045642 polymorphism in response to chronic pain treatment with a nortriptyline + morphine combination.
Effects of eHealth-Based Interventions on Adherence to Components of Cardiac Rehabilitation
Authors: Kebapci Ayda , Ozkaynak Mustafa , Lareau Suzanne C. 
Published: November 2019

Objective
The aim of this study was to determine the effects of eHealth-based interventions on patient adherence to components of cardiac rehabilitation (CR).

Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guided this review. Medline, CINAHL, Embase, and Cochrane Library databases were searched for studies published from January 1996 to December 2017. All studies were included in which eHealth-based components of CR and its effects on patient adherence were measured. Because this review included a heterogeneous group of study designs, the authors qualitatively described the effect of eHealth on adherence into a narrative approach.

Results
A total of 1520 studies were identified, with 1415 excluded after screening. Of the remaining 105 studies, 90 were excluded after full text assessment, leaving 15 studies for analysis. Most (11) of the 15 studies reported on medication adherence. Other studies focused on adherence to diet, physical activity, vital signs, weight, step counts, smoking, and fluid restriction. The type of eHealth used also varied, ranging from telemonitoring and web-based applications to telephone calls. Of the 15 studies, 7 reported significant improvements with eHealth-based components of CR on adherence.

Discussion and Conclusion
This review summarizes the effects of eHealth on components of CR and revealed variations in measurement and evaluation methods. The telemonitoring and web-based applications for self-care behaviors were most effective in promoting adherence. The measurement of adherence should be based on an explicit definition of adherence and should be measured with validated scales tested in the CR population.
Binge eating behavior among a cohort of normal weight college women
Authors: Kells Meredith , Kelly-Weeder Susan 
Published: November 2019

ABSTRACT

Background and purpose:
Binge eating (BE) has been linked to the development of eating disorders and obesity, and it has been reported in college women. Few studies investigate BE by weight category. The purpose of this study was to examine BE in “normal” weight college women.

Methods:
Secondary analysis of Web-based survey at a private university in the northeastern United States.

Results:
Sample was 317 female subjects, 75.4% were White. Binge eating was reported by 99 women (31.2%); 7.6% of binge eaters were underweight, 73.5% normal weight, 15.3% overweight, and 4.1% obese. Normal weight binge eaters were more likely to purge (x
2 = 6.830; p = .033) and overexercise (x
2 = 15.179, p = .019). All binge eaters reported feeling sad, guilty, or distressed after eating and weight dissatisfaction. Normal weight binge eaters reported negative affect before (x
2 = 33.187; p < .001) and after eating (x
2 = 36.329; p < .001) more frequently than normal weight non–binge eaters. Normal weight binge eaters more often described themselves as overweight when compared with normal weight non–binge eaters (x
2 = 9.267; p = .026).

Implications for practice:
Nearly one third of college women report BE, the majority are of normal weight. These women are more likely to engage in compensatory mechanisms and have distorted body image and a negative affective state with eating. Findings highlight the importance of screening for BE in college women regardless of weight.
What is curbside consultation for the nurse practitioner?
Authors: Papermaster Amy , Champion Jane Dimmitt 
Published: November 2019

ABSTRACT

Background:
Curbside or informal consultations between clinicians regarding patient care occur frequently in clinical practice. Evaluation of curbside consultation (CC) among nurse practitioners (NPs) is limited.

Purpose:
To develop an understanding of NP perceptions of the CC process.

Methodological orientation:
A qualitative descriptive design was used to assess the context of CCs among NPs. Inductive content analysis was conducted, and Atlas.ti was used to organize the data.

Sample:
Purposive sampling was used to recruit 20 NPs within primary care and specialty settings.

Conclusions:
Themes describing CC included the description of the CC process, advantages and disadvantages, documentation, legal liability, unspoken rules, and patient-centered engagement. There was a lack of consensus on the boundaries of the CC definition including difficulty in distinguishing a CC from a formal consultation. Generally, the NP acknowledges limitations and views the CC favorably as a helpful tool for receiving practical feedback and expanding learning, collegiality, and collaboration.

Implications for practice:
Findings provide insight regarding the common practice of CC in management of patients at the point of care, what it means to the NP, and a description of the breadth of the CC use. Given its potentially substantial impact on patient care, further assessment of the context of CC among NPs is obligatory.
Diaphragm protection: what should we target?
Authors: Schepens Tom , Dianti Jose 
Published: November 2019

Purpose of review
Diaphragm weakness can impact survival and increases comorbidities in ventilated patients. Mechanical ventilation is linked to diaphragm dysfunction through several mechanisms of injury, referred to as myotrauma. By monitoring diaphragm activity and titrating ventilator settings, the critical care clinician can have a direct impact on diaphragm injury.

Recent findings
Both the absence of diaphragm activity and excessive inspiratory effort can result in diaphragm muscle weakness, and recent evidence demonstrates that a moderate level of diaphragm activity during mechanical ventilation improves ICU outcome. This supports the hypothesis that by avoiding ventilator overassistance and underassistance, the clinician can implement a diaphragm-protective ventilation strategy. Furthermore, eccentric diaphragm contractions and end-expiratory shortening could impact diaphragm strength as well. This review describes these potential targets for diaphragm protective ventilation.

Summary
A ventilator strategy that results in appropriate levels of diaphragm activity has the potential to be diaphragm-protective and improve clinical outcome. Monitoring respiratory effort during mechanical ventilation is becoming increasingly important.
Anti‐tumor Necrosis Factor‐alpha Exposure Impacts Vedolizumab Mucosal Healing Rates in Pediatric Inflammatory Bowel Disease
Authors: Jossen Jacqueline , Kiernan Bridget D. , Pittman Nanci , Dubinsky Marla C. 
Published: November 2019

ABSTRACTBackground:Vedolizumab (VDZ) is effective for treating both adult and pediatric onset inflammatory bowel disease (IBD). Clinical outcomes, however, have been reported to be superior in patients naïve to anti‐tumor necrosis factor (TNF). With the growing interest in endoscopic endpoints, we aimed to describe rates of mucosal healing in pediatric patients being treated with VDZ and examine the influence of anti‐TNF on outcomes.Methods:We conducted a retrospective review of all IBD patients ⩽21 years of age who initiated VDZ and underwent endoscopy. Primary outcome was mucosal healing (composite of endoscopic [SES‐CD] and Mayo score UC) and histological remission [Nancy index‐UC and Crohn disease (CD) histologic activity]. Descriptive statistics summarized the data. Comparisons were made for endpoints based on anti‐TNF exposure using univariate testing.Results:Sixty‐eight patients were included in the final analysis; 35 with UC and 33 with CD. Thirty‐two patients (22 UC and 10 CD) were anti‐TNF‐naïve and 36 patients (13 UC and 23 CD) were anti‐TNF‐exposed. The median duration on VDZ before endoscopic assessment was 49 (IQR 32–73) weeks. A total of 38% (25/66) of patients met the primary outcome of mucosal healing and did not differ between anti‐TNF‐naïve or anti‐TNF‐exposed. Endoscopic remission was achieved by 51% with significantly more anti‐TNF naïve patients reaching this endpoint (66% vs 40%, P = 0.03). Histologic remission was achieved by 42% of patients with a nonsignificant trend towards improved histologic remission rates in anti‐TNF‐naïve patients (52% vs 33%, P = 0.13).Conclusions:VDZ is associated with mucosal healing in pediatric IBD. Anti‐TNF exposure significantly impacted endoscopic remission, but not histologic remission in children on VDZ.
The Independent Relationships of Metacognition, Mindfulness, and Cognitive Insight to Self-Compassion in Schizophrenia
Authors: Hochheiser Jesse , Lundin Nancy B. , Lysaker Paul H. 
Published: November 2019

Abstract
The debilitating nature of psychosis may be exacerbated by societal stigma and feelings of social isolation over and above positive (e.g., hallucinations) and negative (e.g., flat affect) symptoms. Thus, recovery may be facilitated by increasing self-compassion, the ability to respond with a nonjudgmental attitude of kindness toward oneself as a result of connecting with one's own inadequacies and suffering. We conducted a stepwise regression in individuals with schizophrenia-spectrum disorders (n = 92) to determine the unique contributions of cognitive variables in predicting self-compassion, such as metacognition (the ability to form complex and integrated ideas about oneself and others), mindfulness, and cognitive insight. Results indicated that increased metacognitive awareness of others and mindfulness uniquely predicted greater self-compassion (i.e., self-kindness), whereas increased cognitive insight predicted greater lack of self-compassion (i.e., self-judgment). These findings suggest the potential for mindfulness and metacognitive interventions to increase positive self-compassion and promote recovery in psychosis.
Examining the Overlap Between Moral Injury and PTSD in US Veterans and Active Duty Military
Authors: Koenig Harold G. , Youssef Nagy A. , Ames Donna , Teng Ellen J. , Hill Terrence D. 
Published: November 2019

Abstract
Moral injury (MI) is a syndrome thought to be separate from posttraumatic stress disorder (PTSD), yet having some overlap. To determine the overlap, we examined the relationship between MI and the four DSM-5 PTSD symptom clusters (B, C, D, E) in US veterans and active duty military (ADM). The 45-item Moral Injury Symptom Scale (MISS-M) was administered to 591 veterans and ADM who had served in a combat theater and had PTSD symptoms. PTSD symptoms were measured with the PTSD Symptom Checklist-5, which assesses the four PTSD symptom clusters. Total MISS-M scores were more strongly associated with PTSD symptom cluster D (negative cognitions and emotions) in both bivariate and multivariate analyses. Findings for a 10-item version of the MISS-M (MISS-M-SF) closely followed those of the MISS-M. Although the overlap between MI and PTSD occurs to some extent across all PTSD symptoms clusters, the largest overlap tends to be with the negative cognitions and emotions cluster.
Toxoplasmosis in a Cohort of Italian Patients With Bipolar and Psychotic Disorders
Authors: Del Grande Claudia , Schiavi Elisa , Masci Isabella , Barbuti Margherita , Maccariello Giuseppe , Massimetti Gabriele , Bruschi Fabrizio , Dell'Osso Liliana 
Published: November 2019

Abstract
This study investigated the seroprevalence of Toxoplasma gondii in a cohort of 101 Italian inpatients affected by mood or schizophrenia-spectrum disorders and compared clinical features between seronegative and seropositive subjects. Patients diagnosed according to DSM-5 criteria underwent clinical assessments and blood collection to test parasite-specific IgG/IgM serum levels. Twenty-eight patients (27.7%) had IgG anti–T. gondii, and none had IgM antibodies. We found higher prevalence rate in patients aged 40 years or older, as compared with younger. No significant association was detected between T. gondii and a specific diagnostic category; however, bipolar disorder (BD)-II showed the highest positivity rate (40.9%). The seropositive status was significantly associated with a lower presence of psychotic symptoms, higher number of total episodes of predominant excitatory polarity, longer illness duration, and lower severity of current episode, particularly anxiety, depressive, and withdrawal/retardation symptoms. These preliminary results seem to point out an association between chronic toxoplasmosis and a specific subtype of BD.
Investigating Fetal Growth Restriction and Perinatal Risks in Appropriate for Gestational Age Infants: Using Cohort and Within-Sibling Analyses
Authors: Cnattingius S. , Kramer M. S. , Norman M. , Ludvigsson J. F. , Fang F. , Lu D. 
Published: November 2019

(Abstracted from BJOG 2019;126(7):842–850)
Fetal growth restriction, defined as fetal growth below expectations, is statistically measured by a cutoff of birthweight for gestational age. Small-for-gestational-age (SGA) birth, however, is not always linked with fetal growth restriction: SGA infants may have reached their growth potential and just be small, while larger, non-SGA infants sometimes fail to reach their growth potential.
Neonatal Outcomes of Live Births After Blastocyst Biopsy in Preimplantation Genetic Testing Cycles: A Follow-up of 1721 Children
Authors: He Hui , Jing Shuang , Lu Chang Fu , Tan Yue Qiu , Luo Ke Li , Zhang Shuo Ping , Gong Fei , Lu Guang Xiu , Lin Ge 
Published: November 2019

(Abstracted from Fertil Steril 2019;112:82–88)
Blastocyst biopsy as a means of preimplantation genetic testing (PGT) continues to increase in popularity and might provide a greater number of viable cells per biopsy compared with cleavage-stage biopsy. The increased number of testable cells enables the application of comprehensive chromosome screening modalities including next-generation sequencing, as well as the combination of multiple genetic tests.
Clearance of Mycoplasma genitalium Infection With Moxifloxacin in the Presence of Quinolone Resistance–Associated Mutations
Authors: Conway Ruairi James Harwood , Cook Seamus , Malone Cassandra , Bone Simon , Hassan-Ibrahim Mohammed Osman , Soni Suneeta 
Published: November 2019

Abstract
We present 2 cases of Mycoplasma genitalium infection that were successfully treated with moxifloxacin despite the presence of quinolone resistance–associated mutations in these strains.
Characteristics Associated With Presence of Pediatric Mental Health Care Policies in Emergency Departments
Authors: Cree Robyn A. , So Marvin , Franks Jessica , Richards Rachel , Leeb Rebecca , Hashikawa Andrew , Krug Steven , Ludwig Lorah , Olson Lenora M. 
Published: November 2019

Objectives
The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy.

Methods
We analyzed data from the National Pediatric Readiness Project, a nationally representative cross-sectional survey of US EDs. Nurse managers reported whether their hospitals had a policy to care for children with social/mental health concerns (n = 3612). We calculated prevalence estimates, prevalence ratios (PRs), and confidence intervals (CIs) for regional and ED characteristics (eg, rurality and types of personnel) by whether EDs had a pediatric mental health care policy.

Results
Overall, 46.2% (n = 1668/3612) of EDs had a pediatric mental health care policy. Emergency departments located in remote areas were 60% less likely to have such a policy compared with EDs in urban areas (PR, 0.4; CI, 0.3–0.5). Emergency department characteristics associated with having a pediatric mental health care policy included having a policy to transfer children with social/mental health concerns (PR, 5.4; CI, 4.7–6.2), having a policy to address maltreatment (PR, 3.4; CI, 2.6–4.4), and having nurse and physician pediatric emergency care coordinators (PR, 1.6; CI, 1.5–1.8).

Conclusions
Lower prevalence of pediatric mental health policies in rural EDs is concerning considering EDs are often the first point of contact for pediatric patients. This work highlights the importance of pediatric emergency care coordinators in fostering ED capacity to meet children's mental health needs.
Sternocleidomastoid Tendinopathy in a Pediatric Athlete
Authors: Chen Boqing , Yae Sophia , Delbert Matthew , Stitik Todd , Foye Patrick 
Published: November 2019

AbstractTo our knowledge, this case report describes the first known case of sternocleidomastoid tendinopathy, occurring in a pediatric athlete who had gone undiagnosed for a period of 2 yrs. She presented to our pain clinic with bilateral otalgia, occipital headaches, and occasional bouts of tinnitus and dizziness. An extensive workup by otolaryngology (ENT) including computed tomography imaging of the head, ear pressure equalization, and an attempt at therapeutic tonsillectomy left her with no diagnosis and no symptom relief. A clinical diagnosis of sternocleidomastoid tendinopathy was made at the initial visit based on history and physical examination findings, after excluding other diagnoses. Conservative treatment with physical therapy, acupuncture, and a short course of meloxicam and gabapentin resulted in total symptom resolution. This case is a unique reminder to clinicians that head, neck, and ear pain may precipitate from musculoskeletal origins. It emphasizes the importance of understanding local anatomy, obtaining a thorough history, and performing a detailed physical examination in arriving at an accurate diagnosis.
Association of Participation in the American Board of Physical Medicine and Rehabilitation Maintenance of Certification Program and Physician Disciplinary Actions
Authors: Kinney Carolyn L. , Raddatz Mikaela M. , Sliwa James A. , Driscoll Sherilyn W. , Robinson Lawrence R. 
Published: November 2019

Objective
The study analyzed the relationship between participation in the American Board of Physical Medicine and Rehabilitation maintenance of certification program and the incidence of disciplinary actions by state medical boards over a physician’s career. The hypothesis is that physicians who do not maintain their board certification have a higher likelihood of state medical board disciplinary actions.

Design
This retrospective cohort study analyzed American Board of Physical Medicine and Rehabilitation maintenance of certification data from all board-certified physiatrists who were enrolled in the American Board of Physical Medicine and Rehabilitation maintenance of certification program from 1993 to 2007.

Results
Matching examination and license data were available for 4794 physicians, who received a total of 212 disciplinary action reports through the Federation of State Medical Boards. The results showed that physicians who have a lapse in completing the American Board of Physical Medicine and Rehabilitation maintenance of certification program have a 2.5-fold higher incidence of receiving a disciplinary action report through the Federation of State Medical Boards (95% confidence interval = 1.76–3.63) and had higher severity violations (χ2 = 7.14, P < 0.05) than physicians whose certificate never lapsed.

Conclusions
For physicians in physical medicine and rehabilitation, loss of board certification through failure to fulfill the maintenance of certification program requirements is associated with an increased risk of disciplinary action from a state medical licensing board.