bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid Prescription Filling Trends Among Children with Sickle Cell Disease After the Release of State-Issued Guidelines on Pain Management
Authors: Creary Susan E , Chisolm Deena J , Wrona Sharon K , Cooper Jennifer N 
Published: January 2020

Abstract

Objective
To assess the impact of Ohio’s 2012, 2013, and 2016 opioid prescribing guidelines on opioid and nonsteroidal anti-inflammatory drug (NSAID) prescription filling and health care utilization for pain among children with sickle cell disease (SCD).

Design
Quasi-experimental retrospective cohort study.

Setting
Ohio Medicaid claims data from August 2011 to August 2016.

Subjects
Medicaid beneficiaries under age 19 years with SCD.

Methods
Interrupted time series analyses comparing population-level rates of opioids and NSAID prescriptions filled, standardized amounts of opioids dispensed, and acute health care utilization for pain before and after release of each guideline.

Results
In our cohort of 1,505 children with SCD, there was a temporary but significant decrease in the opioid filling rate (–2.96 prescriptions per 100 children, P = 0.01) and in the amount of opioids dispensed (–31.39 milligram morphine equivalents per filled prescription, P &lt; 0.001) after the 2013 guideline but a temporary but significant increase in the opioid filling rate (7.44 prescriptions per 100 children, P &lt; 0.001) and in the amount of opioids dispensed (72.73 mg morphine equivalents per filled prescription, P &lt; 0.001) after the 2016 guideline. The NSAID filling rate did not significantly change after any of the guidelines. Acute health care utilization rates for pain after the 2016 guideline were similar to those before the 2013 guideline (rate ratio = 1.04, P = 0.63).

Conclusions
Our results suggest that Ohio’s 2013 and 2016 guidelines were associated with significant but nonsustained changes in opioid prescription filling among children with SCD. Additional studies are needed to confirm that opioid guidelines have a sustained impact on excessive opioid prescribing, filling, and misuse.
Hepatitis C and Compensated Cirrhosis Drug Approved for Eight-Week Treatment
Authors: Aschenbrenner Diane S. 
Published: December 2019

The antiviral combination drug Mavyret (glecaprevir–pibrentasvir), used to treat patients with hepatitis C virus and compensated cirrhosis, is now approved for a treatment duration of eight weeks in treatment-naive adult and pediatric patients.Changes to the product's labeling regarding the shortened length of therapy are based on preliminary data from the EXPEDITION-8 trial.
Initial experience with ablation of the innervation surrounding sinus and atrioventricular nodes to treat paroxysmal bradyarrhythmia
Authors: Lu Chun-Shan , Guo Cheng-Jun , Fang Dong-Ping , Hao Peng , He Dong-Fang , Xu Ai-Guo 
Published: December 2019

Abstract

Background
The symptomatic bradyarrhythmia is Class I indication for pacing therapy which is not a radical cure. The present study aimed to assess the feasibility and to present the initial results of the restricted ablation of the parasympathetic innervation surrounding sinus and atrioventricular (AV) nodes for treating patients with bradyarrhythmia.

Methods
A total of 13 patients with cardiogenic syncope were included from May 2008 to June 2015. Under the guidance of fluoroscopy and /or three-dimensional geometry by 64-slice spiral computed tomography, atrial activation sequence in sinus rhythm was mapped. Chamber geometry was reconstructed manually or automatically using the Niobe II magnetic navigation system integrated with the CARTO-remote magnetic technology (RMT) system. Cardioneuroablation was targeted at the high-amplitude fractionated electrograms surrounding the regions of His bundle and the site with the earliest activation in sinus rhythm. Areas surrounding the sinus node, AV node, and the phrenic nerve were avoided.

Results
Thirteen patients completed the studies. Ablation was successfully performed in 12 patients and failed in one. The high-frequency potential was recorded in atrial electrograms surrounding the sinus or AV nodes in all the patients and disappeared in 15 s after radiofrequency applications. The vagal reaction was observed before the improvement of the sinus and AV node function. No complications occurred during the procedures. Patients were followed up for a mean of 13.0 ± 5.9 months. During the follow up ten patients remained free of symptoms, and two patients had a permanent cardiac pacemaker implanted due to spontaneous recurrence of syncope. The heart rate of post-ablation was higher than pre-ablation (69.0 ± 11.0 vs. 49.0 ± 10.0 beats/min, t
= 4.56, P = 0.008). The sinus node recovery time, Wenckebach block point, and atrium-His bundle interval were significantly shorter after ablation (1386.0 ± 165.0 vs. 921.0 ± 64.0 ms, t
= 7.45, P = 0.002; 590.0 ± 96.0 vs. 464.0 ± 39.0 ms, t
= 2.38, P = 0.023; 106.0 ± 5.0 vs. 90.0 ± 12.0 ms, t
=
9.80, P = 0.013 before and after ablation procedure, respectively).

Conclusions
Ablation of sinoatrial and AV nodal peripheral fibrillar myocardium electrical activity might provide a new treatment to ameliorate paroxysmal sinus node dysfunction, high degree AV block, and vagal-mediated syncope.
Triple-C SMAS Plication Facelift for Natural Facial Rejuvenation
Authors: Sadati Kevin , Motakef Saba 
Published: December 2019

Background:
Various methods are used to reposition the superficial musculoaponeurotic system (SMAS) during facelift procedures. This study presents a novel, radially oriented, layered SMAS plication: the triple-C SMAS plication. This technique utilizes customizable vectors in the pattern of a “C” to plicate the SMAS in 3 layers to lift and tighten the deep structures of the face.

Methods:
A retrospective review was performed of patients undergoing the triple-C SMAS plication over a 1-year period. Patients with a length of follow-up less than 100 days were excluded from the study. Demographic data, operative data, complication rates, and satisfaction rates were assessed.

Results:
One hundred ninety-one consecutive patients underwent a triple-C SMAS plication over a 12-month period. One hundred ten patients met inclusion criteria. Average follow-up was 404.5 days. Complications assessed included temporary facial nerve neuropraxia (0.91%), major hematoma (1.82%), minor hematoma (2.73%), seroma (4.54%), great auricular nerve injury (0%), postauricular skin slough >2 cm (1.82%), and infection (0.91%). Two revision procedures were performed (1.82%). Patient satisfaction rate was 96.4%.

Conclusions:
Traditional SMAS plication techniques involve single-layer, straight-line plications to lift the lower face and neck, limiting their versatility. The triple-C SMAS plication represents a novel technique to safely and effectively elevate the deep structures of the face in a radial pattern to restore a more youthful contour to the malar area, jawline, and neck. This represents a unique strategy for face lifting by which excellent results can be consistently obtained.
Psychometric Evaluation of the Chinese Version of the Knowledge and Beliefs About Pain in Elderly Patients With Dementia Questionnaire
Authors: LIN Pei-Chao , CHOU Pi-Ling , TSENG Hui-Chen , HSIEH Mei-Hui , LIN Li-Chan 
Published: December 2019

ABSTRACT

Background
The quality of pain management in hospitalized older adult patients with dementia is a crucial issue in healthcare. The knowledge and beliefs of nurses are known to predict their pain management intentions toward this particularly vulnerable patient population.

Purpose
This study was designed to evaluate the reliability and validity of the Chinese version of the Knowledge and Beliefs About Pain in Elderly Patients With Dementia (KBPED-C) questionnaire using a sample of hospital nurses.

Methods
A cross-sectional study was conducted. The 17-item KBPED-C was distributed between September 2013 and August 2014 to 350 nurses working at a hospital in northern Taiwan. Consistency assessment was conducted using Cronbach's alpha, and construct validity was examined using principal component analysis. Three hundred five nurses (19 men and 286 women) were enrolled using convenience sampling.

Results
The mean age of the participants was 30.8 ± 5.8 years. The Cronbach's alpha for internal consistency was .86. The item–total correlation was acceptable. The observed content validity was strong, with a content validity index of .86. Construct validity testing revealed a four-factor structure that accounted for 55.2% of the total variance. The four factors of the KBPED-C questionnaire were “general beliefs about pain and aging,” “pain management in the workplace,” “knowledge about pain management in older adult patients with dementia,” and “beliefs about pain in older people.”

Conclusions/Implications for Practice
This preliminary validation study showed the high acceptability, reliability, and validity of the KBPED-C for hospital nurses. Future studies may use this questionnaire to explore the beliefs and knowledge of nurses regarding pain in older adult patients with dementia.
Psychotic Disorders in Patients Who Use Synthetic Cannabinoids
Authors: SKRYABIN VALENTIN Y. , VINNIKOVA MARIA A. 
Published: December 2019

Objective:
The main objective of this study was to investigate the structure of psychotic disorders due to synthetic cannabinoid use and to determine differences in clinical characteristics and disease course between such substance-induced psychosis and psychosis associated with a primary diagnosis of schizophrenia.

Methods:
This was a longitudinal, observational cohort study that included male patients who underwent inpatient treatment in the intensive care unit or in the emergency department due to substance-induced psychoses. The follow-up period was up to 2 years.

Results:
We identified 4 clinical variants of substance-induced psychoses in patients who use synthetic cannabinoids.

Conclusions:
Our study revealed that psychotic symptoms are typical manifestations in association with intoxication with synthetic cannabinoids, and we identified several nonspecific characteristics of the psychoses that may occur in patients intoxicated with synthetic cannabinoids. We also identified a number of signs that may indicate the presence of substance-induced psychoses.
The Relationship of Early-Life Adversity With Adulthood Weight and Cardiometabolic Health Status in the 1946 National Survey of Health and Development
Authors: Robson Ellie , Norris Tom , Wulaningsih Wahyu , Hamer Mark , Hardy Rebecca , Johnson William 
Published: December 2019

ABSTRACT

Objective
Evidence linking early-life adversity with an adverse cardiometabolic profile in adulthood is equivocal. This study investigates early-life adversity in relation to weight and cardiometabolic health status at ages 60 to 64 years.

Methods
We included 1059 individuals from the 1946 National Survey of Health and Development. Data on adversity between ages 0 to 15 years were used to create a cumulative childhood psychosocial adversity score and a socioeconomic adversity score. Cardiometabolic and weight/height data collected at ages 60 to 64 years were used to create four groups: metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy overweight/obese, and metabolically unhealthy overweight/obese. Associations between the two exposure scores and weight/health status were examined using multinomial logistic regression, with adjustment for sex and age at the outcome visit.

Results
Sixty-two percent of normal-weight individuals were metabolically healthy, whereas only 34% of overweight/obese individuals were metabolically healthy. In a mutually adjusted model including both exposure scores, a psychosocial score of ≥3 (compared with 0) was associated with increased risk of being metabolically unhealthy (compared with healthy) in both normal-weight adults (relative risk = 2.49; 95% confidence interval = 0.87–7.13) and overweight/obese adults (1.87; 0.96–3.61). However, the socioeconomic adversity score was more strongly related to metabolic health status in overweight/obese adults (1.60; 0.98–2.60) than in normal-weight adults (0.95; 0.46–1.96).

Conclusions
Independently of socioeconomic adversity, psychosocial adversity in childhood may be associated with a poor cardiometabolic health profile, in both normal-weight and overweight/obese adults.
Genetic-Ancestry Analysis on >93,000 Individuals Undergoing Expanded Carrier Screening Reveals Limitations of Ethnicity-Based Medical Guidelines
Authors: Kaseniit Kristjan E. , Haque Imran S. , Goldberg James D. , Shulman Lee P. , Muzzey Dale 
Published: December 2019

AbstractPurposeDespite strong association between genetic ancestry and carrier status, current carrier-screening guidelines recommend testing for a limited set of conditions based on a patient’s self-reported ethnicity, which conflates genetic and cultural factors.Materials and MethodsFor 93,419 individuals undergoing a 96-gene expanded carrier screen (ECS), correspondence was assessed among carrier status, self-reported ethnicity, and a dual-component genetic ancestry (e.g., 75% African/25% European) calculated from sequencing data.ResultsSelf-reported ethnicity was an imperfect indicator of genetic ancestry, with 9% of individuals having >50% genetic ancestry from a lineage inconsistent with self-reported ethnicity. Self-reported ethnicity-based carrier-screening guidelines are incomplete, as several conditions not included in guidelines had similarly strong correlation between carrier rate and genetic ancestry as conditions included in screening guidelines. Limitations of self-reported ethnicity led to missed carriers in at-risk populations: for 10 ECS conditions, patients with intermediate genetic ancestry backgrounds—who did not self-report the associated ethnicity—had significantly elevated carrier risk. Finally, for seven of the 16 conditions included in current screening guidelines, most carriers were not from the population the guideline aimed to serve.ConclusionTo provide equitable reproductive care, guidelines should discontinue the use of ethnicity as a basis for determining which patients are appropriate for carrier screening and instead recommend pan-ethnic ECS.
IRAK1-mediated coincidence detection of microbial signals licenses inflammasome activation
Authors: Vayttaden Sharat J. , Smelkinson Margery , Ernst Orna , Carlson Rebecca J. , Sun Jing , Bradfield Clinton , Dorrington Michael G. , Liang Jonathan , Bouladoux Nicolas , Gottschalk Rachel A. , Oh Kyu-Seon , Pegoraro Gianluca , Ganesan Sundar , De Nardo Dominic , Latz Eicke , Belkaid Yasmine , Varma Rajat R. , Fraser Iain D.C. 
Published: December 2019

SummaryThe innate immune system signals through various higher order signaling complexes called supramolecular organizing centers (SMOCs), which typically organize components of a single pathway. While innate immune signaling pathways have been largely characterized using single receptor stimuli, responses to pathogens require the coordinated engagement of multiple pathways. Here, we report an IRAK1-containing SMOC formed specifically when multiple receptors are activated, which recruits select components of the TLR, MAPK and inflammasome pathways. This allows for signal flux redistribution from TLRs to inflammasomes and facilitates inflammasome licensing through an MKK7-JNK axis, which is defective inIrak1−/−mice. Furthermore, this defect inIrak1−/−mice manifests in increased susceptibility to inflammasome-sensitive pathogens and diminished IL1 production from inflammasomes after co-TLR priming. Thus, IRAK1 SMOCs form a multi-pathway coordinating hub for coincidence detection of microbial signals, which may be employed by innate immune cells as a threat assessment and thresholding mechanism for inflammasome activation.
Environmental shedding of toxigenicClostridioides difficileby asymptomatic carriers: A prospective observational study
Authors: Gilboa Mayan , Houri Levi Esther , Cohen Carmit , Tal Ilana , Rubin Carmit , Feld-Simon Olga , Brom Adi , Eden-Friedman Yehudit , Segal Shoshi , Rahav Galia , Regev-Yochay Gili ,   for the ShIC research group
Published: January 2020

AbstractObjectivesTo compare the burden of environmental shedding of toxigenicC. difficileamong asymptomatic carriers,C. difficileinfected (CDI) patients and non-carriers, in an inpatient non-epidemic setting.MethodsC. difficilecarriage was determined by positive toxin-B PCR from rectal swabs of asymptomatc patients. Active CDI was defined as a positive 2-step EIA/PCR test in patients with >3 unformed stools/24 hours.C. difficileenvironmental contamination was assessed by obtaining specimens from 10 sites in the patients’ rooms. Toxigenic strains were identified by PCR. We created a contamination scale to define the overall level of room contamination that ranged from clean to heavy contamination.Results117 rooms were screened; 70 rooms inhabited byC. difficilecarriers, 30 rooms by active CDI patients and 17 rooms by nonC. difficile-carriers (Control). In the carrier rooms 29 (41%) had more than residual contamination, from which 17 (24%) were heavily contaminated. In the CDI rooms 12 (40%) had more than residual contamination from which 3 (10%) were heavily contaminated, while in the control rooms, one room (6%) had more than residual contamination and none were heavily contaminated. In a multivariate analysis, the contamination score of rooms inhabited by carriers did not differ from rooms of CDI patients, yet both were significantly more contaminated than those of none carriers OR 12.23 and 11.16 (95%CI:1.5-99.96 P=0.0195, and 1.19-104.49 p=0.035), respectively.ConclusionHere we show thatC. difficilecarriers’ rooms are as contaminated as those of patients with active CDI and significantly more than those of non-carriers.
Barriers and opportunities to greening the construction supply chain management
Authors: Ahmed Maria , Thaheem Muhammad Jamaluddin , Maqsoom Ahsen 
Published: January 2020

Purpose
The purpose of this paper is to investigate critical barriers hindering the adoption of green supply chain management (GSCM) and the opportunities that can be exploited with such an implementation in the construction industry of developing countries. It also devises strategies to avoid critical barriers in implementation and exploit opportunities for a better overall environmental performance of the construction industry.

Design/methodology/approach
This research relies upon an extensive literature review; data are collected from 163 professionals and 15 interviews of field professionals from 11 developing countries are conducted. The barriers and opportunities are synthesized through literature review and then data are collected over their significance from the construction professionals through an online survey. To highlight the interconnectedness of the critical barriers and opportunities, a causal loop framework is developed. Furthermore, expert opinion is sought to develop the strategies.

Findings
This research integrates information from different sources and provides a holistic view of the current situation of GSCM in developing countries. In total, 34 barriers and 23 opportunities are extracted from literature. The top 4 barriers fall under the “involvement and support” category, whereas the top four opportunities fall under the “environmental” category. Furthermore, the strategies to implement GSCM include suitable policies by top management to incorporate practices such as innovative green design, green procurement, green packaging, green distribution and even end-of-life management, which play a vital role in emission reduction.

Originality/value
This research is a first attempt at evaluating the barriers and opportunities facing GSCM in the construction sector of the developing countries. The findings encourage the stakeholders in adopting GSCM practices by presenting a clear picture of the potential benefits that can be exploited by implementing the proposed strategies to eliminate critical barriers in the construction industry.
Exploring nuances of green skepticism in different economies
Authors: Silva Minelle E. , Sousa-Filho José Milton de , Yamim Amanda Pruski , Diógenes Abílio Peixoto 
Published: January 2020

PurposeThe purpose of this paper is to investigate the relationship between consumers’ skepticism and green consumption in different economies by exploring antecedents and consequences of skepticism.Design/methodology/approachUsing a cross-country approach, with data from Brazil and France, the relationships between green skepticism and downstream consequences (e.g. intention to purchase green products) were analyzed using the partial least squares path modeling with the results of 996 questionnaires.FindingsContradicting previous research, the authors found that in France, green skepticism represents consumers’ increased green advertising elaboration, not a disbelief in companies’ claims, and it is associated with greater intentions to make green purchases. Meanwhile, in Brazil, green skepticism represents consumers’ disbelief, which is associated to consumers greater suspicion toward (and distance from) companies’ claims in such country. This study shows that the role of skepticism and the valence of its effect on green attitudes depend on market relationships.Research limitations/implicationsThe authors promote the importance of investigating the different meanings of skepticism across countries, what can spill over on research of other marketing aspects, such as advertising elaboration. Managers should consider the importance of consumers’ doubts and skepticism as a useful element that can be explored in green advertising effectiveness.Practical implicationsManagers should consider the importance of consumers’ doubts and skepticism as a useful element that can be explored in green advertising effectiveness.Originality/valueThis research examines an underexplored debate on the role of green skepticism in different economies and demonstrates the nuances green advertising impact on both markets.
Values and beliefs as predictors of pre‐service teachers’ enjoyment of teaching in inclusive settings
Authors: Büssing Alexander Georg , Menzel Susanne , Schnieders Maxime , Beckmann Valerie , Basten Melanie 
Published: December 2019

As several countries have committed themselves to the promotion of inclusive school systems, teachers might feel overwhelmed by the additional competencies needed for inclusive teaching. Beyond an increase in specialised knowledge, these competencies include a coherent belief system to facilitate the adoption of inclusive practices. Currently, there is scarce knowledge concerning the foundation of teachers’ beliefs and values and the possible connections between these personality traits and inclusive practices. Based on the theory of cognitive hierarchy, we investigated the predictive ability of the value of universalism in shaping sentiments, attitudes and concerns about inclusive education (RQ1), as well as their links to the anticipated enjoyment of teaching in inclusive settings as an indicator of enthusiasm for teaching (RQ2). Within a sample of 229 biology pre‐service teachers (Mage = 22.9 years, SDage = 3.5 years; 76% female, 68% bachelor) we found universalism to be a direct predictor of sentiments, attitudes and concerns regarding inclusive education. Furthermore, universalism was the strongest predictor of anticipated enjoyment of teaching in inclusive settings, while only sentiments about inclusive education were not predictive for enjoyment. The study illustrates how deeper underlying values like universalism is connected to beliefs about inclusive education and subsequent motivations in the classroom. When teacher educators intend to motivate pre‐service teachers to teach in inclusive settings, these variables should be kept in mind, though further study must be done on the generalisability of the results for pre‐service teachers of other school subjects.