bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescribing Practices of Nurse Practitioners and Physician Assistants Waivered to Prescribe Buprenorphine and the Barriers They Experience Prescribing Buprenorphine
Authors: Andrilla C. Holly A. , Jones Kendall C. , Patterson Davis G. 
Published: October 2019

AbstractBackgroundIn 2016, the Comprehensive Addiction Recovery Act permitted nurse practitioners (NPs) and physician assistants (PAs) to obtain a waiver to prescribe buprenorphine to treat opioid use disorder (OUD), with the goal of increasing access to this treatment. This study's purpose was to describe the buprenorphine prescribing practices of NPs and PAs and compare the barriers rural and urban providers face delivering treatment.MethodsFrom the October 2018 Drug Enforcement Administration list of providers with the waiver to prescribe buprenorphine, all rural NPs and PAs (1,057) and a random sample of 500 urban NPs and PAs were surveyed. The questionnaire queried respondents about demographics, prescribing practices, practice characteristics, reimbursement policies, and barriers to prescribing buprenorphine to treat OUD.ResultsOf the waivered NPs and PAs, 80.3% reported having prescribed buprenorphine and 71.1% said they were currently accepting new patients with OUD. Providers with the 30‐patient waiver were treating, on average, 13.2 patients; 37.0% were not treating any patients. The most common barrier, cited by half of providers, was concerns about diversion/medication misuse. More rural providers indicated lack of specialty backup and mental health providers as a barrier than urban providers. Never‐prescribers and former‐prescribers reported 6 barriers at significantly higher rates than did current prescribers. More rural providers accepted Medicaid and cash reimbursement than urban providers.ConclusionsNPs and PAs face many of the same barriers to providing buprenorphine as physicians have reported. Interventions to address these barriers have the potential to benefit all providers with the waiver to prescribe buprenorphine.
Let's Talk About Maths: The Role of Observed “Maths‐Talk” and Maths Provisions in Preschoolers' Numeracy
Authors: von Spreckelsen Megan , Dove Emma , Coolen Ilse , Mills Annelot , Dowker Ann , Sylva Kathy , Ansari Daniel , Merkley Rebecca , Murphy Victoria , Scerif Gaia 
Published: October 2019

ABSTRACTDevelopmental cognitive neuroscience highlights the importance of interactions between children and their environment. As young children spend increasing time in childcare, it is key to investigate the impact of “maths‐talk” and maths provisions in preschools. Qualitative insights from early educators indicate a greater bias toward counting activities than would be expected given the Early Years curriculum. In addition, we quantified the observed breadth of preschool practitioners' maths language (e.g., place‐value language), setting‐based maths provisions (e.g., quality of maths‐related activities), and their relation with children's early numeracy skills. In settings with greater practitioners' breadth of maths language, children display greater cardinality skills although our data call for the further investigation of parental socioeconomic status and education. We conclude with a discussion on the need to operationalize children's maths learning environments as diversely as possible. Enriching practitioners' skill sets may be an effective and needed way of improving early maths outcomes.
Introverted Metaphysics
Authors: Kriegel Uriah 
Published: October 2019

AbstractThis paper pulls together three debates fundamental in metaphysics and proposes a novel unified approach to them. The three debates are (i) between bundle theory and substrate theory about the nature of objects, (ii) dispositionalism and categoricalism about the nature of properties, and (iii) regularity theory and production theory about the nature of causation. The first part of the paper suggests that although these debates are metaphysical, the considerations motivating competing approaches in each debate tend to be epistemological. The second part argues that the two underlying epistemological pictures supporting these competing views lead to highly unsatisfying conceptions of the world. The final part proposes an alternative epistemological picture, which I call “introverted empiricism,” and presents the way this alternative provides for a more satisfying grasp of the ultimate nature of objects, properties, and causation. It is a consequence of this alternative picture that there is a kind of intimate self‐understanding that underlies our understanding of the deep nature of reality.
Polyphasic identification of three new species in Alternaria section Infectoriae causing human cutaneous infection
Authors: Iturrieta‐González Isabel , Pujol Isabel , Iftimie Simona , García Dania , Morente Vanesa , Queralt Rosana , Guevara‐Suarez Marcela , Alastruey‐Izquierdo Ana , Ballester Frederic , Hernández‐Restrepo Margarita , Gené Josepa 
Published: October 2019

SummaryBackgroundCutaneous phaeohyphomycosis is an emerging disease in immunocompromised patients, being Alternaria one of the most common genera reported as a causative agent. Species identification is not carried out mainly due to the complexity of the genus. Analysis of the ITS barcode has become standard for fungal identification, but in Alternaria it is only able to discriminate among species‐groups or sections.MethodsWe present three cases of cutaneous infection caused by Alternaria isolates morphologically identified as belonging to section Infectoriae. They have been morphologically characterised and phylogenetically delineated with five molecular markers (ITS, ATPase, gapdh, rpb2 and tef1).ResultsMycotic infections have been diagnosed by repeated cultures and histopathological examination in two of the cases. The polyphasic approach has allowed to delineate three new species of Alternaria section Infectoriae, that is A anthropophila, A atrobrunnea and A guarroi. ATPase has been the only locus able to discriminate most of the species (29 out of 31) currently sequenced in this section, including A infectoria the commonest reported species causing alternariosis. Susceptibility test showed different antifungal patterns for the three species, although terbinafine was the most active in vitro drug against these fungi.ConclusionsThe ATPase gene is recommended as an alternative barcode locus to identify Alternaria clinical isolates in section Infectoriae. Our results reinforce the relevance of identification of Alternaria isolates at the species level and the necessity to carry out antifungal susceptibility testing to determine the most adequate drug for treatment.
Family socioeconomic status, parental attention, and health behaviors in middle childhood: A cross‐sectional study
Authors: Eo Yong‐Sook , Kim Ji‐Soo 
Published: October 2019

AbstractThis study examined the relationships among family socioeconomic status, parental attention, and health behaviors in children during middle childhood. For this descriptive cross‐sectional study, six elementary schools in a metropolitan city in South Korea were selected for recruitment. We surveyed 857 elementary school students aged 8 to 10 years by using self‐report questionnaires. A hierarchical multilinear regression analysis found that family socioeconomic status positively related to children's health behaviors and that parental attention had a moderating effect on this relationship. These results suggest that family socioeconomic status influences health behaviors from the child's perspective. The influence of family socioeconomic status on children's health behaviors might be weakened by parental attention. Healthcare providers should be aware of children's health behaviors and focus interventions on families with low socioeconomic status. Nurses should emphasize to parents that parental supervision and monitoring might benefit their children and improve their health behaviors.
Anatomical relationship between the maxillary posterior teeth and the sinus floor according to an anterior overbite
Authors: Son Woo‐Sung , Kim Yong‐Il , Kim Seong‐Sik , Park Soo‐Byung , Kim Sung‐Hun 
Published: October 2019

AbstractObjectiveTo evaluate the vertical relationship between the maxillary sinus floor (MSF) and the maxillary posterior teeth (MPT) according to an anterior overbite.Settings and Sample PopulationThe patients were divided into three groups according to an anterior overbite. The open bite group (OBG) included patients with an anterior overbite of ≤0 mm, the normal overbite group (NBG) included patients with an overbite of 0‐3 mm, and the deep bite group (DBG) included patients with an overbite ≥3 mm. Thirty patients were randomly matched into each group based on age and sex.Materials and MethodsThe distances and vertical relationship between the MSF and the MPT was analysed using cone‐beam computer tomography. The vertical relationship between the two was classified as either favourable or unfavourable for the intrusion of the posterior teeth.ResultsA higher ratio of patients in the OBG had MPT positioned close to the MSF than the DBG. Intrusion of the posterior teeth was unfavourable for an average of 87.2%, 77.2% and 70.2% molars in the OBG, NBG and DBG, respectively.ConclusionsThe vertical distance between the MSF and the MPT is associated with an anterior overbite. The posterior teeth were in an unfavourable position for the orthodontic intrusion in the OBG as compared to the other groups. Additional caution is needed when planning orthodontic intrusion treatment for patients with an anterior open bite. But, there were some individual variations within each group.
New clade of silicified bolidophytes that belong to Triparma (Bolidophyceae, Stramenopiles)
Authors: Yamada Kazumasa , Sato Shinya , Yamazaki Masashi , Yoshikawa Shinya , Kuwata Akira , Ichinomiya Mutsuo 
Published: October 2019

SUMMARYThe small phytoplankton genus Triparma belongs to the class Bolidophyceae and contains two distinct forms: silicified species and naked flagellated species (formerly Bolidomonas). Recent studies showed that four silicified species/strains (Triparma laevis f. inornata, T. laevis f. longispina, T. strigata, and T. aff. verrucosa) belong to a single clade that is paraphyletic, because it also contains an unclassified flagellated strain, and is sister to a flagellated species, T. eleuthera. In this study, we isolated and characterized two new strains of silicified species to test the phylogenetic unity of silicified bolidophytes. The isolates were identified as T. retinervis strains because they possessed fine areolation on the cell wall. 18S rDNA and rbcL phylogenetic analyses demonstrated that T. retinervis formed a new silicified clade that is sister to the flagellated species T. pacifica. This reveals that there are at least two distinct clades including both silicified and flagellated Triparma species.
Abnormal Sysmex XT‐2000iV DIFF scattergram in a cat with a prominent mastocytemia
Authors: Lavabre Typhaine , Betting Adeline , Bourgès‐Abella Nathalie , Layssol‐Lamour Catherine , Trumel Catherine 
Published: October 2019

AbstractA 2‐year‐old neutered male domestic shorthair cat was presented to the emergency service of the National Veterinary School of Toulouse (France) for acute vomiting and diarrhea with lethargy, inappetence, and adypsia for the past 48 hours. Complete blood counts were performed with the ProCyte DX at the emergency department and with the Sysmex XT‐2000iV at the laboratory 2 weeks later. The scattergrams from the two analyzers revealed similar unusual and abnormal dot plots. The Sysmex XT‐2000iV DIFF scattergram also showed no clear separation between different leukocyte populations. The eosinophil cluster was in an abnormal location compared with that of the “typical” location in a normal cat. A blood smear evaluation revealed the presence of numerous mast cells. Thus, we hypothesized that the Sysmex XT‐2000iV had detected the mast cell population, and this led to errors in the differential counts. To explore this hypothesis, we manually gated on the DIFF scattergram and performed a manual differential on the blood smear. With this new gating strategy, the Sysmex XT‐2000iV and manual differentials were similar. Thus, in the case of systemic mastocytosis, mast cells can be located between the lymphocyte, monocyte, and eosinophil clusters on scattergrams.
CAD-CAM en prótesis total. Reporte de caso
Authors: Matiz Cuervo Jimmy 
Published: October 2019

Antecedentes: En los últimos 15 años, la robótica ha incursionado en el campo de la prostodoncia total a través de la cual se han desarrollo técnicas clínicas y de laboratorio para elaborar dentaduras. Objetivo: Rehabilitar un paciente desdentado total con una técnica actual que utiliza la robótica y acrílicos industrializados. Descripción del caso: El tratamiento prostodóntico de un paciente desdentado total superior e inferior se realizó mediante tecnología de diseño y manufacturación asistidas por computador (CAD-CAM). Resultado: Se emplearon impresiones digitales y acrílicos industriales de alto rendimiento, así como escáner, programa de computador y fresadora. El caso fue exitoso en cuanto a estabilidad, retención y soporte del tratamiento efectuado.
Política pública nacional de salud bucodental del Paraguay 2009-2018
Authors: Caballero García Cristina Raquel , Giménez de Chamorro Concepción Elizabeth , Flores Alatorre Francisco 
Published: October 2019

Antecedentes: la Política Pública Nacional de Salud Bucodental (SBD) “Por el Derecho de Volver a Sonreír” se inició en el marco de la reforma de salud del año 2008 dirigida hacia un sistema de salud basado en la Atención Primaria de Salud. Objetivo: Analizar el proceso del desarrollo e implementación de la Política Pública Nacional de SBD del Ministerio de Salud Pública y Bienestar Social del Paraguay (MSPBS) 2009-2018. Análisis de la política: Se expone la experiencia del Paraguay utilizando el marco de referencia propuesto por la Organización Mundial de la Salud para la redacción de políticas de SBD. Se describe el proceso dinámico de formulación de la política que incluye: el contexto del Sistema Nacional de Salud, la identificación de la necesidad, las estrategias de intervención implementadas, los pilares que la sustentaron, su evaluación, desafíos y logros. Conclusiones: El establecimiento de la Política Pública Nacional de SBD del MSPBS 2009-2018, logró posicionar a la SBD en la agenda pública del país ubicándola en un sitial de privilegio, nunca antes logrado dentro de la Institución. Su consolidación requirió de una profunda restructuración del programa, así como la implementación de diversas líneas de acción, cuyas evaluaciones, permitieron visualizar un fortalecimiento en la prestación de los servicios y un impacto positivo en la SBD de la población.
Low-dose (0.01%) atropine eye-drops to reduce progression of myopia in children: a multicentre placebo-controlled randomised trial in the UK (CHAMP-UK)—study protocol
Authors: Azuara-Blanco Augusto , Logan Nicola , Strang Niall , Saunders Kathryn , Allen Peter M , Weir Ruth , Doherty Paul , Adams Catherine , Gardner Evie , Hogg Ruth , McFarland Margaret , Preston Jennifer , Verghis Rejina , Loughman James J , Flitcroft Ian , Mackey David A , Lee Samantha Sze-Yee , Hammond Christopher , Congdon Nathan , Clarke Mike 
Published: October 2019

Background/aimsTo report the protocol of a trial designed to evaluate the efficacy, safety and mechanism of action of low-dose atropine (0.01%) eye-drops for reducing progression of myopia in UK children.MethodsMulticentre, double-masked, superiority, placebo-controlled, randomised trial. We will enrol children aged 6–12 years with myopia of −0.50 dioptres or worse in both eyes.We will recruit 289 participants with an allocation ratio of 2:1 (193 atropine; 96 placebo) from five centres. Participants will instil one drop in each eye every day for 2 years and attend a research centre every 6 months. The vehicle and preservative will be the same in both study arms.The primary outcome is SER of both eyes measured by autorefractor under cycloplegia at 2 years (adjusted for baseline). Secondary outcomes include axial length, best corrected distance visual acuity, near visual acuity, reading speed, pupil diameter, accommodation, adverse event rates and allergic reactions, quality of life (EQ-5D-Y) and tolerability at 2 years. Mechanistic evaluations will include: peripheral axial length, peripheral retinal defocus, anterior chamber depth, iris colour, height and weight, activities questionnaire, ciliary body biometry and chorioretinal thickness. Endpoints from both eyes will be pooled in combined analysis using generalised estimating equations to allow for the correlation between eyes within participant. Three years after cessation of treatment, we will also evaluate refractive error and adverse events.ConclusionsThe Childhood Atropine for Myopia Progression in the UK study will be the first randomised trial reporting outcomes of low-dose atropine eye-drops for children with myopia in a UK population.Trial registration numberISRCTN99883695,NCT03690089.
Reducing waste: a guidelines-based approach to reducing inappropriate vitamin D and TSH testing in the inpatient rehabilitation setting
Authors: Bateman Emma A , Gob Alan , Chin-Yee Ian , MacKenzie Heather M 
Published: October 2019

BackgroundLaboratory overutilisation increases healthcare costs, and can lead to overdiagnosis, overtreatment and negative health outcomes. Discipline-specific guidelines do not support routine testing for Vitamin D and thyroid-stimulating hormone (TSH) in the inpatient rehabilitation setting, yet 94% of patients had Vitamin D and TSH tests on admission to inpatient rehabilitation at our institution. Our objective was to reduce Vitamin D and TSH testing by 25% on admission to inpatient Stroke, Spinal Cord Injury, Acquired Brain Injury and Amputee Rehabilitation units.MethodsA fishbone framework for root cause analysis revealed potential causes underlying overutilisation of Vitamin D and TSH testing. A series of Plan-Do-Study-Act (PDSA) cycles were introduced to target remediable factors, starting with an academic detailing intervention with key stakeholders that reviewed applicable clinical guidelines for each patient care discipline and the rationale for reducing admission testing. Simultaneously, computerised clinical decision support (CCDS) limited Vitamin D testing to specific criteria. Audit and feedback were used in a subsequent PDSA cycle. Frequency of Vitamin D and TSH testing on admission was the primary outcome measure. The number of electronic admission order caresets containing automatic Vitamin D and/or TSH orders before and after the interventions was the process measure. Rate of Vitamin D supplementation and changes in thyroid-related medication were the balancing measures.ResultsAfter implementation, 2.9% of patients had admission Vitamin D testing (97% relative reduction) and 53% of patients had admission TSH testing (43% relative reduction). Admission order caresets with prepopulated Vitamin D and TSH orders decreased from 100% (n=6) to 0%. The interventions were successful; similar to previous literature, CCDS was more effective than education and audit and feedback interventions alone. The interventions represent >$9000 annualised savings.
Blood glucose reduction in patients treated with insulin and dextrose for hyperkalaemia
Authors: Aljabri Ahmed , Perona Stephen , Alshibani Mohannad , Khobrani Moteb , Jarrell Daniel , Patanwala Asad E 
Published: October 2019

BackgroundDextrose is commonly administered with insulin during the management of hyperkalaemia to avoid hypoglycaemia. Previous research has evaluated the incidence of hypoglycaemia; however, none have reported the extent of blood glucose reduction after this regimen. The aim of this study was to better characterise the changes in blood glucose and to identify patients who may have an increased response to insulin.MethodsThis was a multicentre retrospective study evaluating adult patients who received a regimen of 10 units of intravenous regular insulin plus 25 g of intravenous dextrose to manage hyperkalaemia between January 2014 and September 2016. The primary outcome was to evaluate the extent of blood glucose reduction (milligram per decilitre) up to 6 hours following the above regimen. Secondary outcomes included incidence of hypoglycaemia (blood glucose <70 mg/dL) and severe hypoglycaemia (blood glucose <40 mg/dL), and predictors of the extent of blood glucose reduction.ResultsA total of 90 patients were included. The median blood glucose change over 6 hours was −24 mg/dL (IQR −53 to 6 mg/dL). Hypoglycaemia developed in 20 patients (22.2%, 95% CI 14.1% to 32.2%) and five patients (5.6%, 95% CI 1.8% to 12.5%) had severe hypoglycaemia. Patients who developed hypoglycaemia had a median baseline blood glucose of 110 mg/dL (IQR 80 to 127 mg/dL), which decreased to a median value of 52 mg/dL (IQR 40 to 60 mg/dL). Higher baseline blood glucose was significantly associated with greater blood glucose reduction (coefficient −0.36, 95% CI −0.55 to −0.18, p<0.001).ConclusionsThe extent of blood glucose reduction is variable and hypoglycaemia is common. The high incidence of hypoglycaemia highlights the importance of frequent blood glucose monitoring.
Expression of hypoxia-induced proteins in ductal carcinoma in situ and invasive cancer of the male breast
Authors: Vermeulen Marijn A , van Deurzen Carolien HM , Schroder Carolien P , Martens John WM , van Diest Paul J 
Published: October 2019

AimsThe aim of this study was to determine the role of hypoxia in male breast carcinogenesis by evaluating the expression of the hypoxia-related proteins, hypoxia-inducible factor-1α (HIF-1α), carbonic anhydrase IX (CAIX) and glucose transporter-1 (Glut-1), in ductal carcinoma in situ (DCIS) of the male breast in relation to invasive cancer (IC).MethodsTumour tissue blocks of 18 cases of pure DCIS, 58 DCIS cases adjacent to IC (DCIS-AIC) and the 58 IC cases were stained by immunohistochemistry for HIF-1α, CAIX and Glut-1, and expression frequencies and patterns (diffuse and/or perinecrotic) were noted.ResultsHIF-1α overexpression was observed in 61.1% (11/18) of pure DCIS, in 37.9% (22/58) of DCIS-AIC and in 36.2% (21/58) of IC cases (not significant (n.s.)). CAIX overexpression was observed in 16.7% (3/18) of pure DCIS, in 37.9% (22/58) of DCIS-AIC and in 24.1% (14/58) of IC cases (n.s.). Glut-1 overexpression was observed in 61.1% (11/18) of pure DCIS, in 75.9% (44/58) of DCIS-AIC and in 62.1% (36/58) of IC cases (n.s.). Expression of hypoxia-related proteins was seen around necrosis in a little over one-third of DCIS cases, and often coincided with expression in adjacent IC when present. All these observations indicate that the hypoxia response is already at its maximum in the preinvasive DCIS stage.ConclusionsIn conclusion, male DCIS frequently shows activated hypoxia response, comparable to male IC. This indicates that the activated hypoxia response previously seen in male IC is not a late bystander but likely a genuine carcinogenetic event.