bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mapping the nature of distress raised by patients with high-grade glioma and their family caregivers: a descriptive longitudinal study
Authors: Philip Jennifer , Collins Anna , Panozzo Stacey , Staker Jane , Murphy Michael 
Published: July 2019

Abstract

Background
Few supportive and palliative care interventions have been described for people with high-grade glioma (HGG) and their caregivers. A structured intervention, I-CoPE, which includes regular screening of patients’ and caregivers’ needs, was delivered as a pilot study in a tertiary neuro-oncological unit. This study prospectively described the severity and content of key concerns raised by patients and their caregivers in the 3 months following a diagnosis of HGG.

Methods
Consecutive patients and caregivers were screened for distress longitudinally using the Distress Thermometer at 3 time points. Exploration of the issues raised during screening was undertaken by the care coordinator and the issues documented. This documentation was subsequently audited to map patterns and nature of distress. The key reasons underlying distress and responses offered were grouped thematically and summarized using descriptive statistics.

Results
Thirty-two patients and 31 caregivers were recruited and underwent screening. At diagnosis, 87% of caregivers (n = 27) and 60% of patients (n = 19) reported distress scores meeting clinical significance. The predominant concerns reported by patients during screening related to existential issues such as fear of dying, whereas caregivers were more focused on practical caring responsibilities. Over time, the reasons for distress changed to include more physical health concerns for patients and more psychological concerns for caregivers.

Conclusions
This prospective longitudinal descriptive study revealed that following a new diagnosis of HGG, patients and caregivers had changing needs for support and fluctuating distress, mirroring the illness trajectory. Palliative care needs were apparent from diagnosis, and early integration of palliative care should be considered.
Technology transfer at the US National Institute of Standards and Technology
Authors: Link Albert N 
Published: July 2019

Abstract
This article analyzes the interrelationship among technology transfer mechanisms using data specific to the US National Institute of Standards and Technology (NIST). An overview of the history of NIST and US policies that emphasize the economic importance of technology transfer are discussed. The empirical analysis focuses on NIST investments in research and development (R&D) and the cascading impact of those investments on new inventions disclosed, new patent applications, new patents issued and new patent licenses; and accounting for the effects of R&D on these three investments, an overall estimate of the R&D elasticity of new patent licenses is calculated to be 0.7976. The article concludes with a policy-focused summary of the implications of the empirical findings, and a suggested road map for future research related to technology transfer from US federal laboratories.
An Integrative Computational Approach for a Prioritization of Key Transcription Regulators Associated With Nanomaterial-Induced Toxicity
Authors: Zhernovkov Vadim , Santra Tapesh , Cassidy Hilary , Rukhlenko Oleksii , Matallanas David , Krstic Aleksandar , Kolch Walter , Lobaskin Vladimir , Kholodenko Boris N 
Published: July 2019

Abstract
A rapid increase of new nanomaterial (NM) products poses new challenges for their risk assessment. Current traditional methods for estimating potential adverse health effect of NMs are complex, time consuming, and expensive. In order to develop new prediction tests for nanotoxicity evaluation, a systems biology approach, and data from high-throughput omics experiments can be used. We present a computational approach that combines reverse engineering techniques, network analysis and pathway enrichment analysis for inferring the transcriptional regulation landscape and its functional interpretation. To illustrate this approach, we used published transcriptomic data derived from mice lung tissue exposed to carbon nanotubes (NM-401 and NRCWE-26). Because fibrosis is the most common adverse effect of these NMs, we included in our analysis the data for bleomycin (BLM) treatment, which is a well-known fibrosis inducer. We inferred gene regulatory networks for each NM and BLM to capture functional hierarchical regulatory structures between genes and their regulators. Despite the different nature of the lung injury caused by nanoparticles and BLM, we identified several conserved core regulators for all agents. We reason that these regulators can be considered as early predictors of toxic responses after NMs exposure. This integrative approach, which refines traditional methods of transcriptomic analysis, can be useful for prioritization of potential core regulators and generation of new hypothesis about mechanisms of nanoparticles toxicity.
Hand hygiene compliance and environmental contamination with gram-negative bacilli in a rural hospital in Madarounfa, Niger
Authors: Tang Kevin , Berthé Fatou , Nackers Fabienne , Hanson Kerstin , Mambula Christopher , Langendorf Celine , Marquer Caroline , Isanaka Sheila 
Published: July 2019

AbstractBackgroundHealthcare-associated infections pose a major, yet often preventable risk to patient safety. Poor hand hygiene among healthcare personnel and unsanitary hospital environments may contribute to this risk in low-income settings. We aimed to describe hand hygiene behaviour and environmental contamination by season in a rural, sub-Saharan African hospital setting.MethodsWe conducted a concurrent triangulation mixed-methods study combining three types of data at a hospital in Madarounfa, Niger. Hand hygiene observations among healthcare personnel during two seasons contributed quantitative data describing hand hygiene frequency and its variability in relation to seasonal changes in caseload. Semistructured interviews with healthcare personnel contributed qualitative data on knowledge, attitudes and barriers to hand hygiene. Biweekly environmental samples evaluated microbial contamination from October 2016 to December 2017. Triangulation identified convergences, complements and contradictions across results.ResultsHand hygiene compliance, or the proportion of actions (handrubbing or handwashing) performed out of all actions required, was low (11% during non-peak and 36% during peak caseload seasons). Interviews with healthcare personnel suggesting good general knowledge of hand hygiene contradicted the low hand hygiene compliance. However, compliance by healthcare activity was convergent with poor knowledge of precise hand hygiene steps and the motivation to prevent personal acquisition of infection identified during interviews. Contamination of environmental samples with gram-negative bacilli was high (45%), with the highest rates of contamination observed during the peak caseload season.ConclusionLow hand hygiene compliance coupled with high contamination rates of hospital environments may increase the risk of hospital-acquired infections in sub-Saharan African settings.
Patient and Disease Characteristics Associate With Sensory Testing Results in Chronic Pancreatitis
Authors: Kuhlmann Louise , Olesen Søren S. , Grønlund Debbie , Olesen Anne E. , Phillips Anna E. , Faghih Mahya , Drewes Asbjørn M. 
Published: July 2019

Background:Abdominal pain is the most common symptom in chronic pancreatitis (CP) and has an extensive impact on patients’ lives. Quantitative sensory testing (QST) provides information on sensitivity to pain and mechanisms that can help quantify pain and guide treatment. The aims of this study were (1) to explore sensitivity to pain in patients with CP using QST and (2) to associate patient and disease characteristics with QST results.Methods:Ninety-one patients with painful CP and 28 healthy control participants completed a QST paradigm using static tests (muscle pressure stimulation and electrical skin stimulations) to unravel segmental and widespread hyperalgesia as a consequence of visceral pain. A dynamic conditioned pain modulation (CPM) paradigm was used as a proxy of pain modulation from the brainstem to inhibit incoming nociceptive barrage, and questionnaires were used to gather information on pain experience and quality of life.Results:Patients had impaired CPM compared with controls (18.0±29.3% vs. 30.9±29.3%,P=0.04) and were hypersensitive to pressure stimulation, specifically in the pancreatic (Th10) dermatome (P<0.001). The capacity of CPM was associated with clinical pain intensity (P=0.01) and (in the univariate analysis only) the use of opioids was associated with hyperalgesia to pressure stimulation (P<0.05).Conclusions:Sensitivity to pain in CP patients can be characterized by a simple bedside QST. Severe clinical pain in CP was associated with reduced CPM function and should be targeted in management.
Mandatory Pain Assessment in a Pediatric Emergency Department: Failure or Success?
Authors: Marzona Federico , Pedicini Sara , Passone Eva , Pusiol Anna , Cogo Paola 
Published: July 2019

Objective:
Pain control is a priority in patient evaluation. Despite the proliferation of guidelines, pain is still underassessed and undertreated, especially in children. To improve efficiency and to adhere to best medical practice, our triage software was upgraded; it included mandatory pain scoring for the admission of a child to the pediatric emergency service, thereby limiting the chances of overlooking a child experiencing pain. We conducted this study to verify the effect of routine versus mandatory pain scoring on pain management under the hypothesis that mandatory pain assessment would improve reevaluation and pain treatment.

Methods:
This retrospective case-control study was conducted in our Pediatric Emergency Department (ED). We collected data with regard to pain assessment and reassessment at triage and during the entire stay in the ED, and also with regard to the drugs eventually administered. We reviewed the charts of 1274 patients admitted with the older triage software and those of 1262 patients admitted with the newer triage software (intervention group).

Results:
Pain was evaluated significantly more frequently in the intervention group at triage, during the medical evaluation, and at discharge. In the intervention group, a smaller percentage of patients were treated for pain at both triage and during their stay in the ED (P=0.078 and 0.048). Pain reassessment resulted lower in the intervention group (P<0.01).

Discussion:
Mandatory pain assessment improved the pain evaluation rate. This did not, however, translate into better treatment and management of pain in the pediatric emergency setting.
Acquired Elastotic Hemangioma: A Case Report and Review of 49 Previously Reported Cases
Authors: Jeunon Thiago , Carvalho Wagnes Stöfler Maria E. , Teixeira Rezende Patricia , Staccioli Castro Marcelo , Jeunon-Sousa Maria A. 
Published: July 2019

Abstract:
In the past decades, there was a considerable advance in regard to recognition of morphologic findings and classification of several benign and malignant vascular proliferations. In 2002, attention was called by Requena et al to a new variant of cutaneous hemangioma named acquired elastotic hemangioma. In this article, a case of acquired elastotic hemangioma is reported with documentation of clinical, dermatoscopic, histopathological, and immunohistochemical findings. A systematic review of the previously 49 reported cases is provided. The criteria for clinical and histopathological diagnosis are highlighted.
Comparing Retail Clinics With Other Sites of Care
Authors: Hoff Timothy , Prout Kathryn 
Published: July 2019

Background:
Retail clinics, also referred to as walk-in or convenient care clinics, share common features such as a limited menu of primary care services, on-demand patient appointments, greater use of nonphysician providers such as nurse practitioners, and more convenient hours and access points for patients.

Objectives:
Given their rising popularity as an alternative primary care delivery site, it is important to examine retail clinics’ impact on patient outcomes. This study’s aim was to systematically review the extant literature on retail clinics in the United States with respect to 3 outcomes of interest: quality, cost, and patient satisfaction.

Research Design:
A systematic search of 4 databases was done using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies needed to be empirical, measure care in retail, walk-in, or convenient care clinic, and present quality, cost, and/or satisfaction findings.

Measures:
The majority of studies used commercial, administrative claims databases to procure patient outcome data (n=9). Nine of the 15 studies examined costs, 6 examined quality, and only 1 examined patient satisfaction.

Results:
Overall, retail clinic care compares favorably with similar care in other settings in terms of lower costs, although the evidence on quality and patient satisfaction is minimal and less conclusive.

Conclusions:
Future research on retail clinic care requires more rigorous study designs, richer quality measures, inclusion of the patient experience in outcomes, less reliance on administrative claims data, and greater independence from industry stakeholders with interest in seeing the retail clinic model grow.
Gastric Emptying and Distal Gastrectomy Independently Enhance Postprandial Glucagon-Like Peptide-1 Release After a Mixed Meal and Improve Glycemic Control in Subjects Having Undergone Pancreaticoduodenectomy
Authors: Steiner Emanuel , Breuer Robert , Kazianka Lukas , Wewalka Marlene , Stimpfl Thomas , Reiter Birgit , Holst Jens Juul , Miholic Johannes 
Published: July 2019

Objectives
New-onset diabetes frequently resolves after pancreaticoduodenectomy (PD). Glucagon-like peptide-1 (GLP-1) conceivably is involved as its release is enhanced by rapid gastric emptying and distal bowel exposure to nutrients. We aimed at studying factors associated with GLP-1 release after PD.

Methods
Fifteen PD subjects with distal gastrectomy (Whipple) and 15 with pylorus preservation were evaluated. A test meal containing 1 g paracetamol to measure gastric emptying was ingested. Blood for the measurement of paracetamol, glucose, insulin, and GLP-1 was drawn at baseline and 10, 20, 30, 60, 90, 120, 150, and 180 minutes thereafter. The Matsuda index of insulin sensitivity was calculated.

Results
In univariate analysis, gastric emptying correlated with GLP-1. Glucagon-like peptide-1 responses to the modes of operation did not differ. Multiple regression analysis confirmed gastric emptying and Whipple versus pylorus-preserving pancreaticoduodenectomy as independent predictors of GLP-1 release. The Matsuda index of insulin sensitivity correlated with GLP-1 concentrations and inversely with body mass index. Patients after Whipple procedure revealed lower glycated hemoglobin as compared with pylorus-preserving pancreaticoduodenectomy.

Conclusions
Following PD, the postprandial GLP-1 release seems to be enhanced by rapid gastric emptying and to improve insulin sensitivity. Partial gastrectomy versus pylorus preservation enhanced the release of GLP-1, conceivably because of greater distal bowel exposure to undigested nutrients.
Bleeding and Thrombosis With Pediatric Extracorporeal Life Support: A Roadmap for Management, Research, and the Future From the Pediatric Cardiac Intensive Care Society: Part 1*
Authors: Penk Jamie S. , Reddy Sushma , Polito Angelo , Cisco Michael J. , Allan Catherine K. , Bembea Melania M. , Giglia Therese M. , Cheng Henry H. , Thiagarajan Ravi R. , Dalton Heidi J. 
Published: July 2019

Objectives:
To make practical and evidence-based recommendations on improving understanding of bleeding and thrombosis with pediatric extracorporeal life support and to make recommendations for research directions.

Data Sources:
Evaluation of literature and consensus conferences of pediatric critical care and extracorporeal life support experts.

Study Selection:
A team of 10 experts with pediatric cardiac and extracorporeal membrane oxygenation experience and expertise met through the Pediatric Cardiac Intensive Care Society to review current knowledge and make recommendations for future research to establish “best practice” for anticoagulation management related to extracorporeal life support.

Data Extraction/Synthesis:
The first of a two-part white article focuses on clinical understanding and limitations of medications in use for anticoagulation, including novel medications. For each medication, limitations of current knowledge are addressed and research recommendations are suggested to allow for more definitive clinical guidelines in the future.

Conclusions:
No consensus on best practice for anticoagulation exists. Structured scientific evaluation to answer questions regarding anticoagulant medication and bleeding and thrombotic events should occur in multicenter studies using standardized approaches and well-defined endpoints. Outcomes related to need for component change, blood product administration, healthcare outcome, and economic assessment should be incorporated into studies. All centers should report data on patients receiving extracorporeal life support to a registry. The Extracorporeal Life Support Organization registry, designed primarily for quality improvement purposes, remains the primary and most successful data repository to date.
Strengths and Difficulties Questionnaire Assessment of Long-Term Psychological Outcome in Children After Intensive Care Admission*
Authors: Kyösti Elina , Ala-Kokko Tero I. , Ohtonen Pasi , Peltoniemi Outi , Ebeling Hanna , Spalding Michael , Rautiainen Paula , Kataja Janne , Liisanantti Janne H. 
Published: July 2019

Objectives:
We investigated the long-term psychologic symptoms of patients who survived pediatric intensive care admission.

Design:
Longitudinal follow-up study.

Setting:
Nationwide cohort study based on a national ICU register and a questionnaire survey.

Patients:
All pediatric patients (0–16 yr old) who were admitted to an ICU in Finland in 2009–2010.

Interventions:
None.

Measurements and Main Results:
Six years after ICU admission, all surviving patients were sent the Strengths and Difficulties Questionnaire, and questionnaires regarding chronic diseases and need for medication and therapy. At the end of the follow-up period, there were 3,674 surviving children who had been admitted to an ICU in 2009–2010. Of these children, 1,105 completed the Strengths and Difficulties Questionnaire 6 years after admission. Strengths and Difficulties Questionnaire scores were abnormal for 84 children (7.6%), borderline for 80 (7.2%), and normal for 941 (85.2%). Participants with abnormal scores were younger at admission to the ICU (3.06 vs 4.70 yr; p = 0.02), and more commonly had a chronic disease (79.5% vs 47.4%; p < 0.001), a need for continuous medication (49.4% vs 31.7%; p < 0.001), a need for therapy (58.5% vs 15.9%; p < 0.001), and a need for annual healthcare visits (91.4% vs 85.2%; p = 0.05). Abnormal Strengths and Difficulties Questionnaire scores were associated with higher rates of neurologic (32.1% vs 10.2%), gastrointestinal (7.1% vs 3.9%), psychiatric (3.6% vs 0.5%), and chromosomal disorders (9.5% vs 1.3%), as well as with long-term pain (1.2% vs 0.6%).

Conclusions:
Participants with abnormal Strengths and Difficulties Questionnaire scores (poor psychologic outcome) at 6 years after childhood ICU admission more commonly suffered neurologic, chromosomal, or psychiatric diagnoses or long-term pain, and generally required higher levels of healthcare services, therapies, and medication.
Incidence and Geographic Distribution of Injuries Due to Falls Among Pediatric Communities of Maryland
Authors: Husain Amyna , Sridharma Suganya , Baker Mark Douglas , Kharrazi Hadi 
Published: July 2019

Objectives
Falls are the leading cause of pediatric injury and account for the majority of emergency department injury visits, costing US $5 billion in medical costs annually. Epidemiology of pediatric falls has primarily been studied at single hospital centers and has not been analyzed statewide. We assessed pediatric falls across Maryland and geographically mapped them by census tract and block group.

Methods
The study used Maryland Health Services Cost Review Commission discharge data to retrospectively analyze the demographics and cross-sectional incidence rates of fall injuries in Maryland from 2013 to 2015. Geographical clusters were calculated for pediatric falls in Maryland and Baltimore City.

Results
From 2013 to 2015, Maryland hospitals discharged 738,819 pediatric patients, of whom 77,113 had fall injuries. Falls were more prevalent among males (56%), white race (55%), and patients with public insurance (56%). Over this period, 2 children who presented with fall injuries died. The incidence of falls did not vary from 2013 (27,481 children) to 2014 (27,261) and 2015 (26,451). Mapping fall injuries across Maryland identified Baltimore City as the primary cluster and rural pockets as secondary clusters of high incidence rates. Baltimore City maps showed a stable high-incidence cluster in the southwest region across all 3 years.

Conclusions
Pediatric fall injuries comprise a large volume of emergency department visits yet have a low mortality. Geographic mapping shows that fall incidence varies across the state and persists over time. Statewide geographic information can be used to focus resource management and target prevention strategies.
Diagnostic Efficacy of T2 Dark Spot, T2 Dark Rim Signs, and T2 Shading on Magnetic Resonance Imaging in Differentiating Endometriomas From Hemorrhagic Cysts
Authors: Cansu Aysegul , Bulut Eser , Dinc Gulseren , Bekircavusoglu Suleyman , Eyuboglu Ilker , Guven Emine Seda , Ahmetoglu Ali 
Published: July 2019

Objective
This study aimed to evaluate the diagnostic efficacy of T2 dark spot, T2 dark rim, and T2 shading signs on magnetic resonance imaging in the differentiation of endometriomas from hemorrhagic cysts.

Methods
Seventy-two hemorrhagic lesions were included in this retrospective study. The presence of T2 dark spot, T2 dark rim, and T2 shading signs in the lesions and the presence of complete or incomplete rim in lesions exhibiting T2 dark rim signs were evaluated.

Results
Of 72 lesions, 50 were diagnosed with endometrioma and 22 were diagnosed with hemorrhagic cyst. Twenty-six of 50 endometriomas and none of the hemorrhagic cysts showed T2 dark spot sign. T2 shading was observed in 90% of endometriomas and 18% of hemorrhagic cysts. Incomplete T2 dark rim was detected in 67% of endometriomas and 21% of hemorrhagic cysts.

Conclusions
T2 dark spot and T2 dark rim signs could be useful for distinguishing endometriomas from hemorrhagic cysts.