bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Opioid Prescribing Among Generalist Physicians, Nurse Practitioners, and Physician Assistants
Authors: Ellenbogen Michael I , Segal Jodi B 
Published: January 2019

Abstract

Objective
To determine if there are differences in opioid prescribing among generalist physicians, nurse practitioners (NPs), and physician assistants (PAs) to Medicare Part D beneficiaries.

Design
Serial cross-sectional analysis of prescription claims from 2013 to 2016 using publicly available data from the Centers for Medicare and Medicaid Services.

Subjects
All generalist physicians, NPs, and PAs who provided more than 10 total prescription claims between 2013 and 2016 were included. These prescribers were subsetted as practicing in a primary care, urgent care, or hospital-based setting.

Methods
The main outcomes were total opioid claims and opioid claims as a proportion of all claims in patients treated by these prescribers in each of the three settings of interest. Binomial regression was used to generate marginal estimates to allow comparison of the volume of claims by these prescribers with adjustment for practice setting, gender, years of practice, median income of the ZIP code, state fixed effects, and relevant interaction terms.

Results
There were 36,999 generalist clinicians (physicians, NPs, and PAs) with at least one year of Part D prescription drug claims data between 2013 and 2016. The number of adjusted total opioid claims across these four years for physicians was 660 (95% confidence interval [CI] = 660–661), for NPs was 755 (95% CI = 753–757), and for PAs was 812 (95% CI = 811–814).

Conclusions
We find relatively high rates of opioid prescribing among NPs and PAs, especially at the upper margins. This suggests that well-designed interventions to improve the safety of NP and PA opioid prescribing, along with that of their physician colleagues, could be especially beneficial.
iTALK: an R Package to Characterize and Illustrate Intercellular Communication
Authors: Wang Yuanxin , Wang Ruiping , Zhang Shaojun , Song Shumei , Jiang Changying , Han Guangchun , Wang Michael , Ajani Jaffer , Futreal Andy , Wang Linghua 
Published: January 2019

ABSTRACTCrosstalk between tumor cells and other cells within the tumor microenvironment (TME) plays a crucial role in tumor progression, metastases, and therapy resistance. We present iTALK, a computational approach to characterize and illustrate intercellular communication signals in the multicellular tumor ecosystem using single-cell RNA sequencing data. iTALK can in principle be used to dissect the complexity, diversity, and dynamics of cell-cell communication from a wide range of cellular processes.
Effects of Curative-Intent Lung Cancer Therapy on Functional Exercise Capacity and Patient-Reported Outcomes
Authors: Ha Duc , Ries Andrew L. , Lippman Scott M. , Fuster Mark M. 
Published: January 2019

AbstractBackgroundLung cancer treatment can lead to negative health consequences. We analyzed the effects of curative-intent lung cancer treatment on functional exercise capacity (EC) and patient-reported outcomes (PROs).MethodsWe performed a prospective-observational cohort study of consecutive patients with stage I-IIIA lung cancer undergoing curative-intent therapy and assessed functional EC [primary outcome, six-minute walk distance (6MWD)], cancer-specific quality of life (QoL) [secondary outcome, European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORTC-QLQ-C30) summary score], and exploratory outcomes including dyspnea [University of California San Diego Shortness of Breath Questionnaire (UCSD-SOBQ)] and fatigue [Brief Fatigue Inventory (BFI)] symptoms before and at 1 to 3 months post-treatment. We analyzed the time effect of treatment on outcomes using multivariable generalized estimating equations.ResultsIn 35 enrolled participants, treatment was borderline-significantly associated with a clinically-meaningful decline in functional EC [(mean change, 95% CI) 6MWD = −25.4m (−55.3, +4.47), p=0.10], non-significant change in cancer-specific QoL [EORTC-QLQ-C30 summary score = − 3.4 (−9.8, +3.0), p=0.30], and statistically-significant and clinically-meaningful higher dyspnea [UCSD-SOBQ = +13.1 (+5.7, +20.6), p=0.001] and increased fatigue [BFI = +10.0 (+2.9, +17.0), p=0.006].ConclusionsAmong the first prospective analysis of the effect of curative-intent lung cancer treatment on functional EC and PROs, we observed worsening dyspnea and fatigue, and possibly a decline in functional EC but not cancer-specific QoL at 1 to 3 months post-treatment. Interventions to reduce treatment-related morbidities and improve lung cancer survivorship may need to focus on reducing dyspnea, fatigue, and/or improving functional EC.Consent and ApprovalWritten informed consent was obtained from each participant included in this study. All human investigations were performed after approval by the VA San Diego Healthcare System institutional review board and in accord with an assurance filed with and approved by the U.S. Department of Health and Human Services.
Rise in mortality involving poisoning by medicaments other than narcotics, including poisoning by psychotropic drugs in different age/racial groups in the US
Authors: Goldstein Edward 
Published: January 2019

AbstractBackgroundIncrease in mortality involving poisoning, particularly by narcotics, is known to have been one of the factors that affected life expectancy in the US during the last two decades, especially for white Americans and Native Americans. However, the contribution of medicaments other than narcotics to mortality in different racial/age groups is less studied.MethodsWe regressed annual rates of mortality involving poisoning by medicaments but not narcotics/psychodysleptics (ICD-10 codes T36-39.xx or T41-50.8 but not T40.xx present as either underlying or contributing causes of death), as well as annual rates of mortality for certain subcategories of the above, including mortality involving poisoning by psychotropic drugs but not narcotics/psychodysleptics (ICD-10 codes T43.xx but not T40.xx present as either underlying or contributing causes of death) in different age/racial groups for both the 2000-2011 period and the 2011-2017 period against calendar year.ResultsAnnual numbers of deaths involving poisoning by medicaments but not narcotics/psychodysleptics grew from 4,332 between 2000-2001 to 11,401 between 2016-2017, with the growth in the rates of those deaths being higher for the 2011-2017 period compared to the 2000-2011 period. The largest increases in the rates of mortality involving poisoning by medicaments but not narcotics/psychodysleptics were in non-elderly Non-Hispanic Native Americans, followed by Non-Hispanic whites. Most of those increases came from increases in the rates of mortality involving poisoning by psychotropic medications; the latter rates grew for the period of 2015-2017 vs. 2000-2002 by factors ranging from 2.75 for ages 35-44y to 5.37 for ages 55-64y.ConclusionsThere were major increases in mortality involving poisoning by non-narcotic, particularly psychotropic medicaments, especially in non-elderly non-Hispanic whites and Native Americans. Our results, and the epidemiological data on mortality involving poisoning by different drugs and medications in the US, which are quite different from the ones in many other countries support the need for a comprehensive evaluation of the effect of various drugs, including psychotropic medications on health-related outcomes, the associated mortality the does not involve poisoning being listed on a death certificate, and the impact of medication misuse.
Factors associated with adherence to the Integrated Management of Childhood Illness (IMCI) guidelines for under-five years’ old care in Burkina Faso primary health care facilities
Authors: Traoré Sabere Anselme , Somda Serge M.A. , Kiendrébéogo Joël Arthur , Kouldiati Jean-Louis , Robyn Paul Jacob , Hien Hervé , Méda Nicolas 
Published: January 2019

AbstractObjectiveTo assess the adherence to Integrated Management of Childhood Illness (IMCI) guidelines in primary health care facilities in Burkina Faso and to determine the factors associated.Materials and MethodsWe used data from a large survey on health facilities, held from October 2013 to April 2014. Primary health facilities were evaluated, health workers interviewed and consultations observed. The standard guideline for an under five year’s old child consultation was the Integrated Management of Childhood Illness (IMCI).Results1,571 consultations were observed, carried out by 522 different practitioners. The danger signs were usually not checked (13.9% only checking for at least three general danger signs). The adherence for cough (74.8%), diarrhoea (64.9%), fever (83.8%) and anaemia (70.3%) was higher. The principal factors found to be associated with poorer adherence to guidelines of consultation were female sex (Rate Ratio (RR) = 0.91; 95% CI 0.86 – 0.95), non-nurse practitioner (RR=0.93; 95% CI 0.88 – 0.97), IMCI training (RR=1.06; 95% CI 1.01 – 1.11), non-satisfaction of the salary (RR=0.95 95% CI 0.91 – 0.99).ConclusionThis study highlights a poor adherence to the IMCI guidelines and by then, revealing a poor quality of under-five care. Indeed, many characteristics of health workers including gender, type of profession, training satisfaction with salary were found to be associated with this adherence. Therefore, more initiatives aiming at improving the quality of care should be developed and implemented for improving the child health care.
Blanding’s turtles (Emydoidea blandingii) as a reservoir for Leptospira spp
Authors: Rockwell Kelly E. , Thompson Dan , Maddox Carol , Mitchell Mark A. 
Published: January 2019

AbstractLeptospira spp. are re-emerging zoonotic pathogens. Previous research has found that Blanding’s turtles (Emydoidea blandingii) experimentally infected with Leptospira interrogans shed leptospires in their urine, suggesting that they could play a role in transmitting pathogen within an aquatic ecosystem. This study investigated whether a population of wild Blanding’s turtles known to be exposed to Leptospira spp. actively shed the pathogen under natural conditions. Blood samples were collected for serologic testing and to assess the health of the turtles. Free catch urine was collected for polymerase chain reaction (PCR) testing. All turtles were seropositive for Leptospira spp. and 73.5% (25/34) of the urine samples were PCR positive. All animals appeared clinically healthy and showed no apparent signs of disease. This study confirms that wild Blanding’s turtles can actively shed Leptospira spp. in their urine and suggests that they may play a role in the epidemiology of this disease in habitats in which they reside.
Patterns of Treatment in Patients with Heart Failure with Preserved Ejection Fraction: the REasons for Geographic And Racial Differences in Stroke study
Authors: Poudel Bharat , Loop Matthew S. , Brown Todd M. , Durant Raegan W. , Safford Monika M. , Goyal Parag , Chen Ligong , Levitan Emily B. 
Published: January 2019

AbstractPurposeWe described medication use patterns among REasons for Geographic And Racial Differences in Stroke (REGARDS) participants hospitalized for heart failure with preserved ejection fraction (HFpEF) (152 hospitalizations, 101 unique individuals).MethodsMedication data were obtained from medical record review and Medicare Part D pharmacy claims. We compared discharge medication prescriptions between patients with and without chronic kidney disease (CKD), coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), and diabetes.ResultsThe mean age was 74.8 years, 53.3% were black and 73.7% were female. Hypertension (97.2%), diabetes (65.1%), COPD (51.3%), CKD (41.1%) and history of CHD (60.9%) were common. On admission and discharge, respectively, beta-blockers (66.4%, 72.7%), angiotensin converting enzyme inhibitors or angiotensin receptor blockers (42.8%, 51.7%), diuretics (61.2%, 80.9%), loop diuretics (55.9%, 78.3%), calcium channel blockers (41.0%, 41.2%) and statins (44.7%, 50.3%) were commonly used. Spironolactone, digoxin, hydralazine plus isosorbide dinitrate (HISDN), isosorbide dinitrate alone and aldosterone receptor antagonists were used by <20%. For each medication, prescriptions were more common at discharge than admission. Many participants did not have Medicare claims for filled prescriptions in the year following discharge. A higher percentage of patients with versus without CKD, CHD, and diabetes had discharge prescriptions statins. Participants with CKD were also more likely to receive prescriptions for HISDN.ConclusionBeta-blockers and diuretics were commonly prescribed at admission and discharge among HFpEF, but pharmacy claims for these medications within one-year were substantially less common. The comorbidities CHD, CKD, and diabetes were associated with prescriptions of statins at discharge.
IFT88 controls NuMA enrichment at k-fibers minus-ends to facilitate their reincorporation into mitotic spindles
Authors: Taulet Nicolas , Douanier Audrey , Vitre Benjamin , Anguille Christelle , Maurin Justine , Dromard Yann , Georget Virginie , Delaval Benedicte 
Published: January 2019

ABSTRACTTo build and maintain mitotic spindle architecture, molecular motors exert spatially regulated forces on microtubules (MT) minus-ends. This spatial regulation is required to allow proper chromosomes alignment through the organization of kinetochore fibers (k-fibers). NuMA was recently shown to target dynactin to MT minus-ends and thus to spatially regulate dynein activity. However, given that k-fibers are embedded in the spindle, our understanding of the machinery involved in the targeting of proteins to their minus-ends remains limited. Intraflagellar transport (IFT) proteins were primarily studied for their ciliary roles but they also emerged as key regulators of cell division. Taking advantage of MT laser ablation, we show here that IFT88 concentrates at k-fibers minus-ends and is required for their re-anchoring into spindles by controlling NuMA accumulation. Indeed, IFT88 interacts with NuMA and is required for its enrichment at newly generated k-fibers minus-ends. Combining nocodazole washout experiments and IFT88 depletion, we further show that IFT88 is required for the reorganization of k-fibers into spindles and thus for efficient chromosomes alignment in mitosis. Overall, we propose that IFT88 could serve as a mitotic MT minus-end adaptor to concentrate NuMA at minus-ends thus facilitating k-fibers incorporation into the main spindle.
Genetic dissection of femoral and tibial microarchitecture
Authors: Lu Lu , Huang Jinsong , Xu Fuyi , Xiao Zhousheng , Wang Jing , Zhang Bing , David Nicolae Valentin , Arends Danny , Gu Weikuan , Ackert-Bicknell Cheryl , Sabik Olivia L. , Farber Charles R. , Quarles Leigh Darryl , Williams Robert W. 
Published: January 2019

AbstractOur understanding of the genetic control of bone has relied almost exclusively on estimates of bone mineral density. In contrast, here we have used high-resolution x-ray tomography (8 μm isotropic voxels) to measure femoral and tibial components across a set of ~600 mice belonging to 60 diverse BXD strains of mice. We computed heritabilities of 25 cortical and trabecular compartments. Males and females have well matched trait heritabilities, ranging from 0.25 to 0.75. We mapped 16 QTLs that collectively cover ~8% of all protein-coding genes in mouse. A majority of loci are detected only in females, and there is also a bias in favor of QTLs for cortical traits. To efficiently evaluate candidate genes we developed a method that couples gene ontologies with expression data to compute bone-enrichment scores for almost all protein-coding genes. We carefully collated and aligned murine candidates with recent human BMD genome-wide association results. We highlight a subset of 50 strong candidates that fall into three categories: 1. those linked to bone function that have already been experimentally validated (Adamts4, Ddr2, Darc, Adam12, Fkbp10, E2f6, Adam17, Grem2, Ifi204); 2. candidates with putative bone function but not yet tested (e.g.,Greb1, Ifi202b) but several of which have been linked to phenotypes in humans; and 3. candidates that have high bone-enrichment scores but for which there is not yet any specific link to bone biology or skeletal disease, includingIfi202b, Ly9, Ifi205, Mgmt, F2rl1, Iqgap2. Our results highlight contrasting genetic architecture between the sexes and among major bone compartments. The joint use and alignment of murine and human data should greatly facilitate function analysis and preclinical testing.DisclosureThe authors declare that no competing interests exist.
The Trouble Interpreting fMRI Studies in Populations with Cerebrovascular Risk: The Use of a Subject-Specific Hemodynamic Response Function in a Study of Age, Vascular Risk, and Memory
Authors: McDonough Ian M. , Bender Andrew , Patihis Lawrence , Stinson Elizabeth A. , Letang Sarah K. , Miller William S. 
Published: January 2019

AbstractFunctional magnetic resonance imaging (fMRI) is commonly used to investigate the neural bases of behavior ranging from basic cognitive mechanisms to aging to psychological disorders. However, the BOLD signal captured by fMRI is an indirect measure of neural function and is affected by many factors that are non-neural in origin. These non-neural factors, however, do affect brain vasculature such as the shape and timing of the hemodynamic response function (HRF) during task-evoked fMRI that, in turn, can cause inappropriate and/or misleading interpretations of fMRI differences between groups. In this study, we tested the proposition that vascular health risks, which often go unmeasured in neuroimaging studies, and aging interact to modify the shape and/or timing of the HRF (height, time-to-peak, width), which then affect the differences in patterns of brain activity in a task-evoked memory encoding paradigm. Adult participants (aged 20–74) answered questions about their health history and underwent two fMRI tasks: viewing of a flashing checkerboard using a slow event-related design and a paired associates memory encoding task during a fast event-related design. We found that aging and vascular risk had the largest impacts on the maximum peak value of the HRF. Using a subject-specific HRF resulted in an overall dampening of the estimated brain activity in both task-positive and task-negative regions due to a reduction in the inter-individual variance of that activity. Across three vascular risk factors, using a subject-specific HRF resulted in more consistent brain regions that reached significance and larger effect sizes compared with the canonical HRF. A slight advantage in the reliability of brain-behavior correlations also was found. The findings from this study have far reaching consequences for the interpretation of task-evoked fMRI activity, especially in populations known to experience alterations to brain vasculature including adults of all ages that have higher vascular risk, the majority of older adults, and people with neurocognitive disorders in which vasculature differences may play a role including dementia.HighlightsOlder age was associated with smaller maximum peak of the hemodynamic response.Younger and middle-aged adults with more vascular risk had higher HRF peaks.Using a subject-specific HRF resulted in a “dampening” of brain activity.A subject-specific HRF resulted in more consistent aging and vascular risk effects.
Adolescent forced swim stress increases social anxiety-like behaviors and alters the dynorphin/kappa opioid receptor system in the basolateral amygdala of males
Authors: Varlinskaya E.I. , Johnson J.M. , Deak T. , Diaz M.R. 
Published: January 2019

AbstractAdolescence is a developmental period marked by robust neural alterations and heightened vulnerability to stress, a factor that is highly associated with increased risk for emotional processing deficits, such as anxiety. Stress-induced upregulation of the dynorphin/kappa opioid receptor (DYN/KOR) system is thought to, in part, underlie the negative affect associated with stress. The basolateral amygdala (BLA) is a key structure involved in anxiety, and neuromodulatory systems, such as the DYN/KOR system, can 1) regulate BLA neural activity in an age-dependent manner in stress-naïve animals and 2) underlie stress-induced anxiety in adults. However, the role of the DYN/KOR system in modulating stress-induced anxiety in adolescents is unknown. To test this, we examined the impact of an acute, 2-day forced swim stress (FSS – 10 min each day) on adolescent (~postnatal day (P) 35) and adult Sprague-Dawley rats (~P70), followed by behavioral, molecular and electrophysiological assessment 24 hours following FSS. Adolescent males, but not adult males or females of either age, demonstrated social anxiety-like behavioral alterations indexed via significantly reduced social investigation and preference when tested 24 hours following FSS. Conversely, adult males exhibited increased social preference. While there were no FSS-induced changes in expression of genes related to the DYN/KOR system in the BLA, these behavioral alterations were associated with a robust switch in BLA KOR function. Specifically, while the KOR agonist, U69593, significantly increased GABA transmission in the BLA of non-stressed adolescent males, U69593 significantly inhibited BLA GABA transmission in stressed adolescent males, consistent with the observed anxiogenic phenotype in stressed adolescent males. This is the first study to demonstrate a KOR-dependent mechanism that may contribute to stress-induced social anxiety in adolescent males. Importantly, these findings provide evidence for potential KOR-dependent mechanisms that may contribute to pathophysiological interactions with subsequent stress challenges.
Apollo: Democratizing genome annotation
Authors: Dunn Nathan , Unni Deepak , Diesh Colin , Munoz-Torres Monica , Harris Nomi L. , Yao Eric , Rasche Helena , Holmes Ian H. , Elsik Christine G. , Lewis Suzanna E. 
Published: January 2019

AbstractGenome annotation is the process of identifying the location and function of a genome’s encoded features. Improving the biological accuracy of annotation is a complex and iterative process requiring researchers to review and incorporate multiple sources of information such as transcriptome alignments, predictive models based on sequence profiles, and comparisons to features found in related organisms. Because rapidly decreasing costs are enabling an ever-growing number of scientists to incorporate sequencing as a routine laboratory technique, there is widespread demand for tools that can assist in the deliberative analytical review of genomic information. To this end, Apollo is an open source software package that enables researchers to efficiently inspect and refine the precise structure and role of genomic features in a graphical browser-based platform.In this paper we first outline some of Apollo’s newer user interface features, which were driven by the needs of this expanding genomics community. These include support for real-time collaboration, allowing distributed users to simultaneously edit the same encoded features while also instantly seeing the updates made by other researchers on the same region in a manner similar to Google Docs. Its technical architecture enables Apollo to be integrated into multiple existing genomic analysis pipelines and heterogeneous laboratory workflow platforms. Finally, we consider the implications that Apollo and related applications may have on how the results of genome research are published and made accessible.
Source: https://github.com/GMOD/ApolloLicense (BSD-3): https://github.com/GMOD/Apollo/blob/master/LICENSE.mdDocker: https://hub.docker.com/r/gmod/apollo/tags/, https://github.com/GMOD/docker-apolloRequirements: JDK 1.8, Node v6.0+User guide: http://genomearchitect.org; technical guide: http://genomearchitect.readthedocs.io/en/latest/Mailing list: apollo@lists.lbl.gov