bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of clinical productivity tracking via reporting of quality patient indicators
Authors: Stover Kayla R. , Ballou Jordan M. , Liles Anne M. , Fleming Laurie W. , Fleming Joshua W. , Riche Daniel M. , Pitcock James J. , King S. Travis , Capino Amanda C. 
Published: October 2018

IntroductionAs the role of pharmacists in providing direct patient care continues to expand, the need for and interest in a method for assessing and measuring clinical productivity is becoming more paramount. Unfortunately, there is no consensus on how, when, and which quality indicators or clinical productivity measures should be collected. The primary objective of this study was to assess the landscape of clinical productivity tracking across practice sites.MethodsA 13‐item Qualtrics questionnaire was administered through email lists from several national pharmacy organizations in the Spring of 2018. There were eight items related to quality indicators or clinical productivity measures. The information gathered included the type of indicator/measure collected, how it was collected, and perceived benefits and barriers. The remaining five items were basic demographic questions.ResultsA total of 349 participants responded, with 231 reporting that they currently track some type of patient quality indicator. Of these, 166 reported collecting a total of 903 indicators or measures using a variety of tracking systems. The most frequently reported measures collected were the number of patients seen and the type of recommendation or intervention made. The most cited reason for collecting these data was to demonstrate the impact to a practice site. The time required to collect data and the limitations of data collection systems were the two most frequently cited perceived barriers to collecting information.ConclusionsA majority of respondents are collecting some form of quality indicator or clinical productivity measure. However, there is extensive variety in the exact indicators or measures being collected and the tracking systems being utilized for their collection. Although implementation would be difficult, a more standardized approach to tracking clinical productivity may be beneficial.
Interventions associated with implementation of a pharmacist‐led neurology pharmacotherapy clinic in an ambulatory care setting
Authors: Martin Alison W. , Heberle Anna P. , Knight Joshua M. 
Published: October 2018

ObjectivesMedication management of neurologic disorders can present challenges in an ambulatory care setting. Clinical pharmacy specialists (CPSs) may be uniquely positioned to assist with the medication adjustments and monitoring that is often necessary for these conditions. While pharmacist‐led clinics are well established in some areas of ambulatory care, few examples have been described within neurology. This project aims to describe the interventions associated with a pharmacist‐led neurology clinic within a Veterans Affairs (VA) Medical Center.MethodsA pharmacist‐led neurology clinic was implemented to assist with medication management of various neurologic conditions and increase access to the neurology service. This retrospective chart review included patients referred to the CPS clinic during a 6‐month period, with a minimum follow‐up of 3 months. The number of medication changes, nonpharmacologic interventions, and adverse drug events (ADEs) managed by the CPS was determined. The number of interim pharmacist‐led visits was used as an estimate of neurology provider time saved.ResultsOne hundred sixty‐four patients were included in the analyses. During the 9‐month period assessed, patients had a total of 307 visits in the pharmacist‐led neurology clinic. Patients were referred for multiple neurologic conditions, with headache, neuropathy, Parkinson's disease, non‐Parkinson's tremor, and seizure disorders being the most common. The CPS made 175 dose adjustments, 139 medication additions or discontinuations, and 135 nonpharmacologic interventions. In addition, 41 ADEs were identified and/or managed during CPS encounters. Patients had an average of two visits with the CPS in between scheduled neurology clinic appointments; this allowed for an estimated 34 appointment slots/month to remain open in the neurology provider clinics.ConclusionsThe implementation of a pharmacist‐led neurology clinic allowed for CPS management of medications for multiple neurologic conditions, including the management of ADEs, and increased access to the neurology ambulatory care service at this VA facility.
Cost‐consequence analysis evaluating multifaceted clinical pharmacist intervention targeting patient transitions of care from hospital to primary care
Authors: Rasmussen Maja Kjær , Ravn‐Nielsen Lene Vestergaard , Duckert Marie‐Louise , Lund Mia Lolk , Henriksen Jolene Pilegaard , Nielsen Michelle Lyndgaard , Eriksen Christina Skovsende , Buck Thomas Croft , Hansen Morten Rix , Pottegård Anton , Hallas Jesper , Kidholm Kristian 
Published: October 2018

AimsDrug‐related problems are a common complication in the transition from hospital to primary care and are associated with morbidity and increased health care costs. In this study, we evaluated the cost and consequences of a comprehensive pharmaceutical intervention compared with usual care, comprised of a medication review and patient interview before discharge and follow‐up for polypharmacy patients.MethodsThis economic evaluation was embedded within a randomized clinical trial. Patients were randomized to either the basic intervention group (n = 493) which received a medication review, the extended intervention group (n = 476) which received a medication review, discharge interview, and follow‐up, or the control group (n = 498) which received standard care. Total health care costs were estimated over a period of 180 days at individual patient level from a health sector perspective.ResultsThe mean cost per patient was lower in the intervention groups (basic, €16 748; extended, €15 631) compared with the control group (€17 288), although these differences did not reach statistical significance. The costs of additional time used on medication reviews, patient interviews, and follow‐ups (€88) were outweighed by a decrease in costs of readmissions. The results of the clinical study favored the extended intervention group on clinical outcomes, with statistical significance on a composite of readmissions or emergency department visits within 180 days after inclusion (hazard ratio 0.77, 95% confidence interval 0.64‐0.93).ConclusionsThis comprehensive pharmaceutical intervention was not costly and positive effects were seen in the clinical outcomes, thereby reaching a decrease in total cost per patient on average. The results thus indicate that the intervention is cost‐effective and that the positive net effects can justify costs of the intervention.
Describing education management and perceptions in health‐system pharmacy: A survey of medical institutions
Authors: Tester Carson S. , Wolcott Michael D. 
Published: October 2018

PurposeTo describe current pharmacy education organizational structures and perceptions in medical institutions in order to inform education management practices and prompt greater discussion about strategies to optimize workforce development and patient care.MethodsTwo surveys were created and distributed to collect information from key personnel involved in educational management at medical institutions across the nation. The education management survey was distributed to residency program directors and requested participants to define their current organizational structure around and resources for education. The education perceptions survey was distributed to health‐system pharmacy personnel and requested participants to describe their perceptions and needs about current education programs and management strategies used in their respective institution.ResultsSixty participants from primarily large academic medical institutions (88%) completed the education management survey (37% response rate). Only 27 (45%) institutions were reported to have an individual responsible for education program oversight and 20 (33%) institutions have an education committee. Participants identified that a significant gap remains in resources available for preceptor development, technician continuing education, and conducting research in health‐system pharmacy. The education perceptions survey was completed by 107 participants from 31 institutions; most participants felt their institutional education structure was “above average” (33%) or “average” (45%).ConclusionThe findings from this study suggest education management in a sample of institutions is variable and in need of greater attention. Institutions are encouraged to commit to refining pharmacy education management models to support lifelong learning practices that are integral for organizational success and advancing the profession.
An asymmetrical dual coating on the stent prepared by ultrasonic atomization
Authors: Wang Jingjing , Ren Yuzhen , Huang Yuhua , Du Ruolin , Xi Yadong , Yin Tieying , Wang Yazhou , Zhang Dechuan , Chen Jinju , Wang Guixue 
Published: October 2018

AbstractThis study aims to design an asymmetric dual coating (ADC) on the stent by ultrasonic atomization to solve the problem of delayed endothelialization and late or very late stent thrombosis which caused by drug eluting stent (DES) with symmetric coating. Chitosan‐loaded monoclonal platelet glycoprotein IIIa receptor antibody SZ‐21 coating (CSC) was sprayed on inner surface of stents, and outer surface was sprayed CSC and poly(lactic‐co‐glycolic acid) (PLGA) loaded with docetaxel (DTX) coating (PDC). The coated surface was uniform without aggregation and no shedding phenomenon either before or after stent expanded. Fluorescence labeling has confirmed that the coating has an asymmetric structure. The cumulative release for SZ‐21 and DTX was 40.11% and 27.22% within first 24 h, then DTX became the major released drug from 24 h to 7 d, after released for 28 d about 40% of the SZ‐21 and 50% DTX still remained on the coated stent. It achieved that ADC can inhibit thrombosis at earlier period and inhibit vascular smooth muscle cells (VSMCs) proliferation at later period. And that ADC has good hemocompatibility and can significantly inhibit VSMCs proliferation. Finally, 4 and 12 weeks after the stent with ADC implanted into rabbit carotid arteries, it showed that the stent with ADC was safe and could effectively prevent thrombosis and in‐stent restenosis. © 2018 Wiley Periodicals, Inc. J. Biomed. Mater. Res. Part B, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 825–837, 2019.
Study on bone quality in the human mandible—Alignment of biological apatite crystallites
Authors: Furukawa Takehiro , Matsunaga Satoru , Morioka Toshiyuki , Nakano Takayoshi , Abe Shinichi , Yoshinari Masao , Yajima Yasutomo 
Published: October 2018

AbstractThe importance of considering bone quality during oral implant treatment is increasingly being recognized. Assessment of bone quality in response to changes in the jaw bone is extremely important when planning treatment. The present study analyzed biological apatite (BAp) crystallites, a bone quality factor, in order to investigate crystallographic anisotropy in dentate and edentulous human mandibles. Using mandibular samples from Japanese adult cadavers, a region of interest was established comprising cortical bone in the central incisors. Samples were classified into five morphological categories based on the extent of bone resorption. Bone mineral density (BMD) was measured and diffraction intensity ratios were calculated using a microbeam X‐ray diffraction system. While no differences were observed in BMD, differences were observed in BAp crystallite alignment between the measurement points. In the alveolar region, samples with residual alveolar bone showed strong alignment in the occlusal direction, while samples with marked alveolar bone resorption had preferential alignment in the mesiodistal direction. The present findings suggest that tooth loss and the extent of alveolar bone resorption affects bone quality in the mandible. © 2018 Wiley Periodicals, Inc. J. Biomed. Mater. Res. Part B: 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 838–846, 2019.
Large scale segmental bone defect healing through the combined delivery of VEGF and BMP‐2 from biofunctionalized cortical allografts
Authors: Sharmin Farzana , O'Sullivan Michael , Malinowski Seth , Lieberman Jay R. , Khan Yusuf 
Published: October 2018

AbstractLarge scale cortical allografts suffer from poor incorporation and healing and often end in graft failure 5–10 years after implantation. To reduce these failures we have developed a growth‐factor loaded cortical allograft capable of delivering one or two factors with a degree of temporal control and precision that permits the early release of one growth factor followed by the later and more sustained release of the other. We have loaded vascular endothelial growth factor (VEGF) and bone morphogenetic protein‐2 (BMP‐2), both critical components of bone formation and repair, onto cortical long bone allografts such that the VEGF is released first and followed shortly by BMP‐2. Coated and factor‐loaded allografts were placed into a critical sized rat femoral segmental defect and allowed to heal for either 4 or 8 weeks. Healing at each time point was compared to allografts loaded with only BMP‐2 and allografts containing no growth factors. Results indicate statistically significant increases in new bone formation from 4 to 8 weeks around allografts loaded with both VEGF and BMP‐2 over allografts with no growth factor, suggesting that factor‐loaded polymer‐coated allografts delivering multiple factors with temporal precision may provide a new off‐the‐shelf tool to the orthopedic surgeon for management of large‐scale orthopedic bone defects. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1002–1010, 2019.
In vitro remineralization of artificial enamel caries with resin composites containing calcium phosphate particles
Authors: Alania Yvette , Natale Livia C. , Nesadal Douglas , Vilela Handially , Magalhães Ana C. , Braga Roberto R. 
Published: October 2018

AbstractThe aim of the study was to evaluate the effect of experimental composites containing dicalcium phosphate dihydrate (DCPD) on remineralization of enamel lesions. Five resin‐based composites containing equal parts (in mols) of bisphenol‐A glycidyl dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), and 60 vol % of fillers were manipulated. Filler phase was constituted by silanized barium glass and 0, 10, or 20 vol % of DPCD particles, either functionalized (F) or nonfunctionalized (NF) with TEGDMA. Artificial subsurface lesions were produced in human enamel fragments and divided according to the resin composite applied on the lesion (no DCPD, 20% NF, 20% F, 10% NF, 10% F) plus a group without composite build‐up (nontreated, NT). Fragments were exposed to 16 days of pH cycling. Specimens were evaluated using transverse microradiography (TMR). Calcium and phosphate concentrations in pH‐cycling solutions were determined by spectrophotometry. TMR and ionic concentrations were analyzed using one‐way ANOVA/Tukey and Kruskal–Wallis/Dunn test, respectively (alpha: 0.05). All composite groups showed enamel remineralization (3%–23%). Higher mineral recovery in the middle (7%–11%) and bottom (2%–7%) thirds of the lesion was observed in groups with DCPD‐containing composites compared to the “no DCPD” group (middle: 1%, bottom: −3%). Lesion depth was significantly reduced in groups using DCPD‐containing composites compared to NT group. No noticeable increase in calcium and phosphate ions was observed in the pH‐cycling solutions due to the presence of DCPD in the composites. In conclusion, composites with DCPD fractions as low as 10%, regardless of functionalization, were able to promote mineral recovery and reduce lesion depth of enamel lesions. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1542–1550, 2019.
Evaluation of chemical and morphological changes in radicular dentin after different final surface treatments
Authors: Lopes Fabiane Carneiro , Roperto Renato , Akkus Anna , Silva Sousa Yara Teresinha Corrêa , Sousa‐Neto Manoel D. 
Published: October 2018

AbstractThe aim of this study was to evaluate the chemical and morphological effects of different lasers as a final surface treatment for endodontic therapy through energy dispersive X‐ray spectroscopy (EDS) and scanning electron microscopy (SEM) respectively. Twenty‐five maxillary canines were selected and instrumented with K3 system. Roots were randomly distributed into five groups (n = 5) according to the surface treatment: GI (distilled water), GII (NaOCl + EDTA), GIII (NaOCl + EDTA + 980 nm diode laser), GIV (NaOCl + EDTA+ 1,064 nm Nd:YAG laser), and GV (NaOCl + EDTA+ 2,780 nm Er, Cr:YSGG laser). Lasers were applied for 20 s and samples were bisected, exposing the treated surface and then subjected to elements quantification by EDS and morphological evaluation by scanning electron microscope (SEM). EDS data were submitted to ANOVA‐two way, and SEM scores were submitted to two‐way Kruskal–Wallis and Dunn's tests. The EDS analysis showed no difference for the chemical elements and Ca/P ratio between groups (p > .05). Statistical analysis showed more intense results for GV and less intense results for GI (p < .05). The GIII showed an amorphous organic matrix surface, while GV provided greater removal of intertubular dentin forming craters, and GIV promoted dentin fusion. The EDS method used in this study was not able to verify any chemical changes in root canal dentin; Nd:YAG, Er, Cr:YSGG, and 980 nm diode laser were capable of modifying the dentin morphology, correlating characteristics features for each one, which are essential clinical knowledge to establish the correct indication for each case.Research Highlights

EDS was not able to verify any chemical changes in root canal dentin after 980 nm diode, Nd:YAG and Er;Cr:YSGG laser treatments
Nd:YAG, Er, Cr:YSGG, and 980 nm diode laser modified dentin morphology, correlating characteristics features for each one.
Quantification of crystallinity using zero‐loss filtered electron diffraction
Authors: An Byeong‐Seon , Kwon Yena , Cha Hyun‐Woo , Kang Min‐Chul , Oh Jin‐Su , Yang Cheol‐Woong 
Published: October 2018

AbstractThe quantity of the crystalline phases present in a nanomaterial is an important parameter that governs the correlation between its properties and microstructure. However, quantification of crystallinity in nanoscale‐level applications by conventional methods (Raman spectroscopy and X‐ray diffraction) is difficult because of the spatial limitations of sampling. Therefore, we propose a technique that involves using energy‐filtered electron diffraction in transmission electron microscopy which offers improved spatial resolution. The degree of crystallinity (DOC) was calculated by separating the crystalline and amorphous intensities from the total intensity histogram acquired by the azimuthal averaging of the zero‐loss filtered signals from electron diffraction. In order to validate the method, it was demonstrated that the DOC calculated by zero‐loss filtered electron diffraction was consistent with the DOC measured by the area ratio using an amorphous silicon on crystalline silicon standard sample. In addition, the results obtained from zero‐loss filtered and conventional electron diffractions were compared. The zero‐loss filtered electron diffraction successfully provided the reliable results of the crystallinity quantification. In contrast, the DOC measured using conventional electron diffraction yielded extremely variable results. Therefore, our results provide a crystallinity quantification technique that can extract quantitative information about crystallinity of nanoscale devices by using zero‐loss filtered electron diffraction with better reliability than conventional electron diffraction.Research highlights
The degree of crystallinity can be measured by separating the crystalline and amorphous intensities from the total intensity histogram acquired by the azimuthal averaging of the zero‐loss filtered signals from selected area electron diffraction.
Enamel sample preparation for AFM: Influence on roughness and morphology
Authors: Sorozini Marianna , dos Reis Perez Cesar , Rocha Gustavo Miranda 
Published: October 2018

AbstractHuman dental enamel is organized by prisms that are structured between 3 and 6 µm in diameter. Determining the relationships between different treatments on the surface of enamel using ultrastructural analysis is the purpose of many in vitro experiments. Different sample pretreatments have been reported in the literature. Grinding and polishing are common procedures for enamel preparation. They provide a flat and standardized surface, which is imperative for the use of some techniques such as ATR‐FTIR. However, for morphological analysis, SEM and AFM represent easier methods to measure and reduce the biological sample variation. Therefore, the objective of this study was to establish how different forms of enamel preparation can influence the advent of artifacts during ultrastructural observation, especially by AFM analysis. Four groups (n = 10) were tested: (a) without preparation; (b) polishing with a diamond paste; (c) grinding with decreasing granulations of silicon carbide papers; (d) grinding with polishing. Images were obtained using the Peak‐Force Tapping mode. After the first images were obtained, all fragments were acid etched with 37% phosphoric acid for 30 seconds, rinsed for 60 seconds, and dried intensively. Upon grinding and polishing, the exposure of the inner enamel surfaces provided a less mineralized layer that was marked by scratches and a higher susceptibility to treatments. Moreover, using native enamel provided more valuable information on the surface and the roughness changes for clinical applications. In addition, phosphoric acid is an option for observing the prismatic arrangement after grinding and/or polishing changes the morphology.Research HighlightsThe use of native enamel samples to investigate the effects of different treatments on surface should be preferred in research, when the technique allows it.
Penetrability of a new endodontic sealer: A confocal laser scanning microscopy evaluation
Authors: Piai Gabriela Gonçalez , Duarte Marco Antônio Húngaro , Nascimento Angela Longo do , Rosa Ricardo Abreu da , Só Marcus Vinícius Reis , Vivan Rodrigo Ricci 
Published: October 2018

AbstractThis study aimed to evaluate the penetration of a new endodontic sealer into the dentinal tubules. Twenty single‐rooted teeth were selected. The crown was sectioned, and the canals were instrumented with a reciprocating system. Irrigation was performed with 2 mL of 2.5% sodium hypochlorite between each file change. After instrumentation, the root canals were irrigated with 2 mL of17% EDTA for 3 min followed by saline solution. The specimens were randomized into two groups (n =10) according to the endodontic sealer: AH Plus (AP) or Sealer Plus (SP). All specimens were filled using the lateral compaction technique. Rhodamine B dye (red) was incorporated to the sealers to provide the fluorescence which will enable confocal laser scanning microscopy (CLSM) assessment. The roots were sectioned 2, 4, and 6 mm from the apex and assessed by CLSM. The root canal level affected the penetration of the sealer, but no statistical significant differences were found between the two experimental groups (p > .05). SP presented similar dentinal penetration and perimeter integrity to the gold standard (AP).Research HighlightsSealer Plus presents dentinal penetrability and perimeter integrity similar to the gold standard sealer (AH Plus), demonstrating excellent ability of filling areas of difficult access.