bluuebunny/crossref_metadata_2025_split huggingface dataset:
Change in Second-Trimester Abortion After Implementation of a Restrictive State Law
Authors: White Kari , Baum Sarah E. , Hopkins Kristine , Potter Joseph E. , Grossman Daniel 
Published: March 2019

OBJECTIVE:
To assess whether indicators of limited access to services explained changes in rates of second-trimester abortion after implementation of a restrictive abortion law in Texas.

METHODS:
We used cross-sectional vital statistics data on abortions performed in Texas before (November 1, 2011–October 31, 2012) and after (November 1, 2013–October 31, 2014) implementation of Texas' abortion law. We conducted monthly mystery client calls for information about abortion facility closures and appointment wait times to calculate distance from women's county of residence to the nearest open Texas facility, the number of open abortion facilities in women's region of residence (facility network size), and days until the next consultation visit. We estimated mixed-effects logistic regression models to assess the association between obtaining abortion care after the law's implementation and having a second-trimester abortion (12 weeks of gestation or more), after adjustment for distance, network size, and wait times.

RESULTS:
Overall, 64,902 Texas-resident abortions occurred in the period before the law was introduced and 53,174 occurred after its implementation. After implementation, 14.5% of abortions were performed at 12 weeks of gestation or more, compared with 10.5% before the law (P<.001; unadjusted odds ratio [OR] 1.45; 95% CI 1.40–1.50). Adjusting for distance to the nearest facility and facility network size reduced the odds of having a second-trimester abortion after implementation (OR 1.17; 95% CI 1.10–1.25). Women living 50–99 miles from the nearest facility (vs less than 10 miles) had higher odds of second-trimester abortion (OR 1.24; 95% CI 1.11–1.39), as did women in regions with less than one facility per 250,000 reproductive-aged women compared with women in areas that had 1.5 or more facilities (OR 1.57; 95% CI 1.41–1.75). After implementation, women waited 1 to 14 days for a consultation visit; longer waits were associated with higher odds of second-trimester abortion.

CONCLUSION:
Increases in second-trimester abortion after the law's implementation were due to women having more limited access to abortion services.
An Alternate Approach to Using Candy Cane Stirrups in Vaginal Surgery
Authors: Sze Eddie H. M. 
Published: March 2019

BACKGROUND:
Candy cane stirrups are widely used for vaginal surgery because they provide sufficient operating space. When placed in the standard perpendicular alignment, however, these stirrups cause excessive flexion, abduction, and external rotation of the thigh, which may injure the femoral, lateral femoral cutaneous, sciatic, and common peroneal nerves.

TECHNIQUE:
We corrected this deficiency by positioning the stirrups parallel to the operating table, just above and tilting slightly toward its lower break. After placing the patient in stirrups, we inserted a double-layer foam pad between her knee and the stirrup and adjusted the height of each stirrup until both thighs were flexed 90 degrees and both knees flexed 100 degrees. We then pushed the L-shaped lower stirrup toward or pulled it away from the operating table until each thigh was vertical, with minimal abduction or adduction. Finally, we rotated the curved upper stirrups medially until each leg was pointing slightly laterally.

EXPERIENCE:
Of 1,576 vaginal cases, there were eight (0.5%) instances of postoperative sensory neuropathy, which usually involved the lateral femoral cutaneous nerve.

CONCLUSION:
This simple modification to the candy cane stirrups allows placement of patients in dorsal lithotomy with their legs in an anatomically and neurologically neutral position.
Locally Applied Simvastatin as an Adjunct to Promote Spinal Fusion in Rats
Authors: Iyer Sravisht , Donnelly Patrick E. , Spaniel George , Young Kelsey , Oh Kevin , Cunningham Matthew E. 
Published: March 2019

Study Design.
Basic Science.

Objective.
To determine if locally delivered simvastatin can enhance bone formation in a rat spinal fusion model.

Summary of Background Data.
The bone-anabolic properties of statins in fracture healing are well established, however, few studies have evaluated the impact of locally delivered statins in spinal fusion.

Methods.
We formulated poly(lactic-co-glycolic acid) (PLGA) nanoparticles by adapting previously published techniques. Two types of nanoparticles were created: simvastatin nanoparticles (SimNP) and nanoparticles without simvastatin (BlankNP). Drug elution from SimNP was characterized. Osteoblastic differentiation was analyzed using MC3T3-E1 cells cultured in differentiation medium containing SimNP or BlankNP. Forty male 12 week old outbred Wistar rats underwent uninstrumented posterolateral fusion using iliac crest bone graft and BlankNP, SimNP or simvastatin drug. X-rays to assess bone formation were obtained at 4 weeks and 9 weeks post-operatively. Spines were explanted at 9 weeks for micro-CT analysis, and a blinded manual assessment of fusion (MAF).

Results.
SimNP achieved a release efficiency of 74.1% with ∼50% release occurring in the first day. Simvastatin and SimNP treated cells showed significantly greater expression of osteopontin (OPN) and osteocalcin (OCN). On micro-CT analysis, SimNP animals had higher bone volume and percent bone volume (bone volume/total volume) than control animals. SimNP rats had higher X-ray scores at 4 weeks (p=0.010) and 9 weeks (p<0.001) relative to BlankNP. MAF showed that SimNP had a higher fusion rate than BlankNP (42.9% vs. 0%, p=0.006).

Conclusion.
We were able to validate that sustained release of simvastatin via a PLGA nanoparticle. SimNP was able to induce an increase in mineralization as well as an increase in markers of bone formation. X-ray analysis, micro-CT quantification, and MAF assessment of SimNP treated rats showed significantly greater bone formation and fusion mass strength relative to vehicle treated animals. Simvastatin may be a safe, cost-effective bone anabolic agent for use in spinal fusion.

Level of Evidence.
N/A
Pregnancy history and cognitive aging among older women: the Rancho Bernardo Study
Authors: Ilango Sindana D. , McEvoy Linda K. , Laughlin Gail A. , Bergstrom Jaclyn , Barrett-Connor Elizabeth , Kritz-Silverstein Donna 
Published: March 2019

Abstract

Objective:
The aim of the study was to examine the association of pregnancy history with trajectories of cognitive function in older women.

Methods:
Participants were 1,025 women (mean age = 73.1 ± 9.6 y) enrolled in the Rancho Bernardo Study who attended a clinic visit between 1988 and 1992, when pregnancy history (ever pregnant, number of pregnancies, ages at first and last pregnancy) was recorded and cognitive function was assessed with a battery of four tests repeated up to 7 times through 2016. Linear mixed-effects regression models were used to examine the association between pregnancy history and longitudinal change in cognitive function.

Results:
Overall, 77% of women had at least one pregnancy; number of pregnancies ranged from 1 to 14 (mean = 2.9 ± 1.7). Ages at first and last pregnancy ranged from 16 to 44 years (mean = 24.9 ± 4.7) and 16 to 49 years (mean = 30.7 ± 5.5), respectively. Of 16 associations tested (4 pregnancy exposures by 4 cognitive tests), one was statistically significant without correction for multiple comparisons. Women who reported ever being pregnant recalled 0.12 fewer words on the Buschke Selective Reminding Test for every year increase in age than women who had never been pregnant (P = 0.05). No other significant associations of pregnancy history with cognitive decline were observed.

Conclusions:
Our results show no clinically meaningful long-term influence of pregnancy history on age-related change in cognitive function. These reassuring findings suggest childbearing decisions and timing will not affect cognitive function in older age.
Safety and feasibility of estrogen receptor-β targeted phytoSERM formulation for menopausal symptoms: phase 1b/2a randomized clinical trial
Authors: Schneider Lon S. , Hernandez Gerson , Zhao Liqin , Franke Adrian A. , Chen Yu-Ling , Pawluczyk Sonia , Mack Wendy J. , Brinton Roberta D. 
Published: March 2019

Abstract

Objective:
PhytoSERM is a formulation of genistein, daidzein, and S-equol that has an 83-fold selective affinity for estrogen receptor-β (ERβ); and may enhance neuron function and estrogenic mechanisms in the brain without having peripheral estrogenic activity.

Methods:
We conducted an overarching, two-stage, dose-ranging, double-blinded, randomized, placebo-controlled trial of 12 weeks duration comparing 50 and 100 mg/d of phytoSERM with placebo for noncognitively impaired, perimenopausal women aged 45 to 60, with intact uteri and ovaries, with at least one cognitive complaint, and one vasomotor-related symptom. Primary objectives were to assess safety and tolerability of a 50 and 100 mg daily dose; and, secondly, to evaluate potential indicators of efficacy on cognition and vasomotor symptoms over 4 and 12 weeks, and using an embedded, 4-week, 2-period, placebo-controlled crossover trial for a subset of participants.

Results:
Seventy-one women were randomized to treatment; 70 were evaluated at 4 weeks; 12 were entered into the crossover study; 5 did not complete 12 weeks. Reasons for discontinuation were withdrawal of consent (n = 1) and lost to follow-up (n = 4). Adverse events occurred in 16.7% (n = 4) placebo, 39.1% (n = 9) 50 mg/d, and 29.2% (n = 7) 100 mg/d treated participants; 85% were mild and none was severe. Vaginal bleeding occurred in 0, placebo; 1, 50 mg; and 3, 100 mg/d participants.

Conclusions:
The phytoSERM formulation was well tolerated at 50 and 100 mg daily doses. Based on safety outcomes, vaginal bleeding at the 100 mg dose, and vasomotor symptoms and cognitive outcomes at 12 weeks, a daily dose of 50 mg was considered preferable for a phase 2 efficacy trial.
RETINAL TELANGIECTASIA ASSOCIATED WITH OPTIC DISK PIT MACULOPATHY
Authors: Padidam Sneha , Burke Marie T. , Mishulin Aleksey , Akhter Mashal , Abrams Gary W. 
Published: March 2019

Purpose:
To report a case of optic pit maculopathy with retinoschisis-like edema with a rare finding of retinal telangiectasia.

Methods:
Retrospective case report.

Results:
A 22-year-old white man with a right optic pit presented with blurry vision and was found to have optic pit maculopathy with retinoschisis-like macular edema and retinal telangiectasia along the superior-temporal arcade. The patient underwent pars plana vitrectomy with separation of posterior vitreous and inner retinal fenestration. Upon follow-up, retinal telangiectasia was resolved and retinoschisis-like edema was mostly resolved 2 years after surgery.

Conclusion:
Retinal telangiectasia seen in optic disk maculopathy may be secondary to ischemia induced by the intense stretching of the superficial vascular plexus in the inner retina because of macular edema. In our patient, when traction was relieved following surgical intervention, there was remodeling of the superficial vascular plexus that allowed for resolution of the retinal telangiectasia.
Pain-related functional interference in patients with chronic neuropathic postsurgical pain: an analysis of registry data
Authors: Stamer Ulrike M. , Ehrler Michaela , Lehmann Thomas , Meissner Winfried , Fletcher Dominique 
Published: March 2019

Abstract
Although chronic postsurgical pain (CPSP) is a major health care problem, pain-related functional interference has rarely been investigated. Using the PAIN OUT registry, we evaluated patients' pain-related outcomes on the first postoperative day, and their pain-related interference with daily living (Brief Pain Inventory) and neuropathic symptoms (DN4: douleur neuropathique en 4 questions) at 6 months after surgery. Endpoints were pain interference total scores (PITS) and their association with pain and DN4 scores. Furthermore, possible risk factors associated with impaired function at M6 were analyzed by ordinal regression analysis with PITS groups (no to mild, moderate, and severe interference) as a dependent three-stage factor. Odds ratios with 95% confidence intervals were calculated. Of 2322 patients, 15.3% reported CPSP with an average pain score ≥3 (numeric rating scale 0-10). Risk for a higher PITS group increased by 190% (odds ratio [95% confidence interval]: 2.9 [2.7-3.2]; P < 0.001) in patients with CPSP, compared to without CPSP. A positive DN4 independently increased risk by 29% (1.3 [1.12-1.45]; P < 0.001). Preexisting chronic pain (3.6 [2.6-5.1]; P < 0.001), time spent in severe acute pain (2.9 [1.3-6.4]; P = 0.008), neurosurgical back surgery in males (3.6 [1.7-7.6]; P < 0.001), and orthopedic surgery in females (1.7 [1.0-3.0]; P = 0.036) were the variables with strongest association with PITS. Pain interference total scores might provide more precise information about patients' outcomes than pain scores only. Because neuropathic symptoms increase PITS, a suitable instrument for their routine assessment should be defined.
Evaluating the Effectiveness of Interventions on Increasing Participation in Cervical Cancer Screening
Authors: KURT Gonul , AKYUZ Aygul 
Published: March 2019

ABSTRACT

Background:
Although cervical cancer is highly preventable through regular screenings using Pap smear or human papillomavirus–deoxyribonucleic acid tests, cervical cancer remains a prevalent women's health issue across the world. Therefore, encouraging women to screen for cervical cancer is very important for the early detection of cervical cancer.

Purpose:
The purposes of this study were to (1) assess the effectiveness of three interventions that are typically used to increase the uptake of cervical cancer screening during home visits and (2) determine the participation rate in cervical cancer screenings after invitation, the health promotion perceptions, and the cervical cancer and screening-related knowledge of women. The three interventions noted in Purpose 1 were one-on-one training accompanied by an educational brochure, providing the educational brochure only, and giving an invitation without any relevant information.

Methods:
This interventional study was conducted on women who were between the ages of 30 and 65 years in three Turkish provinces (Ankara, Malatya, and Trabzon). Five hundred twenty home visits were made, and 356 women who did not have a Pap smear test within the previous year were invited for cervical cancer screening. Women were randomized into one of three intervention groups, and the participants in each group were invited to attend a national cervical cancer screening program and to undergo a cervical cancer screening using the related intervention type.

Results:
The results showed that the interventions used during home visits and knowledge were effective in encouraging women to participate in cervical cancer screening. It was determined that the participants who had received one-on-one training accompanied by an educational brochure had a higher cervical cancer screening rate than their peers who were offered a brochure only or a verbal invitation only.

Conclusions:
Invitations to screenings that are made by providing training accompanied with a brochure were found to be effective in increasing the participation of women in cervical cancer screening.
A Randomized Cross-over Trial Comparing a Pressure-free, Adhesive to a Conventional Bone Conduction Hearing Device
Authors: Dahm Valerie , Auinger Alice B. , Liepins Rudolfs , Baumgartner Wolf-Dieter , Riss Dominik , Arnoldner Christoph 
Published: March 2019

Objectives:
The main aim of this study was to compare the average daily wearing time of a conventional bone conduction device with a pressure-free, adhesive bone conduction device. Further, audiologic and quality-of-life outcome parameters were evaluated.

Methods:
An academic, prospective, randomized cross-over trial was performed at a single center.
Thirteen subjects between 12 and 63 years with conductive hearing loss were included.
Average daily wearing time and subjective observations were assessed in a diary. Sound field audiometry, Freiburg monosyllables word test, and Oldenburg sentence test in quiet and in noise were carried out after 2 weeks of habituation to each device. AQoL-8D and SSQ-12 questionnaires were completed at baseline and after a 2-week test interval.

Results:
Median wearing time of the devices was 8.1 hours (5.8–10.2 interquartile range) for the adhesive and 4.3 hours (2.7–7.1) for the conventional bone conduction device, the difference was statistically significant (p = 0.033). There were no statistically significant differences in sound field audiometry, Freiburg monosyllables word test, and Oldenburg sentence test when comparing the two devices. AQoL-8D and SSQ-12 showed a significant improvement with the devices in comparison with baseline, with no significant difference between devices in the total scores. Ten subjects reported pain using the conventional device, two subjects reported skin irritations using the adhesive device.

Conclusion:
For patients with mixed or conductive hearing loss, the adhesive device is a valuable alternative with a significantly longer daily wearing time.
A Meta-Analysis of the Associations Between the Nurse Work Environment in Hospitals and 4 Sets of Outcomes
Authors: Lake Eileen T. , Sanders Jordan , Duan Rui , Riman Kathryn A. , Schoenauer Kathryn M. , Chen Yong 
Published: March 2019

Background:
The nurse work environment is theorized to influence the quality of nursing care, nurse job outcomes, and patient outcomes.

Objective:
The aim of this meta-analysis was to evaluate quantitatively the association of the work environment with job and health outcomes.

Research Design:
Relevant studies published through September 2018 were identified. Inclusion criteria were use of a nationally endorsed work environment measure and reporting of odds ratios (ORs) and 95% confidence intervals from regression models of 4 outcome classes: nurse job outcomes, safety and quality ratings, patient outcomes, and patient satisfaction. Pooled ORs and confidence intervals were estimated for each outcome using fixed or random effects models.

Subjects:
Of 308 articles reviewed, 40 met inclusion criteria. After excluding 23 due to sample overlap or too few observations to meta-analyze, a set of 17 articles, comprising 21 independent samples, was analyzed. Cumulatively, these articles reported data from 2677 hospitals, 141 nursing units, 165,024 nurses, and 1,368,420 patients, in 22 countries.

Measures:
Practice Environment Scale of the Nursing Work Index, a National Quality Forum nursing care performance standard.

Results:
Consistent, significant associations between the work environment and all outcome classes were identified. Better work environments were associated with lower odds of negative nurse outcomes (average OR of 0.71), poor safety or quality ratings (average OR of 0.65), and negative patient outcomes (average OR of 0.93), but higher odds of patient satisfaction (OR of 1.16).

Conclusions:
The nurse work environment warrants attention to promote health care quality, safety, and patient and clinician well-being.
Senescent cells in the development of cardiometabolic disease
Authors: Postmus Andrea C. , Sturmlechner Ines , Jonker Johan W. , van Deursen Jan M. , van de Sluis Bart , Kruit Janine K. 
Published: March 2019

Purpose of review
Senescent cells have recently been identified as key players in the development of metabolic dysfunction. In this review, we will highlight recent developments in this field and discuss the concept of targeting these cells to prevent or treat cardiometabolic diseases.

Recent findings
Evidence is accumulating that cellular senescence contributes to adipose tissue dysfunction, presumably through induction of low-grade inflammation and inhibition of adipogenic differentiation leading to insulin resistance and dyslipidaemia. Senescent cells modulate their surroundings through their bioactive secretome and only a relatively small number of senescent cells is sufficient to cause persistent physical dysfunction even in young mice. Proof-of-principle studies showed that selective elimination of senescent cells can prevent or delay the development of cardiometabolic diseases in mice.

Summary
The metabolic consequences of senescent cell accumulation in various tissues are now unravelling and point to new therapeutic opportunities for the treatment of cardiometabolic diseases.
Barriers and Enablers to Implementing a High-Dependency Care Model in Pediatric Care
Authors: Cassidy Christine , MacEachern Lauren , Egar Jeanne , Best Shauna , Foley Laura , Rowe Mary Elizabeth , Curran Janet 
Published: March 2019

Background:
As the level of acuity of pediatric hospital admissions continues to increase, additional pressure is being placed on hospital resources and the nursing workforce.

Local Problem:
Currently, there is no formalized approach to care for high-acuity patients on our pediatric inpatient unit.

Methods:
We used a qualitative descriptive design, guided by the Theoretical Domains Framework and Capability, Opportunity, Motivation-Behaviour (COM-B) model, to conduct focus groups and interviews with clinicians and administrators to identify potential barriers and enablers to implementing a high-dependency care (HDC) model. An HDC model focuses on the relationship between adequate nursing staff resources and patient acuity to improve patient health outcomes.

Results:
Participants identified the need for clear guidelines and supportive physical structures to facilitate HDC implementation. Anticipated benefits included enhanced nursing confidence and family-centered care.

Conclusions:
Study findings highlight multilevel factors to consider prior to implementing an HDC model on a pediatric inpatient unit.
A Mobile Application to Collect Daily Data on Preexposure Prophylaxis Adherence and Sexual Behavior Among Men Who Have Sex With Men: Use Over Time and Comparability With Conventional Data Collection
Authors: Finkenflügel Renee N.N. , Hoornenborg Elske , Achterbergh Roel C.A. , Marra Elske , Davidovich Udi , de Vries Henry J.C. , Prins Maria , Schim van der Loeff Maarten F. 
Published: March 2019

Background
We studied the use of a mobile application (app) to measure human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) adherence and sexual behavior, assessed determinants of app use, and we compared data in app and questionnaires.

Methods
Men who have sex with men participating in the Amsterdam PrEP project (AMPrEP) on daily or event-driven PrEP at the Public Health Service of Amsterdam completed the data on sexual risk behavior and PrEP adherence through a standard questionnaire every 3 months and on a daily basis using the project's app. Regression analyses were used to assess factors associated with app use. Among those who reported 90% or greater of data in the app, the number of PrEP pills taken and number of unknown casual sex partners were compared between the app and the questionnaires by Wilcoxon signed-rank test.

Results
Of all participants (n = 374), 94% (352 of 374) reported data in the app at least once; 72% (261 of 362) reported data ≥90% of the days in the sixth month and 62% (222 of 359) in the 12th month following PrEP initiation.
Factors associated with reporting data in the app were using daily PrEP and recent initiation of PrEP. The reported numbers of pills taken and unknown sexual partners were comparable between app and questionnaires.

Conclusions
The AMPrEP app was used frequently, especially by those using a daily PrEP regimen. Data collected by app regarding adherence and sexual risk behavior were consistent with questionnaire data among those who used the app consistently. An app is a promising tool to measure PrEP adherence and sexual risk behavior.