bluuebunny/crossref_metadata_2025_split huggingface dataset:
The intentions of Israeli nurses attending university programs to receive seasonal influenza vaccination
Authors: Lipovetski Olga , Delbar Vered , Bar-Yosef Eileen , Riesenberg Klaris , Saidel-Odes Lisa , Livshiz–Riven Ilana 
Published: May 2018

Background: Seasonal influenza vaccination (SIV) among medical personnel is a key factor in preventive medicine and patient safety. Objective: To identify social-cognitive predictors of Israeli Registered Nurses’ (RNs) intentions to receive SIV utilizing the Theory of Planned Behaviour (TPB) model, and to assess its predictive validity. Methods: A cross-sectional study was conducted. A structured, self-reported, anonymous, 43-item questionnaire, based on an extended version of the TPB, was administered to 80 nurses attending Master’s or Bachelor in Nursing degrees curriculums. A multivariable regression analysis was used to determine independent predictors of influenza vaccination compliance among nurses. Results: A multivariable regression analysis indicated that two TPB model variables: control beliefs (β = 0.277, P < 0.01) and attitudes regarding SIV (β = 0.441, P < 0.001) contributed significantly to the prediction of RNs’ SIV intentions. Conclusions: The results of the current study indicate that the TPB may partially explain the intentions of RNs to receive SIV and illustrates the importance of beliefs and attitudes to health-related behaviours. It may direct us to seek interventions focusing on strengthening beliefs and attitudes to achieve higher intention levels to get vaccinated and thus affect the desired behaviours.
A study of antibiotic prescription pattern in patients referred to tertiary care center in Northern India
Authors: Kaur Amritpal , Bhagat Rajan , Kaur Navjot , Shafiq Nusrat , Gautam Vikas , Malhotra Samir , Suri Vikas , Bhalla Ashish 
Published: May 2018

Background: Tremendous infectious disease burden and rapid emergence of multidrug resistant pathogens continues to burden our healthcare system. Antibiotic stewardship program often implements antibiotic policies that help in preventing unnecessary use of antibiotics and in optimizing management. To develop such a policy for management of infections in the emergency unit, it is important to analyze the information regarding antibiotic prescription patterns in patients presenting to the emergency room referred from various healthcare settings. This study was conducted with the aforementioned background. Methods: We conducted a prospective observational study in triage area of emergency unit of a tertiary care hospital. All the referred patients were screened for antibiotic prescription. Data extraction form was used to capture information on patient demographics, diagnosis and antibiotics prescribed. Antibiotic prescription details with regard to dosage, duration and frequency of antimicrobial administration were also recorded. Data were summarized using descriptive statistics as appropriate. Results: Out of 517 screened patients, 300 were prescribed antimicrobials. Out of 29 antibiotics prescribed, 12 were prescribed in more than 90% of patients. Broad spectrum antibiotics accounted for 67.3% of prescriptions. In 129 out of 300 patients, no evidence of infectious etiology was found. Conclusion: Our study highlights some common but serious lapses in antibiotic prescription patterns in patients referred from various healthcare settings. This emphasizes the need to provide training for rational use of antibiotics across healthcare settings.
Asthma-related health services and asthma control among women in Puerto Rico
Authors: Ortiz-Rivera María Calixta 
Published: May 2018

Objectives: This study evaluates social, behavioral, and environmental determinants to differentiate between active and inactive asthma and how predisposing, enabling, and need factors elucidate asthma-related health services and asthma control among women in Puerto Rico. Methods: This study analyzed secondary cross-sectional data from a subsample of 625 adult females who participated in the Asthma Call Back Survey in Puerto Rico. Logistic and multinomial regression analyses were conducted to examine associations between explanatory variables and asthma outcomes. Results: In total, 63% of women reported active asthma, from which 37.9% have not well controlled or very poorly controlled asthma. Women with active asthma were significantly more likely to be out of work, have middle income (US$25,000–<US$35,000), and be obese (≥30 kg/m2). Perceived need of health status is a good predictor to know the odds ratio of women to use emergency room. Women with poorly controlled asthma were significantly associated with increased units of physician urgent visits and emergency room visits. Conclusion: The findings confirmed significant determinants for active asthma and adds information on odds ratio for sensitive subgroups that utilize asthma-related health services in higher proportion than their counterparts. These associations suggest a development of asthma management plan targeting women to control the condition and reduce health-care utilization.
The Importance of Determining Trainee Perspectives on Procedural Competencies During Spine Surgery Clinical Fellowship
Authors: Bateman Antony H. , Larouche Jeremie , Goldstein Christina L. , Sciubba Daniel M. , Choma Theodore J. , Lawrence Brandon , Cheng Joseph , Fehlings Michael G. , Paquette Scott J. , Yee Albert J. M. 
Published: May 2018

Study Design: Longitudinal survey. Objective: It remains important to align competence-based objectives for training as deemed important by clinical fellows to those of their fellowship supervisors and program educators. The primary aim of this study was to determine trainee views on the relative importance of specific procedural training competencies. Secondarily, we aimed to evaluate self-perceived confidence in procedural performance at the commencement and completion of fellowship. Methods: Questionnaires were administered to 68 clinical fellows enrolled in the AOSNA fellowship program during the 2015-2016 academic year. A Likert-type scale was used to quantify trainee perspectives on the relative importance of specific procedural competencies to their training base on an established curriculum including 53 general and 22 focused/advanced procedural competencies. We measured trainee self-perceived confidence in performing procedures at the commencement and completion of their program. Statistical analysis was performed on fellow demographic data and procedural responses. Results: Our initial survey response rate was 82% (56/68) and 69% (47/68) for the follow-up survey. Although most procedural competencies were regarded of high importance, we did identify several procedures of high importance yet low confidence among fellows (ie, upper cervical, thoracic discectomy surgery), which highlights an educational opportunity. Overall procedural confidence increased from an average Likert score of 4.2 (SD = 1.3) on the initial survey to 5.4 (SD = 0.8) by follow-up survey ( P < .0001). Conclusions: Understanding trainee goals for clinical fellowship remains important. Identification of areas of low procedural confidence and high importance to training experience will better guide fellowship programs and supervisors in the strategic delivery of the educational experience.
Are bilateral idiopathic clubfeet more severe than unilateral feet? A severity and treatment analysis
Authors: Agarwal Anil , Agrawal Nargesh , Barik Sitanshu , Gupta Neeraj 
Published: May 2018

Introduction: Evidences suggest that different subgroups of idiopathic clubfoot exist with differences in severity and treatment outcomes. This study compares the severity and treatment outcomes of unilateral and bilateral clubfoot. Material and methods: We retrospectively studied 161 patients (bilateral 66, unilateral 95) with primary idiopathic clubfeet to evaluate the differences in severity and treatment. The parameters analyzed were precasting Pirani score, number of casts required, pretenotomy Pirani score, pretenotomy dorsiflexion, rate of tenotomy, and post-tenotomy dorsiflexion achieved. A Pirani score of at least 5 was classified as very severe and 4.5 or less was classified as less severe. Results: There were 49=(74.24%) male and 17 (25.75%) female patients in the bilateral group and 76 (80%) male and 19 (20%) female patients in the unilateral group. Out of 95 unilateral patients, 34 were left sided (35.8%). Comparing severity, the mean precasting Pirani score in bilateral patients (5.4 ± 0.6) was statistically more than the unilateral patients (4.9 ± 0.7). The number of casts required was significantly more in bilateral feet compared to unilateral (bilateral 5.3 ± 1.7, unilateral 4.7 ± 1.7; p < 0.011). Achilles tenotomy was required in all feet. Post Ponseti treatment, the foot deformity correction achieved (pretenotomy Pirani score, pretenotomy, and post-tenotomy dorsiflexion) was statistically similar in both unilateral and bilateral feet. Conclusions: Idiopathic bilateral clubfoot was more severe than unilateral foot at initial presentation and required more number of corrective casts. Post Ponseti treatment, the deformity correction in bilateral foot was similar to unilateral foot.
The estimation of bone cyst volume using the Cavalieri principle on computed tomography images
Authors: Say Ferhat , Gölpınar Murat , Kılınç Cem Yalın , Şahin Bünyamin 
Published: May 2018

Purpose: To evaluate the volume of bone cyst using the planimetry method of the Cavalieri principle. Methods: A retrospective analysis was carried out on data from 25 computed tomography (CT) images of patients with bone cyst. The volume of the cysts was calculated by two independent observers using the planimetry method. The procedures were repeated 1 month later by each observer. Results: The overall mean volume of the bone cyst was 29.25 ± 25.86 cm3. The mean bone cyst volumes calculated by the first observer for the first and second sessions were 29.18 ± 26.14 and 29.27 ± 26.19 cm3, respectively. The mean bone cyst volumes calculated by the second observer for the first and second sessions were 29.32 ± 26.36 and 29.23 ± 26.36 cm3, respectively. Statistical analysis showed no difference and high agreement between the first and second measurements of both observers. The Bland–Altman plots showed strong intraobserver and interobserver concordance in the measurement of the bone cyst volume. The mean total time necessary to obtain the cyst volume by the two observers was 5.27 ± 2.30 min. Conclusion: The bone cyst of the patients can be objectively evaluated using the planimetry method of the Cavalieri principle on CT. This method showed high interobserver and intraobserver agreement. This volume measurement can be used to evaluate cyst remodeling, including complete healing and cyst recurrence.
Analysis of the thrombotic and fibrinolytic activities of tumor cell–derived extracellular vesicles
Authors: Durrieu Ludovic , Bharadwaj Alamelu , Waisman David M. 
Published: May 2018

Key Points
Microvesicles, but not exosomes, from tumor cells have thrombotic activity. Tumor derived–exosomes can confer increased plasmin-generating capacity to a recipient cell.
An open-label, flexible dose adaptive study evaluating the efficacy of vortioxetine in subjects with panic disorder
Authors: Shah Anish , Northcutt Joanne 
Published: May 2018

AbstractBackgroundDespite the current treatments available for panic disorder (PD), as many as one-third of patients have persistent and treatment-resistant panic attacks. Vortioxetine is an approved medicine for major depressive disorder and has been shown to have anxiolytic properties. The purpose of this study was to evaluate its efficacy and safety in an adult population with a diagnosis of PD.MethodsThe study design was open label with flexible dose strategies (5, 10, or 20 mg) with a treatment period of 10 weeks. 27 male and female subjects aged between 18 and 60 years, who met DSM-IV criteria for PD with or without agoraphobia, or who had a Panic Disorder Severity Scale (PDSS) score > 8 at baseline were enrolled. Statistical significance was established by the Student’sTtest.ResultsA statistically significant decrease in the occurrence of panic attacks was measured with the PDSS with vortioxetine. In addition, a moderate improvement in the quality of life and no significant side effects were observed using the Quality-of-Life Scale and Monitoring of Side Effects Scale, respectively.ConclusionsThese results provide some support for the use of vortioxetine in the management of panic disorder.Trial registrationClinicalTrials.gov ID#: NCT02395510. Registered March 23, 2015,https://clinicaltrials.gov/ct2/show/NCT02395510
Schwann cell durotaxis can be guided by physiologically relevant stiffness gradients
Authors: Evans Elisabeth B. , Brady Samantha W. , Tripathi Anubhav , Hoffman-Kim Diane 
Published: May 2018

Abstract

Background
Successful nerve regeneration depends upon directed migration of morphologically specialized repair state Schwann cells across a nerve defect. Although several groups have studied directed migration of Schwann cells in response to chemical or topographic cues, the current understanding of how the mechanical environment influences migration remains largely understudied and incomplete. Therefore, the focus of this study was to evaluate Schwann cell migration and morphodynamics in the presence of stiffness gradients, which revealed that Schwann cells can follow extracellular gradients of increasing stiffness, in a form of directed migration termed durotaxis.

Methods
Polyacrylamide substrates were fabricated to mimic the range of stiffness found in peripheral nerve tissue. We assessed Schwann cell response to substrates that were either mechanically uniform or embedded with a shallow or steep stiffness gradient, respectively corresponding to the mechanical niche present during either the fluid phase or subsequent matrix phase of the peripheral nerve regeneration process. We examined cell migration (velocity and directionality) and morphology (elongation, spread area, nuclear aspect ratio, and cell process dynamics). We also characterized the surface morphology of Schwann cells by scanning electron microscopy.

Results
On laminin-coated polyacrylamide substrates embedded with either a shallow (∼0.04 kPa/mm) or steep (∼0.95 kPa/mm) stiffness gradient, Schwann cells displayed durotaxis, increasing both their speed and directionality along the gradient materials, fabricated with elastic moduli in the range found in peripheral nerve tissue. Uniquely and unlike cell behavior reported in other cell types, the durotactic response of Schwann cells was not dependent upon the slope of the gradient. When we examined whether durotaxis behavior was accompanied by a pro-regenerative Schwann cell phenotype, we observed altered cell morphology, including increases in spread area and the number, elongation, and branching of the cellular processes, on the steep but not the shallow gradient materials. This phenotype emerged within hours of the cells adhering to the materials and was sustained throughout the 24 hour duration of the experiment. Control experiments also showed that unlike most adherent cells, Schwann cells did not alter their morphology in response to uniform substrates of different stiffnesses.

Conclusion
This study is notable in its report of durotaxis of cells in response to a stiffness gradient slope, which is greater than an order of magnitude less than reported elsewhere in the literature, suggesting Schwann cells are highly sensitive detectors of mechanical heterogeneity. Altogether, this work identifies durotaxis as a new migratory modality in Schwann cells, and further shows that the presence of a steep stiffness gradient can support a pro-regenerative cell morphology.
Size and clustering of ethnic groups and rates of psychiatric admission in England
Authors: Venkatesan Gayathri , Weich Scott , McBride Orla , Twigg Liz , Parsons Helen , Scott Jan , Bhui Kamaldeep , Keown Patrick 
Published: May 2018

Aims and methodTo compare rates of admission for different types of severe mental illness between ethnic groups, and to test the hypothesis that larger and more clustered ethnic groups will have lower admission rates. This was a descriptive study of routinely collected data from the National Health Service in England.ResultsThere was an eightfold difference in admission rates between ethnic groups for schizophreniform and mania admissions, and a fivefold variation in depression admissions. On average, Black and minority ethnic (BME) groups had higher rates of admission for schizophreniform and mania admissions but not for depression. This increased rate was greatest in the teenage years and early adulthood. Larger ethnic group size was associated with lower admission rates. However, greater clustering was associated with higher admission rates.Clinical implicationsOur findings support the hypothesis that larger ethnic groups have lower rates of admission. This was a between-group comparison rather than within each group. Our findings do not support the hypothesis that more clustered groups have lower rates of admission. In fact, they suggest the opposite: groups with low clustering had lower admission rates. The BME population in the UK is increasing in size and becoming less clustered. Our results suggest that both of these factors should ameliorate the overrepresentation of BME groups among psychiatric in-patients. However, this overrepresentation continues, and our results suggest a possible explanation, namely, changes in the delivery of mental health services, particularly the marked reduction in admissions for depression.Declaration of interestNone.
Computerized Approach to Creating a Systematic Ontology of Hematology/Oncology Regimens
Authors: Malty Andrew M. , Jain Sandeep K. , Yang Peter C. , Harvey Krysten , Warner Jeremy L. 
Published: May 2018

Purpose The systemic treatment of cancer is primarily through the administration of complex chemotherapy protocols. To date, this knowledge has not been systematized, because of the lack of a consistent nomenclature and the variation in which regimens are documented. For example, recording of treatment events in electronic health record notes is often through shorthand and acronyms, limiting secondary use. A standardized hierarchic ontology of cancer treatments, mapped to standard nomenclatures, would be valuable to a variety of end users. Methods We leveraged the knowledge contained in a large wiki of hematology/oncology drugs and treatment regimens, HemOnc.org. Through algorithmic parsing, we created a hierarchic ontology of treatment concepts in the World Wide Web Consortium Web Ontology Language. We also mapped drug names to RxNorm codes and created optional filters to restrict the ontology by disease and/or drug class. Results As of December 2017, the main ontology includes 30,526 axioms (eg, doxorubicin is an anthracycline), 1,196 classes (eg, regimens used in the neoadjuvant treatment of human epidermal growth factor receptor 2–positive breast cancer, nitrogen mustards), and 1,728 individual entities. More than 13,000 of the axioms are annotations including RxNorm codes, drug synonyms, literature references, and direct links to published articles. Conclusion This approach represents, to our knowledge, the largest effort to date to systematically categorize and relate hematology/oncology drugs and regimens. The ontology can be used to reason individual components from regimens mentioned in electronic health records (eg, R-CHOP maps to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and also to probabilistically reconstruct regimens from individual drug components. These capabilities may be particularly valuable in the implementation of rapid-learning health systems on the basis of real-world evidence. The derived Web Ontology Language ontology is freely available for noncommercial use through the Creative Commons 4.0 Attribution-NonCommercial-ShareAlike license.
Outcome of Patients With Breast Cancer Treated in a Private Health Care Institution in Brazil
Authors: Boukai Alexandre , Gonçalves Aline C. , Padoan Monica , Andrade Perla , Carvalho Natalia , Lemos Flavio , Almeida Thamires , Salem Jonas , Gauí Maria F. D. , Teich Nelson , Araujo Luiz H. 
Published: May 2018

Purpose Middle-income countries like Brazil often have a dichotomous health care system in which patients may be treated in either public or private institutions that differ substantially in terms of level of access to diagnostic and therapeutic procedures. Patients and Methods This was a prospective, observational study to assess real-world data in 1,230 female patients with breast cancer who were treated in a private health care institution between 2012 and 2016 in Brazil. Results Breast cancer in these patients mostly was diagnosed at early (79.0% stages I or II) or locally advanced (16.1% stage III) stages. The primary tumor was resected in 89.0% of cases, most often through breast-conserving surgery (55.1%). Patients with locally advanced disease received more aggressive therapy (eg, higher rates of mastectomy, axillary dissection and chemotherapy use) than patients with early-stage disease. The estimated 2-year overall survival (OS) was 95.3%. Survival was significantly longer among patients with stage I or II disease (2-year OS, 97.9% and 97.5%, respectively) than those with stage III or IV disease (89.4% and 69.5%, respectively; P < .01). Tumor grade was also correlated with OS in the overall cohort ( P = .05); triple-negative status was only prognostic for patients with stage III disease ( P < .01). Conclusion The data provided aid understanding of the current scenario of breast cancer presentation and treatment in the Brazilian private health care system and may serve as a foundation to guide resource allocation. Our results reinforce the need to pursue adequate access to cancer care in low- and middle-income countries to optimize patient outcome.
Delivering Precision Oncology in a Community Cancer Program: Results From a Prospective Observational Study
Authors: Powell Steven F. , Dib Elie G. , Bleeker Jonathan S. , Keppen Michael D. , Mazurczak Miroslaw , Hack Keely M. , Gitau Mark M. , Steen Preston D. , Terstriep Shelby A. , Reynolds John , Landsverk Megan L. , Chan Chun-Hung , Nelson Morgan E. , Thompson Paul A. , Ellison Christie , Black Lora J. , Ford James M. , Chung Jon H. , Anhorn Rachel , Gaba Anu G. 
Published: May 2018

Introduction Precision oncology (PO) is a growing treatment approach in the era of next-generation sequencing (NGS) and matched therapies. Effective delivery of PO in the community has not been extensively studied. Our program developed a virtual molecular tumor board (MTB) strategy to help guide PO care. Materials and Methods Over 18 months, eligible adult patients with advanced, incurable solid tumor malignancies were enrolled in a molecular profiling (MP) study using the Foundation Medicine NGS panel. Results were reviewed through a weekly, videoconferenced MTB conducted across our largely rural integrated health system. Recommendations from the MTB were used to identify actionable alterations (AAs). Feasibility of PO care delivery was assessed as the primary outcome. Secondary outcomes included the frequency of AAs, genomic matched treatments, genomic matched clinical trial enrollment, and clinical outcomes. Results A total of 120 participants with a variety of advanced tumor types were enrolled. Of these, 109 (90.8%) had successful MP. Treatment on the basis of an AA was recommended by the MTB in 58% of patients (63 of 109) who had a successful MP result. For those completing MP, treatments included enrollment in a genomic matched clinical trial (n = 16; 14.6%) and genomic matched treatment with a Food and Drug Administration–approved agent (n = 23; 21.1%). Response and survival data were similar regardless of the matched treatment option chosen. Conclusion A video-conferenced MTB-facilitated NGS testing and treatment delivery system was implemented in our integrated community oncology program. Continued use of this model aims to increase understanding of the impact of PO in this setting.