bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation and evaluation of a team-based pharmacy practice model in a community health system
Authors: Gill Taylor K , Thornton Luciana M , Schroeder Todd R , Garrelts James C , Schminke Brandon C , Utz Kenneth J , Gerlach Charles T 
Published: March 2019

Abstract

Purpose
The development and implementation of a team-based pharmacy practice model is described.

Methods
In January 2016 a transition from a staff-specialist to a team-based pharmacy practice model was implemented. The overall goal of the model change was to enhance the pharmacist’s clinical roles and further integrate pharmacists into the healthcare team. Before implementation of the new staffing model, a formalized metric evaluation process was created. The aim of this metric evaluation was to gauge model success, determine areas of model revision, and objectively communicate pharmacist impact. Objective metrics were evaluated before implementation and 1 year after implementation. In addition, surveys were distributed to pharmacists, physicians, nursing and hospital administration before and after model implementation.

Results
At 1-year postimplementation, the pharmacist:patient bed ratio decreased from 1:87 to 1:47, the number of rounds/huddles with pharmacist attendance increased by 63% to 80 per week, and the number of clinical interventions and new clinical consultations increased from 57 to 62 and from 12 to 16 per day, respectively. Nonformulary medication use also decreased from 1.77 to 0.623 per 1000 patient days, and compliance with therapeutic initiatives increased from 77%to 91%. Overall, 72% of pharmacist survey responses indicated satisfaction with the model change.

Conclusion
A team-based pharmacy practice model was designed and successfully implemented over a 3-year period. Data analysis revealed improvements in clinical and operational endpoints and enhanced pharmacist, physician, and nursing satisfaction.
Pearson’s chi-squared statistics: approximation theory and beyond
Authors: Xu Mengyu , Zhang Danna , Wu Wei Biao 
Published: March 2019

Summary
We establish an approximation theory for Pearson’s chi-squared statistics in situations where the number of cells is large, by using a high-dimensional central limit theorem for quadratic forms of random vectors. Our high-dimensional central limit theorem is proved under Lyapunov-type conditions that involve a delicate interplay between the dimension, the sample size, and the moment conditions. We propose a modified chi-squared statistic and introduce an adjusted degrees of freedom. A simulation study shows that the modified statistic outperforms Pearson’s chi-squared statistic in terms of both size accuracy and power. Our procedure is applied to the construction of a goodness-of-fit test for Rutherford’s alpha-particle data.
Social Workers’ Reflections on Ethics in Relation to Adoption in the UK: Everywhere but Nowhere?
Authors: Featherstone Brid , Gupta Anna 
Published: March 2019

AbstractEmpirical research with social workers exploring their understandings and use of codes or ethical theories in practice remain underdeveloped in the UK. This article, based on the British Association of Social Work commissioned Enquiry into the role of the social worker in adoption with a focus on ethics and human rights, provides an important contribution in this context. The Enquiry engaged with a range of stakeholders and explored their perspectives on the adoption process, but the primary focus of this article is on how ethics were understood and discussed by social workers. One hundred and five social workers participated in the Enquiry through questionnaires, interviews and group discussions, and a thematic analysis of their data revealed important findings. For example, the social workers made no explicit reference to codes of ethics or specific ethical theories. However, some of the themes that emerge from the analysis support discussions in what is now a substantial international literature on the importance of recognising ‘ethics work’ by social workers (Banks, 2016). Weinberg’s (2009) explorations of moral distress and ethical trespass are also important and underdeveloped concepts that resonate with themes from the Enquiry and could support more ethically enquiring cultures within organisations and more broadly.
Omadacycline: A Novel Tetracycline Derivative With Oral and Intravenous Formulations
Authors: Watkins Richard R , Deresinski Stan 
Published: March 2019

AbstractOmadacycline, an aminomethylcycline, is a novel member of the tetracycline class of antibiotics. It has received approval by the US Food and Drug Administration for the treatment of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections, and is available in both oral and intravenous formulations. It is also being evaluated in clinical trials for the treatment of cystitis and pyelonephritis. The omadacycline molecule was designed to overcome tetracycline resistance and has broad-spectrum activity that includes gram-positive bacteria, gram-negative bacteria, anaerobes, atypicals, and other drug-resistant strains, like methicillin-resistant Staphylococcus aureus, as well as Yersinia pestis and Bacillus anthracis, organisms of biodefense interest. Omadacycline has minimal drug-drug pharmacokinetic interactions and a favorable safety profile, with the most common adverse events being gastrointestinal symptoms.
Chest tube drainage versus video-assisted thoracoscopic surgery for a first episode of primary spontaneous pneumothorax: a systematic review and meta-analysis
Authors: Daemen Jean H T , Lozekoot Pieter W J , Maessen Jos G , Gronenschild Michiel H M , Bootsma Gerben P , Hulsewé Karel W E , Vissers Yvonne J L , de Loos Erik R 
Published: March 2019

Summary

Primary spontaneous pneumothorax affects up to 28 patients per 100 000 population yearly and is commonly resolved by chest tube drainage. However, drainage is also known to be associated with ipsilateral recurrence rates ranging from 25% to 43%. Preventive video-assisted thoracoscopic surgery (VATS) may be an effective alternative to diminish these recurrence rates and its associated morbidity. The aim of this study was to compare the efficacy of chest tube drainage and VATS as first line treatments of an initial episode of primary spontaneous pneumothorax. The MEDLINE, EMBASE, CENTRAL and Clinicaltrials.gov databases were searched through 16 September 2018. Data regarding the ipsilateral recurrence rate and the length of hospitalization were extracted and submitted to meta-analysis using the random-effects model and the I2 test for heterogeneity. Two randomized controlled trials and 2 observational studies were included, enrolling a total of 479 patients. Pairwise analysis demonstrated significantly reduced ipsilateral recurrence rates [odds ratio 0.15, 95% confidence interval (CI) 0.07–0.33; P < 0.00001] and length of hospitalization (standardized mean difference −2.19, 95% CI −4.34 to −0.04; P = 0.046) in favour of VATS. However, a significant level of heterogeneity was detected for the length of hospitalization (I2 = 97%; P < 0.00001). Subgroup analysis that stratified study design found no statistical differences regarding recurrence rate. In conclusion, VATS can be an effective and attractive alternative to standard chest tube drainage, with reduced ipsilateral recurrence rates and length of hospitalization. However, given the low quality of the majority of included studies, more well-designed randomized controlled trials are necessary to strengthen the current evidence.
Carotid artery wave intensity in mid- to late-life predicts cognitive decline: the Whitehall II study
Authors: Chiesa Scott T , Masi Stefano , Shipley Martin J , Ellins Elizabeth A , Fraser Alan G , Hughes Alun D , Patel Riyaz S , Khir Ashraf W , Halcox Julian P , Singh-Manoux Archana , Kivimaki Mika , Celermajer David S , Deanfield John E 
Published: March 2019

Abstract

Aims
Excessive arterial pulsatility may contribute to cognitive decline and risk of dementia via damage to the fragile cerebral microcirculation. We hypothesized that the intensity of downstream-travelling pulsatile waves measured by wave intensity analysis in the common carotid artery during mid- to late-life would be associated with subsequent cognitive decline.

Methods and results
Duplex Doppler ultrasound was used to calculate peak forward-travelling compression wave intensity (FCWI) within the common carotid artery in 3191 individuals [mean ± standard deviation (SD), age = 61 ± 6 years; 75% male] assessed as part of the Whitehall II study in 2003–05. Serial measures of cognitive function were taken between 2002–04 and 2015–16. The relationship between FCWI and cognitive decline was adjusted for sociodemographic variables, genetic and health-related risk factors, and health behaviours. Mean (SD) 10-year change in standardized global cognitive score was -0.39 (0.18). Higher FCWI at baseline was associated with accelerated cognitive decline during follow-up [difference in 10-year change of global cognitive score per 1 SD higher FCWI = −0.02 (95% confidence interval −0.04 to −0.00); P = 0.03]. This association was largely driven by cognitive changes in individuals with the highest FCWI [Q4 vs. Q1–Q3 = −0.05 (−0.09 to −0.01), P = 0.01], equivalent to an age effect of 1.9 years. Compared to other participants, this group was ∼50% more likely to exhibit cognitive decline (defined as the top 15% most rapid reductions in cognitive function during follow-up) even after adjustments for multiple potential confounding factors [odds ratio 1.49 (1.17–1.88)].

Conclusion
Elevated carotid artery wave intensity in mid- to late-life predicts faster cognitive decline in long-term follow-up independent of other cardiovascular risk factors.
Impact of transcatheter mitral valve repair on ventricular arrhythmias
Authors: Ledwoch Jakob , Nommensen Anna , Keelani Ahmed , Meyer-Saraei Roza , Stiermaier Thomas , Saad Mohammed , Pöss Janine , Desch Steffen , Tilz Roland , Thiele Holger , Eitel Ingo , Eitel Charlotte 
Published: March 2019

Abstract

Aims
Patients with heart failure and severe mitral regurgitation (MR) have a poor prognosis and carry an increased risk for ventricular arrhythmias. The present study evaluates the impact of transcatheter mitral valve repair using the MitraClip on the potential reduction of ventricular arrhythmias.

Methods and results
Patients undergoing MitraClip implantation were prospectively enrolled into the present study and received 24 h Holter ECG assessment prior to and 6 months after the procedure. In addition, left ventricular dimensions and function were assessed at baseline and follow-up. A total of 50 patients with mainly functional MR (82%) were included. Non-sustained or sustained ventricular tachycardia (nsVT and/or sVT) occurred in 32% of patients and was reduced to 14% at follow-up (P = 0.01). Also, premature ventricular complex (PVC) burden ≥5% decreased from 16% to 4% (P = 0.04). Patients with persistent (n = 6) or new (n = 1) nsVT and/or sVT at follow-up showed a significant decrease in left ventricular ejection fraction from 38% (interquartile range 26–45%) to 33% (interquartile range 22–44%; P = 0.03).

Conclusions
In this prospective study, transcatheter mitral valve repair using MitraClip was associated with a reduced prevalence of ventricular arrhythmias. The subset of patients with persistent or new ventricular arrhythmias after MitraClip implantation showed progression of left ventricular dysfunction.
‘Swimming mosquitoes’: a key stepping stone to prevent Dengue, Zika and Chikungunya: an educative experience in Colima, Mexico
Authors: Medone Paula , Hernï¿½ndez-Suï¿½rez Carlos M 
Published: March 2019

Abstract
Dengue, Zika and Chikungunya arboviruses (DZC), mainly transmitted by mosquito Aedes aegypti, are global health public issues affecting 390 million people each year. In most endemic countries, vector control strategies have been focused on reducing breeding sites and adult mosquito populations. Most health communication strategies have pointed out adult mosquito as the main responsible of the transmission, persuading people to eliminate domestic containers. However, it is not clear how should people understand the relationship between adult mosquitoes and water domestic containers. So, the main goal of the present study was to assess the people understanding of this relationship. Results showed that most people associate adult mosquitoes with DZC, but only few could associate swimming larvae with mosquitoes. The unawareness of larva presence leads to an underestimation of risk perception about DZC transmission. In this context, we consider that educative interventions for health promotion, based on meaningful knowledge and social representations arise as long-term strategies to control transmission of vector-borne diseases. Here, we propose innovative health strategies focused on increase the risk perception about swimming larvae, considering social representations, which may be a key stepping stone to increase people adherence to massive campaigns and reducing DZC burden.
Concentration–response model of rilpivirine in a cohort of HIV-1-infected naive and pre-treated patients
Authors: Néant Nadège , Solas Caroline , Bouazza Naïm , Lê Minh Patrick , Yazdanpanah Yazdan , Dhiver Catherine , Bregigeon Sylvie , Mokhtari Saadia , Peytavin Gilles , Tamalet Catherine , Descamps Diane , Lacarelle Bruno , Gattacceca Florence 
Published: March 2019

Abstract

Background
Rilpivirine is widely prescribed in people living with HIV. Although trough plasma concentrations have been associated with virological response, the drug pharmacodynamics remain incompletely characterized.

Objectives
To develop the first pharmacodynamic model of rilpivirine in order to establish the rilpivirine concentration–response relationship for future treatment optimization.

Methods
A retrospective observational study was conducted in patients receiving the once-daily rilpivirine/tenofovir disoproxil fumarate/emtricitabine regimen. Individual rilpivirine trough plasma concentrations over time were predicted using a previous pharmacokinetic model. An established susceptible, infected, recovered model was used to describe HIV dynamics without assuming disease steady-state. Population analysis was performed with MONOLIX 2018 software. Simulations of the viral load evolution as a function of time and rilpivirine trough plasma concentration were performed.

Results
Overall, 60 naive and 39 pre-treated patients were included with a follow-up ranging from 2 to 37 months. The final model adequately described the data and the pharmacodynamic parameters were estimated with a good precision. The population typical value of rilpivirine EC50 was estimated at 65 ng/mL. A higher infection rate constant of CD4 cells for HIV-1 was obtained in pre-treated patients. Consequently, the time to obtain virological suppression was longer in pre-treated than in naive patients.

Conclusions
The concentration–response relationship of rilpivirine was satisfactorily described for the first time using an original population pharmacodynamic model. Simulations performed using the final model showed that the currently used 50 ng/mL rilpivirine trough plasma concentration efficacy target might need revision upwards, particularly in pre-treated patients.
Scarcity of Recurrent Regulatory Driver Mutations in Colorectal Cancer Revealed by Targeted Deep Sequencing
Authors: Poulos Rebecca C , Perera Dilmi , Packham Deborah , Shah Anushi , Janitz Caroline , Pimanda John E , Hawkins Nicholas , Ward Robyn L , Hesson Luke B , Wong Jason W H 
Published: March 2019

Abstract

Background
Genetic testing of cancer samples primarily focuses on protein-coding regions, despite most mutations arising in noncoding DNA. Noncoding mutations can be pathogenic if they disrupt gene regulation, but the benefits of assessing promoter mutations in driver genes by panel testing has not yet been established. This is especially the case in colorectal cancer, for which few putative driver variants at regulatory elements have been reported.

Methods
We designed a unique target capture sequencing panel of 39 colorectal cancer driver genes and their promoters, together with more than 35 megabases of regulatory elements focusing on gene promoters. Using this panel, we sequenced 95 colorectal cancer and matched normal samples at high depth, averaging 170× and 82× coverage, respectively.

Results
Our target capture sequencing design enabled improved coverage and variant detection across captured regions. We found cases with hereditary defects in mismatch and base excision repair due to deleterious germline coding variants, and we identified mutational spectra consistent with these repair deficiencies. Focusing on gene promoters and other regulatory regions, we found little evidence for base or region-specific recurrence of functional somatic mutations. Promoter elements, including TERT, harbored few mutations, with none showing strong functional evidence. Recurrent regulatory mutations were rare in our sequenced regions in colorectal cancer, though we highlight some candidate mutations for future functional studies.

Conclusions
Our study supports recent findings that regulatory driver mutations are rare in many cancer types and suggests that the inclusion of promoter regions into cancer panel testing is currently likely to have limited clinical utility in colorectal cancer.
The Wendelstein Weak Lensing (WWL) pathfinder: accurate weak lensing masses for Planck clusters
Authors: Rehmann R L , Gruen D , Seitz S , Bender R , Riffeser A , Kluge M , Goessl C , Hopp U , Mana A , Ries C , Schmidt M 
Published: March 2019

ABSTRACT
We present results from the Wendelstein Weak Lensing (WWL) pathfinder project, in which we have observed three intermediate-redshift Planck clusters of galaxies with the new 30 arcmin × 30 arcmin wide field imager at the 2 m Fraunhofer Telescope at Wendelstein Observatory. We investigate the presence of biases in our shear catalogues and estimate their impact on our weak lensing mass estimates. The overall calibration uncertainty depends on the cluster redshift and is below 8.1–16 per cent for z ≈ 0.27–0.77. It will decrease with improvements on the background sample selection and the multiplicative shear bias calibration. We present the first weak lensing mass estimates for PSZ1 G109.88+27.94 and PSZ1 G139.61+24.20, two Sunyaev-Zeldovich (SZ)-selected cluster candidates. Based on Wendelstein colours and SDSS (Sloan Digital Sky Survey) photometry, we find that the redshift of PSZ1 G109.88+27.94 has to be corrected to z ≈ 0.77. We investigate the influence of line-of-sight structures on the weak lensing mass estimates and find upper limits for two groups in each of the fields of PSZ1 G109.88+27.94 and PSZ1 G186.98+38.66. We compare our results to SZ and dynamical mass estimates from the literature, and in the case of PSZ1 G186.98+38.66 to previous weak lensing mass estimates. We conclude that our pathfinder project demonstrates that weak lensing cluster masses can be accurately measured with the 2 m Fraunhofer Telescope.
The Importance of Antimicrobial Resistance Monitoring Worldwide and the Origins of SENTRY Antimicrobial Surveillance Program
Authors: Fuhrmeister Andrew S , Jones Ronald N 
Published: March 2019

Abstract
The origins of how and why the SENTRY Antimicrobial Surveillance Program was created are briefly described, with additional details on how the isolates are collected and tested as well as the important uses of the data in monitoring antimicrobial resistance and drug development.
Applying circulating tumor DNA methylation in the diagnosis of lung cancer
Authors: Li Lei , Fu Kai , Zhou Wenyu , Snyder Michael 
Published: March 2019

AbstractLung cancer is the leading cause of cancer-related deaths worldwide. Low dose computed tomography (LDCT) is commonly used for disease screening, with identified candidate cancerous regions further diagnosed using tissue biopsy. However, existing techniques are all invasive and unavoidably cause multiple complications. In contrast, liquid biopsy is a noninvasive, ideal surrogate for tissue biopsy that can identify circulating tumor DNA (ctDNA) containing tumorigenic signatures. It has been successfully implemented to assist treatment decisions and disease outcome prediction. ctDNA methylation, a type of lipid biopsy that profiles critical epigenetic alterations occurring during carcinogenesis, has gained increasing attention. Indeed, aberrant ctDNA methylation occurs at early stages in lung malignancy and therefore can be used as an alternative for the early diagnosis of lung cancer. In this review, we give a brief synopsis of the biological basis and detecting techniques of ctDNA methylation. We then summarize the latest progress in use of ctDNA methylation as a diagnosis biomarker. Lastly, we discuss the major issues that limit application of ctDNA methylation in the clinic, and propose possible solutions to enhance its usage.
Gender-Stratified Prevalence of Psychiatric and Pain Diagnoses in a Primary Care Patient Sample with Fibromyalgia
Authors: Wan Betsy , Gebauer Sarah , Salas Joanne , Jacobs Christine K , Breeden Matthew , Scherrer Jeffrey F 
Published: March 2019

Abstract

Objective
Comorbid psychiatric and pain-related conditions are common in patients with fibromyalgia. Most studies in this area have used data from patients in specialty care and may not represent the characteristics of fibromyalgia in primary care patients. We sought to fill gaps in the literature by determining if the association between psychiatric diagnoses, conditions associated with chronic pain, and fibromyalgia differed by gender in a primary care patient population.

Design
Retrospective cohort.

Setting and Subjects
Medical record data obtained from 38,976 patients, ≥18 years of age with a primary care encounter between July 1, 2008, to June 30, 2016.

Methods
International Classification of Diseases–9 codes were used to define fibromyalgia, psychiatric diagnoses, and conditions associated with chronic pain. Unadjusted associations between patient demographics, comorbid conditions, and fibromyalgia were computed using binary logistic regression for the entire cohort and separately by gender.

Results
Overall, 4.6% of the sample had a fibromyalgia diagnosis, of whom 76.1% were women. Comorbid conditions were more prevalent among patients with vs without fibromyalgia. Depression and arthritis were more strongly related to fibromyalgia among women (odds ratio [OR] = 2.80, 95% confidence interval [CI] = 2.50–3.13; and OR = 5.19, 95% CI = 4.62–5.84) compared with men (OR = 2.16, 95% CI = 1.71–2.71; and (OR = 3.91, 95% CI = 3.22–4.75). The relationship of fibromyalgia and other diagnoses did not significantly differ by gender.

Conclusions
Except for depression and arthritis, the burden of comorbid conditions in patients with fibromyalgia is similar in women and men treated in primary care. Fibromyalgia comorbidities in primary care are similar to those found in specialty care.