bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current Weight Management Approaches Used by Primary Care Providers in Six Multidisciplinary Healthcare Settings in Ontario
Authors: Aboueid Stephanie , Jasinska Monika , Bourgeault Ivy , Giroux Isabelle 
Published: April 2018

Background Obesity management in primary care has been suboptimal due to lack of access to allied health professionals, time, and resources. Purpose To understand the weight management approaches used by primary care providers working in team-based settings and how they assess the most suitable approach for a patient. Methods A total of 20 primary care providers (13 nurse practitioners and 7 family physicians) working in 6 multidisciplinary clinics in Ontario were interviewed. All interviews were recorded, transcribed verbatim, and coded using NVivo qualitative software. Conventional content analysis was used to inductively elucidate codes, which were then clustered into categories. Results A referral to on-site programming was the most frequent weight management approach used. The pharmacological approach was underutilized due to adverse side effects and cost to patients. Primary care providers assessed the most suitable weight management approach based on patients’: preference, level of motivation, income status and access to resources, body mass index and comorbidities, and previous weight loss attempts. Primary care providers perceived that referring to health professionals and educational resources were the approaches preferred by patients. Conclusions The team-based nature of these clinics allowed for referrals to various on-site professionals and/or programs. Some barriers to pursuing weight management avenues with patients were patient dependent.
Community Pharmacist Preferences in Transition of Care Communications
Authors: Dolan Mackenzie A. , Renfro Chelsea P. , Ferreri Stefanie P. , Shilliday Betsy B. , Ives Timothy J. , Cavanaugh Jamie J. 
Published: April 2018

Objective: To determine community pharmacist preferences in transition of care (TOC) communications. Methods: In this cross-sectional study, data were gathered via electronic survey of community pharmacists regarding their preferences for TOC communications. The survey was distributed via email by the North Carolina Board of Pharmacy. Results were analyzed using descriptive statistics. Results: Survey responses were received from 343 community pharmacists (response rate = 6.1%). Responders most commonly worked in an independent, single store (29.2%, n = 100) or national chain (29.2%, n = 100) pharmacy setting. Preferred method for a TOC communication was via electronic health record (63.0%, n = 184). Preferred TOC communication content are mentioned as follows: active (93.2%, n = 274) and discontinued (86.4%, n = 254) medications and reason for hospitalization (85.0%, n = 250). The top 3 self-identified barriers to utilizing a TOC communication: lack of care coordination with community pharmacy (35.0%, n = 14), lack of support from other health-care providers (22.5%, n = 9), and absence of compensation for providing the service (17.5%, n = 7). When asked if TOC communications were available, 97.5% (n = 278) indicated it would be useful. Conclusion: Community pharmacists acknowledged a need for TOC communications and shared their preferences in the content and method of communication. Future research is warranted to implement TOC communications between a health system and community pharmacy.
Sub-acromial balloon spacer for irreparable rotator cuff tears: Is it an appropriate salvage procedure?
Authors: Prat Dan , Tenenbaum Shay , Pritsch Moshe , Oran Ariel , Vogel Guy 
Published: April 2018

Introduction: Irreparable rotator cuff tear (RCT) presents a difficult treatment challenge for the orthopaedic surgeon. Many treatment strategies with varying degrees of success have been performed over the years. One of the suggested surgical treatment options is the use of a biodegradable sub-acromial balloon spacer. Methods: A retrospective study of patients treated with sub-acromial balloon spacer between the years 2011 and 2016 was conducted. Mean follow-up time was 14.4 months. Patient charts were reviewed to evaluate the early clinical results and complications of sub-acromial spacer for irreparable RCTs. Results: The study cohort included 24 shoulders in 22 patients. The average postoperative Disability of the Arm, Shoulder and Hand score was 62.4. The average preoperative University of California at Los-Angeles Shoulder score was 10.9 and improved to 15.9 ( p = 0.001). Forty-six per cent of patients were satisfied with their clinical postoperative outcome. We found moderate–strong positive correlation ( r = 0.64) between preoperative range of motion (ROM) and general satisfaction. None of the postoperative radiographs showed an improvement regarding the proximal migration of the humeral head. In total, four (16.7%) patients experienced postoperative complications, and two (8.3%) patients required an additional surgery as a consequence of a postoperative complication. Conclusion: Our results show unsatisfactory improvement in patients with irreparable RCT treated with the sub-acromial balloon spacer. Careful patient selection with attention to preoperative ROM should be considered. Level of Evidence: Therapeutic level IV.
Radial Head Changes in Osteochondritis Dissecans of the Humeral Capitellum
Authors: Wu Mark , Eisenberg Katherine , Williams Kathryn , Bae Donald S. 
Published: April 2018

Background: Osteochondritis dissecans (OCD) of the elbow has almost exclusively been described in the humeral capitellum, with only a small number of reports describing secondary osteochondral changes in the radial head. Hypothesis: The authors hypothesized that concomitant radial head lesions (RHLs) would be seen with capitellar OCD and that patients with RHLs would present with more advanced capitellar OCD lesions and would respond better to procedures restoring articular congruity. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 86 elbows from 82 patients (39 female patients; mean ± SD age, 13.8 ± 2.2 years; age range, 9.8-23.6 years) were treated for capitellar OCD and enrolled in a prospective registry. Clinical and radiographic data were compared between those with and without RHLs, with a median follow-up of 10.8 months (interquartile range, 6.2-17.1 months). Magnetic resonance imaging was used to characterize and measure RHLs and OCD lesions. Postoperative clinical results were compared between patients who underwent drilling and those who had osteochondral autograft transplantation surgery (OATS). Results: RHLs were present in 26 (30%) elbows—17 in the dominant arm. Edema was seen in 22 elbows; 17 had involvement of the anterior third of the radial epiphysis. Cysts were present in 4 elbows: 2 in the anterior third and 2 in the middle third. Blunting of the normal concave contour of the radial epiphysis was present in 10 elbows in the anterior third. Demographic and presenting clinical features were similar between those with and without RHLs. RHLs were more commonly seen in Nelson grade 4 OCD lesions ( P = .04) as compared with elbows without RHLs. Elbows with RHLs that underwent OATS (n = 9) trended toward greater improvement in forearm range of motion ( P = .058) and fewer persistent mechanical symptoms ( P = .06) postoperatively as compared with elbows having RHLs that underwent drilling. There were no postoperative differences in elbows without RHLs that underwent OATS versus drilling. Conclusion: RHLs were seen in one-third of elbows with capitellar OCD. Lesions predominantly occurred in the anterior RH in patients with more advanced capitellar lesions. Short-term clinical follow-up suggested greater improvement in range of motion and resolution of mechanical symptoms for patients with RHLs who were treated with OATS than with drilling.
Medical Imaging Outpatients' Experiences With Receiving Information Required for Informed Consent and Preparation: A Cross-Sectional Study
Authors: Hyde Lisa L , J Mackenzie Lisa , Boyes Allison W , Symonds Michael , Brown Sandy , Sanson-Fisher Rob 
Published: April 2018

Background: Medical imaging outpatients often experience inadequate information provision and report high levels of anxiety. However, no studies have assessed patients’ receipt of preparatory information in this setting. Objective: To examine medical imaging outpatients’ perceived receipt or non-receipt of preparatory information from health professionals and imaging department staff prior to their procedure. Method: Computed tomography and magnetic resonance imaging outpatients at one Australian hospital self-completed a touchscreen computer survey assessing their perceived receipt of 33 guideline-recommended preparatory information items. Results: Of 317 eligible patients, 280 (88%) consented to participate. Eight percent (95% confidence interval: 5%-12%) of participants reported receiving all information items. The median number of information items not received was 18 (interquartile range: 8-25). Items most frequently endorsed as “not received ” were: how to manage anxiety after (74%) and during the scan (69%). Items most commonly endorsed as “received” were: reason for referral (85%) and how to find the imaging department (74%). Conclusion: Few medical imaging outpatients recalled receiving recommended preparatory information. Preparatory communication needs to be improved to better meet patient-centered service imperatives.
Ectopic Lck expression in CLL demarcates intratumoral subpopulations with aberrant B-cell receptor signaling
Authors: Theofani Efthymia , Alexis Spyridon , Costeas Paul , Andriopoulos Christos , Feleskoura Georgia , Zikos Panagiotis , Aktypi Anthi , Spyridonidis Alexandros , Nika Konstantina 
Published: April 2018

Key Points
Ectopic Lck expression signifies interpatient and intratumoral heterogeneity in CLL. Lck expression identifies CLL subpopulations with aberrant BCR signaling.
The Bayeux embroidery: a dust deposition assessment
Authors: Uring Pauline , Chabas Anne , De Reyer Dominique , Gentaz Lucile , Triquet Sylvain , Mirande-Bret Cécile , Alfaro Stéphane 
Published: April 2018

Abstract
Particulate matter in the showcase of the Bayeux embroidery was studied for 8 months in order to determine the conservation state of this precious and fragile work of art. Both the suspended and deposited particles were observed, analysed, and quantified. Microclimatic conditions were also monitored. This study presents different methods for the qualification (SEM–EDS and ion chromatography) and quantification (haze, surface coverage, deposition thickness, fibre concentration) of the deposition of particulate matter in such an environment. It allowed the evaluation of the hazard represented by particulate matter for the piece of art and the effectiveness of the measures taken to preserve it, namely air filtration in its over-pressured showcase. The results are very positive, since the PM concentration is very low (ISO 8 regarding the ISO 14644-1 norm) and dust deposition is still negligible after five and a half month.
Activated ezrin controls MISP levels to ensure correct NuMA polarization and spindle orientation
Authors: Kschonsak Yvonne T. , Hoffmann Ingrid 
Published: April 2018

ABSTRACT
Correct spindle orientation is achieved through signaling pathways that provide a molecular link between the cell cortex and spindle microtubules in an F-actin-dependent manner. A conserved cortical protein complex, composed of LGN (also known as GPSM2), NuMA (also known as NUMA1) and dynein–dynactin, plays a key role in establishing proper spindle orientation. It has also been shown that the actin-binding protein MISP and the ERM family, which are activated by lymphocyte-oriented kinase (LOK, also known as STK10) and Ste20-like kinase (SLK) (hereafter, SLK/LOK) in mitosis, regulate spindle orientation. Here, we report that MISP functions downstream of the ERM family member ezrin and upstream of NuMA to allow optimal spindle positioning. We show that MISP directly interacts with ezrin and that SLK/LOK-activated ezrin ensures appropriate cortical MISP levels in mitosis by competing with MISP for actin-binding sites at the cell cortex. Furthermore, we found that regulation of the correct cortical MISP levels, by preventing its excessive accumulation, is essential for crescent-like polarized NuMA localization at the cortex and, as a consequence, leads to highly dynamic astral microtubules. Our results uncover how appropriate MISP levels at the cortex are required for proper NuMA polarization and, therefore, an optimal placement of the mitotic spindle within the cell.
This article has an associated First Person interview with the first author of the paper.
Tissue stiffening promotes keratinocyte proliferation through activation of epidermal growth factor signaling
Authors: Kenny Fiona N. , Drymoussi Zoe , Delaine-Smith Robin , Kao Alexander P. , Laly Ana C. , Knight Martin M. , Philpott Michael P. , Connelly John T. 
Published: April 2018

ABSTRACT
Tissue biomechanics regulate a wide range of cellular functions, but the influences on epidermal homeostasis and repair remain unclear. Here, we examined the role of extracellular matrix stiffness on human keratinocyte behavior using elastomeric substrates with defined mechanical properties. Increased matrix stiffness beyond normal physiologic levels promoted keratinocyte proliferation but did not alter the ability to self-renew or terminally differentiate. Activation of epidermal growth factor (EGF) signaling mediated the proliferative response to matrix stiffness and depended on focal adhesion assembly and cytoskeletal tension. Comparison of normal skin with keloid scar tissue further revealed an upregulation of EGF signaling within the epidermis of stiffened scar tissue. We conclude that matrix stiffness regulates keratinocyte proliferation independently of changes in cell fate and is mediated by EGF signaling. These findings provide mechanistic insights into how keratinocytes sense and respond to their mechanical environment, and suggest that matrix biomechanics may play a role in the pathogenesis keloid scar formation.
Research into occupational noise induced hearing loss in South African large-scale mines: Access denied?
Authors: Moroe Nomfundo F. , Khoza-Shangase Katijah 
Published: April 2018

Background: The South African mining industry is frequently criticized for its poor health and safety record and high numbers of fatalities, thereby prompting researchers to conduct research on challenges faced by this industry. Therefore, this study aimed to investigate the feasibility of conducting audiological research into occupational noise induced hearing loss (ONIHL) within the South African mining sector. Specific objectives involved determining ease of identifying focal persons in charge of hearing conservation programmes (HCP); establishing response time and rate of identified focal person for interviews; and exploring focal person’s willingness to share information regarding HCP. Methods: A qualitative research strategy comprising online desk research and interviews was undertaken through purposive sampling to recruit participants. Data were collected through checklists, logbooks and interviews. Deductive thematic analysis was used to analyse data. Results: Gaining access into the mining sector is negatively impacted by the following factors: firstly, contact details of focal person are not always listed on the websites. Secondly, prolonged response rate between initial contact and the time in which the participants respond. Lastly, unwillingness to share information regarding the management of ONIHL and progress made in HCP at various mines. Conclusions: Findings contribute evidence regarding possible barriers to effective and successful implementation of application of best practice in HCPs; guided by evidence that is contextually relevant. Challenges with accessing mines for research purposes by external and independent researchers arguably impacts on the available evidence produced by mines, due to a possible unavoidable conflict of interest. Success of HCPs depend on objective evidence regardless of whether it paints the mining industry in positive or negative light. It is only when this evidence is critically engaged with, that real and effective solutions can be deliberated and implemented. Clear, transparent, and open lines of communication between various stakeholders are key to achieving this.
The Collaborative African Genomics Network (CAfGEN): Applying Genomic technologies to probe host factors important to the progression of HIV and HIV-tuberculosis infection in sub-Saharan Africa
Authors: Mboowa Gerald , Mwesigwa Savannah , Katagirya Eric , Retshabile Gaone , Mlotshwa Busisiwe C. , Williams Lesedi , Kekitiinwa Adeodata , Kateete David , Wampande Eddie , Wayengera Misaki , Kintu Betty Nsangi , Kisitu Grace P. , Kyobe Samuel , Brown Chester W. , Hanchard Neil A. , Mardon Graeme , Joloba Moses , Anabwani Gabriel , Pettitt Ed , Tsimako-Johnstone Masego , Kasvosve Ishmael , Maplanka Koketso , Mpoloka Sununguko W. , Hlatshwayo Makhosazana , Matshaba Mogomotsi 
Published: April 2018

Background: The Human Heredity and Health in Africa consortium (H3Africa) was conceived to facilitate the application of genomics technologies to improve health across Africa. Here, we describe how the Collaborative African Genomics Network (CAfGEN) of the H3Africa consortium is using genomics to probe host genetic factors important to the progression of HIV and HIV-tuberculosis (TB) coinfection in sub-Saharan Africa. Methods: CAfGEN is an H3Africa collaborative centre comprising expertise from the University of Botswana; Makerere University; Baylor College of Medicine Children’s Clinical Centers of Excellence (COEs) in Botswana, Uganda, and Swaziland; as well as Baylor College of Medicine, Texas. The COEs provide clinical expertise for community engagement, participant recruitment and sample collection while the three University settings facilitate processing and management of genomic samples and provide infrastructure and training opportunities to sustain genomics research. Results: The project has focused on utilizing whole-exome sequencing to identify genetic variants contributing to extreme HIV disease progression phenotypes in children, as well as RNA sequencing and integrated genomics to identify host genetic factors associated with TB disease progression among HIV-positive children. These cohorts, developed using the COEs’ electronic medical records, are exceptionally well-phenotyped and present an unprecedented opportunity to assess genetic factors in individuals whose HIV was acquired by a different route than their adult counterparts in the context of a unique clinical course and disease pathophysiology. Conclusions: Our approach offers the prospect of developing a critical mass of well-trained, highly-skilled, continent-based African genomic scientists. To ensure long term genomics research sustainability in Africa, CAfGEN contributes to a wide range of genomics capacity and infrastructure development on the continent, has laid a foundation for genomics graduate programs at its institutions, and continues to actively promote genomics research through innovative forms of community engagement brokered by partnerships with governments and academia to support genomics policy formulation.
Ethical and scientific considerations on the establishment of a controlled human infection model for schistosomiasis in Uganda: report of a stakeholders’ meeting held in Entebbe, Uganda.
Authors: Elliott Alison M. , Roestenberg Meta , Wajja Anne , Opio Christopher , Angumya Francis , Adriko Moses , Egesa Moses , Gitome Serah , Mfutso-Bengo Joseph , Bejon Philip , Kapulu Melissa , Seager Zoe , Lutalo Tom , Nazziwa Winfred Badanga , Muwumuza Asuman , Yazdanbakhsh Maria , Kaleebu Pontiano , Kabatereine Narcis , Tukahebwa Edridah 
Published: April 2018

Controlled human infection (CHI) models are gaining recognition as an approach to accelerating vaccine development, for use in both non-endemic and endemic populations: they can facilitate identification of the most promising candidate vaccines for further trials and advance understanding of protective immunity. Helminths present a continuing health burden in sub-Saharan Africa. Vaccine development for these complex organisms is particularly challenging, partly because protective responses are akin to mechanisms of allergy. A CHI model forSchistosoma mansoni(CHI-S) has been developed at Leiden University Medical Centre, the Netherlands. However, responses to schistosome infections, and candidate vaccines, are likely to be different among people from endemic settings compared to schistosome-naïve Dutch volunteers. Furthermore, among volunteers from endemic regions who have acquired immune responses through prior exposure, schistosome challenge can be used to define responses associated with clinical protection, and thus to guide vaccine development. To explore the possibility of establishing the CHI-S in Uganda, a Stakeholders’ Meeting was held in Entebbe in 2017. Regulators, community members, researchers and policy-makers discussed implementation challenges and recommended preparatory steps: risk assessment; development of infrastructure and technical capacity to produce the infectious challenge material in Uganda; community engagement from Parliamentary to grass-roots level; pilot studies to establish approaches to assuring fully informed consent and true voluntariness, and strategies for selection of volunteers who can avoid natural infection during the 12-week CHI-S; the building of regulatory capacity; and the development of study protocols and a product dossier in close consultation with ethical and regulatory partners. It was recommended that, on completion, the protocol and product dossier be reviewed for approval in a joint meeting combining ethical, regulatory and environment management authorities. Most importantly, representatives of schistosomiasis-affected communities emphasised the urgent need for an effective vaccine and urged the research community not to delay in the development process.