bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combining timing characteristics with physical broad-band spectral modelling of black hole X-ray binary GX 339–4
Authors: Connors R M T , van Eijnatten D , Markoff S , Ceccobello C , Grinberg V , Heil L , Kantzas D , Lucchini M , Crumley P 
Published: February 2019

ABSTRACTGX 339–4 is a black hole X-ray binary that is a key focus of accretion studies, since it goes into outburst roughly every 2–3 yr. Tracking of its radio, infrared (IR), and X-ray flux during multiple outbursts reveals tight broad-band correlations. The radio emission originates in a compact, self-absorbed jet; however, the origin of the X-ray emission is still debated: jet base or corona? We fit 20 quasi-simultaneous radio, IR, optical, and X-ray observations of GX 339–4 covering three separate outbursts in 2005, 2007, 2010–2011, with a composite corona+jet model, where inverse Compton emission from both regions contributes to the X-ray emission. Using a recently proposed identifier of the X-ray variability properties known as power-spectral hue, we attempt to explain both the spectral and evolving timing characteristics, with the model. We find the X-ray spectra are best fit by inverse Compton scattering in a dominant hot corona (kTe ∼ hundreds of keV). However, radio and IR-optical constraints imply a non-negligible contribution from inverse Compton scattering off hotter electrons (kTe ≥ 511 keV) in the base of the jets, ranging from a few up to ∼50 per cent of the integrated 3–100 keV flux. We also find that the physical properties of the jet show interesting correlations with the shape of the broad-band X-ray variability of the source, posing intriguing suggestions for the connection between the jet and corona.
Concern About Falling Is Associated With Gait Speed, Independently From Physical and Cognitive Function
Authors: van Schooten Kimberley S , Freiberger Ellen , Sillevis Smitt Myriam , Keppner Veronika , Sieber Cornel , Lord Stephen R , Delbaere Kim 
Published: February 2019

Abstract

Background
Higher levels of concern about falling in older people have been associated with slower walking speed and an increased risk of falls. However, it is unclear whether this relationship is independent or confounded by other fall risk factors, such as physical and cognitive function.

Objective
The aim of this study was to examine the effects of concern about falling on gait speed, adjusted for physiological fall risk and cognitive function.

Design
This was an observational, cross-sectional study.

Methods
A total of 204 community-dwelling older people aged 70 years or older were recruited from 2 sites (Germany, n = 94; Australia, n = 110). Walking speed was measured over 6 m under 4 conditions: preferred speed, fast speed, speed while carrying a tray (functional dual task), and speed while answering a question (cognitive dual task). The Falls Efficacy Scale–International was used to assess concern about falling, the Physiological Profile Assessment was used to assess physiological fall risk, and the Digit Symbol Substitution Test and Trail Making Test were used to assess attention and executive function.

Results
Higher levels of concern about falling were associated with slower gait speed. Following adjustment for age, history of falls, and female sex, and further adjustment for physical and cognitive function, the association between concern about falling and walking speed remained significant, with a considerable effect size (standardized β = 0.18 ± 0.08; P = .037).

Limitations
The use of walking speed as a sole measure of gait was a limitation of this study.

Conclusions
Gait speed, especially under dual-task conditions, was affected by concern about falling. Concern about falling was the strongest predictor of gait speed under all 4 conditions and should be included in routine geriatric assessments.
Hyperbaric Oxygen Therapy for Second-Degree Burn Healing: An Experimental Study in Rabbits
Authors: Hatibie Mendy J. , Islam Andi A. , Hatta Mochammad , Moenadjat Yefta , Susilo Rudy H. , Rendy Leo 
Published: February 2019

ABSTRACT

BACKGROUND:
The wound healing process includes inflammation, proliferation, and remodelling phases, the main features of which are inflammation, neoangiogenesis, and epithelialization. Hyperbaric oxygen therapy (HBOT) is one modality postulated to improve wound healing. The objective of this study was to determine whether HBOT could improve selected features of burn wound healing in an experimental rabbit model.

METHODS:
Researchers conducted an experimental study with 36 rabbits given second-degree burns. Subjects were separated into two groups: a control group (n = 18) and an intervention group that was given HBOT at 2.4 atmospheres absolute for 6 days (n = 18). The main outcome measure was wound healing.

RESULTS:
Compared with the control group, the HBOT group showed more robust inflammatory cells (P = .025) and epithelialization (P = .024), but no significant difference in angiogenesis (P = .442).

CONCLUSIONS:
The authors conclude that HBOT may improve second-degree burn healing by increasing inflammatory cell migration and re-epithelialization.
Reexamining the Literature on Terminal Ulcers, SCALE, Skin Failure, and Unavoidable Pressure Injuries
Authors: Ayello Elizabeth A. , Levine Jeffrey M. , Langemo Diane , Kennedy-Evans Karen Lou , Brennan Mary R. , Gary Sibbald R. 
Published: February 2019

ABSTRACT
This article synthesizes the literature regarding the concepts of “terminal” skin injuries that are found in patients at the end of life, including Kennedy terminal ulcers, Skin Changes At Life’s End, Trombley-Brennan terminal tissue injuries, and skin failure. Also included is a discussion of avoidable and unavoidable pressure injuries as defined and differentiated by the Centers for Medicare & Medicaid Services and the National Pressure Ulcer Advisory Panel. To help clarify the controversy among these terms, a unifying concept of “skin failure” that may occur with an acute illness, chronic illness, or as part of the dying process is proposed. This proposed concept of skin failure is etiologically different than a pressure injury, although pressure injury and skin failure can occur concomitantly. These proposed concepts require further research and validated diagnostic criteria. Consensus around appropriate terminology is essential to reduce confusion among stakeholders and ensure appropriate patient care.

GENERAL PURPOSE:
To synthesize the literature regarding skin injuries that are found in patients at the end of life and to clarify the terms used to describe these conditions.

TARGET AUDIENCE:
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:
After completing this continuing education activity, you should be better able to:1. Define the terms used to describe pressure injuries and skin changes at the end of life.2. Discuss the concept of skin failure as applied to end-of-life skin injuries and implications for practice.
Specialty certification and clinical flexibility
Authors: Peterson Eric D. , Hussaini Sobia Shariff , Murfin Melissa , Smith Benjamin J. , Polansky Maura , Klingler Amy M. , Peterson Phyllis R. , Mast Jane , Wright Karen A. 
Published: February 2019

ABSTRACT
The ability for PAs to easily move from one specialty to another without additional formal training is a unique feature of the profession that is valued by PAs and their employers. Specialty certification has been viewed as a threat to this flexibility, yet 73% of PAs are in specialty practice. How can the desire to preserve flexibility be balanced against the desire of specialized PAs to distinguish themselves in their chosen specialty? This article reviews the issue of specialty certification in the context of contemporary PA practice and concludes that although specialty certification remains a threat to the flexibility of the PA model, it may be appropriate in some situations. In particular, specialty certification may be appropriate as a means for promotion within healthcare systems so long as it is not used as a requirement for entry into specialty practice, credentialing, or third-party reimbursement. A portfolio model may give stakeholders an alternative way to assess the experience and competencies of PAs in specialty practice areas.
Over-The-Counter Asthma Inhaler Returns to the Market
Authors: Aschenbrenner Diane S. 
Published: February 2019

The Primatene Mist inhaler has returned to the market as an over-the-counter treatment for mild, intermittent asthma.The administration technique for this revised product is different from that of the original drug. The inhaler is now approved for use in people ages 12 and older.
New Warning for the Multiple Sclerosis Drug Alemtuzumab
Authors: Aschenbrenner Diane S. 
Published: February 2019

The Food and Drug Administration has added a black box warning for alemtuzumab (Lemtrada) stating that the drug, used in the treatment of relapsing multiple sclerosis, may cause ischemic and hemorrhagic stroke and cervicocephalic arterial dissection, rare but serious adverse effects.Nurses should teach patients prescribed this medication to recognize and seek emergency medical care if they develop any signs or symptoms of stroke.
Holding the line against workplace violence
Authors: Toon Molly F. , Weaver Christy , Frasier Nora , Brown Kristie L. 
Published: February 2019

Abstract:
As caregivers, nurses often dismiss violent patient interactions as “just part of the job.” This article addresses this misconception, differentiates between two types of violence present in healthcare settings, and stresses the importance of reporting and evaluating violent acts to plan mitigation strategies.
Using Interactive Learning Modules to Teach Value-Based Health Care to Health Professions Trainees Across the United States
Authors: Moriates Christopher , Valencia Victoria , Stamets Sara , Joo Joseph , MacClements Jonathan , Wilkerson LuAnn , Nelson Elizabeth A. , Bozic Kevin , Cox Susan M. 
Published: February 2019

Problem
Despite prominent calls to incorporate value-based health care (VBHC) into medical education, there is still a global need for robust programs to teach VBHC concepts throughout health professions training.

Approach
In June 2017, Dell Medical School released the first collection (three modules) of a set of free interactive online learning modules, which aim to teach the basic foundations of VBHC to health professions learners at any stage of training and can be incorporated across diverse educational settings. These modules were designed by an interprofessional team based on principles of cognitive engagement for active learning.

Outcomes
From June 2017 to September 2018, the website received 130,098 pageviews from 8,546 unique users (2,072 registered users), representing 45 states in the United States and 10 foreign countries. As of October 15, 2018, 568 (27%) of registered users completed modules 1–3. Five-hundred thirty-five of these users completed a survey (94% response rate). Nearly all (484/535; 90%) reported overall satisfaction with the curriculum, 522/535 (98%) agreed “after completing the modules, I can define value in health care,” and 520/535 (97%) agreed “after completing the modules, I can provide examples of low- and high-value care.” Second-year Dell Medical School students reported that they have incorporated value into their clinical clerkships (e.g., by discussing VBHC with peers [43/45; 96%]) as a result of completing the modules.

Next Steps
Future plans for the curriculum include the release of additional modules, more robust knowledge assessment, and an expanded learning platform that allows for further community engagement.
Clinical Updates in Women’s Health Care Summary: Evaluation and Management of Lipid Disorders
Authors: Christopher Bridgette A. , Pagidipati Neha J. 
Published: February 2019

Abstract:
Cardiovascular disease (CVD) remains the leading cause of mortality for women, and only a small percentage of women have optimally managed risk factors. One of the strongest risk factors for CVD is an increased lipid level. Many women seek primary care from obstetrician–gynecologists who often identify and provide initial management of dyslipidemia in these women. Thus, it is imperative that obstetrician–gynecologists become familiar with the identification and treatment of women with dyslipidemia to minimize their future risk of CVD. This monograph provides a brief primer on the epidemiology, pathophysiology, diagnosis, and management of dyslipidemia in women, as it pertains to CVD risk.
What Is in the Myopathy Literature?
Authors: Lacomis David , Abdel-Hamid Hoda Z. 
Published: February 2019

Abstract
We review the development of exon 51 skipping therapy with eteplirsen for Duchenne muscular dystrophy, including the recent report of long-term, sustained dystrophin production. Studies of the late-life health profile of patients with Duchenne muscular dystrophy, early detection of left ventricular systolic dysfunction, and caregiver burden are also covered. A study of skeletal muscle magnetic resonance imaging in dysferlinopathies provides an extensive, detailed map of the involved muscles and consistency across phenotypes. Regarding the category of autoimmune myopathies, we discuss an article on the clinical and laboratory features associated with PM/Scl antibodies in comparison with other autoimmune myopathy subgroups. Finally, the overall increase in mortality in inflammatory myopathies is highlighted in a recent report from Sweden.
Melanoma With Loss of BAP1 Expression in Patients With No Family History of BAP1-Associated Cancer Susceptibility Syndrome: A Case Series
Authors: Aung Phyu P. , Nagarajan Priyadharsini , Tetzlaff Michael T. , Curry Jonathan L. , Tang Guilin , Abdullaev Zied , Pack Svetlana D. , Ivan Doina , Prieto Victor G. , Torres-Cabala Carlos A. 
Published: February 2019

Abstract:
The presence of multiple BAP1-negative melanocytic neoplasms is a hallmark of familial cancer susceptibility syndrome caused by germline mutations in BAP1. Melanocytic tumors lacking BAP1 expression may also present as sporadic lesions in patients lacking a germline BAP1 mutation. Here, we report histomorphologic and clinical characteristics of cutaneous melanomas with loss of BAP1 expression in 4 patients with no known history of BAP1-associated cancer susceptibility syndrome. The lesions were nodular melanomas composed predominantly of intradermal large epithelioid (Spitzoid) melanocytes with nuclear pseudoinclusions as well as scattered multinucleated cells, arising in association with a typical intradermal nevus. Of the 4 patients, only 1 had recurrence. This patient had multiple recurrences with in-transit and regional lymph node metastases. To the best of our knowledge, this is the first reported series of cutaneous melanomas with loss of BAP1 expression arising in patients without a family history of cancer.
Turkish Version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia Scale
Authors: Zehirlioglu Lemye , Erunal Merve , Akyol Merve Aliye , Mert Hatice , Hatipoglu Nur Sehnaz , Kucukguclu Ozlem 
Published: February 2019

ABSTRACT

Objective: This methodological study evaluates the validity and reliability of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale in Turkish. Methods: The study enrolled 220 individuals aged 40 years and older between September 2017 and June 2018. The Kendall W analysis and content validity index were used for validity; test-retest and confirmatory factor analyses were used for the reliability analysis. Results: The Turkish version of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale has valid content. The Cronbach α coefficient of the scale was .809, and the subscales were in the ranges of .781 to .609. A statistically significant, positive correlation was found between the test and retest scores. Conclusions: These results show that the scale has validity and reliability for use in the Turkish population.
Physician Assistant Educator Competencies
Authors: Zaweski Joseph , Melcher Betsy Quick , Sedrak Mona , Von Mary , Fletcher Sara 
Published: February 2019

Abstract
The rapid expansion of physician assistant (PA) programs over the past decade has led to a shortage of experienced PA faculty. This has prompted many faculty development initiatives to help provide the skills needed by new faculty making the jump from clinical practice to academia. Faculty development is a key necessity in health professions education because many of the professionals attracted to the educator role are primarily trained as clinicians. Although this issue has been extensively evaluated by our colleagues in medical, nursing, and health education and various faculty development interventions have been implemented, this has not been done in the PA profession. In an effort to correct this, the Physician Assistant Education Association assembled a task force of experienced PA educators and charged them to evaluate the literature on faculty competencies in health professions education and to develop a set of PA educator competencies to help codify the essential knowledge, skills, attitudes, and behaviors that faculty need to be successful in their academic roles.
The task force met its charge by engaging in an extensive review of the literature, developing a competency framework and proposed competencies, and soliciting the input of a diverse panel of experts in PA education to vet the proposed competencies. Using the insights and recommendations from the expert panel, the task force refined the competencies—resulting in the framework of PA educator competencies presented in this document.
Fallback technique with circular stapler prevents anastomotic obstruction after esophagectomy
Authors: Zhou Peng , Wang Ya-Li , Liu Quan , Li Jin-Song 
Published: February 2019

Abstract

Rationale:
While performing esophago-ileal anastomosis after esophagectomy with circular staplers, the mucosal folds of the ileum can complicate stapling and lead to obstruction, especially when the diameter of the circular stapler is equal or greater than that of the small bowel lumen.

Patient concerns:
A 53-year-old man, presented with complaints of difficulty in swallowing for 2 weeks. Fifteen years previously, he had undergone partial gastrectomy for gastric ulcers.

Diagnosis:
The endoscopy showed that there was a large ulcer in the middle-third of the esophagus, about 28 to 32 cm from the incisors. Biopsy of the ulcer confirmed esophageal squamous cell carcinoma.

Interventions:
We performed an esophageal replacement using the right colon with circular staplers, but anastomotic site occurred due to stacking of the mucosa ahead of the stapler. To revise the anastomosis, we inserted the stapler 2 to 3 cm farther into the lumen than the intended site of anastomosis, and then pulled it back and rotated the stapler to complete the anastomosis. Consequently, the obstruction was corrected.

Outcomes:
With nearly 16 months’ follow-up duration until now, the patient has no difficulty swallowing and has twice received chemotherapy, and returned to his normal life relatively.

Lessons:
In the event of potential anastomotic obstruction due to accumulated mucosa, the stapler fallback technique can be successfully used achieve patent anastomosis.
Efficacy and safety of Zuogui Pill in treating osteoporosis
Authors: Chen Guoming , Zhang Zhaoping , Liu Yunyun , Lu Jiaxin , Qi Xiangjun , Fang Caishan , Zhou Chi 
Published: February 2019

Abstract

Background:
Osteoporosis (OP) is a common skeletal disorder worldwide, resulting in increased bone fragility and high risk of fractures. The Zuogui Pill (ZGP), a classic Chinese herbal formulation, has played a vital role in the clinical practice of OP in China for centuries. Increasing studies have been performed for clarifying its anti-osteoporotic mechanisms. However, this treatment still lacks a systematic review for its efficacy and safety in the treatment of OP.

Methods:
Eight electronic databases will be searched from inception to November 2018 by 2 independent researchers, in order to collect qualified randomized controlled trials (RCTs) on the ZGP treatment for OP. The therapeutic effects according to bone mineral density (BMD) will be adopted as the primary outcomes. RevMan V.5.3 software will be used for the data synthesis and the Cochrane's risk of bias assessment tool will be used to assess the risk of bias.

Results:
This review will conduct a high-quality synthesis on present evidence of ZGP for OP.

Conclusion:
The conclusion of the study will indicate whether ZGP is an effective treatment for OP by providing updated evidence.

PROSPERO registration number: PROSPERO CRD 42018114366
The genetic relationship of SOX9 polymorphisms with osteoarthritis risk in Chinese population
Authors: Wang Yongcheng , Zhang Xinyu , Niu Xiaobo , Xu Yongsheng , Lu Long , Li Hua 
Published: February 2019

Abstract
This research aimed to reveal the relationship of SRY-type HMG box 9 (SOX9) gene polymorphisms with osteoarthritis (OA) risk in a Chinese population.
Polymerase chain reaction and direct sequencing were used for genotyping polymorphism in 152 OA patients and 139 controls. Firstly, the conformity of genotype distribution to Hardy–Weinberg equilibrium in the control group was checked. The differences in genotype and allele frequencies of our studied polymorphism were compared between the two groups using chi-square test. Odds ratio (OR) with 95% confidence interval (95%CI) was used to appraise the strength of the relationship between the polymorphism and OA occurrence. Cross-over analysis was conducted to reveal the interaction between polymorphisms in SOX9.
The AA genotype of the polymorphism rs1042667 was significantly correlated to the increased susceptibility to OA (OR = 2.075, 95%CI = 1.042–4.132). We also detected that the A allele of the polymorphism rs1042667 also obviously increased the occurrence of OA in our study (OR = 1.401, 95%CI = 1.009–1.945). Moreover, the G allele of the polymorphism rs12601701 and the A allele of the polymorphism rs1042667 could significantly elevate the risk of OA (OR = 2.075, 95%CI = 1.021–4.218).

SOX9 polymorphism rs1042667 may be a risk factor for OA in Chinese Han population. The interaction between the polymorphisms rs1042667 and rs12601701 also contribute to OA risk.