bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Sedation Team Approach
Authors: Turmelle Michael 
Published: January 2019

Abstract
The administrative organization of a pediatric procedural sedation service is guided by Center for Medicare and Medicaid Services (CMS) regulations. CMS specifically allows, within the broader regulations, institution-specific policies and structures to be developed and applied to the needs of the patient population served and institutional staff available. The sedation team approach has both advantages and disadvantages when compared to a sedation unit approach. A sedation team allows more flexibility to function outside the four walls of one set unit. The providers who deliver the sedation may vary within the team. Although there are many ways to structure a sedation team, the key to success is having a flexible yet well-organized approach that works in the given system and meets the needs of the patients who need procedural sedation care.
Introduction
Authors: Svrakic Dragan M. , Divac-Jovanovic Mirjana 
Published: January 2019

Abstract
The term “fragmented personality” evokes the neuro-psychological essence of personality disorder (all variants), i.e., a suboptimal brain and mind integration within a person that leads to social maladaptation, together known as a personality disorder. Diagnostic aspects pivotal to the analysis of personality and its disorders are twofold. One aspect examines the level of mental functioning (a qualitative aspect of personality integration, i.e., “vertical” or in-depth diagnosis), while the second aspect is concerned with that individual’s habitual (mal)adaptive styles in relation to the environment (“horizontal diagnosis”). These two aspects provide answers to the three most important questions relevant to diagnosis and therapy: what (habitual patterns of behavior and relationships), how (characteristics of mental functioning), and why (factors in the development and maintenance of the observed patterns).
Psychotherapy of Personality Disorder
Authors: Svrakic Dragan M. , Divac-Jovanovic Mirjana 
Published: January 2019

Abstract
This chapter reviews the therapeutic process, strategies, and goals in psychotherapy of personality disorder that have been accepted by consensus. Psychotherapy can be thought of as environmental intervention that consistently trends in the right direction, proven capable of correcting the pathogenic impact of past environments or excessive neurobiology. The correction is both mental and structural. With personality disorder, psychotherapy must be transtheoretical, integrative, and eclectic in order to meet the uniquely multicausal and multidimensional nature of the syndrome. The chapter introduces Reconstructive Interpersonal Therapy (RIT), an integrative, transtheoretical psychotherapy of personality disorder drawing from psychoanalytic, cognitive, and humanist traditions. The RIT is presented in detail, with a comprehensive review of its basic principles and tools along with a number of practical tips in everyday therapeutic work. A detailed review of empirical studies of the efficacy and effectiveness of psychotherapy in personality disorder concludes the chapter.
A Puzzle About What the NVVRS “Projected Probability of Current PTSD” Measures
Authors: Dohrenwend Bruce P. , Murphy Eleanor , Yager Thomas J. , Wall Melanie M. , Hatch Stephani L. 
Published: January 2019

Abstract
This chapter asks and answers a critical question regarding the lack of difference in rates of NVVRS projected probability of PTSD in veterans who served in high and low combat periods of the Vietnam war. This chapter finds that the projected probability measure reflects symptoms of general distress more than it reflects symptoms of PTSD. If the previous NVVRS analyses had been able to use diagnoses of PTSD in the full sample, it is likely that they would have found differences in outcome between high and low combat periods of the war. After intensive study of the diagnosed onsets of, and current PTSD in, veterans in the NVVRS subsample who fought in four distinct periods of the war, this chapter concludes that the projected probability of current PTSD measure is a weak, if not misleading, measure of war-related PTSD.
Long-Term Impact of the War on Veterans’ Lives Nearly 40 Years After the War Ended
Authors: Dohrenwend Bruce P. , Yager Thomas J. , Wall Melanie M. 
Published: January 2019

Abstract
This chapter finds that the rate of war-related PTSD declined by about half in the years between the NVVRS and the Longitudinal Study. This furthered the previously reported decline of PTSD by almost half from its initial onset before the NVVRS was conducted. The chapter reports that most Vietnam veterans found value in their war experience, but they also put the war behind them after homecoming, suggesting successful transitions to civilian life. However, while readjustment to life after leaving Vietnam was satisfying and productive for most veterans, a minority believed that their wartime experiences still had a major negative effect on their current lives. Moreover, at the time of the Longitudinal Study, a small group of veterans (4%) suffered from current PTSD, and over three-quarters who had experienced PTSD onsets continued to experience one or more PTSD symptoms.
Endosaccular Flow Disruption: A New Frontier in Endovascular Aneurysm Management
Authors: Dmytriw Adam A , Salem Mohamed M , Yang Victor X D , Krings Timo , Pereira Vitor M , Moore Justin M , Thomas Ajith J 
Published: January 2019

Abstract
Flow modification has caused a paradigm shift in the management of intracranial aneurysms. Since the FDA approval of the Pipeline Embolization Device (Medtronic, Dublin, Ireland) in 2011, it has grown to become the modality of choice for a range of carefully selected lesions, previously not amenable to conventional endovascular techniques. While the vast majority of flow-diverting stents operate from within the parent artery (ie, endoluminal stents), providing a scaffold for endothelial cells growth at the aneurysmal neck while inducing intra-aneurysmal thrombosis, a smaller subset of endosaccular flow disruptors act from within the lesions themselves. To date, these devices have been used mostly in Europe, while only utilized on a trial basis in North America. To the best of our knowledge, there has been no dedicated review of these devices. We therefore sought to present a comprehensive review of currently available endosaccular flow disruptors along with high-resolution schematics, presented with up-to-date available literature discussing their technical indications, procedural safety, and reported outcomes.
Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke
Authors: Rennert Robert C , Wali Arvin R , Steinberg Jeffrey A , Santiago-Dieppa David R , Olson Scott E , Pannell J Scott , Khalessi Alexander A 
Published: January 2019

Abstract
Large vessel occlusions (LVOs), variably defined as blockages of the proximal intracranial anterior and posterior circulation, account for approximately 24% to 46% of acute ischemic strokes. Commonly refractory to intravenous tissue plasminogen activator (tPA), LVOs place large cerebral territories at ischemic risk and cause high rates of morbidity and mortality without further treatment. Over the past few years, an abundance of high-quality data has demonstrated the efficacy of endovascular thrombectomy for improving clinical outcomes in patients with LVOs, transforming the treatment algorithm for affected patients. In this review, we discuss the epidemiology, pathophysiology, natural history, and clinical presentation of LVOs as a framework for understanding the recent clinical strides of the endovascular era.
Direct Health Care Cost and Work Incapacity Related to Complex Regional Pain Syndrome in Switzerland: A Retrospective Analysis from 2008 to 2015
Authors: Scholz-Odermatt Stefan Markus , Luthi François , Wertli Maria Monika , Brunner Florian 
Published: January 2019

Abstract

Objective
First, to determine the number of accident-related complex regional pain syndrome (CRPS) cases from 2008 to 2015 and to identify factors associated with an increased risk for developing CRPS. Second, to analyze the duration of work incapacity and direct health care costs over follow-up periods of two and five years, respectively.

Design
Retrospective data analysis.

Setting
Database from the Statistical Service for the Swiss National Accident Insurances covering all accidents insured under the compulsory Swiss Accident Insurance Law.

Subjects
Subjects were registered after an accident between 2008 and 2015.

Methods
Cases were retrospectively retrieved from the Statistical Service for the Swiss National Accident Insurances. Cases were identified using the appropriate International Classification of Diseases, 10th Revision, codes.

Results
CRPS accounted for 0.15% of all accident cases. Age, female gender (odds ratio [OR] = 1.53, 95% confidence interval [CI] = 1.47–1.60), and fracture of the forearm (OR = 38, 95% CI = 35–42) were related to an increased risk of developing CRPS. Over five years, one CRPS case accumulated average insurance costs of $86,900 USD and treatment costs of $23,300 USD. Insurance costs were 19 times and treatment costs 13 times the average costs of accidents without CPRS. Within the first two years after the accident, the number of days lost at work was 20 times higher in patients with CRPS (330 ± 7 days) than in patients without CRPS (16.1 ± 0.1 days). Two-thirds of all CRPS cases developed long-term work incapacity of more than 90 days.

Conclusion
CRPS is a relatively rare condition but is associated with high direct health care costs and work incapacity.
Pharmacokinetics of Micafungin in Critically Ill Patients Receiving Continuous Venovenous Hemodialysis With High Cutoff Membranes
Authors: Tenorio-Cañamás Teresa , Grau Santiago , Luque Sonia , Fortún Jesús , Liaño Fernando , Roberts Jason A. 
Published: January 2019

Background:
An optimal antifungal therapy for invasive candidiasis in critically ill patients is essential to reduce the high mortality rates. Acute kidney injury is common, and continuous renal replacement therapies are frequently used. Previous studies have demonstrated a lack of effect from different continuous renal replacement techniques on micafungin clearance. However, the use of high cutoff pore size membranes could potentially allow for the loss of albumin and alter micafungin pharmacokinetics. The objective was to explore the pharmacokinetics of micafungin in critically ill patients undergoing continuous venovenous high cutoff membrane hemodialysis (CVVHD-HCO).

Methods:
Prospective observational study performed in critically ill patients treated with 100 mg/d of micafungin and undergoing CVVHD-HCO. CVVHD-HCO sessions were performed using Prisma-Flex monitors and dialyzers with a membrane of polyarylethersulfone of 1.1-m2 surface area and 45-kDa pore size. Blood samples were collected from arterial prefilter, venous postfilter, and the drainage line ports at 0 (predose), 1, 4, 12, 24 hours after dose, and micafungin concentrations were determined using HPLC-UV.

Results:
Nine patients (55.6% male; age: 28–80 years) were included. Median (range) of micafungin concentrations in the effluent were <0.2 (<0.2–0.4) mg/L at low (predose) and 0.4 (<0.2–0.7) mg/L at high (1 h) concentrations. The extraction ratio was <12% at each time point. A 2-compartment model best described the time course of plasma concentrations, and body weight was the only covariate that improved the model.

Conclusions:
This is the first study demonstrating that CVVHD-HCO does not alter the pharmacokinetics of micafungin, and that standard doses of this antifungal can be used.
A Standard Form of Cardiac Rehabilitation Can Improve Self-Reported Positive Behavior Changes in the Short- to Medium-Term
Authors: Tang Clarice Y. , Blackstock Felicity C. , O'Halloran Paul D. , Aldcroft Sheryl A. , Taylor Nicholas F. 
Published: January 2019

Purpose:
Little is known about the impact of standard cardiac rehabilitation (CR), consisting of health education and exercise, on self-reported behavior change among people who have completed rehabilitation. This qualitative study aimed to explore the lived experiences of participants' behaviors toward exercise and diet in the short- to medium-term after CR program completion.

Methods:
Using a phenomenological framework, we interviewed participants who had completed a 4-wk CR program and then 6 mo later. The program included education and exercise in a private outpatient facility. A thematic analysis was conducted to explore changes in self-reported behavior. These themes were triangulated with Bandura's self-efficacy scales and Stages of Readiness for Change questionnaires to identify any convergence of themes.

Results:
A total of 21 participants were recruited to the study. One main theme and 4 subthemes emerged from analysis of the data. Most participants reported that they had either maintained or initiated positive lifestyle changes in both exercise and diet in the short- and medium-term. Fear of having another myocardial infarction, seeing the benefits of adhering with recommendations, and family involvements were motivating factors along with the involvement of the multidisciplinary staff in the program. The themes converged with the results from the questionnaires.

Conclusions:
A standard form of CR can result in positive self-reported behavior change in the short- to medium-term. Further trials are needed to determine whether a standard form of rehabilitation is sufficient to change health behaviors at sufficient levels to result in long-term health benefits.
Effects of Pursed Lip Breathing on Exercise Capacity and Dyspnea in Patients With Interstitial Lung Disease
Authors: Parisien-La Salle Stéfanie , Abel Rivest Ellie , Boucher Vincent Gosselin , Lalande-Gauthier Mélina , Morisset Julie , Manganas Hélène , Poirier Claude , Comtois Alain-Steve , Dubé Bruno-Pierre 
Published: January 2019

Background:
Although mainly described in patients with chronic obstructive pulmonary disease, pursed lip breathing (PLB) could prove useful in patients with interstitial lung disease (ILD) by improving exertional tachypnea and respiratory control. This prospective, randomized, crossover trial aimed at evaluating the impact of PLB on dyspnea and walking distance in ILD patients.

Methods:
ILD patients with total lung capacity of <80% predicted were randomized to 6-min walk tests using either PLB or usual breathing. Patients were crossed over for the second 6-min walk tests and served as their own controls. Ventilatory and metabolic variables were recorded using a portable metabolic cart and were compared at 1-min intervals.

Results:
Thirty-five patients were included (mean forced vital capacity of 64 ± 10% predicted). Use of PLB resulted in lower mean respiratory rates and larger tidal volumes (both P < .001), worsened dyspnea ratings (post-6-min walk test Borg score: 5.2 ± 2.6 vs 4.2 ± 2.3, P < .001), and walking distance (403 ± 102 m vs 429 ± 93 m, P < .001). Twenty-nine patients (83%) described PLB as less comfortable than usual breathing. Both groups had similar total ventilation and oxygen saturation (all P > .05), but PLB resulted in higher mean oxygen uptake (13.9 ± 3.6 vs 12.9 ± 3.2 mL/kg/min, P = .02), even when corrected for walking distance (P < .001).

Conclusion:
In ILD patients, acute exposure to PLB did not improve exertional dyspnea, walking distance, or gas exchange, and was associated with higher metabolic demands than usual breathing. These results cast doubt on the usefulness of this technique in ILD patients and should be taken into account when tailoring pulmonary rehabilitation programs to this population.
Left Ventricular Function Before and After Aerobic Exercise Training in Women With Pulmonary Arterial Hypertension
Authors: Woolstenhulme Joshua G. , Guccione Andrew A. , Herrick Jeffrey E. , Collins John P. , Nathan Steven D. , Chan Leighton , Keyser Randall E. 
Published: January 2019

Background:
Pulmonary arterial hypertension (PAH) is a chronic debilitating illness. The effects of vigorous aerobic exercise training (AET) on heart function in PAH are poorly understood.

Methods:
Eighteen women with PAH (aged 56.2 ± 8.8 yr, body mass index: 28.8 ± 7.3 kg/m2) underwent 10 wk of vigorous AET. Cardiac function was observed at rest and peak exercise using bioelectrical impedance cardiography before and after the AET. Cardiac function was observed in a small PAH subset (n = 7) for 10 wk before beginning the AET. A cohort of sedentary women (n = 19) served as healthy controls.

Results:
Left ventricular ejection fraction (48 ± 9.2 vs 61.5 ± 13.3%, P = .034) and the systemic vascular resistance index (2258 ± 419.1 vs 2939 ± 962.4 dyn·sec/cm5·m2, P = .008) were lower at supine rest in the baseline PAH group versus the healthy group, as were peak exercise heart rate (140 ± 13.3 vs 170 ± 13.8 beats/min, P < .001) and systemic vascular resistance index (828 ± 141.1 vs 824 ± 300.9 dyn·sec/cm5·m2, P = .050) after controlling for age and heart rate. Systemic vascular resistance index measured at peak exercise decreased in the PAH group after AET (828 ± 141.1 vs 766 ± 139.6 dyn·sec/cm5·m2, P = .020). Left ventricular early diastolic filling ratio worsened in the PAH subset prior to AET (95.9 ± 19.4 vs 76.2 ± 18.9%, P = .043) and remained unchanged after AET.

Conclusion:
Vigorous AET was not associated with significant declines in left ventricular systolic or diastolic function in women with PAH. Aerobic exercise training may be beneficial for reducing afterload and may preserve left ventricular diastolic function.
Effect of Sex on Biomarker Response in a Mouse Model of the Hematopoietic Acute Radiation Syndrome
Authors: Jones Jace W. , Alloush Jenna , Sellamuthu Rajendran , Chua Hui Lin , MacVittie Thomas J. , Orschell Christie M. , Kane Maureen A. 
Published: January 2019

Abstract
Sex is an important confounding variable in biomarker development that must be incorporated into biomarker discovery and validation. Additionally, understanding of sex as a biological variable is essential for effective translation of biomarkers in animal models to human populations. Toward these ends, we conducted high-throughput targeted metabolomics using liquid chromatography tandem mass spectrometry and multiplexed immunoassay analyses using a Luminex-based system in both male and female mice in a model of total-body irradiation at a radiation dose consistent with the hematopoietic acute radiation syndrome. Metabolomic and immunoassay analyses identified metabolites and cytokines that were significantly different in plasma from naive and irradiated C57BL/6 mice consisting of equal numbers of female and male mice at 3 d after 8.0 or 8.72 Gy, an approximate LD60–70/30 dose of total-body irradiation. An additional number of metabolites and cytokines had sex-specific responses after radiation. Analyses of sham-irradiated mice illustrate the presence of stress-related changes in several cytokines due simply to undergoing the irradiation procedure, absent actual radiation exposure. Basal differences in metabolite levels between female and male were also identified as well as time-dependent changes in cytokines up to 9 d postexposure. These studies provide data toward defining the influence of sex on plasma-based biomarker candidates in a well-defined mouse model of acute radiation syndrome.
The Meaning of Self-efficacy for Symptom Management in the Acute Phase of Hematopoietic Stem Cell Transplantation
Authors: White Lynn L. , Cohen Marlene Z. , Berger Ann M. , Kupzyk Kevin A. , Bierman Philip J. 
Published: January 2019

Background
Hematopoietic stem cell transplantation (HSCT) is an intensive treatment that offers the potential for longer life or cure for some types of cancer. Hematopoietic stem cell transplant is associated with decreased quality of life and functional status and distressing symptoms. Self-efficacy for symptom management (SESM) is a person's belief in his/her ability to implement behaviors to manage these symptoms. Presence of SESM can affect symptom distress, healthcare utilization, and posttransplantation outcomes.

Objective
The aim of this study was to explore the meaning of SESM in adults during the acute phase of HSCT.

Methods
Interviews were conducted before and at 30 days after transplantation. Descriptive thematic analysis was performed on verbatim interview transcripts.

Results
Themes of confidence, being responsible, and caring for mind, body, and spirit were identified, with subthemes of self-confidence, confidence in others, confidence and symptom level, vigilance, self-advocacy, and normalcy. Participants reported having high SESM before transplantation and having much less or no SESM when symptom distress was the most severe.

Conclusions
This is the first study to examine the patient's perspective of self-efficacy in the acute phase of HSCT. This contributes to existing literature on the concept of symptom management and expands nursing knowledge of SESM in patients undergoing HSCT.

Implications for Practice
Nurses can assess SESM before transplantation and implement interventions to enhance SESM when symptoms are at their most distressing after HSCT. The findings from this study can provide the basis for creating behavioral interventions to enhance self-efficacy for symptom management in HSCT patients.
Mindfulness Training and Physical Health: Mechanisms and Outcomes
Authors: Creswell J. David , Lindsay Emily K. , Villalba Daniella K. , Chin Brian 
Published: January 2019

ABSTRACT

Objective
There has been substantial research and public interest in mindfulness interventions, biological pathways, and health for the past two decades. This article reviews recent developments in understanding relationships between mindfulness interventions and physical health.

Methods
A selective review was conducted with the goal of synthesizing conceptual and empirical relationships between mindfulness interventions and physical health outcomes.

Results
Initial randomized controlled trials in this area suggest that mindfulness interventions can improve pain management outcomes among chronic pain populations, and there is preliminary evidence for mindfulness interventions improving specific stress-related disease outcomes in some patient populations (i.e., clinical colds, psoriasis, irritable bowel syndrome, posttraumatic stress disorder, diabetes, HIV). We offer a stress-buffering framework for the observed beneficial effects of mindfulness interventions and summarize supporting biobehavioral and neuroimaging studies that provide plausible mechanistic pathways linking mindfulness interventions with positive physical health outcomes.

Conclusions
We conclude with new opportunities for research and clinical implementations to consider in the next two decades.