bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transforming osteopathic medical education
Authors: Ross-Lee Barbara , Kiss Lois E. , Weiser Michael A. 
Published: October 2018

Abstract
The evolution of the healthcare marketplace to a managed care-based system requires dramatic changes in the fragmented medical education infrastructure and curricula to more adequately train the physician workforce needed to staff and support the new system_ Graduating physicians, in large numbers, feel poorly prepared to function effectively in the very areas adjudged to be essential to a successful transition, such as cost effective care and caring for patients in outpatient settings. Managers of the new systems, such as health maintenance organizations, have expressed dissatisfaction with the skill levels of many of the practitioners whom they are hiring; Many physicians who have made the transition to a new practice paradigm by restructuring their practices are dissatisfied with several aspects of the new practice environment and equally concerned about the quality of care they can deliver. The conflict between rhetoric and incentives, and the difficulty of reforming a fragmented academic system pose barriers to effective change as the nation's academic health centers prepare to respond. Osteopathic medicine is better positioned to change because of its community-based education, its track record in primary care, and its national move to create a vertically integrated continuum of education from undergraduate through graduate study. Medical education and workforce issues are essential components of the cost, quality, and access triad. Without reform in medical education, the ability of the new paradigm to adequately address these other issues is critically compromised.
Epidemiological characteristics and factors affecting length of hospital stay for children and adults with burns in Zunyi, China: a retrospective study
Authors: Wang Tao , Nie Chan , Zhang Hong , Zeng Xueqin , Yu Huiting , Wei Zairong , Yang Chenglan , Shi Xiuquan 
Published: October 2018

Objective
Burn wounds are a global public health problem, and a large number of casualties are caused by burns each year. In this study, we explored the epidemiological characteristics associated with burns and the factors affecting the length of hospital stay (LOS) in children and adults with burn wounds.

Methods
Records of patients with burns in the Affiliated Hospital of Zunyi Medical University from January 1, 2014 to August 31, 2016 were retrieved. Information on demographic characteristics, mechanism of burns, first treatment received, clinical details of burns, and LOS were extracted from hospital medical records.

Results
A total of 465 children and 327 adults with burns were identified over about 2.5 years. The ratio of male to female children with burn wounds was 1.6 and 2.3 in adults. The epidemiological characteristics of burns, including gender, season, location, etiology, degree and site, differed between children and adults. There were differences in external remedies used (e.g., traditional Chinese medicine powder) and wound protection (towels covering wounds) between children and adults, but few patients had both protected wounds and did not use external remedies. LOS was reduced with age (hazard ratio [HR] = 0.993) and skin grafting (HR = 0.339). LOS increased with the male gender (HR = 1.234), deep partial thickness burns (HR = 3.128), and full-thickness burns (HR = 1.791). LOS was increased when total body surface area (TBSA) of burns reached from 10% to 29% (HR = 3.978), when TBSA was greater than 30% (HR = 1.787), and heat vs. non-heat etiologies (HR = 1.497).

Conclusion
Our findings for the epidemiological characteristics of burns in children and adults in Zunyi will help with a targeted awareness campaign and improve knowledge of first-aid and wound treatment.
Health needs of puerperal women with chemical dependence according to Nursing professionals / Necessidades em saúde de puérperas dependentes químicas na perspectiva dos profissionais de Enfermagem
Authors: De Aquino Gustavo Selenko , Pivatto Liane Führ , Da Silva Daniel Ignacio , Ramallo Veríssimo Maria De La Ó 
Published: October 2018

Objetivo: caracterizar as necessidades em saúde de puérperas dependentes químicas, na percepção dos profissionais de Enfermagem. Métodos: Pesquisa exploratória qualitativa, realizada no alojamento conjunto de uma Maternidade Pública do Sul do Brasil. Participaram dez profissionais de Enfermagem, sendo sete Auxiliares e três Enfermeiros. Dados coletados por meio de entrevista semiestruturada, analisados pela análise temática categorial e sintetizados de acordo com as Necessidades em Saúde propostas por Cecílio e Matsumoto. Resultados: Da análise dos discursos emergiram as seguintes necessidades: higiene, alimentação saudável, adesão ao cuidado em saúde, vigilância profissional, qualificação do cuidado, orientação em saúde, Integralidade do cuidado, escuta ativa, humanização do cuidado, apoio familiar e de vínculo com a criança. Considerações Finais: A compreensão das necessidades dessas puérperas permite o delineamento de intervenções em Saúde que busquem promover a sua autonomia e empoderamento para o cuidado de sua Saúde, possibilitando uma prática, que vise à reabilitação e promoção da saúde.
Nursing care towards the home care user / Cuidados do enfermeiro ao usuário nas modalidades de atenção domiciliar
Authors: Tavares Juliana Marques weykamp , Cecagno Diana , Tolfo Fernando Dalmaso , Scarton Juliane , De Andrade Gustavo Baade , De Siqueira Hedi Crecencia Heckler 
Published: October 2018

Objetiva-se conhecer a produção científica publicada no período de 2004 a 2015, a respeito dos cuidados do enfermeiro ao usuário do Sistema Único de Saúde nas modalidades de atenção domiciliar. Método: Revisão integrativa realizada via online na Biblioteca Virtual em Saúde na base de dados da Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online e Banco de dados da Enfermagem. Resultados e discussão: A amostra constituiu-se de 38 artigos científicos completos e gratuitos. Observa-se que o enfermeiro atuante no serviço domiciliar é capaz de participar e contribuir no desenvolvimento de ações de promoção, prevenção e recuperação da saúde dos usuários. Conclusão: Conclui-se que novos estudos são necessários, pois existe um movimento tendente a estimular a organização de arranjos estruturais de atenção à saúde, que necessitam de aprofundamento e adaptação para atender atuais as necessidades da modalidade de atendimento domiciliar.
Professionals’ view regarding the transition process from a nurse technician to a nurse / A transição funcional de técnico de enfermagem para enfermeiro na perspectiva do profissional
Authors: De Souza Bruna Caroline Hirle , Ponte Cruz Virginia Luiza da Silva , Martins Elizabeth Rose Costa , De Moraes Paula Costa , Francisco Marcio Tadeu Ribeiro , Alves Raphaela Nunes 
Published: October 2018

Objetivos: Descrever como o profissional de enfermagem lida com novas atribuições e responsabilidades, identificar e discutir os fatores facilitadores e dificultadores dessa transição para o trabalho de enfermagem. Método: Estudo descritivo, exploratório com abordagem qualitativa. Os participantes foram treze técnicos de enfermagem que passaram pela transição funcional e atualmente desenvolvem funções enquanto enfermeiros. Apresenta como cenário, unidades cirúrgicas de um hospital universitário, no rio de janeiro. Foram respeitados os aspectos éticos e legais da resolução nº466/2012 do CNS aprovado pelo CEP, com o nº 1.432.069. Utilizou-se a entrevista semiestruturada, para análise dos dados, realizou-se a análise de conteúdo. Resultados: Apresenta como categorias: o profissional técnico de enfermagem e a transição funcional para enfermeiro e os fatores facilitadores e dificultadores na transição funcional. Conclusão: A transição funcional atende a necessidade do técnico na busca por conhecimento científico, crescimento profissional e evolução pessoal.
Conception of old age: a study with health professionals from a university hospital / Concepção de velhice: um estudo com profissionais de saúde de um Hospital Universitário
Authors: Raposo Maria Aparecida Moreira , Leite Franciele Marabotti Costa , Maciel Paulete Maria Ambrósio 
Published: October 2018

Objetivo: Analisar a concepção de velhice dos profissionais de saúde que atuam no ambiente hospitalar. Método: Trata-se de um estudo exploratório descritivo, de abordagem qualitativa, realizado em uma Unidade de Clinica Médica de um Hospital Universitário no Município de Vitória, Espírito Santo. Participaram 22 profissionais de saúde: enfermeiros, médicos, médicos residentes e assistentes sociais. Os dados foram coletados no período de março a abril de 2013, por meio de um questionário e analisados pela técnica de análise de conteúdo proposta por Bardin. Resultados: A análise desses permitiu a construção de quatro categorias: Velhice nas dimensões: biológica; cronológica; psicológica e social. Conclusão: Constatou-se que a concepção de velhice dos profissionais de saúde independe da idade cronológica sendo norteada por fatores como dependência, capacidade funcional e de como o idoso vê a sua condição de velhice.
Reader, interrupted: Do disruptions during encoding influence the use of inaccurate information?
Authors: Donovan Amalia M. , Theodosis Elias , Rapp David N. 
Published: October 2018

SummaryPeople routinely rely on inaccuracies they have read to complete subsequent tasks, even when they should already possess accurate prior knowledge. This problematic reliance maintains even when people are warned about potential inaccuracies prior to reading. In contrast, reductions have been observed when interventions target encoding of inaccuracies during reading. We investigated whether interruptions during encoding would similarly prove beneficial for disrupting attention to and memory for inaccuracies. Participants read a story containing both accurate and inaccurate assertions. Their readings were interrupted at 300‐word intervals (Experiment 1) or immediately after each assertion (Experiments 2 and 3). After reading, participants judged the validity of statements summarizing the assertions. Interruptions were ineffective: Participants overall made more incorrect judgments after reading inaccurate than accurate assertions, at rates comparable with participants who read without interruption. These results help identify the mechanisms that underlie reliance on inaccuracies, and suggest useful targets for more effective interventions.
Assessment of baseline pretreatment factors and on‐treatment virological response to predict sustained virological response in patients with chronic hepatitis C treated with pegylated interferon and ribavirin
Authors: Wen Shi‐Chi , Cheng Lung‐Chih , Hsu Jui‐Hung , Lai Hsin‐Wen , Shih Pei‐Chen , Tsai Chi‐Chang , Kuo Wu‐Hsien 
Published: October 2018

SummaryBackgroundsPegalated interferon (PEG‐IFN) combination with ribavirin (RBV) (PR) in accordance to response‐guide therapy (RGT) is a treatment option for chronic hepatitis C (CHC) in the past decade. Baseline host and viral factors and early viral kinetics are important determinants for patient using combination therapy.AimsWe aimed to investigate the effects of host and viral factors on sustained virus response (SVR). We researched the possible predictors of an SVR.MethodsWe retrospectively analyzed a total of 158 CHC patients who had been treated with a PR dual therapy. Clinical parameters and virological responses were analyzed for their relationship with SVR.ResultsThe overall SVR rate was 71.5% (113/158). Factors associated with an SVR were ALT levels > 3xULN, non‐AST/ALT > 1, non‐genotype 1 and non‐cirrhosis. Non‐genotype 1 (OR: 3.154; 95% CI: 1.309‐7.601; P = 0.010), and non‐cirrhosis (OR: 2.696; 95% CI: 1.045‐6.956; P = 0.004) were the predictors of an SVR. An SVR significantly increased in patients with an RVR and significantly reduced in patients with cEVR, pEVR, null response and relapse. In addition, an RVR was a powerful independent predictor of an SVR (OR: 38.263; 95% CI: 10.184‐143.757; P = 0.000). The positive predictive value (PPV) of an RVR on SVR was 92.2% (94/102).ConclusionsNon‐cirrhosis, non‐genotype 1 and achievement of an RVR are independent predictors of SVR. A 4 week RVR is the best predictor of an SVR in CHC patients with a PR dual treatment. An RVR predicts treatment success early.Copyright © 2016, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.
Major bleeding events after endoscopic sphincterotomy and endoscopic papillary balloon dilatation in cirrhotic patients: A nationwide population‐based cohort study
Authors: Wang Chi‐Chih , Tsai Ming‐Chang , Tseng Ming‐Hseng , Yang Tzu‐Wei , Wang Yao‐Tung , Lin Chun‐Che 
Published: October 2018

SummaryBackgrounds and aimsEndoscopic sphincterotomy (EST) or endoscopic papillary balloon dilatation (EPBD) were two important methods for therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Post‐ERCP bleeding is a troublesome issue especially in patients with bleeding tendency, like cirrhotic patients. In viewing the need of a safer method, we thus aimed to evaluate the post‐EST or post‐EPBD bleeding rate among cirrhotic patients based on Taiwan's National Health Insurance Research Database (NHIRD).MethodsAs per one million population data selected from NHIRD, patients who were hospitalized or accessing outpatient clinics for 3 times with a primary diagnosis of liver cirrhosis (ICD‐9 codes 571.2 and 571.5) between January 1, 2004 and December 31, 2011, were collected as research subjects. Rates of major gastrointestinal tract bleeding events appeared within 14 days after EST or EPBD in both cirrhosis and non‐cirrhosis patients were compared.ResultsA total of 1852 patients, age above 18 years old without end stage renal disease, accepted total 2132 EST or EPBD procedures during the sampling period picked. EST was adopted much more often than EPBD not only in cirrhotic patients (154 vs. 15 events), but also in non‐cirrhotic patients (1793 vs. 170 events). Post‐EST bleeding events occurred more frequently in cirrhotic patients than in non‐cirrhotic patients (4.55% vs. 2.12%; p = 0.119). Post‐EPBD bleeding events were similar in both groups (0.00% vs. 0.59%; p > 0.999). Post‐EST bleeding rate was higher than post‐EPBD bleeding rate in both non‐cirrhotic patients (2.12% vs. 0.59%; p = 0.269) and cirrhotic patients (4.55% vs. 0.00%; p > 0.999), although results did not meet the significant statistical difference in our study.ConclusionsIn contrast to EST, EPBD showed fewer post‐EPBD major bleeding events especially in cirrhotic patients. Thus EPBD tend to be a relative safer method of therapeutic ERCP especially for cirrhotic patients.Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.
Uterine cervical squamous cell carcinoma with duodenal metastasis causes obstructive jaundice
Authors: Shen Chia‐I , Wu Wen‐Chieh , Kao Wei‐Yu , Su Chien‐Wei , Lin Han‐Chieh , Hou Ming‐Chih , Lin Chih‐Lin , Chen Kuan‐Yang 
Published: October 2018

SummaryThis 73‐year‐old female had undergone right middle lobe lobectomy for adenocarcinoma of lung (pT2N0M0) and got cured without recurrence. However, two years later, she was diagnosed as another cancer, uterine cervical squamous cell carcinoma (the International Federation of Gynecology and Obstetrics stage IIB), and received a series of concurrent chemoradiotherapy (CCRT). After 6 months of CCRT, she was admitted due to abdominal pain and nausea for one week. Physical examination disclosed mild epigasrtic tenderness and icteric sclera. Upper gastrointestinal endoscopy showed friable mucosa and narrowed lumen over the 2nd portion of duodenum, and the result of biopsy confirmed metastatic carcinoma of uterine cervix by positive for P16 immunohistochemically. Moreover, abdominal computed tomography (CT) scan disclosed increased infiltrative soft tissue at pancreatic head, uncinate process, pancreaticoduodenal groove, with eccentric thickening of the wall of bulb to 1st – 2nd portion of duodenum. The diagnosis was made as uterine cervical squamous cell carcinoma with duodenal metastasis and intestinal obstruction. The patient received supportive care. However, she died due to sepsis about one month later. Small intestinal neoplasm is rare and adenocarcinoma is more prevalent than other types of tumors. Common metastatic sites of uterine cervical cancer are the liver, lung, and bone marrow. Small intestine metastasis is found only in about 1.5 – 5.3% of patients with uterine cervical carcinoma beyond stage IIA. The presentation of patients with duodenal metastasis varies from epigastric pain, upper gastrointestinal hemorrhage to intestinal obstruction. Diagnosis is difficult and dependent on high alert of clinical physicians.Upper gastrointestinal endoscopy, CT scan or endoscopic retrograde cholangiopancreatography could be used to detect obstructive lesion, but the diagnosis is only made by biopsy with immunohistochemical stain. However, to diagnose it correctly and instantly is important because long term prognosis of patients with duodenal metastases is extremely poor without effective treatment. The pearl of this case is that clinical physician should keep alert for small intestinal neoplasm, even the flat type, in the patients who have history of other primary malignancy, such as cervical cancer.Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.
Unusual cause of intestinal obstruction: Breast cancer with solitary ileal metastasis diagnosed after enteroscopy
Authors: Su Hsuan‐An , Chen Chih‐Jung , Yen Hsu‐Heng 
Published: October 2018

SummaryAlthough extremely rare, small intestinal metastasis of tumors from the breast has been increasingly reported and reviewed as an uncommon cause of intestinal obstruction. We report a case of a 41‐year‐old Taiwanese woman with small bowel obstruction by a tumor metastasized from the breast, which was diagnosed after enteroscopy. Enteroscopy as well as enteroscopy‐assisted enterography can be very helpful in identifying such disease. In particular, in patients with a history of breast cancer, clinicians should consider the possibility of small intestinal obstructive tumor metastasized from the breast even after a long cancer‐free latency.Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.
Synthesis of the Campylobacter jejuni 81‐176 Strain Capsular Polysaccharide Repeating Unit Reveals the Absolute Configuration of its O‐Methyl Phosphoramidate Motif
Authors: Thota V. Narasimharao , Ferguson Michael J. , Sweeney Ryan P. , Lowary Todd L. 
Published: October 2018

AbstractThe O‐methyl phosphoramidate (MeOPN) motif is a non‐stoichiometric modification of capsular polysaccharides (CPS) in ≈70 % of all Campylobacter jejuni strains. Infections by C. jejuni lead to food‐borne illnesses and the CPS they produce are key virulence factors. The MeOPN phosphorus atom in these CPS is stereogenic and is found as a single stereoisomer. However, to date, the absolute stereochemistry at this atom has been undefined. We report the synthesis of the three repeating units found in C. jejuni 81‐176 CPS; one of these possesses a MeOPN group. In the course of these studies we established that the stereochemistry of the phosphorus atom in this MeOPN group is R. These studies represent the first unequivocal proof of stereochemistry of this group in any C. jejuni CPS. The compounds produced are anticipated to be useful tools in investigations targeting the function and biosynthesis of this structurally‐interesting modification, which so far has only been identified in campylobacter.
Angiographic characteristics and long‐term prognostic impact of coronary artery disease in survivors after sudden cardiac arrest with a non‐diagnostic electrocardiogram
Authors: Nogales‐Romo María Teresa , Ferrera Carlos , Salinas Pablo , Martínez‐Losas Pedro , Nombela‐Franco Luis , Núñez‐Gil Iván Javier , Noriega Francisco Javier , del Trigo María , Gonzalo Nieves , Jiménez‐Quevedo Pilar , Escaned Javier , Fernández‐Ortiz Antonio , Macaya Carlos , Viana‐Tejedor Ana 
Published: October 2018

AbstractObjectivesOur purpose was to describe the prevalence, distribution, extension, and prognostic value of coronary artery disease (CAD) in patients resuscitated from sudden cardiac arrest (SCA) with non‐diagnostic electrocardiogram (ECG).BackgroundThe impact of CAD and the indication for cardiac catheterization (CC) in patients resuscitated from SCA with non‐diagnostic ECG are uncertain.MethodsWe included prospectively and consecutively 545 patients resuscitated from SCA with at least one CC during hospitalization. From them, 203 patients with a non‐diagnostic ECG formed our study population. Patients were followed‐up 5 years after discharge.ResultsOverall, 125 (61.6%) patients had significant CAD, and at least one acute culprit lesion was found in 25 (12.4%). Regarding the burden and complexity of CAD, 78 (38.4%) patients had a CAD Prognostic Index of 0 and a SYNTAX score of 0. There was higher 5‐year mortality only in patients with very high burden of CAD: three vessels with severe stenosis (P = 0.015) and CAD Prognostic Index Score ≥ 56 (P < 0.001). Tertiles of SYNTAX score did not predict higher 5‐year mortality.ConclusionsIn survivors from SCA with a non‐diagnostic ECG, significant CAD is highly prevalent. SYNTAX score was not associated with a different long‐term prognosis in this patient population. Patients with severe disease in the three main coronary vessels and patients with higher (≥56) CAD Prognostic Index Score had a worse long‐term prognosis.
Percutaneous closure of paravalvular leak after Cone repair for Ebstein's anomaly
Authors: Alderweireldt Ann‐Sofie , De Wolf Daniel 
Published: October 2018

AbstractWe report the use of an Amplatzer Vascular plug for percutaneous closure of a paravalvular leak after Cone repair in a 5‐year‐old boy with Ebstein's anomaly. A paravalvular leak of the tricuspid valve developed gradually after Cone repair‐surgery. The combination of fluoroscopy, transesophageal and transthoracic imaging during general anesthesia was necessary for correct and safe positioning of the device by percutaneous approach. The results were promising.