bluuebunny/crossref_metadata_2025_split huggingface dataset:
Level of readiness of chronic pain patients to practise active self‐care
Authors: Scala E. , Decosterd I. , Faouzi M. , Burnand B. , Rodondi P.‐Y. 
Published: June 2018

AbstractBackgroundGiven the limited alleviation of chronic pain with pharmacological treatments, various nonpharmacological and self‐care approaches are often proposed that require patients’ motivation.ObjectiveTo evaluate the level of readiness (LOR) to practise different types of active self‐care among chronic pain patients.MethodA quantitative cross‐sectional survey was conducted among all chronic pain patients seeking care at the Pain Center of an academic hospital from June 2013 to March 2015. Sociodemographic data, pain characteristics, treatments and the LOR to practise active self‐care were investigated.ResultsAmong the 1524 eligible patients, 639 (41.9%) were included. The median pain duration was 8.5 years (interquartile range = 7.5). Two‐thirds (63.7%) of the patients reported high pain‐related disability, and 64.6% had used opioids during the previous six months. Most patients had a high (44.1%) or moderate (24.6%) LOR to practise active self‐care. Multivariable multinomial regression analysis showed that independent factors associated with a high LOR were a higher level of education (relative risk ratio (RRR) = 3.42, 95% confidence interval (CI): 1.90–6.13, p < 0.001), unemployed status due to medical condition (RRR = 2.92, 95% CI: 1.30–6.56, p = 0.009), the use of dietary supplements ‘against pain’ (RRR = 2.77, 95% CI: 1.52–5.04, p = 0.001) and neuropathic pain characteristics (RRR = 1.80, 95% CI: 1.40–3.12, p = 0.036). Older age was a factor predicting a lower LOR (RRR = 0.97, 95% CI: 0.94–0.99, p = 0.039). Long‐term chronic pain, severe pain‐related disability and the presence of a mood disorder were not associated with a lower LOR.ConclusionMost chronic pain patients, including those severely affected, indicated their readiness to practise active self‐care methods.SignificanceMost chronic pain patients, even those severely affected, appeared to be ready to practise active self‐care therapies and we believe that further studies are needed to investigate their impact on pain and quality of life.
Comparison of orofacial thermal sensitivity assessed with simple devices and sophisticated equipment
Authors: Ayranci M. , Koutris M. , Lobbezoo F. , Svensson P. , Baad‐Hansen L. 
Published: June 2018

AbstractBackgroundSimple thermal devices providing reliable data are needed to detect somatosensory disturbances in non‐specialized clinical settings. Currently, evidence is lacking about their use. Therefore, the aim was to compare the assessment of perceived thermal sensitivity/pain in healthy humans with a state‐of‐the‐art thermotester and with simple inexpensive customized thermal aluminium devices.MethodsTwenty healthy volunteers participated in the study. The infraorbital region and the tip of the tongue were tested with the Medoc Pathway thermotester and simple aluminium thermal devices, with temperatures varying between 5–50°C. A numerical rating scale (NRS) from 0–50–100 was used for rating the perceived thermal sensitivity/painfulness. A control experiment was performed with 10 of the participants to test the potential impact of temporal summation of thermal stimuli with the use of temperature ramps (Medoc) compared with static temperature (simple devices).ResultsIn the original experiment, the scores from the thermotester stimulation were higher than the scores for stimulation with the simple thermal devices with mean NRS differences between devices of 7.2 and 10.2 for the two tested regions. In the control experiment, the mean NRS differences decreased to −0.3 and 2.2, respectively.ConclusionsProvided that temporal summation of the thermal stimuli was avoided, there were only minor differences in perceived thermal sensitivity/painfulness between the two different assessment methods at both test sites. Therefore, the simple thermal devices can be useful for assessment of thermal sensitivity in clinical settings without access to expensive sophisticated equipment. However, more sophisticated equipment is needed for threshold measurements.SignificanceThis study indicates that simple thermal devices to some extent can be used in a comparable way with sophisticated thermal stimulators. Therefore, they can be useful in clinical practice, where access to further equipment is lacking.
DNA methylation assay based on pyrosequencing for determination of smoking status
Authors: Alghanim Hussain , Wu Wensong , McCord Bruce 
Published: June 2018

AbstractThe goal of this study was to utilize pyrosequencing to identify CpG sites indicative of tobacco smoking using DNA sequences surrounding ten frequently reported smoking‐related CpGs. Initially, six genetic loci were investigated including AHRR, 2q37, 6p21.33, GFI1, F2RL3, and MYO1G in order to detect novel CpG sites associated with tobacco smoking. The methylation data revealed a set of 23 consecutive CpG sites in blood (Chr5:373,115‐Chr5:373,653) that were significantly hypomethylated in current smokers. In addition, 10 of these 23 CpGs were also significantly hypomethylated in the saliva of current smokers. The most significant CpG sites were located at Chr5:373,490 in blood and Chr5:373,476 in saliva with a decrease in methylation in current smokers of 42.3% and 21.3% respectively. In the model‐building steps of this study, a quick 4‐CpG assay was developed. The assay consisted of the top ranked CpG sites in blood and saliva. The assay was applied in a leave‐one‐out approach to test its ability to infer an individual's self‐identified history of smoking habits. A multinomial logistic regression model (MLR) containing all 4 CpG sites gave the most accurate results in blood and saliva. In blood, the model correctly predicted 90.0% of current smokers, 66.7% of former smokers, and 84.9% of never smokers. In addition, the MLR model correctly predicted 86.9% of current smokers, 54.5% of former smokers, and 77.8% of never smokers in saliva. These results demonstrate that this pyrosequencing‐based assay can provide an effective tool for identifying individuals who smoke tobacco, particularly when using epigenetic markers in blood.
Impact of frequency of internet use on development of brain structures and verbal intelligence: Longitudinal analyses
Authors: Takeuchi Hikaru , Taki Yasuyuki , Asano Kohei , Asano Michiko , Sassa Yuko , Yokota Susumu , Kotozaki Yuka , Nouchi Rui , Kawashima Ryuta 
Published: June 2018

AbstractExcessive internet use is shown to be cross sectionally associated with lower cognitive functioning and reduced volume of several brain areas. However, the effects of daily internet use on the development of verbal intelligence and brain structures have not been investigated. Here, we cross sectionally examined the effects of the frequency of internet use on regional gray/white matter volume (rGMV/rWMV) and verbal intelligence as well as their longitudinal changes after 3.0 ± 0.3 (standard deviation) years in a large sample of children recruited from the general population (mean age, 11.2 ± 3.1 years; range, 5.7–18.4 years). Although there were no significant associations in cross sectional analyses, a higher frequency of internet use was found to be associated with decrease of verbal intelligence and smaller increase in rGMV and rWMV of widespread brain areas after a few years in longitudinal analyses. These areas involve areas related to language processing, attention and executive functions, emotion, and reward. In conclusion, frequent internet use is directly or indirectly associated with decrease of verbal intelligence and development to smaller gray matter volume at later stages.
A random forest and simulation approach for scheduling operation rooms: Elective surgery cancelation in a Chinese hospital urology department
Authors: Luo Li , Liu Chuang , Feng Li , Zhao Shuzhen , Gong Renrong 
Published: June 2018

SummaryMany hospitals encounter surgery cancelations for various reasons. We present a methodology applying data mining and simulation to optimize operating room (OR) scheduling in a urology department in West China Hospital. To the best of our knowledge, this is 1 of the first efforts to seek an optimal schedule solution based on cancelation risk of elective surgeries as well as OR allocation between elective and nonelective surgeries. First, chi‐square test and random forest prediction modeling were used to predict potential elective surgeries with high cancelation risk, and the factors, including surgeon, number of days since admission of patient, first surgery or not, etc., that influence elective surgery cancelation were identified. Second, a simulation technology was designed to compare 7 different scheduling strategies. The results demonstrated that for elective surgery, cancelation rate low surgery first outperformed the others and increased the productivity of the ORs from 72% to 83%, while for nonelective surgery performed in a separate OR, there was no improvement because the supply was greater than necessary at present. However, in total, the selected strategies led to 7% higher productivity.
How might organisational institutionalism support the challenges of the modern hospice?
Authors: Hodges Emma , Read Sue 
Published: June 2018

SummaryThe external environment within which UK charitable hospice care operates is changing. More people are dying with conditions other than cancer; however, this disease still dominates modern hospice care. Organisational institutionalism offers a theoretical lens through which to consider the challenges facing the hospice movement. Concepts such as legitimacy, decoupling, deinstitutionalisation, and reinstitutionalisation can help hospice leaders understand the challenges of change and some of the strategies that can be employed at local and national levels. This paper outlines a number of environmental and influencing factors driving and impacting change. A model of institutional change is introduced, explored, and considered from the context of hospice. When it comes to understanding change, legitimacy is a major concept introduced to challenge and pose questions for hospices to address. This paper proposes a model demonstrating a perspective regarding the current structure of services within hospice organisations. The model argues that only hospice care for people with cancer is truly institutionalised and that other areas of care lack comparable legitimacy. It provides 3 directions for hospice in addressing the challenges faced: (i) decoupling, (ii) deinstitutionalisation then reinstitutionalisation, and (iii) a new social movement. The paper concludes with recommendations for future consideration.
Groundwater and surface water connectivity within the recharge area of Guarani aquifer system during El Niño 2014–2016
Authors: Batista Ludmila Vianna , Gastmans Didier , Sánchez‐Murillo Ricardo , Farinha Bárbara Saeta , dos Santos Sarah Maria Rodrigues , Kiang Chang Hung 
Published: June 2018

AbstractRecharge areas of the Guarani Aquifer System (GAS) are particularly sensitive and vulnerable to climate variability; therefore, the understanding of infiltration mechanisms for aquifer recharge and surface run‐off generation represent a relevant issue for water resources management in the southeastern portion of the Brazilian territory, particularly in the Jacaré‐Pepira River watershed. The main purpose of this study is to understand the interactions between precipitation, surface water, and groundwater using stable isotopes during the strong 2014–2016 El Niño Southern Oscillation event. The large variation in the isotopic composition of precipitation (from −9.26‰ to +0.02‰ for δ18O and from −63.3‰ to +17.6‰ for δ2H), mainly associated with regional climatic features, was not reflected in the isotopic composition of surface water (from −7.84‰ to −5.83‰ for δ18O and from −49.7‰ to +33.6‰ for δ2H), mainly due to the monthly sampling frequency, and groundwater (from −7.04‰ to −7.76‰ for δ18O and from −49.5‰ to −44.7‰ for δ2H), which exhibited less variation throughout the year. However, variations in deuterium excess (d‐excess) in groundwater and surface water suggest the occurrence of strong secondary evaporation during the infiltration process, corresponding with groundwater level recovery. Similar isotopic composition in groundwater and surface water, as well as the same temporal variations in d‐excess and line‐conditioned excess denote the strong connectivity between these two reservoirs during baseflow recession periods. Isotopic mass balance modelling and hydrograph separation estimate that the groundwater contribution varied between 70% and 80%, however, during peak flows, the isotopic mass balance tends to overestimate the groundwater contribution when compared with the other hydrograph separation methods. Our findings indicate that the application of isotopic mass balance methods for ungauged rivers draining large groundwater reservoirs, such as the GAS outcrop, could provide a powerful tool for hydrological studies in the future, helping in the identification of flow contributions to river discharge draining these areas.
A method for uncertainty constraint of catchment discharge and phosphorus load estimates
Authors: Hollaway Michael J. , Beven Keith J. , Benskin Clare Mc W. H. , Collins Adrian L. , Evans Robert , Falloon Peter D. , Forber Kirsty J. , Hiscock Kevin M. , Kahana Ron , Macleod Christopher J. A. , Ockenden Mary C. , Villamizar Martha L. , Wearing Catherine , Withers Paul J. A. , Zhou Jian G. , Barber Nicholas J. , Haygarth Philip M. 
Published: June 2018

AbstractRiver discharge and nutrient measurements are subject to aleatory and epistemic uncertainties. In this study, we present a novel method for estimating these uncertainties in colocated discharge and phosphorus (P) measurements. The “voting point”‐based method constrains the derived stage‐discharge rating curve both on the fit to available gaugings and to the catchment water balance. This helps reduce the uncertainty beyond the range of available gaugings and during out of bank situations. In the example presented here, for the top 5% of flows, uncertainties are shown to be 139% using a traditional power law fit, compared with 40% when using our updated “voting point” method. Furthermore, the method is extended to in situ and lab analysed nutrient concentration data pairings, with lower uncertainties (81%) shown for high concentrations (top 5%) than when a traditional regression is applied (102%). Overall, for both discharge and nutrient data, the method presented goes some way to accounting for epistemic uncertainties associated with nonstationary physical characteristics of the monitoring site.
Strontium isotope identification of water mixing and recharge sources in a river system (Oder River, central Europe): A quantitative approach
Authors: Zieliński Mateusz , Dopieralska Jolanta , Belka Zdzislaw , Walczak Aleksandra , Siepak Marcin , Jakubowicz Michał 
Published: June 2018

AbstractThis study uses Sr isotope composition (87Sr/86Sr) and Sr content of waters of the Oder, one of the largest rivers in central Europe, to fingerprint natural and anthropogenic contributions to its Sr budget and to evaluate water mixing processes in its hydrological system. It also demonstrates a simple method of quantifying natural and anthropogenic Sr inputs in the watershed. The method has potential for environmental and archaeological research because past Sr geochemistry of river water can easily be reconstructed. For the first time, a catchment‐scale impact of anthropogenic sources on the Sr budget of a middle‐size river is shown in a quantitative way. The water of the Oder is characterized by a relatively uniform Sr isotope composition, from 0.7100 to 0.7108, contrasting with strong variations in Sr concentration, from 0.25 to 1.27 mg/L. There is a general seasonal trend in variability, with waters becoming more radiogenic and dilute with respect to the Sr in the spring time. This Sr systematics differs significantly from the Sr budgets of the majority of the Oder tributaries that exhibit more radiogenic composition and systematically lower Sr concentrations. A mixing scenario in the Oder involves Sr contribution from four principal water sources: (a) shallow ground waters with Sr derived from near‐surface weathering of silicates, (b) moderately radiogenic mine waters from the Upper Silesian Coal Basin, (c) unradiogenic mine waters from the Permian sequence of the copper district, and (d) unradiogenic ground waters from shallow‐seated Palaeogene, Neogene, and Mesozoic aquifers. The Sr budget of the Oder is primarily controlled by inputs of dissolved Sr from anthropogenic sources, which overprint the natural background, controlled by geology. Thus, about 47.5% of Sr originates from agriculture, industrial, and municipal additions, 31.5% from mine water inputs, and only 21% from natural sources, that is, rock weathering and atmospheric precipitation. Reconstruction of the past Sr chemistry of the Oder reveals that its present‐day Sr isotope composition is temporary and significantly different from that of the preindustrial times.
Individualized Pharmacokinetic Dosing of Vancomycin Reduces Time to Therapeutic Trough Concentrations in Critically Ill Patients
Authors: Truong James , Smith Shawn R. , Veillette John J. , Forland Steven C. 
Published: June 2018

AbstractDosing vancomycin in critically ill patients often results in subtherapeutic and supratherapeutic trough concentrations. In this retrospective study, we compared the time to goal trough attainment and incidence of acute kidney injury in intensive care unit (ICU) patients whose vancomycin was dosed by a pharmacy pharmacokinetic (PK) dosing and monitoring service to the standard of care. Three‐hundred fifty adult ICU patients at a Level 1 trauma, teaching hospital who received vancomycin for >24 hours from February 1, 2016, to November 30, 2016, were screened. Patients were included in the PK group if consecutive serum concentrations were used to calculate individualized PK and determine a dosing regimen. Patients who were dosed using troughs only were then matched 1‐to‐1 to the PK group by date of vancomycin initiation and included in the traditional group. Fifty patients were included in each group. Baseline characteristics were similar, except the PK group had more patients under the care of the neuromedical ICU service (42% vs 18%; P = .02) and fewer patients with a corrected creatinine clearance <30 mL/min/1.73 m2 (22% vs 46%; P = .02). Attainment of goal trough concentrations for the PK and traditional groups were 84.4% and 29.4% by 48 hours (P = .0001), 88.4% and 60.7% by 72 hours (P = .009), and 92.9% and 77.8% by 96 hours (P = .1), respectively. Incidence of acute kidney injury between the PK and traditional groups was not statistically significant (8.3% vs 14%; P = .5). Utilization of individualized pharmacokinetic dosing of vancomycin in critically ill patients resulted in faster goal trough attainment without an increase in nephrotoxicity.
Sex‐based differences in antiretroviral therapy initiation, switching and treatment interruptions: global overview from the International Epidemiologic Databases to Evaluate AIDS (IeDEA)
Authors: Giles Michelle L , Achhra Amit C , Abraham Alison G , Haas Andreas D , Gill Michael John , Lee Man Po , Luque Marco , McGowan Catherine , Cornell Morna , Braitstein Paula , de Rekeneire Nathalie , Becquet Renaud , Wools‐Kaloustian Kara , Law Matthew 
Published: June 2018

AbstractIntroductionIn 2015, the World Health Organization recommended that all HIV‐infected individuals consider ART initiation as soon as possible after diagnosis. Sex differences in choice of initial ART regimen, indications for switching, time to switching and choice of second‐line regimens have not been well described. The aims of this study were to describe first‐line ART and CD4 count at ART initiation by sex, calendar year and region, and to analyse time to change or interruption in first‐line ART, according to sex in each region.MethodsParticipating cohorts included: Southern, East and West Africa (IeDEA‐Africa), North America (NA‐ACCORD), Caribbean, Central/South America (CCASAnet) and Asia‐Pacific including Australia (IeDEA Asia‐Pacific). The primary outcomes analysed for each region and according to sex were choice of initial ART, time to switching and time to discontinuation of the first‐line regimen.Results and DiscussionThe combined cohort data set comprised of 715,252 participants across seven regions from low‐ to high‐income settings. The median CD4 count at treatment initiation was lower in men compared with women in nearly all regions and time periods. Women from North America and Southern Africa were more likely to switch ART compared to men (p < 0.001) with approximately 90% of women reporting a major change after 10 years in North America. Overall, after 8 years on ART, >50% of HIV‐ positive men and women from Southern Africa, East Africa, South and Central America remained on their original regimen. Men were more likely to have a treatment interruption compared with women in low‐ and middle‐income countries from the Asia/Pacific region (p < 0.001) as were men from Southern Africa (p < 0.001). Greater than 75% of men and women did not report a treatment interruption after 10 years on ART from all regions except North America and Southern Africa.ConclusionsThere are regional variations in the ART regimen commenced at baseline and rates of major change and treatment interruption according to sex. Some of this is likely to reflect changes in local and international antiretroviral guideline recommendations but other sex‐specific factors such as pregnancy may contribute to these differences.
Cross‐sectional association of physical activity and periodontal antibodies
Authors: Anderson A. Paige , Park Yong‐Moon , Shrestha Deepika , Zhang Jiajia , Liu Jihong , Merchant Anwar T. 
Published: June 2018

AbstractBackgroundThe objective of this study was to evaluate the cross‐sectional association between physical activity and serum IgG antibodies against selected periodontal microorganisms.MethodsThe study population consisted of 5,611 randomly selected US adults who participated in the National Health and Nutrition Examination Survey (NHANES) III (1988 to 1994), who were 40 years and older with complete IgG antibody data against 19 oral microorganisms. We used cluster analysis to classify the 19 antibody titers into 4 mutually exclusive groups called “Orange‐Red,” “Red‐Green,” “Yellow‐ Orange,” and “Orange‐Blue,” and calculated cluster scores by summing antibody titer z‐scores for each of the four groups. Physical activity was evaluated based on reported frequency and intensity of physical activity conducted in the last month. Participants were grouped into three categories: adequately physically active, inadequately physically active, and inactive. The outcomes were IgG cluster scores with physical activity as the predictor. Multivariable models adjusted for age, sex, race, smoking status, waist circumference, education, poverty‐income‐ratio, alcohol, and diabetes.ResultsIn adjusted models, physical activity was positively associated with the antibodies in the Orange‐Blue cluster (E. nodatum, A. naeslundii), a cluster that is associated with healthy periodontal states. The mean differences in cluster scores were 15.2 (95% CI −1.0, 31.4) for Model 3, and 7.0 (95% CI −8.3, 22.3) for Model 4 comparing the sufficiently active group to the inactive group.ConclusionsAntibody titers against periodontal microorganisms reflecting good oral health trended higher among physically active individuals, but the results were not statistically significant at the 0.05 level.