bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular Chlamydia trachomatis Infection Under the Surgery, Antibiotics, Facial Cleanliness, and Environmental Improvement Strategy in Amhara, Ethiopia, 2011–2015
Authors: Nash Scott D , Stewart Aisha E P , Zerihun Mulat , Sata Eshetu , Gessese Demelash , Melak Berhanu , Endeshaw Tekola , Chanyalew Melsew , Chernet Ambahun , Bayissasse Belay , Moncada Jeanne , Lietman Thomas M , Emerson Paul M , King Jonathan D , Tadesse Zerihun , Callahan E Kelly 
Published: May 2018

Abstract

Background
World Health Organization (WHO) recommendations for starting and stopping mass antibiotic distributions are based on a clinical sign of trachoma, which is indirectly related to actual infection with the causative agent, Chlamydia trachomatis.

Methods
This study aimed to understand the effect of SAFE (surgery, antibiotics, facial cleanliness, and environmental improvement) interventions on ocular chlamydia in Amhara, Ethiopia, by describing the infection prevalence in a population-based sample of children aged 1–5 years. Trachoma surveys were conducted in all districts of Amhara, from 2011 to 2015 following approximately 5 years of SAFE. Ocular swabs were collected from randomly selected children to estimate the zonal prevalence of chlamydial infection. The Abbott RealTime polymerase chain reaction assay was used to detect C. trachomatis DNA.

Results
A total of 15632 samples were collected across 10 zones of Amhara. The prevalence of chlamydial infection in children aged 1–5 years was 5.7% (95% confidence interval, 4.2%–7.3%; zonal range, 1.0%–18.5%). Chlamydial infection and trachomatous inflammation–intense (TI) among children aged 1–9 years were highly correlated at the zonal level (Spearman correlation [r] = 0.93; P &lt; .001), while chlamydial infection and trachomatous inflammation–follicular were moderately correlated (r = 0.57; P = .084).

Conclusions
After 5 years of SAFE, there is appreciable chlamydial infection in children aged 1–5 years, indicating that transmission has not been interrupted and that interventions should continue. The sign TI was highly correlated with chlamydial infection and can be used as a proxy indicator of infection.
Association of Cutibacterium avidum Colonization in the Groin With Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection
Authors: Böni Laura , Kuster Stefan P , Bartik Bianka , Zbinden Reinhard , Zingg Patrick O , Achermann Yvonne 
Published: May 2018

Abstract

Background
An increase in the incidence of hip periprosthetic joint infections caused by Cutibacterium avidum has recently been detected after hip arthroplasty with an anterior surgical approach. We raised the question of whether skin colonization with C. avidum differs between the anterior and the lateral thigh as areas of surgical incision fields.

Methods
Between February and June 2017, we analyzed skin scrapings from the groin and the anterior and lateral thigh in patients undergoing a primary hip arthroplasty. We anaerobically cultured plated swab samples for Cutibacterium spp. for ≥7 days. Univariate logistic regression analysis was used to explore associations between body mass index (BMI) and colonization rate at different sites.

Results
Twenty-one of 65 patients (32.3%) were colonized with C. avidum at any site, mainly at the groin (n = 16; 24.6%), which was significantly higher at the anterior (n = 5; 7.7%; P = .009) or lateral (n = 6; 9.2%; P = .02) thigh. Patients colonized with C. avidum did not differ from noncolonized patients in age or sex, but their BMIs were significantly higher (30.1 vs 25.6 kg/m2, respectively; P = .02). Furthermore, increased BMI was associated with colonization at the groin (odds ratio per unit BMI increase, 1.15; 95% confidence interval; 1.03–1.29; P = .01).

Conclusions
The groin, rather than the anterior thigh, showed colonization for C. avidum in obese patients. Further studies are needed to evaluate current skin disinfection and draping protocols for hip arthroplasty, particularly in obese patients.
Benefits of Caloric Restriction in Longevity and Chemical-Induced Tumorigenesis Are Transmitted Independent of NQO1
Authors: Diaz-Ruiz Alberto , Di Francesco Andrea , Carboneau Bethany A , Levan Sophia R , Pearson Kevin J , Price Nathan L , Ward Theresa M , Bernier Michel , de Cabo Rafael , Mercken Evi M 
Published: May 2018

AbstractCaloric restriction (CR) is the most potent nonpharmacological intervention known to both protect against carcinogenesis and delay aging in laboratory animals. There is a growing number of anticarcinogens and CR mimetics that activate NAD(P)H:quinone oxidoreductase 1 (NQO1). We have previously shown that NQO1, an antioxidant enzyme that acts as an energy sensor through modulation of intracellular redox and metabolic state, is upregulated by CR. Here, we used NQO1-knockout (KO) mice to investigate the role of NQO1 in both the aging process and tumor susceptibility, specifically in the context of CR. We found that NQO1 is not essential for the beneficial effects of CR on glucose homeostasis, physical performance, metabolic flexibility, life-span extension, and (unlike our previously observation with Nrf2) chemical-induced tumorigenesis.
eHealth and adolescents in Serbia: psychometric properties of eHeals questionnaire and contributing factors to better online health literacy
Authors: Gazibara Tatjana , Cakic Jelena , Cakic Milica , Pekmezovic Tatjana , Grgurevic Anita 
Published: May 2018

Abstract
Internet is important resource of health-related information and health services. Factors associated with higher level of online health (eHealth) literacy among adolescence have been understudied. The aim of this study was to assess psychometric properties of the eHealth Literacy Scale (eHEALS) in Serbian language and to evaluate eHealth literacy among adolescents in Serbia. The study was carried out in four high schools in Belgrade, Serbia in the period December 2016 to January 2017. A total of 702 students comprised the study sample. The eHEALS was translated according to internationally accepted methodology and its psychometric properties were analyzed. The Cronbach’s alpha coefficient for the entire eHEALS was 0.849. On exploratory factor analysis we obtained two-factorial structure. Our adolescents reported low confidence in knowing what health resources are available online. High confidence was observed for knowing how to use and how to find health information online. There was no difference in eHEALS score between genders or between school years. After adjustment for gender, type of school program, parental marital status, fathers’ education level and household income, being female was associated with higher eHealth literacy (B = 1.12, 95% confidence interval 0.07–2.18; p = 0.036). Serbian version of the eHEALS is a valid instrument in assessment of online health literacy and can be further used in evaluation of eHealth literacy in other population groups in Serbian language. It is advised that some classes in school are dedicated to appraisal and use of online health websites. This could be achieved through peer-education.
Components of Affine Springer Fibers
Authors: Tsai Cheng-Chiang 
Published: May 2018

Abstract
Let G be a connected split reductive group over a field of characteristic zero or sufficiently large characteristic, $\gamma _0\in (\operatorname{Lie}\mathbf{G})((t))$ be any topologically nilpotent regular semisimple element, and $\gamma =t\gamma _0$. Using methods from p-adic orbital integrals, we show that the number of components of the Iwahori affine Springer fiber over $\gamma$ modulo $Z_{\mathbf{G}((t))}(\gamma )$ is equal to the order of the Weyl group.
Perioperative Multimodal Evaluation and Surgical Tactics of Tumor-Related Epilepsy: 2-Dimensional Operative Video
Authors: Ma Chengxin , Feng Rui , Hameed N U Farrukh , Zhang Jie , Zhuang Dongxiao , Wu Jinsong 
Published: May 2018

Abstract
Treatment of tumor-related epilepsy (TRE), especially for tumors near critical areas, requires surgeons to strike a balance between the epileptic benefit and functional outcome after surgery. Here, we present a case in which multimodal evaluation facilitated the achievement of such surgical balance. Informed patient consent was obtained.
A 17-yr-old female presented with seizure attacks for 2 yr. Magnetic resonance imaging (MRI) revealed a right parietal mass lesion with hypointense signal on T1W imaging, hyperintense signal on T2W imaging, and homogeneous enhancement. Carbamazepine and valproate administration were unable to control the intermittent seizures. From the patient's history and imaging, the initial diagnosis was refractory TRE.
Whether lesionectomy would achieve seizure freedom in this case was not certain. Therefore, dESI (dense array EEG source imaging) was used to localize the epileptic zone preoperatively; results showed that the epileptic zone was very close to the lesion in the primary motor cortex. Surgery was carried out under awake-anesthesia, with the aid of multimodal neuronavigation, intraoperative neurophysiological monitoring, and intraoperative MRI evaluation. A gross total lesion resection was achieved while preserving critical motor areas. Histopathology revealed ganglioglioma grade I diagnosis. No motor deficits following surgery were detected except slight increase of muscle tension in the right lower limb. At 6-mo follow-up, the patient was without any motor impairment or any other neurological deficits and completely seizure-free with the antiepileptic drug Carbamazepine 1200 mg/day.
Early Rainfall Shocks and Later-Life Outcomes: Evidence from Colombia
Authors: Carrillo Bladimir 
Published: May 2018

Abstract
This paper uses birth cohorts spanning several hundred locations over 40 years to examine the long-term consequences of in utero exposure to abnormal rainfall events in Colombia. The identification strategy exploits exogenous variation in extreme droughts or floods experienced by individuals while in utero in their birth location. The results indicate that individuals prenatally exposed to adverse rainfall shocks are more likely to report serious mental illness, have fewer years of schooling, display increased rates of illiteracy, and are less likely to work. These results are larger in magnitude for individuals born in areas with a higher risk of malaria, which is consistent with the notion that exposure to infectious and parasitic diseases may play an important role.
Mortality Measures to Profile Hospital Performance for Patients With Septic Shock*
Authors: Walkey Allan J. , Shieh Meng-Shiou , Liu Vincent X. , Lindenauer Peter K. 
Published: May 2018

Objectives:
Sepsis care is becoming a more common target for hospital performance measurement, but few studies have evaluated the acceptability of sepsis or septic shock mortality as a potential performance measure. In the absence of a gold standard to identify septic shock in claims data, we assessed agreement and stability of hospital mortality performance under different case definitions.

Design:
Retrospective cohort study.

Setting:
U.S. acute care hospitals.

Patients:
Hospitalized with septic shock at admission, identified by either implicit diagnosis criteria (charges for antibiotics, cultures, and vasopressors) or by explicit International Classification of Diseases, 9th revision, codes.

Interventions:
None.

Measurements and Main Results:
We used hierarchical logistic regression models to determine hospital risk–standardized mortality rates and hospital performance outliers. We assessed agreement in hospital mortality rankings when septic shock cases were identified by either explicit International Classification of Diseases, 9th revision, codes or implicit diagnosis criteria. Kappa statistics and intraclass correlation coefficients were used to assess agreement in hospital risk–standardized mortality and hospital outlier status, respectively. Fifty-six thousand six-hundred seventy-three patients in 308 hospitals fulfilled at least one case definition for septic shock, whereas 19,136 (33.8%) met both the explicit International Classification of Diseases, 9th revision, and implicit septic shock definition. Hospitals varied widely in risk-standardized septic shock mortality (interquartile range of implicit diagnosis mortality: 25.4–33.5%; International Classification of Diseases, 9th revision, diagnosis: 30.2–38.0%). The median absolute difference in hospital ranking between septic shock cohorts defined by International Classification of Diseases, 9th revision, versus implicit criteria was 37 places (interquartile range, 16–70), with an intraclass correlation coefficient of 0.72, p value of less than 0.001; agreement between case definitions for identification of outlier hospitals was moderate (kappa, 0.44 [95% CI, 0.30–0.58]).

Conclusions:
Risk-standardized septic shock mortality rates varied considerably between hospitals, suggesting that septic shock is an important performance target. However, efforts to profile hospital performance were sensitive to septic shock case definitions, suggesting that septic shock mortality is not currently ready for widespread use as a hospital quality measure.
Barriers to implementation of long-acting reversible contraception: A systematic review
Authors: Phillips Jessamyn , Sandhu Prabjot 
Published: May 2018

ABSTRACT

Background and purpose:
Long-acting reversible contraception (LARC) is one of the most effective forms of contraception available. The utilization of LARC remains low despite being recommended by major health organizations such as Centers for Disease Control and Prevention, American Congress of Obstetricians and Gynecologists, American Academy of Pediatrics, American Academy of Family Physicians, and the National Committee for Quality Assurance. Health care professionals play an essential role in the potential increased use of LARC. This review aims to highlight key barriers to the utilization of LARC and discuss interventions to address this issue.

Methods:
A systematic review of 14 peer-reviewed articles focused on LARC utilization rates that help identify barriers to the utilization of LARC in current education and practice. Articles were evaluated for strength of research design using the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal tool.

Conclusions:
Three categories affecting LARC utilization emerged: deficits in provider education/competency, lack of hands-on training, and barriers to practice.

Implications for practice:
The importance of including LARC training and education in the advanced practice nursing curriculum and providing opportunities for continuing education with LARC is demonstrated.
American Association of Nurse Practitioners National Nurse Practitioner sample survey: Update on acute care nurse practitioner practice
Authors: Kleinpell Ruth , Cook Michelle L. , Padden Diane L. 
Published: May 2018

ABSTRACT

Background and purpose:
Data from national surveys on the practice of nurse practitioners (NPs) provides valuable information on aspects of practice, demographic characteristics of providers and patients, plans for continued employment, and role satisfaction. The American Association of Nurse Practitioners (AANP) has been conducting the AANP Sample Survey since 1988.

Methods:
The most recent AANP Sample Survey was conducted in 2016 with a random stratified survey of 40,000 NPs. Data were collected bimodally, by internet and mail surveys. Responses were received from 3,970 respondents (9.9% response rate), with 335 respondents reporting NP certification in acute care as adult-gerontology acute care and/or pediatric acute care.

Results:
Almost all acute care nurse practitioners (ACNPs) reported that they were clinically practicing in 2016 (99.3%), with the top three areas encompassing cardiovascular (20.5%), critical care (12.1%), and hospitalist roles (6.3%). More than 1 in 4 ACNPs worked in a hospital inpatient setting, with 16.1% reporting work in a hospital outpatient clinic, 7.7% in a private group practice, 6.5% at a public university, and some in combined roles covering both inpatient and outpatient care, or on consultation service or specialty-based teams. On average, 34.1% of the patients ACNPs saw were between the ages of 66 and 85 years, and 11.2% were 85 years and older. The top 3 medication classes in which ACNPs regularly prescribe were diuretics (31.9%), analgesic narcotics (31.2%), and antibiotics (27.3%). Majority (88%) report satisfaction with the role, and approximately one third (31.1%) expect to continue to work in their current practice for more than 10 years.

Implications for practice:
The findings of the 2016 AANP National NP Sample Survey data related to ACNP practice identify expansion of work settings, practice consistent with acute care scope of practice, role satisfaction, and intent to continue working. Continued monitoring of practice components and employment is indicated to track ACNP workforce trends.
Maximizing your “nutrition minute”: Bridging nutritional gaps across the life span
Authors: Wright Wendy L. , Zelman Kathleen M. 
Published: May 2018

ABSTRACT

Background and Purpose:
Poor diet quality has been associated with increased mortality and an increased risk of chronic disease. Given the shortfalls in the typical American diet and the prevalence of nutrition-related chronic disease among US adults, the need for nutrition education is paramount. Nurse practitioners (NPs) are well placed to provide basic nutrition counseling but often face challenges to making this a reality. In a typical office visit, the time available to discuss diet and nutrition can be as little as one minute or less.

Methods:
Nutritional issues of concern facing specific age and risk groups are reviewed. The “Nutrition Minute,” a tool comprising 5 questions that enable NPs to identify patients at higher risk of nutritional shortfalls, has been developed.

Conclusions:
Nutrition counseling includes discussion of not only fat, carbohydrate, and protein intake, but also micronutrient intake. Although a food-first approach to nutrition is preferred, nutritional shortfalls exist even in the best diets. Supplementation with a multivitamin is an effective approach to bridge many nutritional gaps and can be recommended for many patients with poor diet quality. In addition to shortfalls apparent from a patient's diet, nutritional needs change across the life span (e.g., women of childbearing age and older persons) and in those with certain medical conditions such as diabetes and obesity.

Implications for practice:
Although NPs clearly have an important role to play in the nutrition management of many patients, they should work in collaboration with registered dietitians wherever possible, especially for medical nutrition therapy in those patients needing specialist counseling, such as those with diabetes, obesity, cardiovascular disease, and renal disease.
The primary care provider and the patient living in poverty: Applying the Bridges to Health and Healthcare model to NP practice
Authors: Wise Barbara , Dreussi-Smith Terie 
Published: May 2018

ABSTRACT

Background and purpose:
There is a much recent emphasis on the social determinants of health, and poverty is the most influential of these. It is not enough merely to understand the influence of poverty on health—the primary care provider must understand how to effectively treat patients who live in poverty.

Methods:
This article applies the Bridges to Health and Healthcare model for understanding poverty to primary care practice from an individual provider's perspective. The article walks the reader through the implications of generational poverty for the primary care clinician in a typical office visit from history taking to following up.

Conclusions:
Most primary care practitioners approach patients from a middle-class perspective. Awareness of the challenges and different perspectives of those in generational poverty can enhance care and outcomes.

Implications for practice:
The individual provider can use the understanding of driving forces, resources, language and cognition, environment, and relationships provided by the Bridges to Health and Healthcare model to benefit patients in generational poverty.
Predictors of nurse practitioner retention
Authors: Hagan Joseph , Curtis Derek L. 
Published: May 2018

ABSTRACTBackground and Purpose:Increased utilization of nurse practitioners (NPs) has been proposed to reduce the shortage of primary care providers, so identifying factors related to retention of NPs is important for health care organizations. The purpose of this study was to examine the relationship of Misener Nurse Practitioner Job Satisfaction Scale factors and nurse demographic characteristics with NP retention, as defined by the number of years at the current position and intention to leave the current position within 5 years.Methods:A survey was distributed via email to members of the Texas NP Organization.Conclusions:Three hundred fifteen NPs participated in the study. Years of experience (p< .001), salary (p= .018), and benefits (p= .007) were significantly associated with longer duration of employment at the current position, after controlling for the other variables in the linear regression model. After adjusting for the other variables in the logistic regression model, higher challenge/autonomy factor scores (p= .016) and higher annual salary (p= .032) were associated with significantly lower odds of intention to leave the current position within 5 years.Implications for practice:Interventions to increase NP autonomy and facilitate employment in positions with more competitive salaries are likely to improve NP retention.
Controlled attenuation parameter for steatosis grading in chronic hepatitis C compared with digital morphometric analysis of liver biopsy: impact of individual elastography measurement quality
Authors: Mendes Leandro C. , Ferreira Paulo A. , Miotto Noelle , Zanaga Letícia , Lazarini Maria S. , Gonçales Eduardo S.L. , Pedro Marcelo N. , Gonçales Fernando L. , Stucchi Raquel S.B. , Vigani Aline G. 
Published: May 2018

Background and objective
Controlled attenuation parameter (CAP) diagnostic performance for steatosis grading has been controversial and considerable observer-related variability in liver biopsy has been reported. This is a subanalysis of a larger chronic hepatitis C study on noninvasive fibrosis staging.

Materials and methods
Patients were prospectively enrolled for paired liver biopsy and transient elastography. Biopsy fragments were subjected to digital morphometric steatosis quantification. Associated patient and technical factors, including a newly described elastogram quality score, were evaluated.

Results
A total of 312 patients were included in the final analysis. The mean liver stiffness was 8.7±2.1 kPa. Morphometry showed S0 in 19.2% of patients, S1 in 28.5%, S2 in 31.1%, and S3 in 21.2%. CAP showed S0 in 11.2% of patients, S1 in 26.6%, S2 in 56.7%, and S3 in 5.4%. Spearman coefficient showed a positive and independent correlation between CAP and morphometric analysis (r=0.48, P<0.05), except for distinguishing S1 and S2 (P=0.11). Area under the receiver operating characteristic curves for the presence or absence of steatosis was 0.944; differentiation between levels I, II, and III were 0.776, 0.812, and 0.879. Elastogram quality independently predicted accuracy [odds ratio (OR): 6.95, 95% confidence interval (95%CI): 4.45–9.06 as well as CAP interquartile range OR: 2.81, 95%CI: 1.67–3.99] and liver stiffness (OR: 0.78, 95%CI: 0.51–0.80).

Conclusion
We present an external validation for CAP against the objective steatosis quantification provided by digital morphometry. Fairly good performance indicators were found, except for S1 versus S2 differentiation. Variability and higher liver stiffness were associated with lower performance. Achieving higher quality measurements, however, overcame such limitations with excellent accuracy.