bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improvement in sleep outcomes with a 17β-estradiol–progesterone oral capsule (TX-001HR) for postmenopausal women
Authors: Kagan Risa , Constantine Ginger , Kaunitz Andrew M. , Bernick Brian , Mirkin Sebastian 
Published: December 2018

Abstract

Objective:
The aim of the study was to evaluate the effects of TX-001HR, a single-capsule 17β-estradiol–progesterone on sleep parameters in postmenopausal women with vasomotor symptoms (VMS) using the Medical Outcomes Study (MOS)-Sleep scale questionnaire in the REPLENISH trial.

Methods:
In the REPLENISH trial (NCT01942668), women were randomized to one of four doses of TX-001HR or placebo, and the 12-item MOS-Sleep questionnaire (secondary endpoint) was self-administered at baseline, week 12, and months 6 and 12. Changes from baseline in the MOS-Sleep total score and 7 subscale scores were analyzed for treatment groups versus placebo at all time points. Somnolence was also collected as an adverse event.

Results:
Women (mean age 55 y) were randomized to TX-001HR (estradiol/ progesterone [E2/P4] [mg/mg]) doses: 1/100 (n = 415), 0.5/100 (n = 424), 0.5/50 (n = 421), 0.25/50 (n = 424), or placebo (n = 151). TX-001HR significantly improved MOS-Sleep total score, Sleep Problems Index II subscale, and sleep disturbance subscale versus placebo at all time points, except with 0.25 mg E2/50 mg P4 at week 12. Differences in LS mean changes between TX-001HR and placebo for MOS-Sleep total scores ranged from −6.5 to −7.6 at 12 months (all; P ≤ 0.001). All doses of TX-001HR significantly improved the Sleep Problems Index I subscale at all time points. The sleep somnolence subscale significantly improved from baseline with 0.5 mg E2/100 mg P4 and 0.5 mg E2/50 mg P4 at month 12. The incidence of somnolence as a treatment-emergent adverse event ranged from 0.2% to 1.2% versus 0% with placebo.

Conclusion:
TX-001HR significantly improved MOS-Sleep parameters from baseline to week 12, which was sustained for up to 12 months, and was associated with a very low incidence of somnolence.
Innovations in Computer Technologies Have Impacted Radiation Dosimetry Through Anatomically Realistic Phantoms and Fast Monte Carlo Simulations
Authors: George Xu X. 
Published: December 2018

Abstract
Radiological physics principles have not changed in the past 60 y when computer technologies advanced exponentially. The research field of anatomical modeling for the purpose of radiation dose calculations has experienced an explosion in activity in the past two decades. Such an exciting advancement is due to the feasibility of creating three-dimensional geometric details of the human anatomy from tomographic imaging and of performing Monte Carlo radiation transport simulations on increasingly fast and cheap personal computers. The advent of a new type of high-performance computing hardware in recent years—graphics processing units—has made it feasible to carry out time-consuming Monte Carlo calculations at near real-time speeds. This paper introduces the history of three generations of computational human phantoms (the stylized medical internal radiation dosimetry-type phantoms, the voxelized tomographic phantoms, and the boundary representation deformable phantoms) and new development of the graphics processing unit-based Monte Carlo radiation dose calculations. Examples are given for research projects performed by my students in applying computational phantoms and a new Monte Carlo code, ARCHER, to problems in radiation protection, imaging, and radiotherapy. Finally, the paper discusses challenges and future opportunities for research.
Quality and Safety Initiatives for Radiation Safety in Imaging
Authors: Bhargavan-Chatfield Mythreyi 
Published: December 2018

Abstract
There is a substantial infrastructure for quality and safety in radiologic imaging, built over decades, that is available to practices and providers. The purpose of this review is to provide an overview of those resources and place them in the context of patient care. Successful application of these resources requires both the technology as well as the culture to use the techniques. We are beginning to see more tools to support the culture change necessary to take advantage of the resources, and increased attention to the patient perspective.
The 42nd Lauriston S. Taylor Lecture: Radiation Dosimetry Research for Medicine and Protection—A European Journey
Authors: Menzel Hans-Georg 
Published: December 2018

Abstract
The assessment of doses related to exposures to ionizing radiation is an essential part of all applications of ionizing radiation including radiation medicine, radiation protection, radiation biology, radiation epidemiology, and also industrial uses of radiation. Absorbed dose is generally considered to be the fundamental quantity of radiation dosimetry. It is a metrologically sound quantity for which even primary standards exist for some materials, and it is used routinely in practice. However, there is no unique correlation between absorbed dose and the radiation-induced biological effect considered. There are also different objectives of radiation dosimetry for different applications. In radiation protection, quantities are required to set meaningful exposure limits and to implement the principle of optimization. In radiation therapy, the dependence of clinical outcomes on temporal aspects of the irradiations must be accounted for. In radiation diagnostics, quantities are needed to enable and monitor optimization of radiation dose and image quality. In radiation protection and in therapy with high linear-energy-transfer radiations, appropriate methods and parameters are needed to account for differences in radiation quality. These limitations of the quantity absorbed dose have led to the use of a multiplicity of dose quantities and dose modification factors. Radiation dosimetry continues, therefore, to be a field of active research regarding fundamental and conceptual aspects, taking account of advances in technologies, of novel methods in radiation therapy and diagnostics, and of progress in computational dosimetry. Dosimetry of high-energy radiations such as cosmic radiation encountered at flight altitudes and during space missions as well as at high-energy accelerators has become an important issue. In Europe, collaboration and coordination of radiation research in general, and dosimetry research in particular, are playing an important role. Dedicated research programs of the European Commission have been and still are very valuable and include collaborations with institutes in Eastern Europe and non-European countries. Several current and recent research topics in radiation dosimetry are addressed based on research carried out within European research programs, at European research centers including the European Organization for Nuclear Research (known as CERN), in European particle therapy projects, and at national metrological institutes. One focus is the quantification of radiation quality in radiation protection and in high linear-energy-transfer radiation therapy with emphasis on measurements with low-pressure proportional counters. Another focus is dosimetry of high-energy radiations with respect to measurements of cosmic radiation and at CERN’s high-energy accelerators.
Doses, Benefits, Safety, and Risks in Oral and Maxillofacial Diagnostic Imaging
Authors: Lurie Alan G. 
Published: December 2018

Abstract
Diagnostic imaging is essential in dentistry. Doses range from low to very low, benefits to patients can be immense, and safe techniques are well known but widely ignored. Doses range from very low with properly executed intraoral, cephalometric, and panoramic imaging to higher than multidetector computed tomography with cone-beam computed tomography. Benefits are substantial: imaged dental disease, often obscured from direct vision by size and anatomy, can pose a mortal threat to the patient. Additionally, imaging is often central in planning complex dental procedures. Safe imaging in dental environments is straightforward; the means for minimizing dose and maximizing diagnostic efficacy have been widely and inexpensively available for decades. Such techniques reduce patient dose by some 80% over traditional techniques but are infrequently used. Digital panoramic equipment reduces doses markedly. For cone-beam computed tomography imaging, selection criteria are critical in defining appropriate fields of view and presets; several publications address this. It is treacherous to discuss risk in oral and maxillofacial radiology. There are more than 330 million dental x-ray examinations annually, the majority being intraoral examinations, with steady increases in panoramic and cone-beam computed tomography. Radiation carcinogenesis from conventional imaging is unlikely, while large field-of-view, high-resolution preset cone-beam computed tomography can be comparable in carcinogenesis risk to craniofacial multidetector computed tomography. Uncertainties in risk estimation from low doses coupled with the huge numbers of dental images taken annually and the rapid growth of cone-beam computed tomography dictate that safe oral and maxillofacial imaging is in the interests of patients, staff, and the public. As low as reasonably achievable (ALARA) practices and linear no-threshold risk modeling continue to be prudent and appropriate.
Radiation Protection Responsibility in Medicine: A Wrap-up
Authors: Frush Donald P. , Dauer Lawrence T. 
Published: December 2018

Abstract
The 54th Annual Meeting of the National Council on Radiation Protection and Measurements was held at the Hyatt Regency Bethesda, Maryland, on 5–6 March 2018. This annual meeting, entitled “Radiation Protection Responsibility in Medicine,” was the first to deal entirely with radiation protection in medical imaging since the 43rd annual meeting in 2007 (“Advances in Radiation Protection in Medicine”). The 2018 meeting addressed updates for various modalities and included discussion on radiation dose metrics and benefit/risk dialogue. In addition, the 2018 meeting dedicated entire sessions to patient communications and innovations in medical imaging.
Contact Lens Versus Non–Contact Lens–Related Corneal Ulcers at an Academic Center
Authors: Bennett Lisa , Y. Hsu Hugo , Tai Shannon , Ernst Benjamin , Schmidt Eric J. , Parihar Rohit , Horwood Chelsea , Edelstein Sean L. 
Published: December 2018

Purpose:
To compare the infectious contact lens–related corneal ulcer (CLRU) and non-CLRU cases at Saint Louis University.

Methods:
Retrospective review of corneal ulcer cases identified by search of the ophthalmology and microbiology department databases between 1999 and 2016.

Results:
Six hundred seventy-seven cases of corneal ulcers were identified, of which 46% were CLRU. CLRU cases were seen more commonly in younger patients (P<0.001) and women (P=0.03) than non-CLRU cases. Many of the infections were vision-threatening as defined by central/paracentral location (73% CLRU and 71% non-CLRU [P=0.60]) and large size of ulcer >2 mm2 in 36% CLRU and 51% non-CLRU (P=0.002). Causative pathogen in cultured CLRU was predominately Pseudomonas species (44%, P<0.001 vs. the non-CLRU group), other gram-negative (6%), gram-positive (33%), fungi (13%), and Acanthamoeba (5%). Comparatively, cultured non-CLRU was predominately gram-positive (64%, P<0.001 vs. the CLRU group), gram-negative (26%), and fungi (11%). The combined oxacillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus isolates were 35% and 34%, respectively. Despite the progressive increase in the number of corneal ulcers seen, the annual trend for any one particular organism for either CLRU cases or non-CLRU cases did not change significantly.

Conclusions:
Most of the cases were non-CLRU. CLRU was disproportionately associated with Pseudomonas species and non-CLRU with Staphylococcal species. Fungal infections were predominately caused by filamentous organisms in both groups. Acanthamoeba keratitis was exclusively associated with CL use.
Tumor necrosis factor receptor 1 inhibition is therapeutic for neuropathic pain in males but not in females
Authors: del Rivero Tania , Fischer Roman , Yang Fan , Swanson Kathryn A. , Bethea John R. 
Published: December 2018

AbstractTumor necrosis factor (TNF) is a proinflammatory cytokine, which is involved in physiological and pathological processes and has been found to be crucial for pain development. In the current study, we were interested in the effects of blocking Tumor necrosis factor receptor 1 (TNFR1) signaling on neuropathic pain after peripheral nerve injury with the use of transgenic mice and pharmacological inhibition. We have previously shown that TNFR1−/−mice failed to develop neuropathic pain and depressive symptoms after chronic constriction injury (CCI). To investigate the therapeutic effects of inhibiting TNFR1 signaling after injury, we delivered a drug that inactivates soluble TNF (XPro1595). Inhibition of solTNF signaling resulted in an accelerated recovery from neuropathic pain in males, but not in females. To begin exploring a mechanism, we investigated changes in N-methyl-D-aspartate (NMDA) receptors because neuropathic pain has been shown to invoke an increase in glutamatergic signaling. In male mice, XPro1595 treatment reduces elevated NMDA receptor levels in the brain after injury, whereas in female mice, NMDA receptor levels decrease after CCI. We further show that estrogen inhibits the therapeutic response of XPro1595 in females. Our results suggest that TNFR1 signaling plays an essential role in pain induction after CCI in males but not in females.
Role of anxiety in young children's pain memory development after surgery
Authors: Fischer Shanaya , Vinall Jillian , Pavlova Maria , Graham Susan , Jordan Abbie , Chorney Jill , Rasic Nivez , Brookes James T. , Hoy Monica , Yunker Warren K. , Noel Melanie 
Published: December 2018

Abstract
Pediatric pain is common, and memory for it may be distressing and have long-lasting effects. Children who develop more negatively biased memories for pain (ie, recalled pain is higher than initial pain report) are at risk of worse future pain outcomes. In adolescent samples, higher child and parent catastrophic thinking about pain was associated with negatively biased memories for postsurgical pain. This study examined the influence of child and parent anxiety on the development of younger children's postsurgical pain memories. Seventy-eight children undergoing a tonsillectomy and one of their parents participated. Parents reported on their anxiety (state and trait) before surgery, and trained researchers observationally coded children's anxiety at anaesthesia induction. Children reported on their postsurgical pain intensity and pain-related fear for 3 days after discharge. One month after surgery, children recalled their pain intensity and pain-related fear using the same scales previously administered. Results revealed that higher levels of postsurgical pain and higher parent trait anxiety predicted more negatively biased memories for pain-related fear. Parent state anxiety and child preoperative anxiety were not associated with children's recall. Children who developed negatively biased pain memories had worse postsurgical pain several days after surgery. These findings underscore the importance of reducing parental anxiety and effective postsurgical pain management to potentially buffer against the development of negatively biased pain memories in young children.
Current Practices and Perceptions of Admission Criteria at Physical Therapist Education Programs in the United States
Authors: Mitchell Katy , Ellison Jennifer , Gleeson Peggy 
Published: December 2018

Introduction.
Entry-level Doctor of Physical Therapy (DPT) programs in the United States (US) have developed admission criteria (AC) to identify applicants most capable of program success; however, there is little evidence to support these criteria. The purpose of this study was to 1) gather data on the use and weighting of AC, 2) explore the perceptions of the value of AC, 3) explore a possible discrepancy between the use of AC and their perceived value, 4) determine whether differences in AC exist between programs with higher versus lower licensure pass rates, higher versus lower student retention rates, and across geographic regions in the US.

Subjects.
All DPT programs (N = 218) in the US accredited by the Commission on Accreditation of Physical Therapy Education were eligible for recruitment in this study. The survey was completed by a program director, an admission committee chair, or a faculty member familiar with the program's admission process. Of the 218 programs invited to complete the survey, 73 responded with a response rate of 33.5%.

Methods.
An anonymous, 30-item survey was used for data collection. Descriptive and comparative statistical methods were used on the data as a whole and by subgroups.

Results.
Undergraduate overall grade point average (GPA), math/science GPA, or verbal and quantitative Graduate Record Examination (GRE) scores were weighted heavily in admission decisions. The personal essay, volunteer hours, and letters of recommendation were not considered predictive of program success. There were significant differences in the proportion of programs that use the verbal and quantitative GRE scores when subdivided by licensure pass rate, either ≥95% or <95% (P = .005 and P = .049, respectively). There were no proportional differences in the utilization or weighting of criteria when programs were divided by student retention rate, either ≥95% or <95%. Geographic differences were found in the use and weighting of AC when comparing the West region with other parts of the US.

Conclusion.
Previous literature suggests that undergraduate GPA is the best predictor of success in a DPT program; however, this study found no significant differences between the use or weight given to the GPA on licensure examination pass rates or student retention rates. Programs may wish to reconsider requiring a number of criteria that were not weighted heavily or considered to be a top predictor of success in a DPT program, particularly those criteria that are resource intensive.
Effect of Repeating Undergraduate Prerequisite Courses on Academic Performance in Doctor of Physical Therapy Program
Authors: Clark Richard C. , Chiu Yi-Po 
Published: December 2018

Introduction.
Identifying potential candidates with the highest potential for success in a doctoral-level physical therapy (DPT) program continues to challenge admissions boards nationwide. Although multiple studies have looked at admissions factors looking to identify specific relationships that predict academic success, it has been noted that many schools are now limiting the number of prerequisite courses that may be retaken by candidates. The purpose of this study was to identify whether there was a difference in DPT academic performance between students who repeated a prerequisite course (rPR) and those who did not repeat a prerequisite course (nrPR).

Methods.
Admissions data were retrospectively collected for 159 students from 5 graduating classes at 2 separate DPT programs between the years 2012–2015. Students were divided into 2 groups (rPR = 71; nrPR = 88) and were analyzed using 2-tailed independent t tests to identify statistically significant differences in DPT academic performance between groups.

Results.
Although the nrPR group showed better performance than the rPR group in all 3 DPT grade point averages (GPAs), there was no statistically significant difference found in DPT academic performance between the 2 groups: for 1GPA, t(157) = 1.294, P = .198; for 2GPA, t(157) = 0.876, P = .382; and for GGPA, t(157) = 0.682, P = .492.

Discussion and Conclusion.
The results of this study demonstrated no statistically significant difference in DPT academic performance between students repeating prerequisite courses versus those who did not repeat prerequisites. This suggests that the practice of limiting the number of repeated prerequisites may not serve to identify the best candidates.
Understanding Paper-Based Documentation Practices in Medical Resuscitations to Inform the Design of Electronic Documentation Tools
Authors: Jagannath Swathi , Sarcevic Aleksandra , Multak Nina , Myers Sage 
Published: December 2018

Objective
Despite growing use of electronic health records, many resuscitation settings still use paper-based documentation. The fast-paced and safety-critical nature of trauma and medical resuscitation environments pose challenges for real-time documentation. This study aims to understand paper-based documentation practices and inform the design of efficient electronic documentation solutions for supporting safety-critical medical processes.

Methods
Data were collected through in situ observations of nurse documenters during resuscitation events and postevent interviews with nurses. These data were analyzed using frequency distribution and qualitative, open-coding techniques. Data analysis focused on the following 3 main documentation factors: temporal distribution of documentation, total number of filled out sections on the paper flow sheet across all resuscitations, and completeness of documentation per resuscitation.

Results
Findings from this study highlight the time-critical nature of these settings, showing that 74% of the documentation was completed within the first 15 minutes of the resuscitation. Some sections of the paper flow sheet were filled out more than others, and a few sections were left incomplete across all events. Interviews with nurses provided insight about documentation experiences in a fast-paced environment, including variable usage of flow sheet based on nurse experience level and patient scenarios, supplemental documentation mechanisms, and information needs and preferences.

Conclusions
Several design implications are discussed to inform the design of effective electronic documentation systems. Design implications focus on layout structure, prepopulating items, section placement, and completion status of the flow sheet. Future plans for research focus on combining video review with in situ observations and conducting detailed interviews with nurses to better understand their documentation experiences and preferences.
Comparing the Evolution of Risk Culture in Radiation Oncology, Aviation, and Nuclear Power
Authors: Abdulla Ahmed , Schell Kristen R. , Schell Michael C. 
Published: December 2018

Objectives
All organizations seek to minimize the risks that their operations pose to public safety. This task is especially significant if they deal with complex or hazardous technologies. Five decades of research in quantitative risk analysis have generated a set of risk management frameworks and practices that extend across a range of such domains. Here, we investigate the risk culture in three commercial enterprises that require exceedingly high standards of execution: radiation oncology, aviation, and nuclear power.

Methods
One of the characteristics of high reliability organizations is their willingness to learn from other such organizations. We investigate the extent to which this is true by compiling a database of the major publications on risk within each of the three fields. We conduct a bibliographic coupling analysis on the combined database to identify connections among publications. This analysis reveals the strength of engagement across disciplinary boundaries and the extent of cross-adoption of best practices.

Results
Our results show that radiation oncology is more insulated than the other two fields in its adoption and propagation of state-of-the-art risk management tools and frameworks that have transformed aviation and nuclear power into high reliability enterprises with actuarially low risk.

Conclusions
Aviation and nuclear power have established risk cultures that cross-pollinate. In both nature and extent, we found a distinct difference in radiation oncology's engagement with the risk community, and it lags behind the other two fields in implementing best practices that might mitigate or eliminate risks to patient safety.