bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of Neurosurgery Medical Professional Liability Claims in the United States
Authors: Elsamadicy Aladine A , Sergesketter Amanda R , Frakes Michael D , Lad Shivanand P 
Published: January 2018

Abstract

BACKGROUND
Due to disparaging costs and rates of malpractice claims in neurosurgery, there has been significant interest in identifying high-risk specialties, types of malpractice claims, and characteristics of claim-prone physicians.

OBJECTIVE
To characterize the malpractice claims against neurosurgeons.

METHODS
This was a comprehensive analysis of all malpractice liability claims involving a neurosurgeon as the primary defendant, conducted using the Physician Insurers Association of America Data Sharing Project from January 1, 2003 and December 31, 2012.

RESULTS
From 2003 to 2012, 2131 closed malpractice claims were filed against a neurosurgeon. The total amount of indemnity paid collective between 1998 to 2002, 2003 to 2007, and 2008 to 2012 was $109 614 935, $140 031 875, and $122 577 230, respectively. Of all the neurosurgery claims, the most prevalent chief medical factor was improper performance (42.1%, $124 943 933), presenting medical condition was intervertebral disc disorder (20.6%, $54 223 206), and operative procedure performed involved the spinal cord and/or spinal canal (21.0%, $62 614 995). Eighty-five (22.91%) of the total neurosurgery claims resulted in patient death, resulting in $32 067 759 paid. Improper performance of the actual procedure was the most prevalent and highest total paid cause for patient death ($9 584 519).

CONCLUSION
From 2003 to 2012, we found that neurosurgery malpractice claims rank among one of the most costly and prevalent, with the average indemnities paid annually and the overall economic burden increasing. Diagnoses and procedures involving the spine, along with improper performance, were the most prevalent malpractice claims against neurosurgeons. Continued medical malpractice reform is essential to correct the overall health care cost burdens, and ultimately improve patient safety.
Medical Education Videos for the World: An Analysis of Viewing Patterns for a YouTube Channel
Authors: Tackett Sean , Slinn Kyle , Marshall Tanner , Gaglani Shiv , Waldman Vincent , Desai Rishi 
Published: January 2018

Purpose
Medical education videos can enhance learning and easily integrate into common instructional methods. YouTube permits worldwide access to high-quality medical education videos; however, no studies have described the reach of medical education videos on YouTube or what topics are preferred.

Method
One year of YouTube analytics data (February 1, 2016, to January 31, 2017) was collected for a medical-education-focused channel called Osmosis. Created December 20, 2015, the channel had 189 disease-focused videos by January 2017. Viewer and subscriber data were analyzed according to the World Bank’s four income and seven region classifications. Topic viewing was analyzed according to income level.

Results
The channel had accumulated 105,117 subscribers and 5,226,405 views for 20,153,093 minutes (38.3 years) from viewers located in 213/218 (97.7%) World Bank economies. While the number of videos increased 4.8-fold from February 2016 to January 2017, monthly views increased 50-fold and subscribers increased 117-fold. Low- or middle-income countries generated 2.2 million (42%) views and 52,942 (50%) subscribers, with similar view proportions across income level during the 12 months. A plurality of views (1.5 million; 29%) came from North America; Sub-Saharan Africa had the lowest number (150,065; 2.9%). Topic viewing generally corresponded to population health statistics.

Conclusions
Medical education content on YouTube can immediately and consistently reach a global viewership with relevant content. Educators may consider posting videos to YouTube to reach a broad audience. Future work should seek to optimize assessment of learning and investigate how videos may affect patients.
Charting the Publication and Citation Impact of the NIH Clinical and Translational Science Awards (CTSA) Program From 2006 Through 2016
Authors: Llewellyn Nicole , Carter Dorothy R. , Rollins Latrice , Nehl Eric J. 
Published: January 2018

Purpose
The authors evaluated publication and citation patterns for articles supported by Clinical and Translational Science Awards (CTSA) hub investment over the first decade of the CTSA program. The aim was to elucidate a pivotal step in the translational process by providing an account of how time, hub maturity, and hub attributes were related to productivity and influence in the academic literature.

Method
In 2017, the authors collected bibliometric data from PubMed, Web of Science InCites, and National Institutes of Health (NIH) iCite for articles citing any CTSA hub grants published from hub inception through 2016. They compiled data on publication and citation rates and indices of relative citation impact aggregated by hub funding year cohort. They compared hub-level bibliometric activity by multi- versus single-institution structure and total monetary award sums, compiled from NIH RePORTER.

Results
From 2006–2016, CTSA hubs supported over 66,000 publications, with publication rates accelerating as hubs matured. These publications accumulated over 1.2 million citations, with some articles cited over 1,000 times. Indices of relative citation impact indicated CTSA-supported publications were cited more than twice as often as expected for articles of their publication years and disciplines. Multi-institutional hubs and those awarded higher grant sums exhibited significantly higher publication and citation activity.

Conclusions
The CTSA program is yielding a robust and growing body of influential research findings with consistently high indices of relative citation impact. Preliminary evidence suggests multi-institutional collaborations and more monetary resources are associated with elevated bibliometric activity and, therefore, may be worth their investment.
Evaluating Differential Effects of Specific Pain Dismissal Interactions With Physicians
Authors: Lang Amy C. , Igler Eva C. , Defenderfer Ellen K. , Uihlein Julia , Brimeyer Chasity T. , Davies W. Hobart 
Published: January 2018

Objectives:
Over 40% of adolescents with chronic pain report experiencing pain dismissal, which is a response from another individual that is perceived as diminishing, denying, or disbelieving an individual’s report of pain. Pain dismissal by physicians often leaves patients feeling discredited, which may discourage them from seeking and receiving proper treatment for their pain. The purpose of this study was to investigate how the 4 most commonly reported types of physician pain dismissal differentially affect individuals’ reactions.

Materials and Methods:
Emerging adults, age 18- to 25-years old (N=352, 60% female), were randomly assigned to read 1 of 4 vignettes describing patient-provider interactions that included the most commonly reported types of pain dismissal identified by previous research: denial/disbelief, minimizing, faking for secondary gain, and psychogenic. Participants answered questions regarding their reactions to the pain dismissal vignettes.

Results:
All 4 vignettes were perceived as dismissive and problematic by the majority of participants, but participants who read the psychogenic pain dismissal vignette were less dissatisfied overall with the hypothetical medical appointment than participants who read the other 3 vignettes.

Discussion:
All 4 types of physician pain dismissal were broadly perceived negatively, suggesting that the experience of pain dismissal is likely not due to patient hypersensitivity but to physician behavior. Discussion of the psychological factors associated with pain was less likely to be perceived as dismissive. Psychologists and physicians should collaborate to develop recommended language that validates patients’ experiences of pain, communicates appropriate levels of empathy, and reduces the frequency of perceived physician pain dismissal.
Sphingosine Kinase 1 Regulates Inflammation and Contributes to Acute Lung Injury in Pneumococcal Pneumonia via the Sphingosine-1-Phosphate Receptor 2
Authors: Gutbier Birgitt , Schönrock Stefanie M. , Ehrler Carolin , Haberberger Rainer , Dietert Kristina , Gruber Achim D. , Kummer Wolfgang , Michalick Laura , Kuebler Wolfgang M. , Hocke Andreas C. , Szymanski Kolja , Letsiou Eleftheria , Lüth Anja , Schumacher Fabian , Kleuser Burkhard , Mitchell Timothy J. , Bertrams Wilhelm , Schmeck Bernd , Treue Denise , Klauschen Frederick , Bauer Torsten T. , Tönnies Mario , Weissmann Norbert , Hippenstiel Stefan , Suttorp Norbert , Witzenrath Martin 
Published: January 2018

Objectives:
Severe pneumonia may evoke acute lung injury, and sphingosine-1-phosphate is involved in the regulation of vascular permeability and immune responses. However, the role of sphingosine-1-phosphate and the sphingosine-1-phosphate producing sphingosine kinase 1 in pneumonia remains elusive. We examined the role of the sphingosine-1-phosphate system in regulating pulmonary vascular barrier function in bacterial pneumonia.

Design:
Controlled, in vitro, ex vivo, and in vivo laboratory study.

Subjects:
Female wild-type and SphK1-deficient mice, 8–10 weeks old. Human postmortem lung tissue, human blood–derived macrophages, and pulmonary microvascular endothelial cells.

Interventions:
Wild-type and SphK1-deficient mice were infected with Streptococcus pneumoniae. Pulmonary sphingosine-1-phosphate levels, messenger RNA expression, and permeability as well as lung morphology were analyzed. Human blood–derived macrophages and human pulmonary microvascular endothelial cells were infected with S. pneumoniae. Transcellular electrical resistance of human pulmonary microvascular endothelial cell monolayers was examined. Further, permeability of murine isolated perfused lungs was determined following exposition to sphingosine-1-phosphate and pneumolysin.

Measurements and Main Results:
Following S. pneumoniae infection, murine pulmonary sphingosine-1-phosphate levels and sphingosine kinase 1 and sphingosine-1-phosphate receptor 2 expression were increased. Pneumonia-induced lung hyperpermeability was reduced in SphK1
–/– mice compared with wild-type mice. Expression of sphingosine kinase 1 in macrophages recruited to inflamed lung areas in pneumonia was observed in murine and human lungs. S. pneumoniae induced the sphingosine kinase 1/sphingosine-1-phosphate system in blood-derived macrophages and enhanced sphingosine-1-phosphate receptor 2 expression in human pulmonary microvascular endothelial cell in vitro. In isolated mouse lungs, pneumolysin-induced hyperpermeability was dose dependently and synergistically increased by sphingosine-1-phosphate. This sphingosine-1-phosphate–induced increase was reduced by inhibition of sphingosine-1-phosphate receptor 2 or its downstream effector Rho-kinase.

Conclusions:
Our data suggest that targeting the sphingosine kinase 1–/sphingosine-1-phosphate–/sphingosine-1-phosphate receptor 2–signaling pathway in the lung may provide a novel therapeutic perspective in pneumococcal pneumonia for prevention of acute lung injury.
PIGMENTED PARAVENOUS CHORIORETINAL ATROPHY
Authors: Shona Olajumoke a , Islam Farrah , Robson Anthony G. , Webster Andrew R. , Moore Anthony T. , Michaelides Michel 
Published: January 2018

Purpose:
To review and describe in detail the demographics, functional and anatomical characteristics, and clinical course of pigmented paravenous chorioretinal atrophy in a large cohort of adults and children.

Methods:
This is a retrospective case series of consecutive patients diagnosed with pigmented paravenous chorioretinal atrophy at a single U.K. referral center from 1974 to 2016. Clinical records, retinal imaging (color fundus photography, fundus autofluorescence, and optical coherence tomography), and electrophysiological assessments were reviewed.

Results:
Twenty-three patients were identified (13 males and 10 females). The mean age at presentation was 35 years (range 10–67 years). Mean follow-up was 6.7 years (range 0–30 years). There was no family history of similar retinal disease. Thirteen (57%) patients were asymptomatic. Symptoms included photopsia (n = 1.4%), blurred vision (n = 4.17%), peripheral visual field loss (n = 3.13%), and nyctalopia (n = 2.8%). One patient had previous intermediate uveitis. Twenty-one (91%) patients had ≥6/12 in the better seeing eye at final follow-up; visual acuity loss over time was recorded in 2 patients. Color vision was normal in all 14 patients assessed. Paravenous hypoautofluorescence with surrounding increased fundus autofluorescence was characteristically observed. Optical coherence tomography over the retinal changes demonstrated choroidal, retinal pigment epithelium, and outer retinal layer thinning. Peripapillary atrophic changes on fundus photography were evident in 20 (87%) patients. Interocular asymmetry of fundus and electroretinography findings was common. The electroretinography findings showed a similar degree of generalized rod and cone photoreceptor dysfunction in most cases.

Conclusion:
Overall, most patients with pigmented paravenous chorioretinal atrophy maintained stable vision. The lack of other affected family members, slow or absent progression, and interocular asymmetry of the retinal features is suggestive of an acquired rather than inherited retinal disorder, which is generally nonprogressive. We identify that patients commonly have marked interocular asymmetry both on structural and functional assessment.
Are group size and composition associated with treatment outcomes in group cognitive behavioural therapy for chronic pain?
Authors: Wilson Dianne , Mackintosh Shylie , Nicholas Michael K. , Moseley G. Lorimer , Costa Daniel , Ashton-James Claire 
Published: January 2018

Abstract
This study explored whether group size and group member characteristics (age, sex, and compensation status) were associated with patient outcomes (changes in pain and disability). Retrospective analyses of outcome data obtained from 2 independently run group cognitive behavioural therapy (CBT) programs for chronic pain (Program A: N = 317 and Program B: N = 693) were conducted. Intracluster correlations were significant in both studies, indicating group-level effects on patient outcomes in both group CBT programs for chronic pain. Mixed modelling revealed that group size and group member characteristics (age, sex, and compensation status) were related to patient outcomes, but not consistently across programs. The results of our analyses confirm the contribution of group composition to individual treatment outcomes in group CBT for chronic pain, and highlight factors that have the potential to contribute to group-level variability in patient outcomes. Further research is needed to identify the mechanisms that account for the impact of group characteristics on the efficacy of CBT for chronic pain.
Management of Chronic Pain in the Elderly: A Review of Current and Upcoming Novel Therapeutics
Authors: Murphy Neal , Karlin-Zysman Corey , Anandan Sam 
Published: January 2018

Background:
A significant proportion of the elderly are affected by chronic pain, resulting in a decreased quality of life. Opiate use has become increasingly common in older adult patients. This article reviews both well-established current and novel therapies for management of chronic pain in older adults.

Areas of Uncertainty:
The number of studies involving management of chronic pain in elderly patients is limited. Managing pain alongside multiple chronic, comorbid conditions presents therapeutic and appropriate drug dosing challenges.

Therapeutic Advances:
Nonsteroidal anti-inflammatory drug nano-formulations have shown promise in clinical trials. These new formulations have similar efficacy to oral nonsteroidal anti-inflammatory drugs, while minimizing adverse effects. TRV130, a new targeted opioid, selectively activates the analgesic pathway of the mu-opioid receptor. The drug has been proven to have analgesic effects similar to morphine with less opioid-induced adverse effects. Mixed opioids agonists, targeting the mu and ORL1 receptors, may prove superior among the opioid class given their effectiveness, improved safety profile, and low abuse potential. In addition, there is ongoing research assessing reduction of pain by targeted and peripherally restricted cannabinoids, attempting to limit activation of the central receptors responsible for addiction and psychotomimetic effects.

Conclusions:
Management of chronic pain in older adults remains challenging with current medication regimens. In facing the opiate epidemic, providers must use multicomponent strategies to find the most effective and safest combinations of pain medications to achieve adequate pain control. Regardless of the variety and complexity of pain medications available, prescribing physicians should start with low doses, titrate slowly, and monitor pain control frequently. Treating chronic pain is a complex and difficult issue that hopefully will become more manageable as pain medication regimens improve and new therapeutics are developed.
Optimizing Medication Management in the Hospitalized Older Adult
Authors: Pisano Michele , Beizer Judith L. 
Published: January 2018

Background:
Polypharmacy, which is the use of multiple medications, is of great concern for older adults because of the burden it can place on patients and society. Older adults often necessitate more medications due to the fact that they commonly have multiple chronic conditions.

Areas of Uncertainty:
Multiple medications are often necessary to cure or slow the progression of disease, reduce symptoms of disease, improve quality of life and/or decrease complications. However, they can also lead to adverse consequences in older adults, such as adverse drug events, falls, increase in health care costs, and medication nonadherence.

Therapeutic Advances:
Optimizing the medication regimen of an elderly patient starts with appropriate choice of medications, focusing on minimizing adverse effects, and simplifying the regimen to increase adherence. Medications should be evaluated for potentially inappropriate medications for elderly patients, utilizing Beers criteria and START/STOPP criteria. It is also important to deprescribe medications when appropriate. Deprescribing is the process of tapering or stopping drugs, with the goal of decreasing polypharmacy, decreasing costs, and improving outcomes. Medication reconciliation should be performed at every transition point and any change should be communicated to the patient, caregiver, and primary care provider. The teach-back method can be used to ensure proper comprehension by the patient and/or caregiver.

Conclusion:
The challenge that all health care professionals face is to determine the most appropriate drug therapy regimen that will enhance the patient's quality of life without compromising the patient's ability to function or increase the risk of adverse reactions.
Advancements in the Treatment of Constipation in Hospitalized Older Adults: Utilizing Secretagogues and Peripherally Acting Mu-Opioid Receptor Antagonists
Authors: Moore Jacqueline , Firoozan Sheila , Martinez Nichol 
Published: January 2018

Background:Despite its prevalence among hospitalized older adults, constipation is frequently treated with ineffective agents.Areas of Uncertainty:Although data exist to support the use of bulk and osmotic laxatives in geriatric patients, commonly used medications, such as docusate sodium, have been shown to lack clear benefit.Therapeutic Advances:Recently, investigators have developed novel agents that rely on alternative mechanisms of action to promote bowel motility. These innovative agents are rapidly becoming powerful tools in the management of constipation in older adults. Randomized control trials have demonstrated that secretory agents, including lubiprostone and linaclotide, are quite effective in the general population for the management of constipation. Limited subgroup analyses of geriatric subjects in these trials did reveal statistically significant improvement in constipation symptoms with minimal adverse effects. Additionally, with the widespread use of opioids to manage chronic pain in the geriatric population, new pharmacologic interventions have entered the market to counter the frequently encountered adverse effect of opioid-induced constipation. These compounds are known as peripherally acting mu-opioid receptor antagonists (PAMORAs) based on their mechanism of action in the gastrointestinal tract. Compounds such as methylnaltrexone and naloxegol are increasingly being used in the hospital setting for elderly patients with constipation associated with the use of opioids; however, further studies are needed to make specific recommendations regarding its use in older adults. Finally, serotonergic agents have also been extensively studied for their potential to augment gut motility, but many have been associated with an increased risk of cardiovascular events and are thus at this time not recommended as first-line therapy.Conclusions:Although promising new agents are becoming available for the treatment of this highly prevalent condition, both traditional and innovative therapies for constipation need additional study for their efficacy and safety in the elderly population.
Advances in Managing Type 2 Diabetes in the Elderly: A Focus on Inpatient Care and Transitions of Care
Authors: Myers Alyson , Garnica Patricia , Ling Jason 
Published: January 2018

Background:
As the population ages, so does the frequency of chronic illness such as coronary artery disease, hypertension, or diabetes. Type 2 diabetes mellitus (T2DM) has nearly tripled in prevalence among those older than 75 years.

Areas of Uncertainty:
Renal/hepatic failure, poor nutritional status, limited mobility, and cognitive impairment are some of the factors that can predispose elderly patients to hypoglycemia or hyperglycemia. As a result, the diabetes guidelines have been modified to recommend less stringent glycemic control for this vulnerable population.

Therapeutic Advances:
In this review, the authors address the inpatient management of type 2 diabetes, in which patients are transitioned off of their oral antihyperglycemic agents and started on insulin therapy. Insulin dosing has to be adjusted in those with changes in renal function, concomitant steroid use, decreased oral intake, or utilization nonenteral nutrition. In addition, there is a discussion of the transition of inpatient insulin therapy to outpatient care. Medication reconciliation is crucial and has a significant impact on the outcome and quality of care. This review examines established and newer agents such as sodium-glucose cotransporter 2 inhibitors and concentrated insulin. Creatinine clearance is an important factor in the dosing of these agents, as elderly patients can have a normal creatinine with a compromised creatinine clearance. Lastly, this review examines the use of the evolving diabetes therapeutic technology: insulin pumps and sensors. These devices are no longer limited to the outpatient settings, as hospitals are devising insulin pump policies that allow patients to continue to use their device. Its role in the elderly population, however, is poorly understood and requires further research for its applicability.

Conclusions:
As the prevalence of T2DM continues to rise and population continues to age, inpatient care and care transitions remains an essential key in management of elderly persons with T2DM.