bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Secure Is the Diagnosis of Ulcerative Colitis in Children, Even After Colectomy?
Authors: Jones Ian , Ramani Pramila , Spray Christine , Cusick Eleri 
Published: May 2017

ABSTRACTObjectives:We reviewed all children who have undergone a colectomy for ulcerative colitis (UC) in our tertiary referral centre in a 12‐year period to assess the rate of reclassification as Crohn disease (CD). In contrast to CD, a colectomy is considered to be definitive treatment for patients with UC. Distinguishing between the 2 can be challenging when disease is manifest only within the colon—even histological examination of a colectomy specimen may be inconclusive. Historically, the recognised “rediagnosis” rate (post‐colectomy) was reported at approximately 3% to 7%. A recent study suggested that a higher rate of 13% should be expected in children. This has implications in terms of pre‐operative counselling and surgical decision making.Methods:A retrospective case‐note review of all patients who underwent a colectomy for UC between 2003 and 2014 in a single paediatric tertiary referral centre was performed.Results:Of the 570 children diagnosed with inflammatory bowel disease in this period, 190 were diagnosed as UC. Of these 190 cases, 29 underwent a colectomy. None of these was re‐classified following histological examination of the colectomy sample. Seven out of the 29 patients (24%) were subsequently diagnosed with CD (median follow‐up 7.6 years). This is significantly higher than previously reported rates (P = 0.003).Conclusions:Our data suggest that later manifestation of CD is more common than previously thought (24%). Therefore, a diagnosis of UC in children should be regarded as provisional and a potential later diagnosis of CD taken into account when considering colectomy and J‐pouch formation.
Risk of Eating Disorders in Patients With Celiac Disease
Authors: Babio Nancy , Alcázar Mireia , Castillejo Gemma , Recasens Miriam , Martínez‐Cerezo Francesc , Gutiérrez‐Pensado Vanessa , Vaqué Cristina , Vila‐Martí Anna , Torres‐Moreno Miriam , Sánchez Enric , Barrubés Laura , Salas‐Salvadó Jordi 
Published: May 2017

ABSTRACTObjectives:Several cases of eating disorders (EDs) have been reported in patients with celiac disease (CD), suggesting that ED could be a comorbidity associated with CD. Few epidemiological studies have, however, assessed this potential association. We aimed to evaluate the risk of EDs in individuals diagnosed with CD in comparison to healthy controls.Methods:A total of 98 cases and 98 controls matched for sex, age, and body mass index between 10 and 23 years old were studied. A questionnaire was completed on medical history and sociodemographic as well as anthropometric characteristics. Various ED screening self‐reported tests were administered.Results:A total of 61.2% of the study population were girls with a mean age of 15.3 ± 3.7 years old. Patients with CD scored nonsignificantly higher on all the ED screening tests than control participants. No differences were observed between study groups in terms of the frequency of individuals who exceeded the clinical cutoff identifying those at risk of ED. Patients with CD above 13 years old were associated with a 2.15‐point increase in the Eating Attitude Test score compared with controls [β‐coefficient = 2.15 SE 1.04; P = 0.04] after adjusting for various confounders.Conclusions:Although being a patient with CD was associated with a significantly higher Eating Attitude Test score in individuals older than 13 years old, no clear differences were observed between individuals with CD and controls in terms of risk of ED when other screening tests were used. More studies with larger samples and prospective designs are warranted to confirm these findings.
Utilization of the Health Care System of Community Case Management Patients
Authors: Armold Sarah 
Published: May 2017

Purpose of Study:
The Centers for Medicare & Medicaid Services (2015) has reduced payments to hospitals that have excessive readmissions. This mandate has made it imperative for hospitals to implement a plan to manage readmissions and transitions of care for patients they serve. The purpose of this study was to ascertain whether an advanced practice, nurse-led, community-based model is effective in reducing acute health care utilization.

Primary Practice Setting:
The community case management (CCM) program was created more than 20 years ago to assess and manage care of patients demanding frequent emergency department (ED) visits and frequent hospitalizations, by providing in-home visits and care coordination by an advanced practice nurse or masters-prepared nurse.

Methodology and Sample:
The charts of 307 patients who were referred to CCM were reviewed to assess their utilization of the health care system after referral. There were 2 groups of patients: those who accepted CCM services (N = 151) and those who refused CCM services (N = 156) upon referral.

Results:
It was found that if patients accepted CCM services, they had 55% fewer visits to the ED and 61% fewer hospital admissions than patients who refused CCM services. Utilization of urgent care was decreased by 47% in the patients who accepted CCM services, but this decline was not statistically significant.

Implication for Case Management Practice:
The results of this study indicate that CCM is effective in decreasing hospital admissions and ED visits for the patients using CCM services. Implementing a CCM program could be an effective method for decreasing utilization of the hospital and ED by adult patients with at least 1 chronic disease.
Partnerships in Transitions: Acute Care to Skilled Nursing Facility
Authors: Dizon Mae L. , Zaltsmann Ruth , Reinking Cheryl 
Published: May 2017

Purpose/Objectives:
Older adults, in particular those discharged to skilled nursing facilities (SNFs), are at high risk for readmission. As part of a multifaceted approach to reduce readmissions, a community hospital initiated a 3-prong approach (Collaboration, Communication, and Competency) and partnered with regional SNFs.

Primary Practice Settings:
El Camino Hospital, an independent, locally owned, not-for-profit district, acute care hospital in Northern California, and 11 participating SNFs in the same region.

Findings/Conclusions:

Collaboration: The combined leadership team developed a case report form and instituted regular reviews of 7-day readmissions. Communication: Standardized form for transferring patients to SNFs, form for transfer from SNF to emergency department, and consent form to enable SNFs to administer antipsychotic medications were developed. Regular phone and video conferencing between clinicians at the hospital and receiving SNF were instituted. Competency: Educational series to recognize and intervene to prevent readmission, and mutual exchange of best practices among hospital and SNF staff, were instituted. Continued work among ECH and the participating SNFs has improved the flow of information in both directions; favorable results from the broader study to reduce readmissions hospital-wide provide support for these efforts.

Implications for Case Management Practice:
Initiating collaboration with the SNFs is imperative in the changing health care landscape. Because of the complexity of the problem, acute care facilities and SNFs need to create a partnership to ensure smooth patient transition. Communication between care settings is essential in achieving optimum patient outcomes.
Supporting the Support System
Authors: Harkey Jane , Young Jared , Carter Jolynne “Jo” , Demoratz Michael 
Published: May 2017

Purpose/Objective:
The benefits of having a support system, such as social relationships with close friends and family, have been well documented for patients with serious health issues. As scientific evidence has shown, individuals who have the lowest level of involvement in social relationships face a greater mortality risk. Support systems, however, are not infallible. Relationship stress can have a negative impact on people—patient and caregiver alike—behaviorally, psychosocially, and physiologically. The purpose of this article is to encourage case managers who take a patient-centered approach to also consider the existence and extent of the support system, as well as any stresses or tensions that are observable within the support system. Although the case manager is ethically obliged to advocate for the individual receiving case management services, that advocacy can be extended to the support system for the good of all.

Primary Practice Settings:
This discussion applies to numerous case management practices and work settings including (but not limited to) hospital-based case management, home health, geriatrics, catastrophic case management, mental health, palliative care, and end of life/hospice.

Finding/Conclusions:
As part of the assessment phase of the case management process, case managers determine the extent of the patient's support system or social support network such as family and close friends. Although their advocacy is primarily for the patient receiving case management services, case managers also become aware of the needs of the support system members as they face their loved one's serious illness, severe injury, geriatric care demands, or end of life. Case managers can use their communication skills, especially motivational interviewing, with patients and their support systems to identify stresses and issues that can impact the pursuit of health goals. In addition, case managers ensure that individuals and their support systems are kept informed such as about the health condition, stage of disease, plan of care, treatment options, and care transition plan.

Implications for Case Management:
Professional case managers expand their role as advocates, serving primarily the patients (“clients”) who receive case management services and also members of the support system. By becoming more aware and sensitive to the needs of the support system, case managers help reduce stress on the support system, which can contribute to positive outcomes for patients (“clients”).
Pancreatic Cancer and Depression
Authors: Parker Gordon , Brotchie Heather 
Published: May 2017

Abstract
Depression is a common concomitant of pancreatic cancer, and, because it often occurs before the cancer is diagnosed, its occurrence is likely to be intrinsic to the condition rather than a reaction to such a diagnosis. Because pancreatic cancer is associated with a very high mortality, its early detection is a key task. We therefore review relevant literature to determine whether the depression is prototypically distinctive and whether its identification might lead to earlier diagnosis of pancreatic cancer. We report on the epidemiology and prognosis of pancreatic cancer and on the prevalence, description, and possible mechanisms involved for the occurrence of any associated depressive state, before reviewing the comparative utility of depression in relation to other risk factors in aiding diagnosis. Published studies fail to identify any distinct depressive prototypic phenotype to depression associated with pancreatic cancer. Although it is a relatively common concomitant of pancreatic cancer, the utility of depression as a marker of the condition is not suggested from a key study evaluating its contribution in relation to other symptoms and risk factors.
Patient, Provider, and System Factors Contributing to Patient Safety Events During Medical and Surgical Hospitalizations for Persons With Serious Mental Illness
Authors: McGinty Emma E. , Thompson David A. , Pronovost Peter J. , Dixon Lisa B. , Guallar Eliseo , Ford Daniel E. , Cahoon Elizabeth Khaykin , Boonyasai Romsai , Daumit Gail L. 
Published: May 2017

Abstract
This study aimed to explore patient-, provider-, and system-level factors that may contribute to elevated risk of patient safety events among persons with serious mental illness (SMI). We conducted a medical record review of medical/surgical admissions in Maryland hospitals from 1994 to 2004 for a community-based sample of adults with SMI (N = 790 hospitalizations). We estimated the prevalence of multiple patient, provider, and system factors that could influence patient safety among persons with SMI. We conducted a case crossover analysis to examine the relationship between these factors and adverse patient safety events. Patients' mental status, level of consciousness, disease severity, and providers' lack of patient monitoring, delay/failure to seek consultation, lack of trainee supervision, and delays in care were positively associated with adverse patient safety events (p < 0.05). Efforts to reduce SMI-related patient safety risks will need to be multifaceted and address both patient- and provider-level factors.
General Psychiatric Management for Suicidal Patients, With Remarks on Chronicity
Authors: Yager Joel , Feinstein Robert E. 
Published: May 2017

Abstract
Assessing, managing, and treating suicidal patients, particularly those with chronic suicidality, challenge clinical decision making and emotional self-management in trainees and seasoned practitioners. Educators and trainees have noted needs for additional teaching materials in these areas. This article assists in addressing these gaps. We reviewed diagnostic and phenomenological characteristics encountered in acutely and chronically suicidal patients, their comprehensive assessment, general approaches to management, risk mitigation and safety planning, and psychological and biological interventions. Integrating information from research and clinical experience–based literature, we offer concise guidance on comprehensive psychiatric management for the varieties of acutely and chronically suicidal patients encountered in practice. By actively engaging suicidal patients and their families, systematically attending to warning signs, conducting risk mitigation and safety planning, and using psychological and biological treatments as indicated, clinicians are likely to reduce suicidal ideation, plans, and attempts in patients and might reduce completed suicides.
Features of Resting-State Electroencephalogram Theta Coherence in Somatic Symptom Disorder Compared With Major Depressive Disorder: A Pilot Study
Authors: Ahn Jaeyoung , Han Doug Hyun , Hong Ji Sun , Min Kyoung Joon , Lee Young Sik , Hahm Bong-Jin , Kim Sun Mi 
Published: May 2017

ABSTRACT

Objective
Somatic symptom disorder (SSD) often co-occurs with major depressive disorder (MDD). Both conditions share common psychobiological and biobehavioral characteristics, but little is known about differential patterns in brain function. In this study, we compared resting-state functional brain connectivity between SSD and MDD using quantitative electroencephalography.

Methods
Fifteen patients with SSD (SSD group), 15 patients with MDD (MDD group), and 15 healthy volunteers (healthy control [HC] group) participated in this study. Participants were assessed with quantitative electroencephalography using a 21-channel electroencephalogram system. Electroencephalogram coherence in the theta frequency range (3.5–7.5 Hz) was assessed between the following seven electrode pairs: Fp1 and Fp2, F7 and T3, F8 and T4, T5 and P3, P4 and T6, P3 and Pz, and Pz and P4. Differences in coherence between groups were analyzed using analysis of variance.

Results
Theta coherence between the F7 and T3 electrodes was lower in the SSD group than the MDD and HC groups (F(2,42) = 6.67, p = .0030). Theta coherence between the T5 and P3 electrodes was lower in the SSD and MDD groups than the HC group (F(2,42) = 5.65, p = .0067). Theta coherence between the Pz and P4 electrodes was lower in the SSD group than the MDD group (F(2,42) = 6.41, p = .0037).

Conclusions
Both SSD and MDD patients commonly showed decreased functional connectivity within the left temporoparietal junction, which has neurophysiological implications for cognitive-attentional processing and social interaction. Frontostriatal circuit dysfunction affects processes that control perception and emotion, as well as misperception of somatosensory data in the parietal somatosensory area, and is more likely to be a neuropathology of SSD than MDD.
Increased Reporting Accuracy of Alzheimer Disease Symptoms in Caribbean Hispanic Informants
Authors: Azar Martina , Zhu Carolyn , DeFeis Brittany , Gu Yian , Ornstein Katherine , Lawless Siobhan , Cosentino Stephanie 
Published: May 2017

Introduction:
Informant report of symptoms is essential for diagnosing and characterizing Alzheimer disease (AD). Differences in the perception and experience of dementia across ethnicities may influence informant report. Understanding such differences is critical given that among those with AD, Hispanics are disproportionately affected.

Methods:
Cross-sectional analyses examined informant report of cognitive and functional symptoms in mild AD across white (n=107) and Caribbean Hispanic (n=71) informants. To explore its accuracy, informant report of symptoms was compared against objective measures of patient performance.

Results:
Adjusted analyses revealed Hispanics reported more symptoms than white informants. Informant report of symptoms was inversely correlated with patients’ global cognition in both ethnic groups. Only Hispanic report of symptoms was significantly associated with memory and language performance.

Discussion:
Informant report of symptoms was associated with patients’ global cognition, reflecting relatively accurate informant reports in both ethnic groups, and was stronger in Hispanics when examining memory and language. Such differences may reflect cultural caregiving practices and perceptions of dementia, having implications for diagnosis and treatment.
Ultrasound Imaging of Median Nerve Conduit in a Patient With Persistent Median Nerve Symptoms
Authors: Billakota Santoshi , Ruch David S. , Hobson-Webb Lisa D. 
Published: May 2017

Summary:
Peripheral nerve injury can be reconstructed using composite polymer nerve autografts, but the sonographic appearance of nerve wraps and conduits have not been well documented. This case report describes the sonographic findings in a 42-year-old woman with bilateral carpal tunnel syndrome status post nerve repair with a conduit. The cross-sectional area of the left median nerve was 24 mm2 at the carpal tunnel inlet and 5 mm2 at the forearm. The wrist to forearm ratio was 4.8. There was a hypoechoic space surrounding the nerve that was 1.8 to 1.9 mm thick and bordered by a thin, hyperechoic outer rim. On review of the operative record and consultation with her surgeon (DR), it was determined that this represented the 2-mm nerve wrap used in the last surgery. Inclusion of these structures with the median nerve measured a total area of 52 mm2 at its maximum. In describing this image, we hope to lay the foundation for describing the sonographic appearance of peripheral nerve repair.
Single Cell Transcriptomics and Flow Cytometry Reveal Disease-associated Fibroblast Subsets in Rheumatoid Arthritis
Authors: Mizoguchi Fumitaka , Slowikowski Kamil , Marshall Jennifer L , Wei Kevin , Rao Deepak A , Chang Sook Kyung , Nguyen Hung N , Noss Erika H , Turner Jason D , Earp Brandon E , Blazar Philip E , Wright John , Simmons Barry P , Donlin Laura T , Kalliolias George D , Goodman Susan M , Bykerk Vivian P , Ivashkiv Lionel B , Lederer James A , Hacohen Nir , Nigrovic Peter A , Filer Andrew , Buckley Christopher D , Raychaudhuri Soumya , Brenner Michael B 
Published: May 2017

AbstractFibroblasts mediate normal tissue matrix remodeling, but they can cause fibrosis or tissue destruction following chronic inflammation. In rheumatoid arthritis (RA), synovial fibroblasts expand, degrade cartilage, and drive joint inflammation. Little is known about fibroblast heterogeneity or if aberrations in fibroblast subsets relate to disease pathology. Here, we used an integrative strategy, including bulk transcriptomics on targeted subpopulations and unbiased single-cell transcriptomics, to analyze fibroblasts from synovial tissues. We identify 7 phenotypic fibroblast subsets with distinct surface protein phenotypes, and these collapsed into 3 subsets based on transcriptomics data. One subset expressing PDPN, THY1, but lacking CD34 was 3-fold expanded in RA relative to osteoarthritis (P=0.007); most of these cells expressed CDH11. The subsets were found to differ in expression of cytokines and matrix metalloproteinases, localization in synovial microanatomy, and in response to TNF. Our approach provides a template to identify pathogenic stromal cellular subsets in complex diseases.
The eIF2α kinase Heme Regulated Inhibitor (HRI) protects the host from infection by regulating intracellular pathogen trafficking
Authors: Bahnan Wael , Boucher Justin C. , Gayle Petoria , Shrestha Niraj , Rosen Mark , Aktas Bertal , Adkins Becky , Ager Arba , Khan Wasif N. , Schesser Kurt 
Published: May 2017

ABSTRACTPhosphorylation of eIF2α by its kinases is a stress response universally conserved among the eukaryota. Previously, we reported that the eIF2α kinases Heme Regulator Inhibitor (HRI) and Protein Kinase R (PKR) control distinct activities of diverse bacterial pathogens. Specifically forListeria monocytogenes, it was shown that in HRI-deficient cells there was a reduction in the translocation of the pathogen to the cytosolic compartment as well as reduced loading of pathogen-derived antigens on MHC-1 complexes. Here we show thatHri-/- mice, as well as wild-type mice treated with a HRI inhibitor, are more susceptible to listeriosis. In the first few hours ofL. monocytogenesinfection,Hri-/- mice supported greater pathogen proliferation in the liver compared to that observed inHri+/+ mice. This greater susceptibility ofHri-/- mice was not due to deficits in immune cell development as proportions and numbers of innate and adaptive cell compartments were largely normal and these mice could mount potent antibody responses to a model T cell-dependent antigen. Usingin vitrocellular infection assays, we show that the rate of pathogen efflux from infectedHri-/- macrophages and fibroblasts is significantly higher than that observed in infectedHri+/+ cells. In contrast to the stark differences betweenHri+/+ andHri-/- cells in the infection dynamics of virulentL. monocytogenes, HRI was entirely dispensable for killing non-virulent strains ofL. monocytogenes. These results suggest that in wild-type cells, HRI helps ensure the cellular confinement of virulentL. monocytogenesand loading of cytosolic-derived antigens on MHC-1 complexes that limit pathogen spreading and activating innate immune responses, respectively.
Control of microtubule dynamics using an optogenetic microtubule plus end–F-actin cross-linker
Authors: Adikes Rebecca C. , Hallett Ryan A. , Saway Brian F. , Kuhlman Brian , Slep Kevin C. 
Published: May 2017

AbstractWe developed a novel optogenetic tool, SxIP-iLID, to facilitate the reversible recruitment of factors to microtubule (MT) plus ends in an End Binding (EB) protein-dependent manner using blue light. We show that SxIP-iLID can track MT plus ends and recruit tgRFP-SspB upon blue light activation. We then used this system to investigate the effects of cross-linking MT plus ends and F-actin inDrosophilaS2 cells to gain insight into spectraplakin function and mechanism. We show that SxIP-iLID can be used to temporally recruit a F-actin binding domain to MT plus ends and cross-link the MT and F-actin networks. Light-mediated MT-F-actin cross-linking decreases MT growth velocities and generates a MT exclusion zone in the lamella. SxIP-iLID facilitates the general recruitment of specific factors to MT plus ends with temporal control enabling researchers to systematically regulate MT plus end dynamics and probe MT plus end function in many biological processes.SummarySxIP-iLID is a novel optogenetic tool designed to assess the spatiotemporal role of proteins on microtubule dynamics. We establish that optogenetic cross-linking of microtubule and actin networks decreases MT growth velocities and increases the cell area void of microtubules.