bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adenosine Analog NITD008 Is a Potent Inhibitor of Zika Virus
Authors: Deng Yong-Qiang , Zhang Na-Na , Li Chun-Feng , Tian Min , Hao Jia-Nan , Xie Xu-Ping , Shi Pei-Yong , Qin Cheng-Feng 
Published: August 2016

Abstract
The ongoing Zika virus (ZIKV) outbreaks have raised global concerns due to its unexpected clinical manifestations. Antiviral development is of high priority in response to the ZIKV emergency. In this study, we report that an adenosine analog NITD008 has potent in vitro and in vivo antiviral activity against ZIKV. The compound can effectively inhibit the historical and contemporary ZIKV strains in cultures as well as significantly reduce viremia and prevent mortality in A129 mice. Our results have demonstrated that NITD008 is potent inhibitor of ZIKV and can be used as reference inhibitor for future ZIKV antiviral drug screen and discovery.
Duration of Colonization With Klebsiella pneumoniae Carbapenemase-Producing Bacteria at Long-Term Acute Care Hospitals in Chicago, Illinois
Authors: Haverkate Manon R. , Weiner Shayna , Lolans Karen , Moore Nicholas M. , Weinstein Robert A. , Bonten Marc J. M. , Hayden Mary K. , Bootsma Martin C. J. 
Published: August 2016

Abstract
Background.  High prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae has been reported in long-term acute care hospitals (LTACHs), in part because of frequent readmissions of colonized patients. Knowledge of the duration of colonization with KPC is essential to identify patients at risk of KPC colonization upon readmission and to make predictions on the effects of transmission control measures.
Methods.  We analyzed data on surveillance isolates that were collected at 4 LTACHs in the Chicago region during a period of bundled interventions, to simultaneously estimate the duration of colonization during an LTACH admission and between LTACH (re)admissions. A maximum-likelihood method was used, taking interval-censoring into account.
Results.  Eighty-three percent of patients remained colonized for at least 4 weeks, which was the median duration of LTACH stay. Between LTACH admissions, the median duration of colonization was 270 days (95% confidence interval, 91–∞).
Conclusions.  Only 17% of LTACH patients lost colonization with KPC within 4 weeks. Approximately half of the KPC-positive patients were still carriers when readmitted after 9 months. Infection control practices should take prolonged carriage into account to limit transmission of KPCs in LTACHs.
Rotavirus and Norovirus in Pediatric Healthcare-Associated Gastroenteritis
Authors: Yi Jumi , Sederdahl Bethany K. , Wahl Kelly , Jerris Robert R. , Kraft Colleen S. , McCracken Courtney , Gillespie Scott , Kirby Amy E. , Shane Andi L. , Moe Christine L. , Anderson Evan J. 
Published: August 2016

Abstract
Rotavirus and norovirus are important etiologies of gastroenteritis among hospitalized children. During 2012–2013, we tested 207 residual stool specimens from children with healthcare-associated vomiting and/or diarrhea for rotavirus and norovirus. Twenty (10%) were rotavirus positive, and 3 (3%) were norovirus positive, stressing the importance of these pathogens in hospitalized children.
The benefits of expanded physician assistant practice in hospice and palliative medicine
Authors: Boucher Nathan A. , Nix Harvey 
Published: August 2016

ABSTRACT
Patients with advanced or terminal illness, especially racial and ethnic minorities, would benefit from greater access to hospice and palliative care. Expanding the PA role in these areas would help fill gaps in both access and patients' understanding of what hospice and palliative care can offer. This article describes why hospice and palliative care are needed, what PAs can and do offer hospice and palliative care delivery, and what challenges should be overcome to expand PA practice in hospice and palliative care. The article also reviews the legislative outlook for PA practice in hospice care.
Women, family medicine, and career choice
Authors: Essary Alison C. , Coplan Bettie H. , Cawley James F. , Schneller Eugene S. , Ohsfeldt Robert L. 
Published: August 2016

ABSTRACT

Objective:
This study compared the cost of physician versus physician assistant (PA) education for women practicing in family medicine.

Methods:
Using 2013 salary survey data from both the Medical Group Management Association and the American Academy of PAs as well as other publicly available data sources, the authors compared the current net present value (NPV) of physician and PA training for women practicing in family medicine.

Results:
Considering a base case scenario involving a 24-year-old woman, the NPV to become a family medicine physician was $2,015,000 compared with an NPV of $1,751,000 to become a family medicine PA. Alternative projections produced an NPV for PA training that slightly exceeded the NPV for family medicine physician training.

Conclusions:
For a woman practicing in family medicine, becoming a physician or a PA offers similar financial rewards.
What Determines Whether a Pain is Rated as Mild, Moderate, or Severe? The Importance of Pain Beliefs and Pain Interference
Authors: Jensen Mark P. , Tomé-Pires Catarina , de la Vega Rocío , Galán Santiago , Solé Ester , Miró Jordi 
Published: August 2016

Summary
Reliable and valid measures of pain intensity are needed to accurately evaluate the efficacy of pain treatments. Perhaps with the exception of faces pain intensity scales, which are thought to reflect both pain intensity and pain affect, the other most commonly used pain intensity scales—Numerical Rating Scales (NRSs), Visual Analog Scales, and Verbal Rating Scales (VRSs)—are all thought to reflect primarily pain intensity or the magnitude of felt pain. However, to our knowledge, this assumption has not been directly tested for VRSs.

Methods
We evaluated whether VRS pain severity ratings are influenced by pain beliefs, catastrophizing, or pain interference over and above any effects of pain intensity, as measured by a NRS, in 4 samples of individuals with physical disabilities and chronic pain.

Results
As hypothesized, and while controlling for pain intensity as measured by a NRS, higher scores on factors representing pain interference with function, pain catastrophizing, and a number of pain-related beliefs were all associated with a tendency for the study participants to rate their pain as more severe on a VRS.

Discussion
These findings indicate VRSs of pain severity cannot necessarily be assumed to measure only pain intensity; they may also reflect patient perceptions about pain interference and beliefs about their pain. Clinicians and researchers should take these findings into account when selecting measures and when interpreting the results of studies using VRSs as outcome measures.
Paradoxical Truths and Persistent Myths: Reframing the Team Competence Conversation
Authors: Lingard Lorelei 
Published: August 2016

Abstract:
Medicine has conventionally had an individualist orientation to competence. Individual competence is conceptualized as a stable possession that, once acquired, holds across contexts. Individual competence is necessary; however, it is insufficient for quality health care. We also need to attend to collective competence in order to grapple with paradoxical truths about teamwork, such as: competent individuals can form incompetent teams. Collective competence is conceptualized as a distributed capacity of a system, an evolving, relational phenomenon that emerges from the resources and constraints of particular contexts. This article outlines a set of paradoxical truths about teamwork in health care and uses the concept of collective competence to explain how they can hold true. It then considers a set of persistent myths about teamwork which have their roots in an individualist orientation, exploring how they hold us back from meaningful change in how we educate for, and practice as, health care teams. Finally, the article briefly considers the implications of these truths and myths for educational issues such as interprofessional education and competency-based health professional education.
Frame-of-Reference Training: Establishing Reliable Assessment of Teaching Effectiveness
Authors: Newman Lori R. , Brodsky Dara , Jones Richard N. , Schwartzstein Richard M. , Atkins Katharyn Meredith , Roberts David H. 
Published: August 2016

Introduction:
Frame-of-reference (FOR) training has been used successfully to teach faculty how to produce accurate and reliable workplace-based ratings when assessing a performance. We engaged 21 Harvard Medical School faculty members in our pilot and implementation studies to determine the effectiveness of using FOR training to assess health professionals' teaching performances.

Methods:
All faculty were novices at rating their peers' teaching effectiveness. Before FOR training, we asked participants to evaluate a recorded lecture using a criterion-based peer assessment of medical lecturing instrument. At the start of training, we discussed the instrument and emphasized its precise behavioral standards. During training, participants practiced rating lectures and received immediate feedback on how well they categorized and scored performances as compared with expert-derived scores of the same lectures. At the conclusion of the training, we asked participants to rate a post-training recorded lecture to determine agreement with the experts' scores.

Results:
Participants and experts had greater rating agreement for the post-training lecture compared with the pretraining lecture. Through this investigation, we determined that FOR training is a feasible method to teach faculty how to accurately and reliably assess medical lectures.

Discussion:
Medical school instructors and continuing education presenters should have the opportunity to be observed and receive feedback from trained peer observers. Our results show that it is possible to use FOR rater training to teach peer observers how to accurately rate medical lectures. The process is time efficient and offers the prospect for assessment and feedback beyond traditional learner evaluation of instruction.
Enhancing the Effectiveness of Significant Event Analysis: Exploring Personal Impact and Applying Systems Thinking in Primary Care
Authors: Bowie Paul , McNaughton Elaine , Bruce David , Holly Deirdre , Forrest Eleanor , Macleod Marion , Kennedy Susan , Power Ailsa , Toppin Denis , Black Irene , Pooley Janet , Taylor Audrey , Swanson Vivien , Kelly Moya , Ferguson Julie , Stirling Suzanne , Wakeling Judy , Inglis Angela , McKay John , Sargeant Joan 
Published: August 2016

Introduction:
Significant event analysis (SEA) is well established in many primary care settings but can be poorly implemented. Reasons include the emotional impact on clinicians and limited knowledge of systems thinking in establishing why events happen and formulating improvements. To enhance SEA effectiveness, we developed and tested “guiding tools” based on human factors principles.

Methods:
Mixed-methods development of guiding tools (Personal Booklet—to help with emotional demands and apply a human factors analysis at the individual level; Desk Pad—to guide a team-based systems analysis; and a written Report Format) by a multiprofessional “expert” group and testing with Scottish primary care practitioners who submitted completed enhanced SEA reports. Evaluation data were collected through questionnaire, telephone interviews, and thematic analysis of SEA reports.

Results:
Overall, 149/240 care practitioners tested the guiding tools and submitted completed SEA reports (62.1%). Reported understanding of how to undertake SEA improved postintervention (P < .001), while most agreed that the Personal Booklet was practical (88/123, 71.5%) and relevant to dealing with related emotions (93/123, 75.6%). The Desk Pad tool helped focus the SEA on systems issues (85/123, 69.1%), while most found the Report Format clear (94/123, 76.4%) and would recommend it (88/123, 71.5%). Most SEA reports adopted a systems approach to analyses (125/149, 83.9%), care improvement (74/149, 49.7), or planned actions (42/149, 28.2%).

Discussion:
Applying human factors principles to SEA potentially enables care teams to gain a systems-based understanding of why things go wrong, which may help with related emotional demands and with more effective learning and improvement.
CaMKIIα underlies spontaneous and evoked pain behaviors in Berkeley sickle cell transgenic mice
Authors: He Ying , Chen Yan , Tian Xuebi , Yang Cheng , Lu Jian , Xiao Chun , DeSimone Joseph , Wilkie Diana J. , Molokie Robert E. , Wang Zaijie Jim 
Published: August 2016

Abstract
Pain is one of the most challenging and stressful conditions to patients with sickle cell disease (SCD) and their clinicians. Patients with SCD start experiencing pain as early as 3 months old and continue having it throughout their lives. Although many aspects of the disease are well understood, little progress has been made in understanding and treating pain in SCD. This study aimed to investigate the functional involvement of Ca2+/calmodulin-dependent protein kinase II (CaMKIIα) in the persistent and refractory pain associated with SCD. We found that nonevoked ongoing pain as well as evoked hypersensitivity to mechanical and thermal stimuli were present in Berkeley sickle cell transgenic mice (BERK mice), but not nonsickle control littermates. Prominent activation of CaMKIIα was observed in the dorsal root ganglia and spinal cord dorsal horn region of BERK mice. Intrathecal administration of KN93, a selective inhibitor of CaMKII, significantly attenuated mechanical allodynia and heat hyperalgesia in BERK mice. Meanwhile, spinal inhibition of CaMKII elicited conditioned place preference in the BERK mice, indicating the contribution of CaMKII in the ongoing spontaneous pain of SCD. We further targeted CaMKIIα by siRNA knockdown. Both evoked pain and ongoing spontaneous pain were effectively attenuated in BERK mice. These findings elucidated, for the first time, an essential role of CaMKIIα as a cellular mechanism in the development and maintenance of spontaneous and evoked pain in SCD, which can potentially offer new targets for pharmacological intervention of pain in SCD.
Benefit and harm of adding ketamine to an opioid in a patient-controlled analgesia device for the control of postoperative pain: systematic review and meta-analyses of randomized controlled trials with trial sequential analyses
Authors: Assouline Benjamin , Tramèr Martin R , Kreienbühl Lukas , Elia Nadia 
Published: August 2016

Abstract
Ketamine is often added to opioids in patient-controlled analgesia devices. We tested whether in surgical patients, ketamine added to an opioid patient–controlled analgesia decreased pain intensity by ≥25%, cumulative opioid consumption by ≥30%, the risk of postoperative nausea and vomiting by ≥30%, the risk of respiratory adverse effects by ≥50%, and increased the risk of hallucination not more than 2-fold. In addition, we searched for evidence of dose-responsiveness. Nineteen randomized trials (1349 adults, 104 children) testing different ketamine regimens added to various opioids were identified through searches in databases and bibliographies (to 04.2016). In 9 trials (595 patients), pain intensity at rest at 24 hours was decreased by 32% with ketamine (weighted mean difference −1.1 cm on the 0-10 cm visual analog scale [98% CI, −1.8 to −0.39], P < 0.001). In 7 trials (495 patients), cumulative 24 hours morphine consumption was decreased by 28% with ketamine (weighted mean difference −12.9 mg [−22.4 to −3.35], P = 0.002). In 7 trials (435 patients), the incidence of postoperative nausea and vomiting was decreased by 44% with ketamine (risk ratio 0.56 [0.40 to 0.78], P < 0.001). There was no evidence of a difference in the incidence of respiratory adverse events (9 trials, 871 patients; risk ratio 0.31 [0.06 to 1.51], P = 0.08) or hallucination (7 trials, 690 patients; odds ratio 1.16 [0.47 to 2.79], P = 0.70). Trial sequential analyses confirmed the significant benefit of ketamine on pain intensity, cumulative morphine consumption, and postoperative nausea and vomiting and its inability to double the risk of hallucination. The available data did not allow us to make a conclusion on respiratory adverse events or to establish dose-responsiveness.
The Role of Self-Care for Parents in Recovery From Substance Use Disorders
Authors: Raynor Phyllis , Pope Charlene 
Published: August 2016

Abstract

Background
Lack of stress modifiers, such as self-care behaviors (SCBs), can increase vulnerability to drug use for parents in recovery from substance use disorders (SUDs).

Purpose
The purpose of this integrative review was to determine how the existing literature describes, conceptualizes, and measures SCB for parents in the general population for its application to parents with a history of SUD.

Methods
Framed by Bandura’s Social Cognitive Theory of Substance Abuse, four qualitative and five quantitative studies identify SCB, although only one study describes SCB of parents in recovery.

Results
Few studies addressed parental SCB, and most of those studies focused on behaviors for new mothers with or without SUDs during the early child years.

Conclusions
Exploring the role of SCB in relation to parental well-being for the general population is a needed area for further research, even more so for parents who are recovering from SUDs.
Trends in Colposcopy Volume: Where Do We Go From Here?
Authors: Landers Emily E. , Erickson Britt K. , Bae Sejong , Huh Warner K. 
Published: August 2016

Objective
To describe the change in colposcopy volume in light of recent guideline shifts, which target higher-risk women while limiting unnecessary procedures in low-risk women.

Methods
After institutional review board approval, colposcopy clinic visits at a large-volume referral center from January 2010 to December 2015 were reviewed. All women diagnosed with abnormal cervical cytology who were referred and subsequently underwent colposcopic evaluation were included. Mean monthly and annual clinic volumes were calculated. Return visit proportions were compared using chi-square test. Negative binomial regression analysis was used to examine trends.

Results
There were a total of 8722 colposcopy clinic visits between January 2010 and December 2015. Approximately 7395 visits (85%) were new patient visits, and 1327 visits (15%) were return visits. The percentage of return visits declined dramatically during the study period from 22.9% (2011) of total visits to 9.0% in 2015 (P < 0.001). Annual clinic volume ranged from 903 to 1884 with a mean monthly volume of 121.13 visits (SD, 42.1). Annual volume was highest in 2011 (n = 1884) and has since demonstrated a steady decline. In 2015, average monthly volume (75.3 visits) dropped to nearly one third of its peak 218 visits per month in July 2010.

Conclusions
In a large referral clinic that adheres to guideline-based screening and management recommendations, monthly colposcopy volume has declined dramatically with a reduction by two thirds compared with peak volume in 2010.
The Association Between Nonalcoholic Fatty Liver Disease and Metabolic Abnormalities in The United States Population
Authors: Jinjuvadia Raxitkumar , Antaki Fadi , Lohia Prateek , Liangpunsakul Suthat 
Published: August 2016

Background:
Prevalence of nonalcoholic fatty liver disease (NAFLD) and rate of advanced fibrosis among individuals with metabolic syndrome (MetS) and its individual metabolic abnormalities needs better understanding in the United States population. We aim to study these by using a large United States population database, the Third National Health and Nutrition Examination Survey (NHANES III).

Methods:
A total of 11,674 individuals were included in our study cohort. NAFLD was defined as presence of moderate to severe hepatic steatosis on liver ultrasound in absence of viral hepatitis, significant alcohol use, elevated transferrin level, and medication use leading to hepatic steatosis. Advanced fibrosis among those with NAFLD was determined using noninvasive method, the NAFLD fibrosis score. MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III definition.

Results:
The prevalence of NAFLD among included study cohort was 18.2% (95% confidence interval, 16.5-19.9). Individuals with metabolic abnormalities demonstrated higher prevalence (MetS, 43.2%; increased waist circumference, 31.2%; impaired fasting glucose/diabetes, 41.2%; high triglyceride level, 34.7%; low high-density lipoprotein, 27.8%; high blood pressure, 29.2%). The individuals with MetS had significantly higher NAFLD prevalence compared with controls (adjusted odds ratio, 11.5; 95% confidence interval, 8.9-14.7). The severity of hepatic steatosis was also noted to increase with higher number of metabolic abnormalities. Among individual metabolic abnormalities, increased waist circumference, impaired fasting glucose/diabetes, high triglyceride, and low high-density lipoprotein levels were found to be independently associated with NAFLD. Individuals with impaired fasting glucose/diabetes and those with 5 metabolic abnormalities had higher rate of advanced fibrosis (18.6% and 30.3%, respectively). Prevalence of NAFLD among individuals without any metabolic abnormality was 6.1%.

Conclusion:
Prevalence of NAFLD and rate of advanced fibrosis are significantly high among individuals with metabolic abnormalities.
Esophageal involvement is frequent in lichen planus: study in 32 patients with suggestion of clinicopathologic diagnostic criteria and therapeutic implications
Authors: Kern Johannes S. , Technau-Hafsi Kristin , Schwacha Henning , Kuhlmann Jan , Hirsch Gunther , Brass Volker , Deibert Peter , Schmitt-Graeff Anette , Kreisel Wolfgang 
Published: August 2016

Objective
Lichen planus (LP) is a classic skin disease that can involve the skin, hair, and nails, as well as the oral and genital mucosa. Histopathology is characterized by a T-lymphocytic, lichenoid, and interface dermatitis. Multiple case reports and small case series have shown that LP can involve the esophagus. However, the diagnostic criteria, incidence, and best treatment options remain uncertain. This study aimed to refine the diagnostic criteria, estimate prevalence, and present an outlook on treatment options to prevent long-term sequelae.

Patients and methods
Thirty-two consecutive patients with LP of the skin, hair, nails, oral mucosa, and/or genital mucosa underwent a comprehensive clinicopathologic assessment. Esophagogastroduodenoscopy was performed, and biopsies were evaluated histologically, immunohistochemically, and by direct immunofluorescence. Patients diagnosed with esophageal lichen planus (ELP) were followed up prospectively where possible.

Results
In total, 20 of 32 patients had ELP. Ten of these 20 patients were classified as having proven ELP, with clear-cut endoscopically visible lesions; the other 10 were classified as having probable ELP. Eight of 10 patients with proven ELP were started on new or additional therapy because of esophageal findings. Treatment with a topical budesonide formulation or systemic corticosteroids was successful in most patients with proven ELP and reversed functional esophageal stenosis.

Conclusion
ELP can be found in more than 50% of patients with proven mucocutaneous LP when clinical and pathologic findings are correlated carefully. Topical or systemic corticosteroids are the first-line therapy for ELP. Timely medical therapy seems to prevent scarring stenosis of the esophagus.