bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple sites and actions of gabapentin-induced relief of ongoing experimental neuropathic pain
Authors: Bannister Kirsty , Qu Chaoling , Navratilova Edita , Oyarzo Janice , Xie Jennifer Yanhua , King Tamara , Dickenson Anthony H. , Porreca Frank 
Published: August 2017

Abstract
Gabapentin (GBP) is a first-line therapy for neuropathic pain, but its mechanisms and sites of action remain uncertain. We investigated GBP-induced modulation of neuropathic pain following spinal nerve ligation (SNL) in rats. Intravenous or intrathecal GBP reversed evoked mechanical hypersensitivity and produced conditioned place preference (CPP) and dopamine (DA) release in the nucleus accumbens (NAc) selectively in SNL rats. Spinal GBP also significantly inhibited dorsal horn wide-dynamic-range neuronal responses to a range of evoked stimuli in SNL rats. By contrast, GBP microinjected bilaterally into the rostral anterior cingulate cortex (rACC), produced CPP, and elicited NAc DA release selectively in SNL rats but did not reverse tactile allodynia and had marginal effects on wide-dynamic-range neuronal activity. Moreover, blockade of endogenous opioid signaling in the rACC prevented intravenous GBP-induced CPP and NAc DA release but failed to block its inhibition of tactile allodynia. Gabapentin, therefore, can potentially act to produce its pain relieving effects by (a) inhibition of injury-induced spinal neuronal excitability, evoked hypersensitivity, and ongoing pain and (b) selective supraspinal modulation of affective qualities of pain, without alteration of reflexive behaviors. Consistent with previous findings of pain relief from nonopioid analgesics, GBP requires engagement of rACC endogenous opioid circuits and downstream activation of mesolimbic reward circuits reflected in learned pain-motivated behaviors. These findings support the partial separation of sensory and affective dimensions of pain in this experimental model and suggest that modulation of affective–motivational qualities of pain may be the preferential mechanism of GBP's analgesic effects in patients.
Monomethyl fumarate inhibits pain behaviors and amygdala activity in a rat arthritis model
Authors: Kim Hyunyoung , Thompson Jeremy , Ji Guangchen , Ganapathy Vadivel , Neugebauer Volker 
Published: August 2017

Abstract
Neuroplasticity in the amygdala, a brain center for emotions, leads to increased neuronal activity and output that can generate emotional-affective behaviors and modulate nocifensive responses. Mechanisms of increased activity in the amygdala output region (central nucleus, CeA) include increased reactive oxygen species, and so we explored beneficial effects of monomethyl fumarate (MMF), which can have neuroprotective effects through the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) antioxidant response pathway. Systemic (intraperitoneal) MMF dose-dependently inhibited vocalizations and mechanosensitivity (hindlimb withdrawal reflexes) of rats in an arthritis pain model (kaolin-carrageenan-induced monoarthritis in the knee). Stereotaxic administration of MMF into the CeA by microdialysis also inhibited vocalizations but had a limited effect on mechanosensitivity, suggesting a differential contribution to emotional-affective vs sensory pain aspects. Extracellular single-unit recordings of CeA neurons in anesthetized rats showed that stereotaxic administration of MMF into the CeA by microdialysis inhibited background activity and responses of CeA neurons to knee joint stimulation in the arthritis pain model. Monomethyl fumarate had no effect on behaviors and neuronal activity under normal conditions. The results suggest that MMF can inhibit emotional-affective responses in an arthritis pain model through an action that involves the amygdala (CeA).
Uses and Limitations of Claims-based Performance Feedback Reports: Lessons From the Comprehensive Primary Care Initiative
Authors: Gerteis Margaret , Peikes Deborah , Ghosh Arkadipta , Timmins Lori , O'Malley Ann S. , Barna Michael , Taylor Erin F. , Day Timothy J. , Swankoski Kaylyn , Payne Perry W. , Brown Randall 
Published: August 2017

Background:
Performance feedback is central to data-driven models of quality improvement, but the use of claims-based data for feedback has received little attention.

Purpose:
To examine the challenges, uses, and limitations of quarterly Medicare claims-based performance feedback reports generated for practices participating in the Comprehensive Primary Care (CPC) initiative from 2012 to 2015.

Methods:
Mixed methods study of nearly 500 CPC practices in seven regions, combining pilot testing; systematic monitoring; surveys; in-depth interviews; user feedback; and input from data feedback team.

Results:
Designing reports required addressing issues about timing, data completeness and reliability, variations in patient risk across practices, and use of benchmarks and metrics understandable to users. Practices' ability to use reports constructively depended on their experience, analytic resources, expectations, and perceptions about the role of primary care in improving reported outcomes.

Conclusions:
Generating claims-based feedback reports that support practices' quality improvement efforts requires a significant investment of analytic expertise, time, resources, continuous improvement, and technical assistance.

Implications:
Claims-based performance feedback can provide insight into patterns of patients' care across provider settings and opportunities for improvement, but practices need data from other sources to manage patients in real time or assess the short-term effects of specific changes in care delivery.
A Content Analysis on the Media Portrayal of Characters with Limb Loss
Authors: Abernethy Lisa , Duncan John Chad , Childers Walter Lee 
Published: August 2017

ABSTRACT

Background
Mass media, such as movies, may be a factor in how society views people with limb loss. If the portrayal is inaccurate or negative, then this could create additional challenges for people with limb loss to cope with their amputation and reintegrate with society. The purpose of this study was to define the portrayal of characters with amputation in movies. The hypothesis was that positive portrayal of characters with amputation, defined as heroism and realistic prostheses, would increase over time.

Methods
Quantitative content analysis was performed to systematically and objectively analyze the media's portrayal of characters with amputations. Movies released in US theaters from 1966 to 2015 were selected from the International Movie Database. Characters were identified as being portrayed as a hero or a villain and by the type of prosthetic technology they used.

Results
A total of 162 characters in 118 movies were identified, but only 92 characters could be identified as hero or villain for subsequent analysis. Time was found to have no effect on positive portrayal (p = 0.324). Heroism alone was found to increase significantly over time (p = 0.007), whereas realistic prostheses demonstrated a trend to decline over time (p = 0.238).

Conclusion
Positive portrayal did not increase over time. However, heroism did increase over time, whereas inaccurate depictions of prosthetic limbs were more frequent overall, regardless of time. This means that when a character with amputation was a hero, he/she was more likely using prosthetic technology that does not exist in reality. These data demonstrate a need to better educate the public and encourage more accurate depictions in the media.
Autologous hematopoietic cell transplantation of mantle cell lymphoma: emerging trends
Authors: Falcone Umberto , Kuruvilla John 
Published: August 2017

Purpose of review
The management of mantle cell lymphoma has changed significantly with the adoption of immunochemotherapy and dose intensive treatment strategies in specific patient populations. Randomized controlled trials have established the role of rituximab-based treatments and autologous stem cell transplantation as standards of care. Novel therapeutics are also being integrated into these treatment strategies.

Recent findings
Rituximab-based primary treatment has been shown to significantly improve complete remission rates. The addition of autologous stem cell transplantation has also improved progression-free survival (PFS) although data regarding potential overall survival (OS) benefits are not clear. Complete remission and minimal residual disease (MRD) negative disease states are predictive of outcome. Rituximab maintenance post SCT has also been shown to significantly improves PFS and OS.

Summary
Current therapeutic standards in mantle cell lymphoma have clearly improved patient outcomes with improvements in remission rates, PFS, and OS. Autologous stem cell transplant (ASCT) as a consolidation strategy of primary treatment has improved outcomes, and the incorporation of novel drugs into frontline therapy may further improve the efficacy of the treatment. MRD-driven strategies may ultimately define appropriate patient subsets towards ASCT or alternative approaches.
Trial designs for statin muscle intolerance
Authors: Rosenson Robert S. 
Published: August 2017

Purpose of review
This article aims to review the spectrum of statin-associated muscle symptoms (SAMS), the consequences of downtitration of statin therapy on cardiovascular events, the published trials of nonstatin therapy in patients who report SAMS, and to provide a framework for future trials in SAMS patients.

Recent findings
SAMS is reported in 10–25% of patients prescribed statin therapy; however, the few patients enrolled in randomized, double-blind, controlled clinical trials (RCTs) discontinue statin therapy due to adverse events. Several possible reasons for this discrepancy in clinical practice versus RCTs may results from patient selection in clinical trials that excludes patients with characteristics that increase the risk of SAMS, widespread use of higher intensity statins in low-risk populations that evaluated in nearly all RCTs, and perceptions concerning harm of statin therapy. Clinical trials of nonstatin therapy have shown that most patients tolerate statin therapy upon repeat challenge, and thus better tools are needed to more accurately identify SAMS patients and enroll these patients in RCTs of nonstatin therapy.

Summary
Clinical trials in patients who report SAMS have shown better tolerability of certain classes of nonstatin therapy. Low rates of recurrent SAMS in double-blind rechallenge have led some to challenge the concept of statin muscle intolerance. However, patients with perceived SAMS downtitrate their statin therapy and suffer more cardiovascular events. A revised paradigm for evaluation of SAMS is proposed.
Outcomes of Preexposure Prophylaxis Referrals From Public STI Clinics and Implications for the Preexposure Prophylaxis Continuum
Authors: Bhatia Ramona , Modali Laxmi , Lowther Matthew , Glick Nancy , Bell Margo , Rowan Sarah , Keglovitz Kristin , Schneider John 
Published: August 2017

Background
Human immunodeficiency virus preexposure prophylaxis (PrEP) uptake remains low in high-risk populations. Sexually transmitted infection (STI) clinics reach PrEP-eligible persons and may be ideal settings to model PrEP implementation.

Methods
Consenting PrEP-eligible patients identified at Chicago Department of Public Health STI Clinics were actively referred to PrEP partner sites between June 1, 2015, and May 31, 2016. Outcomes included successful contact by a partner site, linkage to a partner site, and receipt of a PrEP prescription. Bivariable and time to event analyses were conducted to determine significant associations of outcomes.

Results
One hundred thirty-seven patients were referred; 126 (92%) were men who have sex with men, and mean age was 29 years. Ninety-eight (72%) were contacted by a PrEP partner, 43 (31%) were linked, and 40 (29%) received a prescription. Individuals aged 25 years and older were more likely to link (odds ratio, 3.10; 95% confidence interval, 1.30–7.41) and receive a PrEP prescription (odds ratio, 2.70; 95% confidence interval, 1.12–6.45) compared with individuals 24 years and younger. The average time between each step was greater for those 24 years and younger compared with those aged 25 years and older for all steps. Time to event analyses revealed that those aged 25 years and older were significantly more likely to receive a prescription compared to those aged 24 years and younger (hazard ratio, 3.62; 95% risk limits, 1.47–8.92).

Conclusions
Preexposure prophylaxis active referrals from STI clinics to partner sites are feasible, though drop out was prominent in the initial steps of the continuum. Youth were less likely to link or receive prescriptions, indicating the need for tailored interventions for this vulnerable population.
Cerebral Syphilitic Gumma Can Arise Within Months of Reinfection: A Case of Histologically Proven Treponema pallidum Strain Type 14b/f Infection With Human Immunodeficiency Virus Positivity
Authors: Koizumi Yusuke , Watabe Takeya , Ota Yasunori , Nakayama Shu-ichi , Asai Nobuhiro , Hagihara Mao , Yamagishi Yuka , Suematsu Hiroyuki , Tsuzuki Toyonori , Takayasu Masakazu , Ohnishi Makoto , Mikamo Hiroshige 
Published: August 2017

Abstract
A 44-year-old man with human immunodeficiency virus positivity developed cerebral gumma 6 months after appropriate therapy for secondary syphilis. It was surgically resected and histologically, Treponema pallidum (14b/f, a relatively rare strain type) was proven. A complete set of modern techniques was performed to depict rare complication of this classic disease.
Perceived Facilitators and Barriers to Local Health Department Workers' Participation in Infectious Disease Emergency Responses
Authors: Rutkow Lainie , Paul Amy , Taylor Holly A. , Barnett Daniel J. 
Published: August 2017

Context:
Local health departments play a key role in emergency preparedness and respond to a wide range of threats including infectious diseases such as seasonal influenza, tuberculosis, H1N1, Ebola virus disease, and Zika virus disease. To successfully respond to an infectious disease outbreak, local health departments depend upon the participation of their workforce; yet, studies indicate that sizable numbers of workers would not participate in such a response. The reasons why local health department workers participate, or fail to participate, in infectious disease responses are not well understood.

Objective:
To understand why local health department workers are willing, or not willing, to report to work during an infectious disease response.

Design:
From April 2015 to January 2016, we conducted 28 semistructured interviews with local health department directors, preparedness staff, and nonpreparedness staff.

Setting:
Interviews were conducted with individuals throughout the United States.

Participants:
We interviewed 28 individuals across 3 groups: local health department directors (n = 8), preparedness staff (n = 10), and nonpreparedness staff (n = 10).

Main Outcome Measures:
Individuals' descriptions of why local health department workers are willing, or not willing, to report to work during an infectious disease response.

Results:
Factors that facilitate willingness to respond to an infectious disease emergency included availability of vaccines and personal protective equipment; flexible work schedule and childcare arrangements; information sharing via local health department trainings; and perceived commitments to one's job and community. Factors that hinder willingness to respond to an infectious disease emergency included potential disease exposure for oneself and one's family; logistical considerations for care of children, the elderly, and pets; and perceptions about one's role during an infectious disease response.

Conclusion:
Our findings highlight opportunities for local health departments to revisit their internal policies and engage in strategies likely to promote willingness to respond among their staff. As LHDs face the persistent threat of infectious diseases, they must account for response willingness when planning for and fielding emergency responses. Our findings highlight opportunities for local health departments to revisit their internal policies and engage in strategies likely to promote response willingness to infectious disease emergencies among their staff.
Evacuation Decision Making and Expanded Roles of Adult Daycare Services in the Great East Japan Earthquake: Qualitative Analysis Using Semistructured Interviews
Authors: Mori Hiroko , Sugawara Yasuhiro , Obuchi Shuichi P. , Shimmei Masaya , Takahashi Ryutaro 
Published: August 2017

Context:
The roles of adult daycare services during disaster evacuations in the relationships with community resilience are unknown. The initial 72 hours after a disaster are crucial because people in the disaster area depend on their own efforts or the resources available at the moment until the arrival of external support.

Objective:
To clarify the evacuation-related decision making of the administrators of adult daycare services within 72 hours after the Great East Japan Earthquake and to describe the roles of adult daycare services during the month following the earthquake.

Design:
Qualitative study using semistructured interviews. The transcribed interviews were analyzed anonymously through an inductive qualitative content analysis using ATLAS.ti.

Setting:
Kesennuma City, Miyagi Prefecture.

Participants:
Eleven key informants (3 primary care providers and 8 administrators) from 8 institutions.

Results:
Immediately after the disaster, 6 institutions implemented shelter-in-place. The evacuation behaviors of the adult daycare institutions were diverse, but each institution was transformed repeatedly within 72 hours. With respect to evacuation decision making, the primary issues involved whether to go to mandatory evacuation sites. However, after 3 days, the institutions relocated from these sites to other places. During a period of approximately 1 month, 7 institutions managed the evacuation of service users and care providers. The expanded institutional roles were as follows: “confirming the safety of the users' families,” “substituting residential facilities,” and “imposing leadership during the evacuation.”

Conclusions:
If institutions choose to shelter-in-place, it should be sustained for as long as possible. Sufficiently planned stores of food and water to accommodate daytime users are needed. Institutions that employ shelter-in-place as an evacuation plan should maintain close contact with local governments. Furthermore, local governments should predetermine how to manage these institutions in the event of a disaster. To build community resilience for disasters, developing linkage with private organizations' resilience is beneficial.
Regular physical activity prevents development of chronic muscle pain through modulation of supraspinal opioid and serotonergic mechanisms
Authors: Brito Renan G. , Rasmussen Lynn A. , Sluka Kathleen A. 
Published: August 2017

Abstract

Introduction:
It is generally believed that exercise produces its effects by activating central opioid receptors; there are little data that support this claim. The periaqueductal gray (PAG) and rostral ventromedial medulla (RVM) are key nuclei in opioid-induced analgesia, and opioids interact with serotonin to produce analgesia.

Objectives:
The purpose was to examine central inhibitory mechanisms involved in analgesia produced by wheel running.

Methods:
C57/Black6 mice were given access to running wheels in their home cages before induction of chronic muscle hyperalgesia and compared with those without running wheels. Systemic, intra-PAG, and intra-RVM naloxone tested the role of central opioid receptors in the antinociceptive effects of wheel running in animals with muscle insult. Immunohistochemistry for the serotonin transporter (SERT) in the spinal cord and RVM, and pharmacological blockade of SERT, tested whether the serotonin system was modulated by muscle insult and wheel running.

Results:
Wheel running prevented the development of muscle hyperalgesia. Systemic naloxone, intra-PAG naloxone, and intra-RVM naloxone reversed the antinociceptive effect of wheel running in animals that had received muscle insult. Induction of chronic muscle hyperalgesia increased SERT in the RVM, and blockade of SERT reversed the hyperalgesia in sedentary animals. Wheel running reduced SERT expression in animals with muscle insult. The serotonin transporter in the superficial dorsal horn of the spinal cord was unchanged after muscle insult, but increased after wheel running.

Conclusion:
These data support the hypothesis that wheel running produced analgesia through central inhibitory mechanisms involving opioidergic and serotonergic systems.
Effect of bupivacaine lozenges on oral mucositis pain: a randomized controlled multicenter phase II study
Authors: Mogensen Stine , Treldal Charlotte , Kristensen Claus A. , Bentzen Jens , Lawson-Smith Louise , Petersen Janne , Andersen Ove 
Published: August 2017

Abstract

Introduction:
A nonblinded parallel-group randomized controlled study investigated the efficacy and tolerability of repeated administration of a bupivacaine lozenge (25 mg) as pain management for oral mucositis pain in head and neck cancer patients as add-on to standard systemic pain management.

Objective:
The primary end point was the difference between the intervention group (Lozenge group) and the Control group in daily mean pain scores in the oral cavity or pharynx (whichever was higher).

Method:
Fifty patients from 2 hospitals in Denmark were randomized 1:1 to 7 days of treatment with bupivacaine lozenges (taken up to every 2 hours) plus standard pain treatment minus topical lidocaine (Lozenge group) or standard pain treatment including topical lidocaine (Control group). The efficacy analysis included 38 patients, as 12 patients were excluded because of changes in study design and missing data.

Results:
Mean pain in the oral cavity or pharynx (whichever was higher) was significantly lower 60 minutes after taking lozenges (35 mm [n = 22]) than for the Control group (51 mm [n = 16]) (difference between groups −16 mm, 95% confidence interval: −26 to −6, P = 0.0032). Pain in the oral cavity was also significantly lower in the Lozenge group (18 mm) vs the Control group (36 mm, P = 0.0002). Pharyngeal mucositis pain did not differ significantly (37 mm [Lozenge group] vs 48 mm [Control group], P = 0.0630). No serious adverse events were reported.

Conclusion:
These results show that the bupivacaine lozenge as an add-on to standard pain treatment had a clinically significant pain-relieving effect in patients with oral mucositis.

ClinicalTrials.gov:
NCT02252926.