bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Access to and Use of Primary Care Practices that Patients Perceive as Having Essential Qualities of a Patient-Centered Medical Home Associated With Positive Patient Experience? Empirical Evidence From a U.S. Nationally Representative Sample
Authors: Xin Haichang , Kilgore Meredith L. , Sen Bisakha (Pia) 
Published: May 2016

Objective:
The patient-centered medical home (PCMH) has emerged as an innovative healthcare delivery model that holds the conceptual promise to improve healthcare quality and patient experience. This study examined how patient perceived PCMH is related to patient satisfaction and experience nationwide. This study advances academic discussion in that it is among the first to examine empirical evidence using a U.S. nationally representative sample.

Methods:
This retrospective cohort study used data from the 2010 to 2011 Medical Expenditure Panel Survey. This study focused on insured individuals aged 18 and older. We measured and identified cohorts for a “full PCMH,” a “partial PCMH” (i.e., with a usual source of care but not a PCMH), and an “unknown PCMH,” with the reference group being the “no regular provider” group and the partial PCMH group, respectively. Using logit models, we assessed patient experiences of the PCMH use controlling for covariates in 2010. Given the nature of the complex survey design, the weights and variance were adjusted using the survey procedures to yield nationally representative results.

Results:
The final study sample consisted of 7,743 individuals, representing 191 million individuals in the weighted population. After controlling for covariates in 2010, the full PCMH group was consistently observed to have higher odds of positive patient experience than individuals with no usual source of care: odds ratio (OR) = 1.89 (p = .003) for providers “listened carefully to you”; OR = 1.81 (p = .001) for providers “spent enough time with you”; OR = 1.85 (p = .007) for providers “showed respect for what you had to say”; and OR = 1.89 (p < .001) for the composite patient experience. Similarly, compared with the partial PCMH group, consistently higher odds of patient satisfaction among all patient experience measures were observed for the full medical home group: OR = 1.45 (p = .070, significant at α = 0.1 level) for providers “explained things so you understood”; OR = 1.69 (p = .002) for providers “listened carefully to you”; OR = 1.57 (p = .003) for providers “spent enough time with you”; OR = 1.48 (p = .039) for providers “showed respect for what you had to say”; and OR = 1.56 (p = .001) for the composite patient experience.

Conclusions:
Overall, the PCMH model was associated with improved patient satisfaction nationwide. Findings from this study have shed light on strategies of innovative healthcare delivery models in improving patient experience, which in turn, may translate to patients' compliance to treatment regimen and improved health outcomes.
Myofascial Trigger Points and Migraine-related Disability in Women With Episodic and Chronic Migraine
Authors: Ferracini Gabriela N. , Florencio Lidiane L. , Dach Fabíola , Chaves Thais C. , Palacios-Ceña María , Fernández-de-las-Peñas César , Bevilaqua-Grossi Débora , Speciali José G. 
Published: May 2016

Objective:
The aim of this study was to investigate the differences in the presence of head and neck-shoulder trigger points (TrPs) between women with episodic or chronic migraine and their association with migraine-related disability.

Materials and Methods:
One hundred forty-three women, aged 18 to 60 years, with migraine were recruited to participate in this study. Migraine-related disability was evaluated with the Migraine Disability Assessment Questionnaire. TrPs were explored bilaterally within the masseter, temporalis, suboccipital, sternocleidomastoid, upper trapezius, and splenius capitis muscles.

Results:
Ninety-eight women exhibited episodic migraine, whereas 45 had chronic migraine. Women with chronic migraine reported a higher related disability than those with episodic migraine (P=0.045). Women with episodic migraine had a similar number of TrPs (total number: 4.3±3.3; active TrPs: 3.0±2.9; and latent TrPs: 1.3±2.1) to those with chronic migraine (total number: 4.8±3.2; active TrPs: 3.4±2.9; and latent TrPs: 1.4±1.9). No linear association was observed between the number of TrPs and migraine-related disability in women with episodic or chronic migraine.

Conclusions:
Women with episodic and chronic migraine had a similar number of TrPs. TrPs may be considered a trigger factor that can facilitate the onset of migraine or also can potentially be a promoting factor for pain once the migraine attack has started and hence may contribute to related disability. Nevertheless, we observed that the number of TrPs in the head and neck-shoulder muscles in an interictal state was not associated with the degree of migraine-related disability, suggesting a multifactorial nature of self-perceived disability in this population.
Posterior Malleolar Fractures Associated With Tibial Shaft Fractures and Sequence of Fixation
Authors: Kempegowda Harish , Maniar Hemil H. , Richard Raveesh , Tawari Akhil , Jove Graham , Suk Michael , Beebe Michael J. , Han Chris , Tornetta Paul , Kubiak Erik N. , Horwitz Daniel S. 
Published: May 2016

Objectives:
The purpose of this study was to evaluate posterior malleolar injuries associated with nailed tibial fractures and to determine the quality of reduction based on the sequence of fixation in associated fracture patterns.

Design:
Retrospective cohort study.

Patients:
1113 tibia fractures treated with an intramedullary nail at 3 level I trauma centers.

Intervention:
Tibial shaft fractures with posterior malleolar injury were analyzed regarding type of fracture, mechanism of injury, energy of injury, fracture characteristic, surgical characteristics including sequence of fixation, obvious intraoperative displacement of the posterior malleolar fragment, and the quality of reduction. One group (“malleolus-first”) consisted of patients in whom the posterior malleolus was fixed before tibial nailing and the other group (“tibia-first”) included patients in whom tibial nailing was done before posterior malleolus fixation.

Outcomes Measured:
Intraoperative displacement, quality of reduction.

Results:
Ninety-six of 1113 (9%) nailed tibial shaft fracture patients had a concomitant posterior malleolus fracture (9%). Of the 96 posterior malleolar fracture patients, 70 patients were operatively treated (73%). In the malleolus-first group (54 patients), intraoperative displacement of the posterior malleolar fragment was observed in 1 patient, and 1 case of poor reduction of the posterior malleolar fragment was observed (2%). In the tibia-first group (16 patients), obvious intraoperative displacement of the posterior malleolar fragment was observed in 5 patients (31%), and poor reduction of the posterior malleolar fragment was observed in 7 patients (44%). These percentages of patients with poor quality of reduction were statistically significantly different (p ≤ 0.01).

Conclusion:
Many low-energy tibia fractures with a spiral configuration do have an associated posterior malleolus fracture. In order to avoid intraoperative displacement and poor reduction, we recommend fixation of the posterior malleolar fragment before nailing of the tibia in associated fracture pattern.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Depressive Symptoms After Critical Illness: A Systematic Review and Meta-Analysis
Authors: Rabiee Anahita , Nikayin Sina , Hashem Mohamed D. , Huang Minxuan , Dinglas Victor D. , Bienvenu O. Joseph , Turnbull Alison E. , Needham Dale M. 
Published: May 2016

Objectives:
To synthesize data on prevalence, natural history, risk factors, and post-ICU interventions for depressive symptoms in ICU survivors.

Data Sources:
PubMed, EMBASE, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and Cochrane Controlled Trials Registry (1970–2015).

Study Selection:
Studies measuring depression after hospital discharge using a validated instrument in more than 20 adults from non-specialty ICUs.

Data Extraction:
Duplicate independent review and data abstraction.

Data Synthesis:
The search identified 27,334 titles, with 42 eligible articles on 38 unique studies (n = 4,113). The Hospital Anxiety and Depression Scale-Depression subscale was used most commonly (58%). The pooled Hospital Anxiety and Depression Scale-Depression subscale prevalence (95% CI) of depressive symptoms at a threshold score greater than or equal to 8 was 29% (22–36%) at 2–3 months (12 studies; n = 1,078), 34% (24–43%) at 6 months (seven studies; n = 760), and 29% (23–34%) at 12–14 months (six studies; n = 1,041). The prevalence of suprathreshold depressive symptoms (compatible with Hospital Anxiety and Depression Scale-Depression subscale, ≥ 8) across all studies, using all instruments, was between 29% and 30% at all three time points. The pooled change in prevalence (95% CI) from 2–3 to 6 months (four studies; n = 387) was 5% (–1% to +12%), and from 6 to 12 months (three studies; n = 412) was 1% (–6% to +7%). Risk factors included pre-ICU psychologic morbidity and presence of in-ICU psychologic distress symptoms. We did not identify any post-ICU intervention with strong evidence of improvement in depressive symptoms.

Conclusions:
Clinically important depressive symptoms occurred in approximately one-third of ICU survivors and were persistent through 12-month follow-up. Greater research into treatment is needed for this common and persistent post-ICU morbidity.
Rare side-effects of checkpoint inhibitors
Authors: Kourie Hampig R. , Awada Gil , Awada Ahmad H. 
Published: May 2016

Purpose of review
The aim of this review is to draw the attention of the physicians and oncologists on the rare side-effects of checkpoint inhibitors not usually reported in clinical trials to treat them quickly and render their prognosis better.

Recent findings
Rare side-effects of checkpoint inhibitors are mainly neurologic, haematologic, rheumatologic, renal, and cardiac. The majority of reported side-effects are consequent of the treatment by ipilimumab in patients diagnosed with melanomas. Neurologic side-effects have poorer prognosis compared with other rare side-effects. There is no relationship between developing rare side-effects and the outcome of the disease.

Summary
It is important to be aware, when treating patients with checkpoint inhibitors, to detect as early as possible the unpredictable and uncontrollable rare side-effects of these agents. The large spectrum of these rare side-effects should be well documented and reported to assure to the physicians a road map for the diagnosis and the management of these toxicities.
Microsomal Prostaglandin E Synthase-1 Expression by Aortic Smooth Muscle Cells Attenuates the Differentiated Phenotype
Authors: Adedoyin Oreoluwa O. , Loftin Charles D. 
Published: May 2016

Abstract:
The development of numerous types of cardiovascular disease is associated with alteration of the vascular smooth muscle cell (SMC) phenotype. We have previously shown that abdominal aortic aneurysm progression in a mouse model of the disease is associated with reduced differentiation of SMCs within the lesion and that cyclooxygenase-2 (COX-2) is critical to initiation and progression of the aneurysms. The current studies used human aortic SMC (hASMC) cultures to better characterize mechanisms responsible for COX-2-dependent modulation of the SMC phenotype. Depending on the culture conditions, hASMCs expressed multiple characteristics of a differentiated and contractile phenotype, or a dedifferentiated and secretory phenotype. The pharmacological inhibition of COX-2 promoted the differentiated phenotype, whereas treatment with the COX-2–derived metabolite prostaglandin E2 (PGE2) increased characteristics of the dedifferentiated phenotype. Furthermore, pharmacological inhibition or siRNA-mediated knockdown of microsomal prostaglandin E synthase-1 (mPGES-1), the enzyme that functions downstream of COX-2 during the synthesis of PGE2, significantly increased expression of characteristics of the differentiated SMC phenotype. Therefore, our findings suggest that COX-2 and mPGES-1–dependent synthesis of PGE2 contributes to a dedifferentiated hASMC phenotype and that mPGES-1 may provide a novel pharmacological target for treatment of cardiovascular diseases where altered SMC differentiation has a causative role.
The Facial Growth Pattern and the Amount of Palatal Bone Deficiency Relative to Cleft Size Should Be Considered in Treatment Planning
Authors: Berkowitz Samuel 
Published: May 2016

Background:
The aim of this study is to determine the best surgical/orthodontic treatment plan for the complete bilateral and unilateral cleft lip and palate patient to achieve all treatment goals of facial aesthetics, speech, dental function, and psychosocial development.

Methods:
Review of 40 years of serial complete bilateral cleft lip and palate and complete unilateral cleft lip and palate dental casts and photographs from birth to adolescence, with serial cephs starting at 4 years. This was part of a multicenter international 3-dimensional palatal growth study of serial dental casts of patients who developed good speech, occlusion, and facial growth.

Results:
Nasoalveolar molding and gingivoperiosteoplasty were introduced without proven longitudinal benefits. The procedure bodily retruded the premaxilla, which “telescoped” backward causing synostosis at the premaxillary vomerine suture. The resulting midfacial recessiveness with an anterior dental crossbite can only be corrected by midfacial protraction or a Le Fort I surgery.

Conclusions:
Staged orthodontic/surgical treatment limiting premaxillary retraction forces to lip adhesion or forces that cause only premaxillary ventroflexion produce the best results. The palatal cleft should be closed between 18 and 24 months when the ratio of the cleft to the palatal size medial to the alveolar ridge is at least 10%. The protruding premaxilla should only be ventroflexed but never bodily retruded. The facial growth pattern and degree of palatal bone deficiency are the main items to be considered in treatment planning.
ACANTHAMOEBA ENDOPHTHALMITIS AFTER RECURRENT KERATITIS AND NODULAR SCLERITIS
Authors: Mammo Zaid , Almeida David R. P. , Cunningham Matthew A. , Chin Eric K. , Mahajan Vinit B. 
Published: May 2016

Purpose:
To describe the clinical course of a patient with Acanthamoeba keratitis, who despite prompt treatment progressed to histopathology-confirmed Acanthamoeba retinitis and endophthalmitis.

Methods:
Case report.

Results:
A healthy 30-year-old male wearing soft contact lens was diagnosed with Acanthamoeba keratitis and treated medically and surgically over the course of 1 year with presumed resolution of the infection. Yet, his infection recurred with documented spread to sclerokeratitis, and overwhelming endophthalmitis. Concerns about extra-ocular spread prompted a therapeutic enucleation with histopathologic evidence of Acanthamoeba organisms throughout the globe.

Conclusion:
This is a case of a severe recurrent Acanthamoeba infection presenting initially as keratitis, followed by sclerokeratitis and histolopathology-confirmed endophthalmitis. This case demonstrates that despite persistent medical and surgical intervention, eradication of organisms may not be possible.
MULTICOLOR IMAGING OF INNER RETINAL ALTERATIONS AFTER INTERNAL LIMITING MEMBRANE PEELING
Authors: Feng Henry L. , Sharma Sumit , Asrani Sanjay , Mruthyunjaya Prithvi 
Published: May 2016

Purpose:
To characterize the appearance of inner retinal alterations after internal limiting membrane (ILM) peeling using multicolor confocal scanning laser ophthalmoscopy (cSLO).

Methods:
Retrospective review of two eyes that underwent pars plana vitrectomy with internal limiting membrane peeling and postoperative multicolor cSLO with spectral-domain optical coherence tomography. Infrared, green, blue, standard multicolor, and blue-green enhanced multicolor reflectance images were evaluated alongside spectral-domain optical coherence tomography for inner retinal alterations.

Results:
Two eyes of 2 patients, aged 70 and 65 years, were identified. Preoperative diagnoses were epiretinal membrane with lamellar macular hole for Case 1 and full-thickness macular hole for Case 2. Time from surgery to initial multicolor cSLO imaging was 9 years in Case 1 and 3 weeks in Case 2. Inner retinal alterations were best visualized on blue reflectance, moderately visualized on green and blue–green enhanced multicolor, and less evident on infrared and standard multicolor. In Case 2, serial multicolor cSLO imaging demonstrated the emergence of inner retinal alterations between 3 weeks and 5 weeks postoperatively.

Conclusion:
Multicolor cSLO is a novel imaging modality capable of detecting inner retinal alterations in patients with a history of internal limiting membrane peeling, and may be clinically useful for monitoring anatomical changes associated with internal limiting membrane peeling.
Does Valsalva Maneuver Affect Corneal Morphology in Eyes With Keratoconus?
Authors: Duru Necati , Duru Zeynep , Çiçek Ayşe , Altınkaynak Hasan , Karatepe Haşhaş Arzu Seyhan , Arifoğlu Hasan Basri 
Published: May 2016

Objectives:
The aim of this study was to investigate the effect of the Valsalva maneuver on corneal morphology and anterior chamber parameters in patients with keratoconus.

Methods:
A total of 39 eyes from 39 patients with keratoconus and 41 eyes from 41 age-matched and gender-matched healthy individuals were included in this cross-sectional study. Measurements of corneal front keratometry values (K-flat, K-steep, and K-max), central corneal thickness, corneal apex thickness, thinnest corneal thickness, corneal volume, anterior chamber volume (ACV), anterior chamber depth (ACD), and iridocorneal angle (ICA) were performed with a Pentacam Scheimpflug camera (Oculus, Germany) before and during the Valsalva maneuver. Changes in the anterior segment parameters from baseline and during the Valsalva maneuver and the differences in parameters between the keratoconus group and the control group were analyzed. A P value less than 0.05 was accepted as statistically significant.

Results:
In the patients with keratoconus, the Valsalva maneuver did not have any significant influence on the corneal parameters (P>0.05). However, ACV, ACD, and ICA decreased markedly during the Valsalva maneuver (P=0.006, P=0.048, and P=0.025, respectively). Changes caused by the Valsalva maneuver were similar for all parameters when compared with those in healthy individuals (P>0.05).

Conclusions:
During corneal topography imaging, the Valsalva maneuver observed in patients with keratoconus does not typically cause any significant change in corneal morphology.
Nonpainful wide-area compression inhibits experimental pain
Authors: Honigman Liat , Bar-Bachar Ofrit , Yarnitsky David , Sprecher Elliot , Granovsky Yelena 
Published: May 2016

Abstract
Compression therapy, a well-recognized treatment for lymphoedema and venous disorders, pressurizes limbs and generates massive non-noxious afferent sensory barrages. The aim of this study was to study whether such afferent activity has an analgesic effect when applied on the lower limbs, hypothesizing that larger compression areas will induce stronger analgesic effects, and whether this effect correlates with conditioned pain modulation (CPM). Thirty young healthy subjects received painful heat and pressure stimuli (47°C for 30 seconds, forearm; 300 kPa for 15 seconds, wrist) before and during 3 compression protocols of either SMALL (up to ankles), MEDIUM (up to knees), or LARGE (up to hips) compression areas. Conditioned pain modulation (heat pain conditioned by noxious cold water) was tested before and after each compression protocol. The LARGE protocol induced more analgesia for heat than the SMALL protocol (P < 0.001). The analgesic effect interacted with gender (P = 0.015). The LARGE protocol was more efficient for females, whereas the MEDIUM protocol was more efficient for males. Pressure pain was reduced by all protocols (P < 0.001) with no differences between protocols and no gender effect. Conditioned pain modulation was more efficient than the compression-induced analgesia. For the LARGE protocol, precompression CPM efficiency positively correlated with compression-induced analgesia. Large body area compression exerts an area-dependent analgesic effect on experimental pain stimuli. The observed correlation with pain inhibition in response to robust non-noxious sensory stimulation may suggest that compression therapy shares similar mechanisms with inhibitory pain modulation assessed through CPM.
The cortical response to a noxious procedure changes over time in preterm infants
Authors: Bembich Stefano , Marrazzo Francesca , Barini Alice , Ravalico Paola , Cont Gabriele , Demarini Sergio 
Published: May 2016

Abstract
The aim of the study was to investigate whether cortical response to a repeated noxious procedure may change over time in preterm infants. Possible reasons for change are: (1) advancing maturation of central nervous system; and (2) increasing experience with noxious procedures during hospital stay. Sixteen preterm infants were recruited, with a postmenstrual age (PMA) ranging between 29 and 36 weeks. Newborns were assessed during a heel-prick procedure, once a week for at least 3 consecutive times. Multichannel near-infrared spectroscopy was used to detect cortical activation, by measuring increase in cortical oxy-haemoglobin (HbO2). Parietal, temporal, and posterior frontal areas were monitored bilaterally. By regression analysis, we studied the effect of (1) increasing PMA and (2) increasing number of heel pricks, on the magnitude of cortical activation. We observed a bilateral nociceptive event-related activation of the posterior frontal cortex, mainly contralateral to the side pricked. Additionally, we found a significant positive effect of PMA, as HbO2 progressively increased in the posterior frontal cortex (P < 0.001), bilaterally, over time. Conversely, the degree of cortical activation decreased as the number of noxious events increased (P < 0.002). We conclude the following: (1) Preterm newborns showed a significant activation of the posterior frontal cortex in association with noxious stimuli; (2) Cortical activation was progressively greater with increasing PMA; (3) There was an inverse relationship between cortical activation and the number of heel pricks. We speculate that such findings may be due to both endogenous cortical maturation and experience-dependent neuroplasticity of the developing brain (eg, synaptogenesis, synaptic pruning).