bluuebunny/crossref_metadata_2025_split huggingface dataset:
The 2017 Academic Emergency Medicine Consensus Conference: Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes
Authors: Bond William F. , Hui Joshua , Fernandez Rosemarie 
Published: August 2017

AbstractOver the past decade, emergency medicine (EM) took a lead role in healthcare simulation in part due to its demands for successful interprofessional and multidisciplinary collaboration, along with educational needs in a diverse array of cognitive and procedural skills. Simulation‐based methodologies have the capacity to support training and research platforms that model micro‐, meso‐, and macrosystems of healthcare. To fully capitalize on the potential of simulation‐based research to improve emergency healthcare delivery will require the application of rigorous methods from engineering, social science, and basic science disciplines. The Academic Emergency Medicine (AEM) Consensus Conference “Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcome” was conceived to foster discussion among experts in EM, engineering, and social sciences, focusing on key barriers and opportunities in simulation‐based research. This executive summary describes the overall rationale for the conference, conference planning, and consensus‐building approaches and outlines the focus of the eight breakout sessions. The consensus outcomes from each breakout session are summarized in proceedings papers published in this issue of Academic Emergency Medicine. Each paper provides an overview of methodologic and knowledge gaps in simulation research and identifies future research targets aimed at improving the safety and quality of healthcare.
Phase III randomized trial comparing intravenous to oral iron in patients with cancer‐related iron deficiency anemia not on erythropoiesis stimulating agents
Authors: Noronha Vanita , Joshi Amit , Patil Vijay Maruti , Banavali Shripad D. , Gupta Sudeep , Parikh Purvish M. , Marfatia Shalaka , Punatar Sachin , More Sucheta , Goud Supriya , Nakti Dipti , Prabhash Kumar 
Published: August 2017

AbstractAimWe aimed to find the optimal route of iron supplementation in patients with malignancy and iron deficiency (true or functional) anemia not receiving erythropoiesis stimulating agents (ESA).MethodsAdult patients with malignancy requiring chemotherapy, hemoglobin (Hb) <12 g/dL and serum ferritin <100 mcg/mL, transferrin saturation <20% or hypochromic red blood cells >10% were randomized to intravenous (IV) iron sucrose or oral ferrous sulfate. The primary endpoint was change in Hb from baseline to 6 weeks. Secondary endpoints included blood transfusion, quality of life (QoL), toxicity, response and overall survival.ResultsA total of 192 patients were enrolled over 5 years: 98 on IV arm and 94 on oral arm. Median age was 51 years; over 95% patients had solid tumors. The mean absolute increase in Hb at 6 weeks was 0.11 g/dL (standard deviation [SD]: 1.48) in IV arm and −0.16 g/dL (SD: 1.36) in oral arm, P = 0.23. Twenty‐three percent patients on IV iron and 18% patients on oral iron had a rise in Hb of ≥1 g/dL at 6 weeks, P = 0.45. Thirteen patients (13.3%) on the IV iron arm and 14 patients (14.9%) on the oral arm required blood transfusion, P = 1.0. Gastrointestinal toxicity (any grade) developed in 41% patients on IV iron and 44% patients on oral iron, P = 1.0. 5 patients on IV iron and none on oral iron had hypersensitivity, P = 0.06. QoL was not significantly different between the two arms.ConclusionIV iron was not superior to oral iron in patients with malignancy on chemotherapy and iron deficiency anemia.
Challenges in the implementation of the EAACI AIT guidelines: A situational analysis of current provision of allergen immunotherapy
Authors: Ryan D. , Gerth van Wijk R. , Angier E. , Kristiansen M. , Zaman H. , Sheikh A. , Cardona V. , Vidal C. , Warner A. , Agache I. , Arasi S. , Fernandez‐Rivas M. , Halken S. , Jutel M. , Lau S. , Pajno G. , Pfaar O. , Roberts G. , Sturm G. , Varga E. M. , Van Ree R. , Muraro A. 
Published: August 2017

AbstractPurposeThe European Academy of Allergy and Clinical Immunology (EAACI) has produced Guidelines on Allergen Immunotherapy (AIT). We sought to gauge the preparedness of primary care to participate in the delivery of AIT in Europe.MethodsWe undertook a mixed‐methods, situational analysis. This involved a purposeful literature search and two surveys: one to primary care clinicians and the other to a wider group of stakeholders across Europe.ResultsThe 10 papers identified all pointed out gaps or deficiencies in allergy care provision in primary care. The surveys also highlighted similar concerns, particularly in relation to concerns about lack of knowledge, skills, infrastructural weaknesses, reimbursement policies and communication with specialists as barriers to evidence‐based care. Almost all countries (92%) reported the availability of AIT. In spite of that, only 28% and 44% of the countries reported the availability of guidelines for primary care physicians and specialists, respectively. Agreed pathways between specialists and primary care physicians were reported as existing in 32%‐48% of countries. Reimbursement appeared to be an important barrier as AIT was only fully reimbursed in 32% of countries. Additionally, 44% of respondents considered accessibility to AIT and 36% stating patient costs were barriers.ConclusionsSuccessful working with primary care providers is essential to scaling‐up AIT provision in Europe, but to achieve this, the identified barriers must be overcome. Development of primary care interpretation of guidelines to aid patient selection, establishment of disease management pathways and collaboration with specialist groups are required as a matter of urgency.
Family nurture intervention in preterm infants increases early development of cortical activity and independence of regional power trajectories
Authors: Welch Martha G. , Stark Raymond I. , Grieve Philip G. , Ludwig Robert J. , Isler Joseph R. , Barone Joseph L. , Myers Michael M. 
Published: August 2017

AbstractAimPremature delivery and maternal separation during hospitalisation increase infant neurodevelopmental risk. Previously, a randomised controlled trial of Family Nurture Intervention (FNI) in the neonatal intensive care unit demonstrated improvement across multiple mother and infant domains including increased electroencephalographic (EEG) power in the frontal polar region at term age. New aims were to quantify developmental changes in EEG power in all brain regions and frequencies and correlate developmental changes in EEG power among regions.MethodsEEG (128 electrodes) was obtained at 34‐44 weeks postmenstrual age from preterm infants born 26‐34 weeks. Forty‐four infants were treated with Standard Care and 53 with FNI. EEG power was computed in 10 frequency bands (1‐48 Hz) in 10 brain regions and in active and quiet sleep.ResultsPercent change/week in EEG power was increased in FNI in 132/200 tests (p < 0.05), 117 tests passed a 5% False Discovery Rate threshold. In addition, FNI demonstrated greater regional independence in those developmental rates of change.ConclusionThis study strengthens the conclusion that FNI promotes cerebral cortical development of preterm infants. The findings indicate that developmental changes in EEG may provide biomarkers for risk in preterm infants as well as proximal markers of effects of FNI.
Clinical significance of CYP2C19 polymorphisms on the metabolism and pharmacokinetics of 11β‐hydroxysteroid dehydrogenase type‐1 inhibitor BMS‐823778
Authors: Cheng Yaofeng , Wang Lifei , Iacono Lisa , Zhang Donglu , Chen Weiqi , Gong Jiachang , Humphreys William Griffith , Gan Jinping 
Published: August 2017

AimsBMS‐823778 is an inhibitor of 11β‐hydroxysteroid dehydrogenase type‐1, and thus a potential candidate for Type 2 diabetes treatment. Here, we investigated the metabolism and pharmacokinetics of BMS‐823778 to understand its pharmacokinetic variations in early clinical trials.MethodsThe metabolism of BMS‐823778 was characterized in multiple in vitro assays. Pharmacokinetics were evaluated in healthy volunteers, prescreened as CYP2C19 extensive metabolizers (EM) or poor metabolizers (PM), with a single oral dose of [14C]BMS‐823778 (10 mg, 80 μCi).ResultsThree metabolites (<5%) were identified in human hepatocytes and liver microsomes (HLM) incubations, including two hydroxylated metabolites (M1 and M2) and one glucuronide conjugate (M3). As the most abundant metabolite, M1 was formed mainly through CYP2C19. M1 formation was also correlated with CYP2C19 activities in genotyped HLM. In humans, urinary excretion of dosed radioactivity was significantly higher in EM (68.8%; 95% confidence interval 61.3%, 76.3%) than in PM (47.0%; 43.5%, 50.6%); only small portions (<2%) were present in faeces or bile from both genotypes. In plasma, BMS‐823778 exposure in PM was significantly (5.3‐fold, P = 0.0097) higher than in EM. Furthermore, total radioactivity exposure was significantly higher (P < 0.01) than BMS‐823778 exposure in all groups, indicating the presence of metabolites. M1 was the only metabolite observed in plasma, and much lower in PM. In urine, the amount of M1 and its oxidative metabolite in EM was 7‐fold of that in PM, while more glucuronide conjugates of BMS‐823778 and M1 were excreted in PM.ConclusionsCYP2C19 polymorphisms significantly impacted systemic exposure and metabolism pathways of BMS‐823778 in humans.
The complexity of school racial climate: Reliability and validity of a new measure for secondary students
Authors: Byrd Christy M. 
Published: August 2017

BackgroundThe conceptualization of the role of race and culture in students’ experience of school has been limited. This study presents a more comprehensive and multidimensional framework than previously conceptualized and includes the two domains of (1) intergroup interactions (frequency of interaction, quality of interaction, equal status, and support for positive interaction) and (2) school racial socialization (cultural socialization, mainstream socialization, promotion of cultural competence, colourblind socialization, critical consciousness socialization, and stereotyping) (Byrd, 2015, Journal of Educational Research, 108, 10).AimsThe scale presents a measure of school racial climate for middle and high school students and tests for evidence of reliability and validity in two independent, nationwide samples.Sample and methodParticipants were 819 children aged 12–18 (M = 15.27, SD = 1.58) who completed the School Climate for Diversity – Secondary Scale and a number of validating measures: general school climate, perceived discrimination, culturally responsive teaching, grades, and academic motivation.Results and conclusionsConfirmatory factor analyses and reliability analyses showed support for the 10‐factor structure of the scale, and the subscales were associated with the validating measures in expected ways.
A longitudinal evaluation of health‐related quality of life in patients with AL amyloidosis: associations with health outcomes over time
Authors: Sanchorawala Vaishali , McCausland Kristen L. , White Michelle K. , Bayliss Martha S. , Guthrie Spencer D. , Lo Stephen , Skinner Martha 
Published: August 2017

SummaryLight chain (AL) amyloidosis is a rare disease associated with significant, irreversible organ dysfunction and high case fatality. An observational study was conducted to assess health‐related quality of life (HRQoL) in patients treated for AL amyloidosis between 1994 and 2014 with both high dose melphalan and stem cell transplantation (HDM/SCT) or non‐SCT chemotherapy regimens. The SF‐36v1® Health Survey (SF‐36) was administered to assess HRQoL during clinic visits. Analysis of variance was used to compare pre‐ and post‐treatment HRQoL within each treatment group to an age‐ and gender‐adjusted general population (GP) normative sample. Cox proportional hazard models were fit to examine associations between pre‐treatment levels of HRQoL and mortality within 1 and 5 years after initiating specific treatment regimens (HDM/SCT: n = 402; non‐SCT chemotherapy regimens: n = 172). Among patients who received HDM/SCT, there were significant improvements following treatment in vitality, social functioning, role‐emotional and mental health. Worse pre‐treatment SF‐36 physical component scores were associated with a greater risk of mortality in both treatment groups and follow‐up periods (P ≤ 0·005 for both). [Correction added on 20 October 2017, after first online publication: This P value has been corrected]. Using HRQoL assessments in every physician visit or treatment may provide valuable insights for treating rare conditions like AL amyloidosis.
α‐Spinasterol: a COX inhibitor and a transient receptor potential vanilloid 1 antagonist presents an antinociceptive effect in clinically relevant models of pain in mice
Authors: Brusco Indiara , Camponogara Camila , Carvalho Fabiano Barbosa , Schetinger Maria Rosa Chitolina , Oliveira Mauro Schneider , Trevisan Gabriela , Ferreira Juliano , Oliveira Sara Marchesan 
Published: August 2017

Background and PurposePostoperative pain is one of the most common manifestations of acute pain and is an important problem faced by patients after surgery. Moreover, neuronal trauma or chemotherapeutic treatment often causes neuropathic pain, which induces disabling and distressing symptoms. At present, treatments of both painful conditions are inadequate. α‐Spinasterol, which is well characterized as a transient receptor potential vanilloid 1 antagonist, has anti‐inflammatory, antioxidant and antinociceptive effects. Therefore, we investigated its antinociceptive potential on postoperative and neuropathic pain, as well as its effect on COX‐1 and COX‐2 activities.Experimental ApproachNociceptive responses in a postoperative pain model (surgical incision‐induced) or different neuropathic pain models (trauma or chemotherapy‐induced) were investigated in mice.Key ResultsOral administration of α‐spinasterol reduced postoperative pain, when given as a pre‐ (0.5 h before incision) or post‐treatment (0.5 h after incision), and reduced cell infiltration in the injured tissue. α‐Spinasterol also reduced the mechanical allodynia induced by partial sciatic nerve ligation and the mechanical and cold allodynia induced by paclitaxel. Moreover, α‐spinasterol inhibited COX‐1 and COX‐2 enzyme activities without altering the body temperature of animals. Importantly, α‐spinasterol did not alter spontaneous or forced locomotor activity. Furthermore, it did not cause gastric damage or liver and kidney changes, nor did it alter cell viability in the cerebral cortex and spinal cord slices of mice.Conclusion and Implicationsα‐Spinasterol is an effective and safe COX inhibitor with antinociceptive effects in postoperative and neuropathic pain models. Therefore, it is an interesting prototype for the development of novel analgesic drugs.
Displaced Syrian children's reported physical and mental wellbeing
Authors: Hamdan‐Mansour Ayman M. , Abdel Razeq Nadin M. , AbdulHaq Bayan , Arabiat Diana , Khalil Amani A. 
Published: August 2017

BackgroundSurviving a warzone inflicts harmful consequences on the physical health and the psychosocial wellbeing of children. This study aimed at exploring the physical and psychosocial perceived state of health of displaced Syrian refugee children in Jordan.MethodsA cross‐sectional explorative design was applied. Structured questionnaires were used to collect data through face‐to‐face interviews with 250 Syrian refugee children. Descriptive and inferential statistics were used.ResultsChildren had fair levels of physical health; their health concerns were minor. Psychosocially, 25% (n = 63) suffered from loneliness and 24% (n = 59) reported feeling depressed. The majority of children (>60%) had low rates of somatic pain. Age had a negative correlation with hyperactivity (r = −.14, p = .034); gender differences were found in anger expression and anger trait (p < .05).ConclusionsThe results in this study highlight a number of physical and psychosocial health concerns among refugee children. The health needs of displaced Syrian children need to be addressed using comprehensive assessment and care. Our findings documented the physical and psychosocial health needs of the displaced Syrian children in Jordan and addressed areas of focus to guide health promotion interventions and community health efforts for them.
Effectiveness of fluoride varnish in preventing early childhood caries in rural areas without access to fluoridated drinking water: A randomized control trial
Authors: Muñoz‐Millán Patricia , Zaror Carlos , Espinoza‐Espinoza Gerardo , Vergara‐Gonzalez Carolina , Muñoz Sergio , Atala‐Acevedo Claudia , Martínez‐Zapata Maria José 
Published: August 2017

AbstractObjectivesEarly childhood caries (ECC) constitutes a serious public health issue, especially in communities without water fluoridation. We assessed the effectiveness of biannual fluoride varnish applications to prevent ECC in children from nonfluoridated rural areas.MethodsA triple‐blind randomized control trial with two parallel arms was conducted with 275 two‐ to three‐year‐old children without cavitated carious lesions from 28 rural public preschools in Chile. The preschools were located in areas of low socioeconomic status without access to fluoridated water. An oral health education component was administered to children, parents and educators. A new toothbrush and toothpaste for each child was delivered to the parents at baseline and at four follow‐up visits. The participants were randomly allocated to receive fluoride varnish or placebo applications every six months. Trained, calibrated dentists blind to the treatment arm performed visual dental assessments at 6, 12, 18 and 24 months. The primary endpoint was the development of cavitated carious lesions in children during the 24‐month follow‐up period using WHO criteria, and the secondary outcomes were an increase in caries measured as a change in the index of decayed, missing or filled teeth (dmft) since the beginning of the study and the development of adverse effects. An intention‐to‐treat (ITT) approach was used for the primary analysis.ResultsWe included 131 participants in the intervention group and 144 participants in the placebo group; of these children, 89 (67.9%) in the intervention group and 100 (69.4%) in the control group completed the protocol. The comparative ITT analysis of caries incidence after 24 months of follow‐up showed a between‐group prevention fraction of 18.9% (−2.9%‐36.2%). Caries incidence was 45.0% for the experiment group and 55.6% for the control group (P = .081), with a mean dmft of 1.6 (SD = 2.4) and 2.1 (SD = 2.5), respectively. No adverse effects were reported.ConclusionsIn conclusion, biannual fluoride varnish application is not effective in preschool children from rural nonfluoridated communities at a high risk of caries.
Assessment of right ventricular systolic function in heart transplant patients: Correlation between echocardiography and cardiac magnetic resonance imaging. Investigation of the accuracy and reliability of echocardiography
Authors: Simsek Evrim , Nalbantgil Sanem , Ceylan Naim , Zoghi Mehdi , Kemal Hatice Soner , Engin Cagatay , Yagdi Tahir , Ozbaran Mustafa 
Published: August 2017

BackgroundRight ventricular (RV) function has great impact on the survival of heart transplantation recipients; therefore, careful evaluation is of high clinical importance. However, there is no standard conventional echocardiographic parameter to assess RV systolic function. Herein, we evaluated the correlation between echocardiographic parameters of RV systolic function and ejection fraction assessed by cardiac magnetic resonance imaging (MRI RVEF) in heart transplantation recipients.Method and ResultsForty‐three patients with at least 6‐month heart transplantation history were included in this study. Each patient had conventional echocardiography and cardiac MRI evaluation, followed by endomyocardial biopsy and right heart catheterization, which were performed in six hours. Echocardiographic parameters of RV systolic function, RV fractional area change (RV FAC), tricuspid annular plane systolic excursion (TAPSE), RV myocardial performance index, and RV global longitudinal strain, were compared with MRI RVEF (P values were <0.001, <0.3, <0.9, and <0.4, respectively). RV FAC was the only parameter to strongly correlate with MRI RVEF (r=0.747, P<0.001); and RV FAC 48.5% value had 90.5% sensitivity and 90.5% specificity to predict the pathologic reference value of MRI RVEF ≤50% (AUC:0.96; 95% CI, 0.908–1.013).ConclusionTo our knowledge, this is the first prospective study to evaluate the correlation between the echocardiographic parameters for RV systolic function and MRI RVEF in heart transplantation recipients. RV FAC is the only parameter to correlate well with MRI RVEF, and its routine use in the follow‐up of heart transplantation recipients should be considered.
Efficiency of different storage media for avulsed teeth in animal models: a systematic review
Authors: Longo Daniele L. , Fumes Ana C. , Küchler Erika C. , Paula‐Silva Francisco W. G. , Nelson‐Filho Paulo , Silva Léa A. B. 
Published: August 2017

AbstractBackground/AimsTooth avulsion consists of the complete displacement of a tooth from the alveolar socket. When immediate replantation is not possible, the avulsed tooth should be kept in a storage medium capable of maintaining the viability of periodontal ligament (PDL) cells on the root surface. However, there is no consensus on the best storage medium able to prevent sequels such as ankylosis and tooth resorption. The aim of this study was to perform a systematic review to evaluate the in vivo effectiveness of different storage media for avulsed teeth.MethodsTwo reviewers performed a database search for studies published between January 1950 and December 2015 which were indexed in the PubMed, Scopus, Web of Science, and Bireme databases. An additional manual search was performed. Studies with animal models that evaluated tooth avulsion, storage media, and replantation were included. After full‐text analysis of the potentially relevant studies, the selected studies were included in the systematic review.ResultsThe database search found 157 distinct studies evaluating avulsed teeth storage media. However, only six studies met the selection criteria and were included in the review. There was a high variability in the study estimates for the parameters analyzed. When assessing the quality and level of evidence of each study, one study was rated as having a very low level of evidence, four studies had low levels of evidence, and one had a moderate level of evidence.ConclusionAs a result of data heterogeneity and limitations of the studies, there was insufficient evidence to determine the most effective storage medium for avulsed teeth.