bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensitivity and specificity of real‐time PCR and bacteriological culture for francisellosis in farm‐raised Nile tilapia (Oreochromis niloticus L.)
Authors: Assis G B N , de Oliveira T F , Gardner I A , Figueiredo H C P , Leal C A G 
Published: September 2016

AbstractDespite the worldwide occurrence of Francisella noatunensis subsp. orientalis (Fno) infection in farmed tilapia, sensitivity and specificity estimates of commonly used diagnostic tests have not been reported. This study aimed to estimate the sensitivity and specificity of bacteriological culture and qPCR to detect Fno infection. We tested 559 fish, sampled from four farms with different epidemiological scenarios: (i) healthy fish in a hatchery free of Fno; (ii) targeted sampling of diseased fish with suggestive external clinical signs of francisellosis during an outbreak; (iii) convenience sampling of diseased and clinically healthy fish during an outbreak; and (iv) sampling of healthy fish in a cage farm without a history of outbreaks, but with francisellosis reported in other farms in the same reservoir. The qPCR had higher median sensitivity (range, 48.8–99.5%) than culture (range, 1.6–74.4%). Culture had a substantially lower median sensitivity (1.6%) than qPCR (48.8%) to detect Fno in carrier tilapia (farm 4). Median specificity estimates for both tests were >99.2%. The qPCR is the superior test for use in surveillance and monitoring programmes for francisellosis in farmed Nile tilapia, but both tests have high sensitivity and specificity which make them fit for use in the diagnosis of Fno outbreaks.
Investigations into the temporal development of epitheliocystis infections in brown trout: a histological study
Authors: Guevara Soto M , Vidondo B , Vaughan L , Rubin J‐F , Segner H , Samartin S , Schmidt‐Posthaus H 
Published: September 2016

AbstractEpitheliocystis in Swiss brown trout (Salmo trutta) is a chlamydial infection, mainly caused by Candidatus Piscichlamydia salmonis and Candidatus Clavichlamydia salmonicola. To gain a better understanding of the temporal development of infections in wild brown trout, we investigated epitheliocystis infections during the course of the summer and autumn months of a single year (2015), and compared this to sampling points over the span of the years 2012–2014. The survey focused on tributaries (Venoge and Boiron) of the Rhone flowing in to Lake Geneva. When evaluated histologically, epitheliocystis infections were found throughout the period of investigation with the exception of the month of June. Fifty to 86 animals per sampling were investigated. Highest prevalence and infection intensities were seen in September. A correlation between epitheliocystis infection and water temperatures was not evident. Interyear comparison revealed consistent levels of prevalence and infection intensities in late summer. The absence of infections in June, combined with the consistent interyear results, indicates seasonal fluctuation of epitheliocystis infections in brown trout with a reservoir persisting during winter months from which infections can re‐initiate each year. This could either be at levels below detection limits within the brown trout population itself or in an alternative host.
Exploring Home Care Interventions for Frail Older People in Belgium: A Comparative Effectiveness Study
Authors: de Almeida Mello Johanna , Declercq Anja , Cès Sophie , Van Durme Thérèse , Van Audenhove Chantal , Macq Jean 
Published: September 2016

ObjectivesTo examine the effects of home care interventions for frail older people in delaying permanent institutionalization during 6 months of follow‐up.DesignLongitudinal quasi‐experimental research study, part of a larger study called Protocol 3.SettingCommunity care in Belgium.ParticipantsFrail older adults who received interventions (n = 4,607) and a comparison group of older adults who did not (n = 3,633). Organizations delivering the interventions included participants provided they were aged 65 and older, frail, and at risk of institutionalization. A comparison group was established consisting of frail older adults not receiving any interventions.InterventionHome care interventions were identified as single component (occupational therapy (OT), psychological support, night care, day care) or multicomponent. The latter included case management (CM) in combination with OT and psychological support or physiotherapy, with rehabilitation services, or with OT alone.MeasurementsThe interRAI Home Care (HC) was completed at baseline and every 6 months. Data from a national database were used to establish a comparison group. Relative risks of institutionalization and death were calculated using Poisson regression for each type of intervention.ResultsA subgroup analysis revealed that 1,999 older people had mild impairment, and 2,608 had moderate to severe impairment. Interventions providing only OT and interventions providing CM with rehabilitation services were effective in both subpopulations.ConclusionThis research broadens the understanding of the effects of different types of community care interventions on the delay of institutionalization of frail older people. This information can help policy‐makers to plan interventions to avoid early institutionalization.
High Prevalence of Medication Discrepancies Between Home Health Referrals and Centers for Medicare and Medicaid Services Home Health Certification and Plan of Care and Their Potential to Affect Safety of Vulnerable Elderly Adults
Authors: Brody Abraham A. , Gibson Bryan , Tresner‐Kirsch David , Kramer Heidi , Thraen Iona , Coarr Matthew E. , Rupper Randall 
Published: September 2016

ObjectivesTo describe the prevalence of discrepancies between medication lists that referring providers and home healthcare (HH) nurses create.DesignThe active medication list from the hospital at time of HH initiation was compared with the HH agency's plan of care medication list. An electronic algorithm was developed to compare the two lists for discrepancies.SettingSingle large hospital and HH agency in the western United States.ParticipantsIndividuals referred for HH from the hospital in 2012 (N = 770, 96.3% male, median age 71).MeasurementsPrevalence was calculated for discrepancies, including medications missing from one list or the other and differences in dose, frequency, or route for medications contained on both lists.ResultsParticipants had multiple medical problems (median 16 active problems) and were taking a median of 15 medications (range 1–93). Every participant had at least one discrepancy; 90.1% of HH lists were missing at least one medication that the referring provider had prescribed, 92.1% of HH lists contained medications not on the referring provider's list, 89.8% contained medication naming errors. 71.0% contained dosing discrepancies, and 76.3% contained frequency discrepancies.ConclusionDiscrepancies between HH and referring provider lists are common. Future work is needed to address possible safety and care coordination implications of discrepancies in this highly complex population.
An Interim Analysis of an Advance Care Planning Intervention in the Nursing Home Setting
Authors: Hickman Susan E. , Unroe Kathleen T. , Ersek Mary T. , Buente Bryce , Nazir Arif , Sachs Greg A. 
Published: September 2016

ObjectivesTo describe processes and preliminary outcomes from the implementation of a systematic advance care planning (ACP) intervention in the nursing home setting.DesignSpecially trained project nurses were embedded in 19 nursing homes and engaged in ACP as part of larger demonstration project to reduce potentially avoidable hospitalizations.SettingNursing homes.ParticipantsResidents enrolled in the demonstration project for a minimum of 30 days between August 2013 and December 2014 (n = 2,709) and residents currently enrolled in March 2015 (n = 1,591).MeasurementsACP conversations were conducted with residents, families, and the legal representatives of incapacitated residents using a structured ACP interview guide with the goal of offering ACP to all residents. Project nurses reviewed their roster of currently enrolled residents in March 2015 to capture barriers to engaging in ACP.ResultsDuring the initial implementation phase, 27% (731/2,709) of residents had participated in one or more ACP conversations with a project nurse, resulting in a change in documented treatment preferences for 69% (504/731). The most common change (87%) was the generation of a Physician Orders for Scope of Treatment form. The most frequently reported barrier to ACP was lack of time.ConclusionThe time‐ and resource‐intensive nature of robust ACP must be anticipated when systematically implementing ACP in the nursing home setting. The fact that these conversations resulted in changes over 2/3 of the time reinforces the importance of deliberate, systematic ACP to ensure that current treatment preferences are known and documented so that these preferences can be honored.
Effects of Longitudinal Glucose Exposure on Cognitive and Physical Function: Results from the Action for Health in Diabetes Movement and Memory Study
Authors: Beavers Kristen M. , Leng Iris , Rapp Stephen R. , Miller Michael E. , Houston Denise K. , Marsh Anthony P. , Hire Don G. , Baker Laura D. , Bray George A. , Blackburn George L. , Hergenroeder Andrea L. , Jakicic John M. , Johnson Karen C. , Korytkowski Mary T. , Dorsten Brent Van , Kritchevsky Stephen B. ,   the Action for Health in Diabetes Movement and Memory Ancillary Study Research Group
Published: September 2016

ObjectivesTo test whether average long‐term glucose exposure is associated with cognitive and physical function in middle‐aged and younger‐old adults with type 2 diabetes mellitus.DesignProspective cohort study.SettingData obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Movement and Memory ancillary study (NCT01410097).ParticipantsOverweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 at baseline (N = 879).MeasurementsGlycosylated hemoglobin (HbA1c) was measured at regular intervals over 7 years, and objective measures of cognitive function (Trail‐Making Test, Modified Stroop Color‐Word Test, Digit Symbol‐Coding, Rey Auditory Verbal Learning Test, Modified Mini‐Mental State Examination) and physical function (Short Physical Performance Battery, expanded Physical Performance Battery, 400‐m and 20‐m gait speed) and strength (grip and knee extensor strength) were assessed at the Year 8 or 9 follow‐up examination.ResultsAverage HbA1c exposure was 7.0 ± 1.1% (53 ± 11.6 mmol/mol), with 57% of participants classified as having HbA1c levels of less than 7% (<53 mmol/mol), 27% having levels of 7% to 8% (53–64 mmol/mol), and 16% having levels of greater than 8% (>64 mmol/mol). After adjustment for age, sex, race, education, smoking status, alcohol intake, knee pain, physical fitness, body mass index, diabetes mellitus medication and statin use, ancillary year visit, and study arm and site, higher HbA1c was associated with worse physical but not cognitive function. Further adjustment for prevalent diabetes mellitus–related comorbidities made all associations nonsignificant. Results did not differ when stratified according to participant baseline age (<60 vs ≥ 60).ConclusionResults presented here suggest that, in the absence of diabetes mellitus–related complications, longitudinal glucose exposure is not associated with future cognitive and physical function. Optimal management of diabetes mellitus–related comorbidities may prevent or reduce the burden of disability associated with type 2 diabetes mellitus.
Nurses’ Use of Race in Clinical Decision Making
Authors: Sellers Sherrill L. , Moss Melissa E. , Calzone Kathleen , Abdallah Khadijah E. , Jenkins Jean F. , Bonham Vence L. 
Published: September 2016

AbstractPurposeTo examine nurses’ self‐reported use of race in clinical evaluation.DesignThis cross‐sectional study analyzed data collected from three separate studies using the Genetics and Genomics in Nursing Practice Survey, which includes items about use of race and genomic information in nursing practice. The Racial Attributes in Clinical Evaluation (RACE) scale was used to measure explicit clinical use of race among nurses from across the United States.MethodsMultivariate regression analysis was used to examine associations between RACE score and individual‐level characteristics and beliefs in 5,733 registered nurses.FindingsAnalysis revealed significant relationships between RACE score and nurses’ race and ethnicity, educational level, and views on the clinical importance of patient demographic characteristics. Asian nurses reported RACE scores 1.41 points higher than White nurses (p < .001), and Black nurses reported RACE scores 0.55 points higher than White nurses (p < .05). Compared to diploma‐level nurses, the baccalaureate‐level nurses reported 0.69 points higher RACE scores (p < .05), master's‐level nurses reported 1.63 points higher RACE scores (p < .001), and doctorate‐level nurses reported 1.77 points higher RACE scores (p < .01). In terms of clinical importance of patient characteristics, patient race and ethnicity corresponded to a 0.54‐point increase in RACE score (p < .001), patient genes to a 0.21‐point increase in RACE score (p < .001), patient family history to a 0.15‐point increase in RACE score (p < .01), and patient age to a 0.19‐point increase in RACE score (p < .001).ConclusionsHigher reported use of race among minority nurses may be due, in part, to differential levels of racial self‐awareness. A relatively linear positive relationship between level of nursing degree nursing education and use of race suggests that a stronger foundation of knowledge about genetic ancestry, population genetics and the concept “race” and genetic ancestry may increase in clinical decision making could allow nurses to more appropriately use of race in clinical care. Integrating patient demographic characteristics into clinical decisions is an important component of nursing practice.Clinical RelevanceRegistered nurses provide care for diverse racial and ethnic patient populations and stand on the front line of clinical care, making them essential for reducing racial and ethnic disparities in healthcare delivery. Exploring registered nurses’ individual‐level characteristics and clinical use of race may provide a more comprehensive understanding of specific training needs and inform nursing education and practice.
Percutaneous Pulmonary Valve Implantation‐Associated Ventricular Tachycardia in Congenital Heart Disease
Authors: Loar Robert W. , Qureshi Athar M. , Miyake Christina Y. , Valdes Santiago O. , Kim Jeffrey J. , De la Uz Caridad M. 
Published: September 2016

BackgroundPercutaneous pulmonary valve implantation (PPVI) is utilized for dysfunctional right ventricular outflow tracts (RVOT) to relieve obstruction, regurgitation, and RV dysfunction. PPVI has not been reported to induce arrhythmias. This study is the first to report the incidence of ventricular tachycardia (VT) after PPVI.MethodsThis was a retrospective study of all patients who had PPVI at a single institution. All patients were admitted after PPVI for overnight telemetry monitoring. Patients with no prior history of VT and newly detected VT within 24 hours post‐PPVI were considered to have VT related to PPVI.ResultsIn total, 79 patients had PPVI (age 17 ± 9 years, 66% tetralogy of Fallot/pulmonary atresia). PPVI‐related VT was detected in 6 patients (7.5%). These patients had a lower BMI (17.5 ± 2.0 vs. 23.1 ± 6.6, P = 0.04). There was no difference in age, native conduit or percutaneous valve size, or change in the minimum diameter of the RVOT from pre‐ to post‐PPVI. In the 6 patients, VT was non‐sustained and monomorphic at rates between 120 and 170. Five started on β‐blockers. No patient required surgical explantation of the valve. Over a median follow‐up of 2 years, 4 have weaned off medications and all are free of recurrence of VT with normal Holters.ConclusionsPPVI may be associated with transient VT in the acute peri‐procedural period. Patients of smaller size may be more susceptible. All patients were managed conservatively and none of the patients had a recurrence, which is suggestive of a transient phenomenon.
Unbalanced lateral mandibular deviation associated with TMJ sound as a sign in TMJ disc dysfunction diagnosis
Authors: Widmalm S. E. , Dong Y. , Li B. X. , Lin M. , Fan L. J. , Deng S. M. 
Published: September 2016

SummaryThe aim was to study the characteristics of lateral mandibular horizontal deviations during opening–closing movements and their association with TMJ sounds of the clicking type. Subjects were 28 healthy volunteers and 38 patients diagnosed with MRI imaging as having TMJ disc dysfunction, 22 with disc displacement without (DD) and 16 as having disc displacement with reduction (DDR). TMJ sounds were recorded with miniature microphones placed in the ear canals, and jaw movements were documented with a kinesiograph. A sign, unbalanced lateral deviation (ubd) was defined as a rapid, short duration, change in jaw movement direction from, and back to, a smooth deviation path in the horizontal plane. The hypotheses were that degrees of maximal deviations, proportions of unbalanced deviation (ubd) and such deviation associated with TMJ sounds (ubdS), differ between healthy subjects and patients with DD or DDR. Comparisons between groups were made using one‐way anova and chi‐square analysis, as appropriate. No differences were found between groups regarding degree of lateral deviation per se. The proportions of ubd and ubdS were significantly higher in patients with DDR than in healthy subjects and than in patients with DD (P < 0·001), but no such differences were found between healthy subjects and patients with DD. For prediction of DDR, the sensitivity and specificity of the sign ubdS were found to be 68·8% and 89·3%, respectively. For the sign ubd, they were 100·0% and 64·3%. This indicates that the sign ubdS has diagnostic value in screening for DDR.
Potential of the Cnidium monnieri fruits as an immune enhancer in Escherichia coli infection model
Authors: Malla Bindu , Chang Bo Yoon , Kim Seon Beom , Park Hyun , Lee Mi Kyeong , Kim Sung Yeon 
Published: September 2016

Abstract

Objectives
The Cnidium monnieri fruits (CMF) were studied how they act on immune system as a novel immunostimulator against the infectious disease.

Methods
Macrophages were treated with CMF, and nitric oxide (NO) and tumour necrosis factor-α (TNF-α) were measured, and phagocytosis of macrophages was detected using FITC-labelled Escherichia coli. The protective effect of CMF against E. coli infection in mice was examined. The survival rate was monitored daily for up to 5 days. And then the viable bacteria count of serum and the immunological mediator (NO, TNF-α, interleukin (IL)-12 and IL-6) of serum, splenocyte and peritoneal macrophages were analysed.

Key findings
The CMF significantly enhanced the concentrations of NO and TNF-α and the phagocytosis activity in macrophages. The oral administration of CMF for five consecutive days before infection prolonged the survival rate. Treatment with CMF significantly stimulated the phagocytosis of peritoneal macrophages and induced the immunological mediator of serum, splenocyte and peritoneal macrophages against the E. coli infection.

Conclusions
The host-protective effects of CMF might be archived by improving immune response, and CMF could act to prevent pathogenic microbial infections with immunomodulation.
Effect of metal-cation antacids on the pharmacokinetics of 1200 mg raltegravir
Authors: Krishna Rajesh , East Lilly , Larson Patrick , Valiathan Chandni , Butterfield Kristin , Teng Yang , Hernandez-Illas Martha 
Published: September 2016

Abstract

Objectives
Raltegravir is a human immunodeficiency virus (HIV)-1 integrase strand transfer inhibitor currently marketed at a dose of 400 mg twice daily (BID). Raltegravir for once-daily regimen (QD) at a dose of 1200 mg is under development. The effect of calcium carbonate and magnesium/aluminium hydroxide antacids on the pharmacokinetics of a 1200 mg dose of raltegravir was assessed in this study.

Methods
An open-label, four-period, four-treatment, fixed-sequence study in 20 HIV-infected patients was performed. Patients needed to be on raltegravir as part of a stable treatment regimen for HIV, and upon entry into the trial received 5 days of 1200 mg raltegravir as pretreatment, before they entered the four-period study: 1200 mg of raltegravir alone (period 1), calcium carbonate antacid as TUMS® Ultra Strength (US) 1000 and 1200 mg raltegravir given concomitantly (Period 2), magnesium/aluminium hydroxide antacid as 20 ml MAALOX® Maximum Strength substitute MS given 12 h after administration of 1200 mg raltegravir (period 3), and calcium carbonate antacid as TUMS® US 1000 given 12 h after administration of 1200 mg raltegravir (period 4). Patients received their dose of 1200 mg QD raltegravir during the intervals between periods to re-establish steady state. AUC0–24, C24, Cmax and Tmax were calculated from the individual plasma concentrations of 1200 mg QD raltegravir after administration alone or with a calcium carbonate antacid or with a staggered dose of a calcium carbonate antacid or magnesium/aluminium hydroxide antacid. Adverse events, in addition to laboratory safety tests (haematology, serum chemistry and urinalysis), 12-lead electrocardiograms and vital signs were assessed.

Key findings
All treatments were well tolerated in the study. Metal-cation antacids variably affected the pharmacokinetics of 1200 mg QD raltegravir. When calcium carbonate antacid was given with 1200 mg raltegravir concomitantly, the geometric mean ratio (GMR) and its associated 90% confidence interval (90% CI) for AUC0–24, Cmax and C24 h were 0.28 (0.24, 0.32), 0.26 (0.21, 0.32) and 0.52 (0.45, 0.61), respectively. When calcium carbonate antacid and magnesium/aluminium hydroxide were given 12 h after raltegravir 1200 mg QD dosing, the GMR (90% CI) values for AUC0–24 and Cmax were 0.90 (0.80, 1.03), 0.98 (0.81, 1.17), and 0.86 (0.73, 1.03), 0.86 (0.65, 1.15), respectively. However, significant reduction in the trough concentrations of raltegravir was observed: C24 h 0.43 (0.36, 0.51) in the presence of calcium carbonate antacids and 0.42 (0.34, 0.52) in presence of magnesium/aluminium hydroxide, respectively.

Conclusions
Overall, the use of metal-cation antacids with 1200 mg QD raltegravir is not recommended.
Deferasirox pharmacokinetic and toxicity correlation in β-thalassaemia major treatment
Authors: Allegra Sarah , De Francia Silvia , Cusato Jessica , Pirro Elisa , Massano Davide , Piga Antonio , D'Avolio Antonio 
Published: September 2016

Abstract

Objectives
Deferasirox adverse effects include the following: gastrointestinal disturbance, mild elevations in serum creatinine levels and intermittent proteinuria; these events are dose-dependent and reversible with drug discontinuation, but this solution can lead to an inadequate iron chelation. For these reasons, interindividual variability of drug plasma concentration could help the clinical management of deferasirox dosage. We sought to describe deferasirox plasma exposure in a cohort of 60 adult patients.

Methods
A fully validated chromatographic method was used to quantify deferasirox concentration in plasma collected from β-thalassaemia adult patients. Samples obtained before and after 2, 4, 6 and 24 h drug administration were evaluated. Associations between variables were tested using the Pearson test.

Key findings
Concerning pharmacokinetic parameters, a higher interindividual variability was shown. A positive correlation was found between deferasirox area under the concentration curve over 24 h and serum creatinine (r = 0.314; P = 0.018) and between area and drug dose (r = 0.311; P = 0.016). Moreover, a negative correlation resulted among area under the concentration curve over 24 h and serum ferritin (r = −0.291; P = 0.026) and among drug half-life and its dose (r = −0.319; P = 0.013).

Conclusions
Treatment decision based on the individual characteristics could strongly contribute to minimize toxicity and increase efficacy of deferasirox therapy.