bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embedding Nursing Interventions into the World Health Organization’s International Classification of Health Interventions (ICHI)
Authors: Fortune Nicola , Hardiker Nicholas R , Strudwick Gillian 
Published: November 2016

AbstractObjective: The International Classification of Health Interventions, currently being developed, seeks to span all sectors of the health system. Our objective was to test the draft classification’s coverage of interventions commonly delivered by nurses, and propose changes to improve the utility and reliability of the classification for aggregating and analyzing data on nursing interventions.Materials and methods: A 2-phase content mapping method was used: (1) three coders independently applied the classification to a dataset comprising 100 high-frequency nursing interventions; (2) the coders reached consensus for each intervention and identified reasons for initial discrepancies.Results: A consensus code was found for 80 of the 100 source terms; for 34% of these, the code was semantically equivalent to the source term, and for 64% it was broader. Issues that contributed to discrepancies in Phase 1 coding results included concepts in source terms not captured by the classification, ambiguities in source terms, and uncertainty of semantic matching between “action” concepts in source terms and classification codes.Discussion: While the classification generally provides good coverage of nursing interventions, there remain a number of content gaps and granularity issues. Further development of definitions and coding guidance is needed to ensure consistency of application.Conclusion: This study has produced a set of proposals concerning changes needed to improve the classification. The novel method described here will inform future health terminology and classification content coverage studies.
Occupational Differences in BMI, BMI Trajectories, and Implications for Employment Status among Older U.S. Workers
Authors: Burgard Sarah A , Sonnega Amanda 
Published: November 2016

Abstract
We examined associations between employment and obesity, arguing that risk for unhealthy weight may vary across occupational groups because they shape workplace exposures, social class standing, material resources, and norms and expectations about healthy behaviors and weight. We used a large sample of 51–61-year-old workers from the Health and Retirement study, tracking their body mass index (BMI) over time while accounting for potentially confounding influences of socioeconomic status and gender and exploring whether gender modified associations between occupational group, BMI, and retirement timing. Compared with women in professional occupations, women managers were less likely to be obese at baseline and were less likely to be in the obese upward trajectory class, while female professionals and operators and laborers were less likely than women in farm and precision production to be in the normal stable trajectory. Male professionals were less likely than men in sales, service, and operator and laborer positions to be obese at baseline and more often followed the normal upward trajectory than most other groups, though they and farm and precision production men were more likely to be in the overweight to obese trajectory than men in service occupations. Adjustment for sociodemographic and lifestyle characteristics reduced associations more for men than for women. While retirement risk differed across occupational groups, most of these differences were explained by socioeconomic, demographic, and lifestyle characteristics, especially for men. Obesity at baseline was an independent predictor of retirement but did not further explain differences in the timing of retirement by occupational group.
Smoking Status and Opioid-related Problems and Concerns Among Men and Women on Chronic Opioid Therapy
Authors: Young-Wolff Kelly C. , Klebaner Daniella , Weisner Constance , Von Korff Michael , Campbell Cynthia I. 
Published: November 2016

Objectives:
Smokers on chronic opioid therapy (COT) for noncancer pain use prescription opioids at higher dosages and are at increased risk for opioid misuse and dependence relative to nonsmokers. The current study aims to assess whether smoking is associated with problems and concerns with COT from the perspective of the patient.

Materials and Methods:
In a large sample (N=972) of adult patients prescribed opioids for chronic noncancer pain, we examined sex-specific associations between smoking status and patient perceptions of problems and concerns with COT using regression analyses, adjusting for covariates.

Results:
The sample self-identified as 27% current smokers, 44% former smokers, and 29% never smokers. Current smoking (vs. never smoking) was associated with increased odds of an opioid use disorder among males and females, and higher daily opioid dose among males only. Current and former smokers reported significantly fewer problems with opioids relative to never smokers, and this was driven primarily by lower endorsement of problems that are affected by the stimulant properties of nicotine (eg, difficulties thinking clearly, felt less alert or sleepy).

Discussion:
This study contributes to an understanding of perceived problems and concerns with COT among current, former, and never smokers with chronic noncancer pain. Results suggest that current and former smokers may be a difficult population to target to decrease COT, given that they perceive fewer problems with prescription opioid use, despite higher odds of having an opioid use disorder (males and females) and greater opioid doses (males only).
A Case of Trichogerminoma With Pilomatrical Differentiation and a Unique Immunohistochemical Profile
Authors: Epperson Jonathan , Libow Lester 
Published: November 2016

Abstract:
Trichogerminomas are rare adnexal neoplasms first described by Sau et al in 1992. Including the initial report, 20 cases have been reported, all with similar histological features, namely tumor nodules composed of basaloid cells that form densely packed, round nests or “cell balls” and which demonstrate variable degrees of pilosebaceous differentiation. In this study, the authors report a case of a trichogerminoma with pilomatrical differentiation and a unique immunohistochemical profile. The patient is a 71-year-old man with a well-delineated nodule on the top of the scalp. Histologically, the lesion measured 16 mm in greatest dimension and was composed of nodules of basaloid cells with central, compact, slightly eosinophilic cells nests. Immunohistochemically, the tumor nodules diffusely expressed cytokeratins 34βE12, AE1/3, and CK5/6. Diffuse expression of β-catenin and nuclear expression of p63 were also evident. The peripheral basaloid cells, but not the cell balls, expressed CD10, Ber-EP4, BCL-2, and CK7, the latter a previously unreported finding. The histological findings and immunohistochemical profile are compatible with a diagnosis of a trichogerminoma.
Effect of Previous Irradiation on Vascular Thrombosis of Microsurgical Anastomosis: A Preclinical Study in Rats
Authors: Barrera-Ochoa Sergi , Gallardo-Calero Irene , López-Fernández Alba , Romagosa Cleofe , Vergés Ramona , Aguirre-Canyadell Marius , Soldado Francisco , Velez Roberto 
Published: November 2016

Background:
The objective of the present investigation was to compare the effect of neoadjuvant irradiation on the microvascular anastomosis in cervical bundle using an experimental model in rats.

Methods:
One hundred forty male Sprague–Dawley rats were allocated into 4 groups: group I, control, arterial microanastomosis; group II, control, venous microanastomosis; group III, arterial microanastomosis with previous irradiation (20 Gy); and group IV, venous microanastomosis with previous irradiation (20 Gy). Clinical parameters, technical values of anastomosis, patency, and histopathological parameters were evaluated.

Results:
Irradiated groups (III and IV) and vein anastomosis groups (II and IV) showed significantly increased technical difficulties. Group IV showed significantly reduced patency rates (7/35) when compared with the control group (0/35). Radiotherapy significantly decreased the patency rates of the vein (7/35) when compared with the artery (1/35). Groups III and IV showed significantly reduced number of endothelial cells and also showed the presence of intimal thickening and adventitial fibrosis as compared with the control group.

Conclusion:
Neoadjuvant radiotherapy reduces the viability of the venous anastomosis in a preclinical rat model with a significant increase in the incidence of vein thrombosis.
Free Medial Plantar Flap Connection with a Posterior Tibial Artery Flap in Reconstruction of Fore–Mid Foot Skin Defect
Authors: Wu Hao , Sheng Jia-Gen , Zhang Chang-Qing 
Published: November 2016

Background:
Although there are many surgical treatments for covering the skin defect of the fore–mid foot, how to reconstruct the weight-bearing region remains a challenge. The weight-bearing region of the sole needs to withstand the pressure and shearing stresses of walking, so the plantar skin is anatomically different from other skins in the areas of texture, thickness, subcutaneous tissue, etc. Medial plantar flaps that are harvested from the instep region are regarded as the first choice for weight-bearing region reconstruction because of their excellent functional and aesthetic long-term result. However, when facing an extensive skin defect on a weight-bearing area such as a fore–mid foot avulsion, the application of this flap is limited because if we put the flap in a weight-bearing area of the forefoot, the set of vessels will be exposed to outside.

Methods:
We suggest 2 connected free flaps (posterior tibial artery flap and medial plantar flap) pedicled with 1 set of vessels. The medial plantar flap was used to cover the skin defect of the weight-bearing area in the forefoot. The dorsal skin defect of the injured foot was covered with a posterior tibial artery flap and supplied the medial plantar flap with the posterior tibial vessel. The midfoot skin defect was repaired by a full-skin grafting.

Results:
Long-term follow-up results showed that the shape and function of the injured limbs recovered almost entirely.

Conclusion:
This method of connected flaps is suitable for repairing large skin defects of the fore–mid foot.
Long-lasting antinociceptive effects of green light in acute and chronic pain in rats
Authors: Ibrahim Mohab M. , Patwardhan Amol , Gilbraith Kerry B. , Moutal Aubin , Yang Xiaofang , Chew Lindsey A. , Largent-Milnes Tally , Malan T. Philip , Vanderah Todd W. , Porreca Frank , Khanna Rajesh 
Published: November 2016

AbstractTreatments for chronic pain are inadequate, and new options are needed. Nonpharmaceutical approaches are especially attractive with many potential advantages including safety. Light therapy has been suggested to be beneficial in certain medical conditions such as depression, but this approach remains to be explored for modulation of pain. We investigated the effects of light-emitting diodes (LEDs), in the visible spectrum, on acute sensory thresholds in naive rats as well as in experimental neuropathic pain. Rats receiving green LED light (wavelength 525 nm, 8 h/d) showed significantly increased paw withdrawal latency to a noxious thermal stimulus; this antinociceptive effect persisted for 4 days after termination of last exposure without development of tolerance. No apparent side effects were noted and motor performance was not impaired. Despite LED exposure, opaque contact lenses prevented antinociception. Rats fitted with green contact lenses exposed to room light exhibited antinociception arguing for a role of the visual system. Antinociception was not due to stress/anxiety but likely due to increased enkephalins expression in the spinal cord. Naloxone reversed the antinociception, suggesting involvement of central opioid circuits. Rostral ventromedial medulla inactivation prevented expression of light-induced antinociception suggesting engagement of descending inhibition. Green LED exposure also reversed thermal and mechanical hyperalgesia in rats with spinal nerve ligation. Pharmacological and proteomic profiling of dorsal root ganglion neurons from green LED-exposed rats identified changes in calcium channel activity, including a decrease in the N-type (CaV2.2) channel, a primary analgesic target. Thus, green LED therapy may represent a novel, nonpharmacological approach for managing pain.
Veterans' Voice Through the Lens of Their Medical Records
Authors: Stevenson Carl W. , Payne Kattie 
Published: November 2016

Purpose of Study:
The medical record is a sea of information that can reveal what patients are trying to tell us about their health condition. It can reveal hints and trends as to why veterans with congestive heart failure (CHF) are being readmitted within 30 days after hospital discharge. These hints and trends lead caregivers to key contributing variables to veterans' readmission. Furthermore, these variables can be used to predict patient outcomes such as readmission and even prognosis. This article looks at readmissions for CHF from documentation within the medical record to see what was driving the 30-day readmissions. Second, it examines whether the driving forces can be used to predict a veteran's increased risk for readmission or other poor prognosis.

Primary Practice Setting(s):
The study was conducted at a rural 84-bed Veterans Health Administration hospital in the Western United States.

Methodology and Sample:
A retrospective screen was performed on 1,279 veterans' admissions of which 217 were identified as having CHF as a primary or secondary diagnosis on admission. The descriptive statistics, odds ratio (OR) and multivariate logistic regression were used to examine the data. The multivariate logistic regression equation was p = 1/1 + e−x
, which can be found in the biostatistics textbook by G. Van Belle, L. Fisher, P. Heagerty, & T. Lumley (2004)
.
B. Tabaei and H. William (2002) developed and validated the equation and used it to screen for undiagnosed diabetic patients. The equation was refined by S. Rose, A. Palmer, and A. Valentine (2003). The variables selected for this study were based on a literature review of 30 articles.

Results:
The probability and OR for 30-day readmissions for all ages increased as the age increased. The ORs for 30-day readmissions for the variables selected were as follows: brain natriuretic peptide 6.21 (95% CI [0.36, 108.24]), ejection fraction 1.298 (95% CI [0.68, 2.49]), hypertension 1.795 (95% CI [0.83, 3.85]), comorbid conditions 1.02 (95% CI [0.04, 25.02]), Stage III and below were protective, Stage IV 2.057 (95% CI [0.63, 9.32]), lack of discharge education 0.446 (95% CI [0.19, 6.45]). The impact of these variables on veterans with more than 3 readmissions (N = 66) was examined. In 32% of these admissions, there was insufficient data to compare the values of the variables between readmissions. In almost 26% (N = 17) of the cases as the number of variables increased, the time between admissions decreased. In 23% of the cases (N = 15), the values did not change; of these, 14 died and the one who survived had assistance with his care in the form of home health and telehealth.

Implications for Case Management Practice:
Use of this evidence-based tool will help case managers to strategically plan care and prioritize interventions to impact the major variables and risk factors that are impacting veterans' health.
Whole-Exome Sequencing to Identify Novel Biological Pathways Associated With Infertility After Pelvic Inflammatory Disease
Authors: Taylor Brandie D. , Zheng Xiaojing , Darville Toni , Zhong Wujuan , Konganti Kranti , Abiodun-Ojo Olayinka , Ness Roberta B. , O’Connell Catherine M. , Haggerty Catherine L. 
Published: November 2016

Background
Ideal management of sexually transmitted infections (STI) may require risk markers for pathology or vaccine development. Previously, we identified common genetic variants associated with chlamydial pelvic inflammatory disease (PID) and reduced fecundity. As this explains only a proportion of the long-term morbidity risk, we used whole-exome sequencing to identify biological pathways that may be associated with STI-related infertility.

Methods
We obtained stored DNA from 43 non-Hispanic black women with PID from the PID Evaluation and Clinical Health Study. Infertility was assessed at a mean of 84 months. Principal component analysis revealed no population stratification. Potential covariates did not significantly differ between groups. Sequencing kernel association test was used to examine associations between aggregates of variants on a single gene and infertility. The results from the sequencing kernel association test were used to choose “focus genes” (P < 0.01; n = 150) for subsequent Ingenuity Pathway Analysis to identify “gene sets” that are enriched in biologically relevant pathways.

Results
Pathway analysis revealed that focus genes were enriched in canonical pathways including, IL-1 signaling, P2Y purinergic receptor signaling, and bone morphogenic protein signaling.

Conclusions
Focus genes were enriched in pathways that impact innate and adaptive immunity, protein kinase A activity, cellular growth, and DNA repair. These may alter host resistance or immunopathology after infection. Targeted sequencing of biological pathways identified in this study may provide insight into STI-related infertility.
Are Centers for Disease Control and Prevention Guidelines for Preexposure Prophylaxis Specific Enough? Formulation of a Personalized HIV Risk Score for Pre-Exposure Prophylaxis Initiation
Authors: Beymer Matthew R. , Weiss Robert E. , Sugar Catherine A. , Bourque Linda B. , Gee Gilbert C. , Morisky Donald E. , Shu Suzanne B. , Javanbakht Marjan , Bolan Robert K. 
Published: November 2016

Background
Preexposure prophylaxis (PrEP) has emerged as a human immunodeficiency virus (HIV) prevention tool for populations at highest risk for HIV infection. Current US Centers for Disease Control and Prevention (CDC) guidelines for identifying PrEP candidates may not be specific enough to identify gay, bisexual, and other men who have sex with men (MSM) at the highest risk for HIV infection. We created an HIV risk score for HIV-negative MSM based on Syndemics Theory to develop a more targeted criterion for assessing PrEP candidacy.

Methods
Behavioral risk assessment and HIV testing data were analyzed for HIV-negative MSM attending the Los Angeles LGBT Center between January 2009 and June 2014 (n = 9481). Syndemics Theory informed the selection of variables for a multivariable Cox proportional hazards model. Estimated coefficients were summed to create an HIV risk score, and model fit was compared between our model and CDC guidelines using the Akaike Information Criterion and Bayesian Information Criterion.

Results
Approximately 51% of MSM were above a cutpoint that we chose as an illustrative risk score to qualify for PrEP, identifying 75% of all seroconverting MSM. Our model demonstrated a better overall fit when compared with the CDC guidelines (Akaike Information Criterion Difference = 68) in addition to identifying a greater proportion of HIV infections.

Conclusions
Current CDC PrEP guidelines should be expanded to incorporate substance use, partner-level, and other Syndemic variables that have been shown to contribute to HIV acquisition. Deployment of such personalized algorithms may better hone PrEP criteria and allow providers and their patients to make a more informed decision prior to PrEP use.
Rate of Decline in Nontreponemal Antibody Titers and Seroreversion After Treatment of Early Syphilis
Authors: Seña Arlene C. , Wolff Mark , Behets Frieda , Martin David H. , Leone Peter , Langley Carol , McNeil Linda , Hook Edward W. 
Published: November 2016

Background
Syphilis management is complex and demonstration of treatment response requires monitoring of nontreponemal antibody titers for a ≥ 4-fold decline and/or seroreversion to nonreactive titers.

Methods
We evaluated data from a multicenter clinical trial of syphilis treatment conducted from 2000 to 2009 involving human immunodeficiency virus (HIV)–negative patients 18 years or older with early syphilis. To assess the rate of titer decline and seroreversion after effective therapy, rapid plasma reagin (RPR) titers were analyzed at 1, 3, 6, 9, and 12 months among patients with an appropriate treatment response. We plotted the rate of RPR titer decline after treatment, estimated the frequency of seroreversion, and conducted multivariate analyses to assess characteristics associated with seroreversion.

Results
Among 369 (79.4%) of 465 HIV-negative patients with early syphilis who had an appropriate treatment response, 333 participants had complete RPR data over 12 months. Although the decline in RPR titers was ≥ 4-fold among 88.0% (293/333) of participants at 3 months and ≥ 8-fold among 77.8% at 6 months, only 9.6% achieved complete RPR seroreversion at 6 months and 17.1% at 12 months after therapy. Male sex (adjusted odds ratio, 4.3; 95% confidence interval, 1.8–10.5) and baseline RPR titers ≤ 1:32 (adjusted odds ratio, 14.5; 95% confidence interval, 6.8–31.2) were associated with higher odds of seroreversion compared with females and titers > 1:32, respectively.

Conclusions
Despite a ≥ 4-fold RPR titer decline after treatment, the majority of HIV-negative patients with early syphilis failed to have seroreversion at 12 months. Nontreponemal antibody titers often persist despite an appropriate treatment response.
Decline in Herpes Simplex Virus Type 2 Among Non-Injecting Heroin and Cocaine Users in New York City, 2005 to 2014: Prospects for Avoiding a Resurgence of Human Immunodeficiency Virus
Authors: Des Jarlais Don C. , Arasteh Kamyar , Feelemyer Jonathan , McKnight Courtney , Tross Susan , Perlman David C. , Campbell Aimee N.C. , Hagan Holly , Cooper Hannah L.F. 
Published: November 2016

Background
Herpes simplex virus type 2 (HSV-2) infection increases both susceptibility to and transmissibility of human immunodeficiency virus (HIV), and HSV-2 and HIV are often strongly associated in HIV epidemics. We assessed trends in HSV-2 prevalence among non-injecting drug users (NIDUs) when HIV prevalence declined from 16% to 8% among NIDUs in New York City.

Methods
Subjects were current non-injecting users of heroin and/or cocaine and who had never injected illicit drugs. Three thousand one hundred fifty-seven NIDU subjects were recruited between 2005 and 2014 among persons entering Mount Sinai Beth Israel substance use treatment programs. Structured interviews, HIV, and HSV-2 testing were administered. Change over time was assessed by comparing 2005 to 2010 with 2011 to 2014 periods. Herpes simplex virus type 2 incidence was estimated among persons who participated in multiple years.

Results
Herpes simplex virus type 2 prevalence was strongly associated with HIV prevalence (odds ratio, 3.9; 95% confidence interval, 2.9–5.1) from 2005 to 2014. Herpes simplex virus type 2 prevalence declined from 60% to 56% (P = 0.01). The percentage of NIDUs with neither HSV-2 nor HIV infection increased from 37% to 43%, (P < 0.001); the percentage with HSV-2/HIV coinfection declined from 13% to 6% (P < 0.001). Estimated HSV-2 incidence was 1 to 2/100 person-years at risk.

Conclusions
There were parallel declines in HIV and HSV-2 among NIDUs in New York City from 2005 to 2014. The increase in the percentage of NIDUs with neither HSV-2 nor HIV infection, the decrease in the percentage with HSV-2/HIV coinfection, and the low to moderate HSV-2 incidence suggest some population-level protection against resurgence of HIV. Prevention efforts should be strengthened to end the combined HIV/HSV-2 epidemic among NIDUs in New York City.