bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topography of itch: evidence of distinct coding for pruriception in the trigeminal nerve
Authors: Andersen Hjalte H. , Elberling Jesper , Lo Vecchio Silvia , Arendt-Nielsen Lars 
Published: December 2016

Introduction:Little is known about the topographical distribution of pruriception (in particular for nonhistaminergic itch), although conditions with chronic itch frequently occur in distinct anatomic and often bilateral patterns. This study aimed to investigate regional differences in the sensitivity to itch stimuli by assessing the intensity of itch, pain, and cutaneous neurogenic flare evoked by histamine and cowhage in different anatomic regions in 20 healthy volunteers.Methods:Itch was induced by 1% histamine applied with a prick lancet or by insertion of 25±5 cowhage spicules in 4 regions: volar/dorsal forearm, lower back, and chin. The duration and intensity of itch and pain following each pruritic stimulus were measured by a continuous visual analogue scale (VAS0-100). Sensitivity to touch-evoked itch was assessed by von Frey filaments and cutaneous flare was quantified by full-field laser perfusion imaging.Results:Peak itch intensity was lower at the chin (19.4±3.6) compared with other areas (mean of 3 locations; 41.3±4.4), independently of whether histamine or cowhage was applied (P<0.01). Baseline sensitivity to touch-evoked itch was higher on the chin (P<0.01), but here hyperknesis did not develop in contrast to other areas (P<0.05). Cutaneous flare was more intense but had a smaller dispersion at the chin, compared with other areas (P<0.01).Discussion:In conclusion, sensitivity to histaminergic and non-histaminergic itch diverges considerably between body regions. Lower density of pruriceptive CMH and CMI-neurons or distinct neuronal substrates for itch in the mandibular part of the trigeminal area may explain the observed reduced itch and vasomotor responses.
The Effectiveness of Health Education on Maternal Anxiety, Circumcision Knowledge, and Nursing Hours: A Quasi-Experimental Study
Authors: Chang Shu-Fang , Hung Chich-Hsiu , Hsu Yu-Yun , Liu Yi , Wang Tsu-Nai 
Published: December 2016

ABSTRACT

Background:
Many studies have shown that providing health education before surgery may significantly increase health knowledge and decrease anxiety in both patients and their family members. However, few studies have compared the effects on pediatric outpatient surgery outcomes of different health education instruction modes.

Purpose:
This study compares the effects of two health education delivery modes on maternal knowledge and anxiety, the number of unexpected early hospital follow-up visits, and the time spent by nurses on health education.

Method:
A quasi-experimental design with pretest and posttest was used to compare the effect on the outcomes of pediatric circumcision of a multimedia compact disc (CD) and a printed material.
Seventy mothers of children who underwent Plastibell circumcision participated in this study.

Results:
Both the printed material and the multimedia CD significantly increased the knowledge and reduced the anxiety levels of the participants. However, no significant differences in unscheduled early hospital follow-up visits postsurgery were found between the two modes of instruction. Furthermore, we found that significantly fewer hours were spent by nurses on health education for the multimedia CD group in comparison with the printed material group.

Conclusions/Implications for Practice:
In the current clinical environment of common staffing shortages, information tools may be used to cost-effectively assist and simplify nursing work. The findings of this study may provide a reference to medical centers that are working to reduce the time spent by nurses on health education for outpatient surgery patients. Furthermore, audiovisual health education tools are recommended to increase nursing effectiveness and save nursing time.
Care, Autonomy, and Gender in Nursing Practice: A Historical Study of Nurses’ Experiences
Authors: Galbany-Estragués Paola , Comas-d’Argemir Dolors 
Published: December 2016

ABSTRACT

Background:
Care is the essence of the nursing role and is closely related to the concept of professional autonomy. Autonomy is implicated in power relations between doctors and nurses and between men and women. These relationships are closely linked to care practices and the inequality of nursing and medicine.

Purpose:
The aim of this study was to analyze nursing discourse regarding the concept of care and its relationship to the concept of autonomy and gender.

Methods:
This is a historical study based on oral interviews that took place between November 2008 and February 2011. We interviewed 19 nursing professionals who currently worked at the Hospital of the Holy Spirit (near Barcelona) or had worked there between 1961 and 2010. Semistructured interviews were recorded, transcribed, and analyzed.

Results:
We highlight four main themes: “a real nurse”; “more technology, less care”; “the fragility of autonomy”; and “the invisibility of nursing work.” These themes show the contradictions in the nursing profession that are based on the concept of care. However, in daily practice, the concept of care varies. Time pressure distances the nursing practice from its theoretical context. Changes in the concept of care are related to transformations in the health system and nursing work.

Conclusions/Implications for Practice:
Changes related to the autonomy of nursing are related to changes in the concept of care. In practice, care has a biomedical orientation. Care has become technologized and bureaucratized, which reduces the time that is spent with the patient. In a context in which medical authority predominates, nursing’s struggle for autonomy is based on the recognition of the value of care. When care becomes invisible, the autonomy of nursing as a profession is threatened. This conclusion allows reflections about shifts in the concept of care and how they affect clinical practice and the autonomy of the nursing profession.
Prognostic value of infrared thermography in an emergency department
Authors: Holm Jesper K. , Kellett John G. , Jensen Nadia H. , Hansen Søren N. , Jensen Kristian , Brabrand Mikkel 
Published: December 2016

Objective
In this study, we aimed to investigate the prognostic potential of infrared thermography in a population of medical patients admitted to the emergency department. Central-to-peripheral temperature gradients were analyzed for association with 30-day mortality.

Methods
This prospective observational study included 198 medical patients admitted to the Emergency Department, at Odense University Hospital. A standardized thermal picture was taken and temperatures of the inner canthus, the earlobe, the nose tip, and the tip of the third finger were reported. The inner canthus was chosen as a marker for central temperature and the three others as markers for peripheral temperatures, resulting in three gradients per patient. Thirty-day follow-up was performed and 30-day mortality was reported.

Results
One hundred and ninety-eight patients were included and the number of events was nine. The gradient between the inner canthus and the nose tip (ΔN) and the gradient between the inner canthus and the fingertip (ΔF) showed a significant association with 30-day mortality (ΔN: odds ratio: 1.31; 95% confidence interval: 1.05–1.64 and ΔF: odds ratio: 1.27; 95% confidence interval: 1.02–1.57).

Conclusion
ΔN and ΔF showed a significant association with 30-day mortality, suggesting a prognostic value. However, this was a small pilot study with few events. Larger studies are warranted for confirmation of these findings.
Microsurgical Reconstruction of Traumatic Lower Extremity Defects in the Pediatric Population
Authors: Momeni Arash , Lanni Michael , Levin L. Scott , Kovach Stephen J. 
Published: December 2016

Background:
Few reports focus exclusively on microsurgical reconstruction of traumatic lower extremity defects in children. Hence, the authors felt it prudent to contribute to this area of clinical research. The authors hypothesized that reconstructive success would be comparable to success rates reported in adults, and that young age or concerns regarding vessel size or behavior do not negatively impact surgical outcome.

Methods:
A retrospective review of microsurgical lower extremity reconstruction cases at two academic medical centers was performed. All pediatric patients who underwent microsurgical reconstruction of traumatic lower extremity defects between 1997 and 2012 were included for analysis.

Results:
Forty flaps transferred in 40 patients with a mean age of 11.4 years (range, 1 to 17 years) were included for analysis. Muscle flaps were predominantly used [n = 23 (57.5 percent)]; however, there was a recent increase in use of fasciocutaneous flaps [n = 16 (40 percent)]. Postoperative complications were seen in 25 percent of patients, with a total flap loss rate of 5 percent. No donor-site complications were observed. The mean postoperative length of hospital stay was 12.9 days (range, 4 to 41 days), with patients returning to full weight-bearing after a mean of 2.6 months (range, 1 to 8 months).

Conclusions:
Microsurgical reconstruction of traumatic lower extremity defects in the pediatric population is safe. Concerns related to patient age, vessel size, or vessel behavior (i.e., vasospasm) should not detract from offering free flap reconstruction, as they do not negatively impact outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Inadequate Enoxaparin Dosing Predicts 90-Day Venous Thromboembolism Risk among Plastic Surgery Inpatients: An Examination of Enoxaparin Pharmacodynamics
Authors: Pannucci Christopher J. , Rockwell W. Bradford , Ghanem Maureen , Fleming Kory I. , Momeni Arash , Agarwal Jayant 
Published: December 2016

Background:
Evidence-based plastic surgery guidelines support the effectiveness of once-daily enoxaparin prophylaxis. Despite prophylaxis, one in 25 highest risk patients has a venous thromboembolism event. The authors examined the pharmacodynamics of standard enoxaparin doses in plastic surgery patients to examine whether patient-level factors predict enoxaparin metabolism, whether inadequate enoxaparin dose predicts downstream venous thromboembolism events, and whether a pharmacist-driven dose-adjustment protocol was effective.

Methods:
The authors recruited adult plastic surgery patients who received postoperative enoxaparin at 40 mg/day. Steady-state peak anti–factor Xa levels, a marker of enoxaparin effectiveness and safety, were determined. Patients with out-of-range anti–factor Xa levels had real-time dose adjustment based on a written protocol. Patients were followed for 90-day venous thromboembolism events.

Results:
Ninety-four patients were recruited, and 44 percent had in-range peak anti–factor Xa levels in response to standard enoxaparin dosing. Patient-level factors including extent of surgical injury and gross weight were independent predictors of enoxaparin metabolism. Patients with low anti–factor Xa levels were significantly more likely to have 90-day venous thromboembolism (10.2 percent versus 0 percent; p = 0.041). Real-time dose adjustment allowed a significantly increased proportion of patients to have in-range levels (67.1 percent versus 44.3 percent; p = 0.002).

Conclusions:
Based on pharmacodynamic data, the majority of plastic surgery patients receive inadequate enoxaparin prophylaxis using fixed dosing. Patient-level factors can predict how patients will metabolize enoxaparin, and patients who receive inadequate enoxaparin prophylaxis are significantly more likely to have downstream venous thromboembolism events. Individualization of enoxaparin prophylaxis may minimize perioperative venous thromboembolism risk and further improve patient safety after plastic and reconstructive surgery procedures.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Stress-Induced Parasympathetic Control and Its Association With Inflammatory Reactivity
Authors: Woody Alex , Figueroa Wilson S. , Benencia Fabian , Zoccola Peggy M. 
Published: December 2016

ABSTRACT

Objective
It has been proposed that the inflammatory cytokine system is regulated through the vagus nerve, where vagal activation inhibits release of inflammatory cytokines and, therefore, inflammation. Thus, loss of vagal activation (i.e., reduced high-frequency heart rate variability [HF-HRV]) should result in greater inflammation. Evidence to date for this relationship has relied on animal models and resting states in humans. The present study used a psychosocial stressor to test whether stress-induced decreases in HF-HRV predict increases in circulating inflammatory markers.

Methods
Thirty healthy young women completed a speech stressor. HF-HRV was assessed before and during the stressor while circulating plasma interleukin 6, tumor necrosis factor α, and C-reactive protein were assessed before and 1 hour after the stressor.

Results
Consistent with the neural reflex for immunity, greater reductions in HF-HRV during the stressor were associated with greater increases in tumor necrosis factor α (β = −0.29 to −0.47) and interleukin 6 (β = −0.40 to −0.68) but not C-reactive protein (β = 0.10 to 0.29) 1 hour after the stressor.

Conclusions
These findings expand on the current literature by showing that changes in HF-HRV predict and precede changes in circulating inflammatory cytokines in humans and may have implications for treatment of inflammatory diseases.
Use of Biologic Therapy in Racial Minorities With Rheumatoid Arthritis From 2 US Health Care Systems
Authors: Kerr Gail S. , Swearingen Christopher , Mikuls Ted R. , Yazici Yusuf 
Published: December 2016

Background
In the United States, there is racial/ethnic disparity in the care of rheumatoid arthritis (RA), yet there are limited data regarding the impact of varied health care systems on treatment outcomes.

Objective
The aim fo this study was to compare the frequencies of use of disease-modifying antirheumatic drugs and biologic agents in racial minorities with RA in a single-payer and variable-access health systems.

Methods
Rheumatoid arthritis disease status was examined in the Ethnic Minority Rheumatoid Arthritis Consortium (EMRAC) and Veterans Affairs Rheumatoid Arthritis Registry (VARA); frequencies of prednisone and disease-modifying antirheumatic drugs and biologic agent use at enrollment were documented. Comparisons in frequencies of RA therapies between RA cohorts and white and nonwhite racial subsets were evaluated.

Results
The combined cohorts provided 2899 subjects for analysis (EMRAC = 943, VARA = 1956). Routine Assessment of Patient Index Data 3 and Disease Activity Score in 28 Joints scores were equivalent (cohort, racial subsets), as was biologic agent use (26% vs. 28%) between whites and nonwhites. Disease-modifying antirheumatic drug use was greater in EMRAC nonwhites compared with their white counterparts, but similar to all VARA patients (33% vs. 22% [P < 0.001], 36%, 39%, respectively). However, biologic agent use was significantly greater in EMRAC versus VARA patients (37% vs. 22%, P < 0.001). In VARA patients, there was no difference in biologic agent use among racial subsets (22% vs. 21%). In EMRAC patients, biologic agent use was greater in whites than in nonwhites (EMRAC white 45% vs. EMRAC nonwhite 33%, P < 0.001; odds ratio, 1.66) and compared with all VARA subjects (EMRAC white 45% vs. all VARA 22%, P < 0.001; odds ratio, 2.91). Younger age, advanced education, longstanding disease, and severe disease were associated with biologic agent use.

Conclusions
When compared with more variable-access systems, a VA system of care that includes a single-payer insurance may afford equality in use of biologic agents among different racial subsets.
Feasibility of Multiparametric Magnetic Resonance Imaging of the Prostate at 7 T
Authors: Lagemaat Miriam W. , Philips Bart W.J. , Vos Eline K. , van Uden Mark J. , Fütterer Jurgen J. , Jenniskens Sjoerd F. , Scheenen Tom W.J. , Maas Marnix C. 
Published: December 2016

Objectives
The aim of this study was to evaluate the technical feasibility of prostate multiparametric magnetic resonance imaging (mpMRI) at a magnetic field strength of 7 T.

Materials and Methods
In this prospective institutional review board–approved study, 14 patients with biopsy-proven prostate cancer (mean age, 65.2 years; median prostate-specific antigen [PSA], 6.2 ng/mL), all providing signed informed consent, underwent 7 T mpMRI with an external 8-channel body-array transmit coil and an endorectal receive coil between September 2013 and October 2014. Image and spectral quality of high-resolution T2-weighted (T2W) imaging (0.3 × 0.3 × 2 mm), diffusion-weighted imaging (DWI; 1.4 × 1.4 × 2 mm or 1.75 × 1.75 × 2 mm), and (1H) MR spectroscopic imaging (MRSI; real voxel size, 0.6 mm3 in 7:16 minutes) were rated on a 5-point scale by 2 radiologists and a spectroscopist.

Results
Prostate mpMRI including at least 2 of 3 MR techniques was obtained at 7 T in 13 patients in 65 ± 12 minutes. Overall T2W and DWI image quality at 7 T was scored as fair (38% and 17%, respectively) to good or very good (55% and 83%, respectively). The main artifacts for T2W imaging were motion and areas of low signal-to-noise ratio, the latter possibly caused by radiofrequency field inhomogeneities. For DWI, the primary artifact was ghosting of the rectal wall in the readout direction. Magnetic resonance spectroscopic imaging quality was rated fair or good in 56% of the acquisitions and was mainly limited by lipid contamination.

Conclusions
Multiparametric MRI of the prostate at 7 T is feasible at unprecedented spatial resolutions for T2W imaging and DWI and within clinically acceptable acquisition times for high-resolution MRSI, using the combination of an external 8-channel body-array transmit coil and an endorectal receive coil. The higher spatial resolutions can yield improved delineation of prostate anatomy, but the robustness of the techniques needs to be improved before clinical adoption of 7 T mpMRI.
The 100 Top-Cited Articles in Pulmonary Imaging
Authors: Hong Su Jin , Lim Kyoung Ja , Hwang Hye Jeon , Baek Sora , Seo Young Lan , Yun Eun Joo , Choi Chul Soon , Yoon Dae Young 
Published: December 2016

Purpose:
The purpose of this study was to identify and characterize the 100 top-cited articles in pulmonary imaging.

Materials and Methods:
From the database of Journal Citation Reports, 274 journals whose scope included pulmonary imaging were selected. The Web of Science search tools were then used to identify the 100 top-cited articles in the subject of pulmonary imaging published in these journals. The parameters used to analyze the characteristics of the 100 top-cited articles were journal (including subject category and impact factor), publication year, number of citations and annual citations, department and institution of authors, country of origin, article type, imaging technique, and topic.

Results:
The 100 top-cited articles in pulmonary imaging were published between 1953 and 2012, with 43 published between 2000 and 2009. Citations ranged from 199 to 1447, and annual citations ranged from 5.1 to 314. The majority of articles were published in radiology or imaging journals (n=64), originated in the United States (n=49), were original articles (n=87), used computed tomography (n=66), and were based on the topic of pulmonary thromboembolism (n=18). Department of Radiology, Mayo Clinic (n=7), and Department of Radiology, University of British Columbia and Vancouver General Hospital (n=7), were the leading institutions, and Müller NL (n=11) was the most prolific author.

Conclusions:
Our study lists the 100 top-cited articles in pulmonary imaging, provides an insight into historical developments, and allows for recognition of advances in this field.
Functional dizziness: from phobic postural vertigo and chronic subjective dizziness to persistent postural-perceptual dizziness
Authors: Dieterich Marianne , Staab Jeffrey P. 
Published: December 2016

Purpose of review
Functional dizziness is the new term for somatoform or psychogenic dizziness. The aim of this study is to review arguments for the new nomenclature, clinical features, possible pathomechanisms, and comorbidities of functional dizziness.

Recent findings
The prevalence of functional dizziness as a primary cause of vestibular symptoms amounts to 10% in neuro-otology centers. Rates of psychiatric comorbidity in patients with structural vestibular syndromes are much higher with nearly 50% and with highest rates in patients with vestibular migraine, vestibular paroxysmia, and Ménière's disease. Pathophysiologic processes seem to include precipitating events that trigger anxiety-related changes in postural strategies with an increased attention to head and body motion and a cocontraction of leg muscles. Personality traits with high levels of neuroticism and low levels of extraversion appear as risk factors for anxiety and depressive disorders and increased morbidity in functional disorders.

Summary
Correct and early diagnosis of functional dizziness, as primary cause or secondary disorder after a structural vestibular syndrome, is very important to prevent further chronification and enable adequate treatment. Treatment plans that include patient education, vestibular rehabilitation, cognitive and behavioral therapies, and medications substantially reduce morbidity and offer the potential for sustained remission when applied systematically.
Improved maize reference genome with single molecule technologies
Authors: Jiao Yinping , Peluso Paul , Shi Jinghua , Liang Tiffany , Stitzer Michelle C. , Wang Bo , Campbell Michael S. , Stein Joshua C. , Wei Xuehong , Chin Chen-Shan , Guill Katherine , Regulski Michael , Kumari Sunita , Olson Andrew , Gent Jonathan , Schneider Kevin L. , Wolfgruber Thomas K. , May Michael R. , Springer Nathan M. , Antoniou Eric , McCombie Richard , Presting Gernot G. , McMullen Michael , Ross-Ibarra Jeffrey , Kelly Dawe R. , Hastie Alex , Rank David R. , Ware Doreen 
Published: December 2016

ABSTRACTComplete and accurate reference genomes and annotations provide fundamental tools for characterization of genetic and functional variation. These resources facilitate elucidation of biological processes and support translation of research findings into improved and sustainable agricultural technologies. Many reference genomes for crop plants have been generated over the past decade, but these genomes are often fragmented and missing complex repeat regions. Here, we report the assembly and annotation of maize, a genetic and agricultural model species, using Single Molecule Real-Time (SMRT) sequencing and high-resolution optical mapping. Relative to the previous reference genome, our assembly features a 52-fold increase in contig length and significant improvements in the assembly of intergenic spaces and centromeres. Characterization of the repetitive portion of the genome revealed over 130,000 intact transposable elements (TEs), allowing us to identify TE lineage expansions unique to maize. Gene annotations were updated using 111,000 full-length transcripts obtained by SMRT sequencing. In addition, comparative optical mapping of two other inbreds revealed a prevalence of deletions in the low gene density region and maize lineage-specific genes.