bluuebunny/crossref_metadata_2025_split huggingface dataset:
Goals of Chronic Pain Management
Authors: Henry Stephen G. , Bell Robert A. , Fenton Joshua J. , Kravitz Richard L. 
Published: February 2017

Objective:
Assess patient-physician agreement on management goals for chronic musculoskeletal pain and its associations with patient and physician visit experiences.

Materials and Methods:
Pre-visit and post-visit questionnaires for 87 primary care visits that involved patients taking opioids for chronic musculoskeletal pain and primary care resident physicians. After each visit, patients and physicians independently ranked 5 pain treatment goals from most to least important.

Results:
In total, 48% of patients ranked reducing pain intensity as their top priority, whereas 22% ranked finding a diagnosis as most important. Physicians ranked improving function as the top priority for 41% of patients, and ranked reducing medication side effects as most important for 26%. The greatest difference between patient and physician rankings was for reducing pain intensity. In regression analyses, neither overall agreement on goals (ie, the physician’s first or second priority included the patient’s top priority) nor difference in patient versus physician ranking of pain intensity was significantly associated with patient-reported visit experience (β for overall agreement, −0.08; 95% confidence interval [CI], −0.45 to 0.30; P=0.69; β for intensity, −0.06; 95% CI, −0.17 to 0.04; P=0.24) or physician-reported visit difficulty (β for overall agreement, 1.92; 95% CI, −2.70 to 6.55; P=0.41; β for intensity, 0.42; 95% CI, −0.87 to 1.71; P=0.53).

Discussion:
Patients and physicians prioritize substantially different goals for chronic pain management, but there is no evidence that agreement predicts patient experience or physician-reported visit difficulty. Primary care physicians may have adapted to new recommendations that emphasize functional goals and avoidance of long-term opioid therapy, whereas patients continue to focus on reducing pain intensity.
A Fortified Donor Milk Policy is Associated With Improved In-Hospital Head Growth and Weight Gain in Very Low-Birth-Weight Infants
Authors: Ginovart Gemma , Gich Ignasi , Gutiérrez Antonio , Verd Sergio 
Published: February 2017

Background:
Previous research has reported that infants fed donor milk grow slower than those fed formula. However, most of the trials used unfortified donor milk, which limits the ability to generalize the results to current clinical practice.

Purpose:
To evaluate the impact of early human milk feeding (donor milk and/or mother's own milk) with standard fortification on in-hospital growth of very low-birth-weight infants.

Methods:
This pre-/postretrospective study included selected newborn infants less than 1500 g admitted to a level IV neonatal intensive care unit before and after the introduction of a policy providing donor milk when mother's own milk was not available in sufficient quantity to meet her infant's need. When enteral feeds reached 80 mL/kg per day, all human milk was fortified.

Results:
Seventy-two “before” (any formula-fed) and 114 “after” (human milk-fed) infants were enrolled in this study. Infant characteristics and neonatal morbidity were similar in both groups. Outcomes revealed that an initial human milk diet with standard fortification was associated with significantly higher early extrauterine weight gain and head growth in very low-birth-weight infants than a formula-fed diet.

Implications for Practice:
Very early initiation of fortified breast and/or donor milk feeding can help promote in-hospital head growth and weight gain of preterm infants. Formula may not be appropriate for early use among preterm infants.

Implications for Research:
Further large-scale clinical trials are needed to determine the best initiation and composition of enteral feeding for preterm infants.
Prenatal Breastfeeding Education
Authors: Crook Kimberley , Brandon Debra 
Published: February 2017

Background:
Neonatal abstinence syndrome (NAS) is a growing problem in the United States, affecting 32,000 infants annually. Although breastfeeding would benefit infants with NAS, rates among these mothers are low.

Purpose:
The purpose of this quality improvement project was to increase breastfeeding rates and decrease hospital length of stay (LOS) for infants with NAS through prenatal breastfeeding initiatives.

Method:
A pre-/postquality improvement design was used to assess the relationship between breastfeeding initiatives on breastfeeding rates and LOS in infants with NAS. A 3-class curriculum was offered to pregnant women at risk for delivering an infant with NAS. Chart review was completed for all infants evaluated for NAS in a hospital at baseline (n = 56), after Baby Friendly Status (BFS) (n = 75), and after BFS plus breastfeeding education (n = 69).

Results:
Although not statistically significant, the BFS plus breastfeeding education cohort had the largest percentage of exclusively breastfed infants during hospitalization (24.6%) and at discharge (31.9%). There was a statistically significant decrease in LOS (P < .001) between cohorts.

Implications for Practice:
The small sample made it not possible to infer direct impact of the intervention. However, results suggest that prenatal education may contribute to an increase in the numbers of infants with NAS who receive human milk and a decrease in hospital LOS.

Implication for Research:
Refinement of best practices around breastfeeding education and support for mothers at risk of delivering an infant with NAS is recommended so that breastfeeding may have the greatest impact for this subgroup of women and their infants.
Metastatic Cellular Blue Nevus: A Rare Case With Metastasis Beyond Regional Nodes
Authors: Bui Justin , Ardakani Nima Mesbah , Tan Irene , Crocker Andrew , Khattak Muhammad Adnan , Wood Benjamin A. 
Published: February 2017

Abstract:
In this study, we present a rare case of a 35-year-old man with a long-standing blue-black lesion on his left hand with subsequent infraclavicular and axillary lymph node tumor deposits. The hand lesion and lymph nodes were excised revealing histological, immunohistochemical, and molecular findings consistent with cellular blue nevus. Despite nonregional lymph node involvement, there has been no progression at 12-months follow-up. This is an index case of a cellular blue nevus with metastasis to both regional and nonregional lymph nodes. The lack of atypical/malignant features in this lesion makes the metastatic behavior extraordinary, and hence the prognosis of lesions of this type is indeterminate.
Label-Free Imaging of Female Genital Tract Melanocytic Lesions With Pump-Probe Microscopy: A Promising Diagnostic Tool
Authors: Robles Francisco E. , Deb Sanghamitra , Fischer Martin C. , Warren Warren S. , Selim Maria Angelica 
Published: February 2017

Objectives
Melanomas of the female genital tract present a unique clinical challenge. Not only are these lesions in an anatomically sensitive area, but also they tend to be multifocal and have high recurrence rates. Furthermore, several benign melanocytic proliferations resemble early-stage melanoma clinically and/or histopathologically. Thus, there is a significant need for additional tools that can help correctly diagnose and stage these lesions. Here, we quantitatively and nondestructively analyze the chemical composition of melanin in excised pigmented lesions of the female genital tract using pump-probe microscopy, a high-resolution optical imaging technique that is sensitive to many biochemical properties of melanin.

Materials and Methods
Thirty-one thin (~5 μm) tissue sections previously excised from female genital tract melanocytic lesions were imaged with pump-probe microscopy and analyzed.

Results
We find significant quantitative differences in melanin type and structure between melanoma and nonmalignant melanocytic proliferations. Our analysis also suggests a link between the molecular signatures of melanins and lesion-specific genetic mutations. Finally, significant differences are found between metastatic and nonmetastatic melanomas. The limitations of this work include the fact that molecular information is restricted to melanin pigment and the sample size is relatively small.

Conclusions
Pump-probe microscopy provides unique information regarding the biochemical composition of genital tract melanocytic lesions, which can be used to improve the diagnosis and staging of vulvar melanomas.
Impact of Age at Conization on Obstetrical Outcome: A Case-Control Study
Authors: Chevreau Julien , Mercuzot Antonin , Foulon Arthur , Attencourt Chirstophe , Sergent Fabrice , Lanta Ségolène , Gondry Jean 
Published: February 2017

Objective
The aim of the study was to assess whether an age younger than 25 years at conization affected future pregnancy outcome as an independent factor.

Materials and Methods
A retrospective study of 115 women who underwent both loop electrosurgical excision procedure (LEEP) and subsequent pregnancy follow-up in a referral center was conducted. Two groups were considered: patients younger than 25 years at the time of LEEP (n = 42) and 25 years or older (n = 73). Analyzed data were occurrence of preterm adverse obstetrical event and, specifically, preterm labor (PL) and preterm rupture of membranes; stratification based on term of occurrence was performed: less than 37 weeks of amenorrhea (WA), less than 34 WA, and less than 26 WA.

Results
Patients characteristics were comparable in terms of excised specimen thickness and pathological analysis, as well as for tobacco intoxication during pregnancy. Although there was no difference of term at delivery or total number of preterm adverse obstetrical events, we found a significant increase of events (19% vs 4.1%) and PL (19% vs 0%) before 26 WA in the group of patients younger than 25 years. After adjusting for excised specimen thickness, the same results were found for thickness of 15 mm or less (respectively, 16.7% vs 3.3% and 16.7% vs 0%). For thickness of greater than 15 mm, only ratio of PL before 26 WA was higher in the group of patients younger than 25 years (33.3% vs 0%).

Conclusions
Age younger than 25 years at the time of LEEP seems to be is associated with a more frequent occurrence of extremely early preterm adverse obstetrical events, particularly PL.
Triaging Atypical Squamous Cells—Cannot Exclude High-Grade Squamous Intraepithelial Lesion With p16/Ki67 Dual Stain
Authors: Šekoranja Daja , Repše Fokter Alenka 
Published: February 2017

Objectives
The management of women with Pap cytology results categorized as “atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion” (ASC-H) can often be challenging. We assessed the performance of p16/Ki67 dual-stained cytology as a potential triage tool for the detection of biopsy-confirmed high-grade squamous intraepithelial lesions (HSILs) in women with ASC-H.

Materials and Methods
Women with ASC-H were followed for a period of 36 months by repeat cytology and colposcopy. p16/Ki67 dual staining was performed retrospectively on the initial Pap cytology slide with ASC-H interpretation. Results were compared with the final histological diagnosis and/or cytological follow-up for at least 1 year. All outcomes were defined as clinically significant at the threshold of HSIL (cervical intraepithelial neoplasia grade 2 or worse).

Results
One hundred sixty-nine cases fulfilled all conditions to be included in the study group. The rate of histologically confirmed HSIL was 57.4%, low-grade squamous intraepithelial lesion was diagnosed in 17.7% of the patients and normal histology or follow-up in 24.9% of the patients. Overall sensitivity and specificity of p16/Ki67 dual stain were 95% and 72%, respectively. Overall positive likelihood ratio of p16/Ki67 in detection of HSIL was 3.41, considerably increasing pretest probability from 57% to posttest probability of 82%.

Conclusions
A substantial subset of patients with ASC-H interpretations is associated with an appreciable risk of clinically significant cervical disease. p16/Ki67 dual stain can provide additional valuable information that may lead to higher-quality management of women with ASC-H, especially when initial colposcopy or biopsy results do not show HSIL lesions.
Validation of a Self‐efficacy Scale for Adolescents and Young Adults With Inflammatory Bowel Disease
Authors: Izaguirre Marisa Rodriguez , Taft Tiffany , Keefer Laurie 
Published: February 2017

ABSTRACTSelf‐efficacy (SE) is a strong predictor of health outcomes in chronic diseases. The aim of the study was to develop a valid and reliable SE scale for adolescents and young adults with inflammatory bowel disease (IBD). Participants with IBD, 12 to 25 years’ old, were recruited via outpatient gastroenterology clinics and online to provide demographic and clinical information and to complete psychosocial questionnaires. Reliability statistics, principle components factor analysis, and Pearson correlations with psychosocial variables assessed the psychometric properties of the IBD Self‐efficacy Scale for Adolescents and Young Adults (IBDSES‐A). A total of 95 participants completed the study. Internal consistency and split‐half reliability of the IBDSES‐A fell above the acceptable standard cutoff. Principle components factor analysis yielded 3 potential subscales. Test‐retest reliability was excellent. Construct validity is supported by significant positive correlations with self‐esteem and health‐related quality of life, and negative correlations with depression and anxiety. IBDSES‐A, a 13‐item disease‐specific scale to assess SE toward disease management, demonstrates good reliability and construct validity and could be a useful tool in understanding the role of SE in pediatric IBD self‐management and outcomes.
A fluorogenic nanobody array tag for prolonged single molecule imaging in live cells
Authors: Ghosh Rajarshi P. , Draper Will E. , Franklin J. Matthew , Shi Quanming , Liphardt Jan T. 
Published: February 2017

AbstractProlonged single molecule imaging in live cells requires labels that do not aggregate, have high contrast, and are photo-stable. To address these requirements, we have generated arrays of modular protein domains that function as fluorophore recruitment platforms. ArrayG, a linear repeat of GFP-nanobodies, recruits free monomeric wild-type GFP, which brightens ~15-fold upon binding the array. The fluorogenic ArrayG tag effectively eliminates background fluorescence from free binders, a major impediment to high-throughput acquisition of long trajectories in recruitment based imaging strategies. The photo-stability of ArrayG and consistently low background made it possible to continuously track single integrins for as long as 105 seconds (2100 frames). Prolonged tracking of both kinesin and integrin revealed repeated state-switching events, a measurement capability that is crucial to a mechanistic understanding of complex cellular processes. We also report an orthogonal array tag, based on a DHFR-nanobody, for prolonged dual color imaging of single molecules.
Novel CRISPR/Cas9 gene drive constructs inDrosophilareveal insights into mechanisms of resistance allele formation and drive efficiency in genetically diverse populations
Authors: Champer Jackson , Reeves Riona , Yeon Oh Suh , Liu Chen , Liu Jingxian , Clark Andrew G. , Messer Philipp W. 
Published: February 2017

ABSTRACTA functioning gene drive system could fundamentally change our strategies for the control of vector-borne diseases by facilitating rapid dissemination of transgenes that prevent pathogen transmission or reduce vector capacity. CRISPR/Cas9 gene drive promises such a mechanism, which works by converting cells that are heterozygous for the drive construct into homozygotes, thereby enabling super-Mendelian inheritance. Though CRISPR gene drive activity has already been demonstrated, a key obstacle for current systems is their propensity to generate resistance alleles. In this study, we developed two CRISPR gene drive constructs based on thenanosandvasapromoters that allowed us to illuminate the different mechanisms by which resistance alleles are formed in the model organismDrosophila melanogaster.We observed resistance allele formation at high rates both prior to fertilization in the germline and post-fertilization in the embryo due to maternally deposited Cas9. Assessment of drive activity in genetically diverse backgrounds further revealed substantial differences in conversion efficiency and resistance rates. Our results demonstrate that the evolution of resistance will likely impose a severe limitation to the effectiveness of current CRISPR gene drive approaches, especially when applied to diverse natural populations.
Tracing the influence of land-use change on water quality and coral reefs using a Bayesian model
Authors: Brown Christopher J. , Jupiter Stacy D. , Albert Simon , Klein Carissa J. , Mangubhai Sangeeta , Mbui Maina , Mumby Peter , Olley Jon , Stewart-Koster Ben , Tulloch Vivitskaia , Wenger Amelia 
Published: February 2017

AbstractCoastal ecosystems can be degraded by poor water quality. Tracing the causes of poor water quality back to land-use change is necessary to target catchment management for coastal zone management. However, existing models for tracing the sources of pollution require extensive data-sets which are not available for many of the world’s coral reef regions that may have severe water quality issues. Here we develop a hierarchical Bayesian model that uses freely available satellite data to infer the connection between land-uses in catchments and water clarity in coastal oceans. We apply the model to estimate the influence of land-use change on water clarity in Fiji. We tested the model’s predictions against underwater surveys, finding that predictions of poor water quality are consistent with observations of high siltation and low coverage of sediment-sensitive coral genera. The model thus provides a means to link land-use change to declines in coastal water quality.
Gene editing in rat embryonic stem cells to producein vitromodels andin vivoreporters
Authors: Chen Yaoyao , Spitzer Sonia , Agathou Sylvia , Karadottir Ragnhildur Thora , Smith Austin 
Published: February 2017

SummaryRat embryonic stem (ES) cells offer the potential for sophisticated genome engineering in this valuable biomedical model species. However, germline transmission has been rare following conventional homologous recombination and clonal selection. Here we used the CRISPR/Cas9 system to target genomic mutations and insertions. We first evaluated utility for directed mutagenesis and recovered clones with biallelic deletions inLef1.Mutant cells exhibited reduced sensitivity to glycogen synthase kinase 3 inhibition during self-renewal. We then generated a non-disruptive knock-in ofDsRedat theSox10locus. Two clones produced germline chimaeras. Comparative expression of DsRed and Sox10 validated the fidelity of the reporter. To illustrate utility, oligodendrocyte lineage cells were visualised by live imaging of DsRed in neonatal brain slices and subjected to patch clamp recording. Overall these results show that CRISPR/Cas9 gene editing technology in germline competent rat ES cells is enabling forin vitrostudies and for generating genetically modified rats.
African innovations in harnessing farmer assets as collateral
Authors: Chapoto Tendayi , Aboagye Anthony Q.Q. 
Published: February 2017

Purpose
The purpose of this paper is to document and appraise two innovations by which nontraditional forms of collateral are being used to make smallholder crop and livestock farmers bankable in Ghana and Zimbabwe.

Design/methodology/approach
The setup and operations of the warehouse receipt system (WRS) in Ghana were evaluated for the extent to which the WRS was meeting crop farmers’ expectations and the WRS’s own objectives. Owners of the WRS, a certified warehouse operator in a big city, and two operators of certified community warehouses in farming communities were interviewed. Two focus group discussions with crop farmers were also held. Information about the setup and operations of the Tawanda Nyambirai Livestock Trust (TNLT) Private Limited in Zimbabwe (TNLT) and extent of serving the credit needs of livestock farmers was obtained by telephone from the managing director. Data were gathered in April 2014 and were analyzed later.

Findings
Due to low output no smallholder farmer targeted by the WRS had been issued with a tradable certified warehouse receipts to serve as collateral to potential lenders. Grain aggregators (non-farmers) have aggregated enough grains from farmers to be issued warehouse receipts. Grain farmers report substantial reduction in post-harvest losses when they lodge farm proceeds with certified community warehouses. For the TNLT, more than 140 farmers had deposited 700 cattle and had been issued with tradable certificates of deposit within one year of TNLT to obtain revolving credit from one bank. Other benefits and challenges are highlighted.

Originality/value
Both approaches have potential of helping to solve liquidity constraints of farmers.
Does access to credit improve household welfare? Evidence from Ethiopia using endogenous regime switching regression
Authors: Bocher Temesgen Fitamo , Alemu Bamlaku Alamirew , Kelbore Zerihun Getachew 
Published: February 2017

PurposeThe purpose of this paper is to investigate how credit access affects the welfare of households and sheds light on how household characteristics influence the decision to take credit and the efficiency in credit use.Design/methodology/approachThis study uses data from the fourth round of the Ethiopian Rural Household Survey conducted in 2009, and examines factors that determine the decision to take credit and the effect of such decision on household welfare. The household welfare variable is measured by the food security indicator and total food expenditure. The study employs endogenous Regime Switching model to account for endogeneity in access to credit and self-selection bias in the decision to participate in credit.FindingsThe result from the kernel distribution shows households with access to credit have more consumption expenditure than those without access to credit. The ordinary least square regression shows that access to credit increases total consumption by 12 percent without considering self-selection bias. Participation in non-farm activity increases the demand for credit by 17 percent. Land holding, household size, and participation in saving associations increase the probability of getting credit by 5, 11, and 20 percent, respectively. Access to credit appears to have a positive impact on food security in both actual and counterfactual cases for the current credit receivers.Originality/valueThis study provides a thorough analysis of the impacts of access to credit on household welfare in Ethiopia. The study contributes to the debate on the link between access to credit and household welfare and provides valuable input for policy makers.