bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ Recall of Diagnostic and Treatment Information Improves with Use of the Pain Explanation and Treatment Diagram in an Outpatient Chronic Pain Clinic
Authors: Finestone Hillel M , Yanni Matthew M , Dalzell Catherine J 
Published: March 2016

Educating patients about their condition and treatment plan is an essential component of successful treatment. Patients need to understand their condition, recall treatment suggestions and comply with the treatment protocol. Unfortunately, the method of patient education most commonly used by physicians is verbal teaching and discussion, which leads to poor patient recall. The authors of this article developed the Pain Explanation and Treatment Diagram, a worksheet that the clinician completes with the patient during their first consultation to function as a record of their diagnosis, pain risk factors and an action plan for when pain occurs. In this study, patient recall, among other variables, was assessed as a function of time since first appointment.BACKGROUND: To maximize the benefit of therapies, patients must understand their condition, recall treatment suggestions and comply with treatments. The Pain Explanation and Treatment Diagram (PETD) is a one‐page worksheet that identifies risk factors (health‐related habits, sleep, exercise, ergonomics and psychosocial factors) involved in chronic pain. Clinician and patient complete the PETD together, and the clinician notes recommended treatments and lifestyle changes.OBJECTIVES: To examine the effect of use of the PETD on patient recall of diagnostic and treatment information on the sheet.METHODS: The present study was a cross‐sectional analysis. Patients with chronic musculoskeletal pain seen by one physiatrist at an outpatient pain clinic in a university‐affiliated hospital between 2009 and 2012 (all of whom received the PETD) were eligible. A structured telephone interview lasting approximately 1 h was used to determine recall of PETD diagnostic and treatment information.RESULTS: Of the 84 eligible patients, 46 were contacted and 29 completed the telephone interview. Participants recalled an average of 12.2% (95% CI 7.8% to 17.4%) of items without prompting and 48.5% (95% CI 42.0% to 53.5%) when prompted. Participants who referred to the PETD at home (n=13) recalled significantly more items than those who did not (n=15) (17.6% [95% CI 11.1% to 23.9%] versus 5.2% [95% CI 3.0% to 14.5%], P=0.004); when prompted, the rates increased to 54.3% (95% CI 48.3% to 61.2%) and 41.2% (95% CI 34.7% to 50.7%), respectively (P=0.032).CONCLUSIONS: The PETD is a promising, feasible and inexpensive tool that can improve patients’ recall of diagnostic‐ and treatment‐related information.
Spinal Antinociceptive Action of Amiloride and Its Interaction with Tizanidine in the Rat Formalin Test
Authors: Ouyang Handong , Wang Peizong , Huang Wan , Li Qiang , Nie Bilin , Zeng Weian 
Published: March 2016

BACKGROUND: Amiloride has been reported to produce a wide variety of actions, thereby affecting several ionic channels and a multitude of receptors and enzymes. Intrathecal α2‐adrenergic receptor agonists produce pronounced analgesia, and amiloride modulates α2‐adrenergic receptor agonist binding and function, acting via the allosteric site on the α2A‐adrenergic receptor.OBJECTIVES: To investigate the antinociceptive interaction of intrathecal amiloride and the α2‐adrenoceptor agonist tizanidine using a rat formalin test.METHODS: Sprague‐Dawley rats were chronically implanted with lumbar intrathecal catheters and were tested for paw flinching using formalin injection. Biphasic painful behaviour was recorded. Amiloride, tizanidine or an amiloride‐tizanidine mixture was administered 10 min before formalin injection. To characterize any interactions, isobolographic analysis was performed. The effects of a pretreatment using intrathecally administered yohimbine was also tested.RESULTS: Intrathecally administered amiloride (12.5 μg to 100 μg) and tizanidine (0.5 μg to 5 μg), given separately, produced a significant dose‐related suppression of the biphasic responses in the formalin test. Isobolographic analysis revealed that the combination of intrathecal amiloride and tizanidine synergistically reduced phase I and II activities. Intrathecally administered yohimbine antagonized or attenuated the antinociceptive effect of amiloride, tizanidine and the amiloride‐tizanidine mixture. Intrathecally administered amiloride synergistically interacts with tizanidine to reduce the nociceptive response in the formalin test, most likely by activating α2‐adrenoceptors in the spinal cord.CONCLUSIONS: Although intrathecal tizanidine produced pronounced analgesia, antinociceptive doses of intrathecal tizanidine also produced several side effects, including bradycardia and sedation. Amiloride produced antinociceptive action against the thermal nociceptive test without side effects in rats.
Fidaxomicin: A Novel Agent for the Treatment of Clostridium difficile Infection
Authors: Zhanel George G , Walkty Andrew J , Karlowsky James A 
Published: March 2016

BACKGROUND: Due to the limitations of existing treatment options for Clostridium difficile infection (CDI), new therapies are needed.OBJECTIVE: To review the available data on fidaxomicin regarding chemistry, mechanisms of action and resistance, in vitro activity, pharmacokinetic and pharmacodynamic properties, efficacy and safety in clinical trials, and place in therapy.METHODS: A search of PubMed using the terms “fidaxomicin”, “OPT‐80”, “PAR‐101”, “OP‐1118”, “difimicin”, “tiacumicin” and “lipiarmycin” was performed. All English‐language articles from January 1983 to November 2014 were reviewed, as well as bibliographies of all articles.RESULTS: Fidaxomicin is the first macrocyclic lactone antibiotic with activity versus C difficile. It inhibits RNA polymerase, therefore, preventing transcription. Fidaxomicin (and its active metabolite OP‐1118) is bactericidal against C difficile and exhibits a prolonged postantibiotic effect (approximately 10 h). Other than for C difficile, fidaxomicin demonstrated only moderate inhibitory activity against Gram‐positive bacteria and was a poor inhibitor of normal colonic flora, including anaerobes and enteric Gram‐negative bacilli. After oral administration (200 mg two times per day for 10 days), fidaxomicin achieved low serum concentration levels but high fecal concentration levels (mean approximately 1400 μg/g stool). Phase 3 clinical trials involving adults with CDI demonstrated that 200 mg fidaxomicin twice daily for 10 days was noninferior to 125 mg oral vancomycin four times daily for 10 days in regard to clinical response at the end of therapy. Fidaxomicin was, however, reported to be superior to oral vancomycin in reducing recurrent CDI and achieving a sustained clinical response (assessed at day 28) for patients infected with non‐BI/NAP1/027 strains.CONCLUSION: Fidaxomicin was noninferior to oral vancomycin with regard to clinical response at the end of CDI therapy. Fidaxomicin has been demonstated to be as safe as oral vancomycin, but superior to vancomycin in achieving a sustained clinical response for CDI in patients infected with non‐BI/NAP1/027 strains. Caution should be exercised in using fidaxomicin monotherapy for treatment of severe complicated CDI because limited data are available. Whether fidaxomicin is cost effective (due to its significantly higher acquisition cost versus oral vancomycin) depends on the acceptable willingness to pay threshold per quality‐adjusted life year as a measure of assessing cost effectiveness.
Postoperative Resource Utilization and Survival among Liver Transplant Recipients with Model for End-Stage Liver Disease Score ≥40: A Retrospective Cohort Study
Authors: Cardoso Filipe S , Karvellas Constantine J , Kneteman Norman M , Meeberg Glenda , Fidalgo Pedro , Bagshaw Sean M 
Published: March 2016

BACKGROUND: Cirrhotic patients with Model for End-stage Liver Disease (MELD) score ≥40 have high risk for death without liver transplant (LT).OBJECTIVE: To evaluate these patients’ outcomes after LT.METHODS: The present study analyzed a retrospective cohort of 519 cirrhotic adult patients who underwent LT at a single Canadian centre between 2002 and 2012. Primary exposure was severity of liver disease measured by MELD score at LT (≥40 versus <40). Primary outcome was duration of first intensive care unit (ICU) stay after LT. Secondary outcomes were duration of first hospital stay after LT, rate of ICU readmission, re-LT and survival rates.RESULTS: On the day of LT, 5% (28 of 519) of patients had a MELD score ≥40. These patients had longer first ICU stays after LT (14 versus two days; P<0.001). MELD score ≥40 at LT was independently associated with first ICU stay after LT ≥10 days (OR 3.21). These patients had longer first hospital stays after LT (45 versus 18 days; P<0.001); however, there was no significant difference in the rate of ICU readmission (18% versus 22%; P=0.58) or re-LT rate (4% versus 4%; P=1.00). Cumulative survival at one month, three months, one year, three years and five years was 98%, 96%, 90%, 79% and 72%, respectively. There was no significant difference in cumulative survival stratified according to MELD score ≥40 versus <40 at LT (P=0.59).CONCLUSIONS: Cirrhotic patients with MELD score ≥40 at LT utilize greater postoperative health resources; however, they derive similar long-term survival benefit from LT.
Noninvasive Ventilation Practice Patterns for Acute Respiratory Failure in Canadian Tertiary Care Centres: A Descriptive Analysis
Authors: Digby Geneviève C , Keenan Sean P , Parker Christopher M , Sinuff Tasnim , Burns Karen E , Mehta Sangeeta , Ronco Juan J , Kutsogiannis Demetrios J , Rose Louise , Ayas Najib T , Berthiaume Luc R , D’Arsigny Christine L , Stollery Daniel E , Muscedere John 
Published: March 2016

BACKGROUND: The extent of noninvasive ventilation (NIV) use for patients with acute respiratory failure in Canadian hospitals, indications for use and associated outcomes are unknown.OBJECTIVE: To describe NIV practice variation in the acute setting.METHODS: A prospective observational study involving 11 Canadian tertiary care centres was performed. Data regarding NIV indication, mode and outcomes were collected for all adults (>16 years of age) treated with NIV for acute respiratory failure during a four‐week period (between February and August 2011). Logistic regression with site as a random effect was used to examine the association between preselected predictors and mortality or intubation.RESULTS: A total of 330 patients (mean [± SD] 30±12 per centre) were included. The most common indications for NIV initiation were pulmonary edema (104 [31.5%]) and chronic obstructive pulmonary disease (99 [30.0%]). Significant differences in indications for NIV use across sites, specialty of ordering physician and location of NIV initiation were noted. Although intubation rates were not statistically different among sites (range 10.3% to 45.4%), mortality varied significantly (range 6.7% to 54.5%; P=0.006). In multivariate analysis, the most significant independent predictor of avoiding intubation was do‐not‐resuscitate status (OR 0.11 [95% CI 0.03 to 0.37]).CONCLUSION: Significant variability existed in NIV use and associated outcomes among Canadian tertiary care centres. Assignment of do‐not‐resuscitate status prevented intubation.
Acetylcarnitine Is a Candidate Diagnostic and Prognostic Biomarker of Hepatocellular Carcinoma
Authors: Lu Yonghai , Li Ning , Gao Liang , Xu Yong-Jiang , Huang Chong , Yu Kangkang , Ling Qingxia , Cheng Qi , Chen Shengsen , Zhu Mengqi , Fang Jinling , Chen Mingquan , Ong Choon Nam 
Published: March 2016

Abstract
The identification of serum biomarkers to improve the diagnosis and prognosis of hepatocellular carcinoma has been elusive to date. In this study, we took a mass spectroscopic approach to characterize metabolic features of the liver in hepatocellular carcinoma patients to discover more sensitive and specific biomarkers for diagnosis and progression. Global metabolic profiling of 50 pairs of matched liver tissue samples from hepatocellular carcinoma patients was performed. A series of 62 metabolites were found to be altered significantly in liver tumors; however, levels of acetylcarnitine correlated most strongly with tumor grade and could discriminate between hepatocellular carcinoma tumors and matched normal tissues. Post hoc analysis to evaluate serum diagnosis and progression potential further confirmed the diagnostic capability of serum acetylcarnitine. Finally, an external validation in an independent batch of 58 serum samples (18 hepatocellular carcinoma patients, 20 liver cirrhosis patients, and 20 healthy individuals) verified that serum acetylcarnitine was a meaningful biomarker reflecting hepatocellular carcinoma diagnosis and progression. These findings present a strong new candidate biomarker for hepatocellular carcinoma with potentially significant diagnostic and prognostic capabilities. Cancer Res; 76(10); 2912–20. ©2016 AACR.
Outcomes According to Cardiac Catheterization Referral and Clopidogrel Use Among Medicare Patients With Non–ST‐Segment Elevation Myocardial Infarction Discharged Without In‐hospital Revascularization
Authors: Hess Connie N. , Hellkamp Anne S. , Roe Matthew T. , Thomas Laine , Scirica Benjamin M. , Peng S. Andrew , Peterson Eric D. , Wang Tracy Y. 
Published: March 2016

Background

While use of P2Y12 receptor inhibitor is recommended by guidelines, few studies have examined its effectiveness among older non–
ST
‐segment elevation myocardial infarction patients who did not undergo coronary revascularization.

Methods and Results

We included unrevascularized non–
ST
‐segment elevation myocardial infarction patients ≥65 years discharged home from 463
ACTION
Registry‐
GWTG
hospitals from 2007 to 2010. Rates of discharge clopidogrel use were described for patients with no angiography, angiography without obstructive coronary artery disease (
CAD
; ≥50% stenosis in ≥1 vessel), and angiography with obstructive
CAD
. Two‐year outcomes were ascertained from linked Medicare data and included composite major adverse cardiac events (defined as all‐cause death, myocardial infarction readmission, or revascularization), and individual components. Outcomes associated with clopidogrel use were adjusted using inverse probability‐weighted propensity modeling. Of 14 154 unrevascularized patients, 54.7% (n=7745) did not undergo angiography, 10.6% (n=1494) had angiography without
CAD
, and 34.7% (n=4915) had angiography with
CAD
. Discharge clopidogrel was prescribed for 42.2% of all unrevascularized patients: 37.8% without angiography, 34.1% without obstructive
CAD
at angiography, and 51.6% with obstructive
CAD
at angiography. Discharge clopidogrel use was not associated with major adverse cardiac events in any group: without angiography (adjusted hazard ratio [95%
CI
]: 0.99 [0.93–1.06]), angiography without
CAD
(1.04 [0.74–1.47]), and angiography with
CAD
(1.12 [1.00–1.25],
P
interaction
=0.20).

Conclusions

We found no association between discharge clopidogrel use and long‐term risk of major adverse cardiac events among older, unrevascularized non–
ST
‐segment elevation myocardial infarction patients. Clopidogrel use in this population requires further prospective evaluation.
Annotated checklist of Georgian oribatid mites
Authors: MURVANIDZE MAKA , MUMLADZE LEVAN 
Published: March 2016

A new updated checklist of Georgian oribatid mites is based on the critical review of existing literature data and new findings. The list includes 534 oribatid species of which 21 species are new for the country recorded from more than 390 locations. For each species information of the global and regional distribution is presented with notes on ecological characteristics. As far as necessary we provide remarks on taxonomic issues to overcome the ambiguities and inconsistencies existing in literature.
Theoretical models of public administration and patterns of state reform in Greece
Authors: Lampropoulou Manto , Oikonomou Giorgio 
Published: March 2016

Departing from the post-war Weberian-oriented bureaucratic model, the Greek administrative system has been subjected to several reform programmes with a view to its modernization. This article aims to explore the main shifts in the course of administrative change and relate this process with the broader theoretical developments in the field of public administration. It is argued that the Greek administration has been unable to follow and take advantage of a vigorously expanded constellation of ideal-types and hybrid models of state (re)organization. Transformations have diachronically produced weak results and failed to build a consistent conceptual and operational administrative paradigm. Even under the current economic contraction and the external conditionality pressure, there is no strong evidence of a paradigm shift in the administrative pattern but rather fragmented changes of limited ambit. Points for practitioners Despite the fact that the Greek public administration has undergone a series of transformations, interestingly almost none of these reform efforts seem to have incorporated a particular administrative pattern. This article summarizes old and more recent theoretical developments on models of administrative reorganization, with a view to broadening practitioners’ choices in the process of state reform.
Family Caregivers’ Pain Management in End-of-Life Care: A Systematic Review
Authors: Chi Nai-Ching , Demiris George 
Published: March 2016

Context: Pain management was the most identified burden faced by family caregivers in end-of-life caregiving. Objectives: To synthesize current scientific evidence on family caregivers’ experience of pain management in end-of-life care. Methods: A systematic review was conducted using CINAHL, Embase, PubMed, and Cochrane Library electronic databases. Data were extracted from each included paper and organized into tables to synthesize the findings. Results: Fourteen research papers focusing on family caregivers’ experience of pain management and strategies in end-of-life care were included. Nine were observational studies, 3 were case studies, and 2 were experimental studies. These studies mainly focused on exploring family caregivers’ engagement in pain management and communication with the hospice care team about pain control; family caregivers’ knowledge, skills, and self-efficacy in pain management; and family caregivers’ concerns and experience of pain management. Conclusion: This review identified themes similar to previous reviews on family caregivers of patients with cancer or in palliative care: inadequate knowledge and assessment skills in pain management, misunderstanding of pain medications, and poor communication with the care team. Future research should design educational programs and material for family caregivers to improve their pain management knowledge and skills, communication, and engagement in care. The scientific knowledge on this topic is scarce, and level of evidence is low; it is therefore imperative to have more exploratory studies to expand the quality and quantity of evidence and increase our understanding of family caregivers’ needs and barriers to pain management based on larger and more diverse patient and caregiver samples.
Intraoral Vacuum of Breast-Feeding Newborns Within the First 24 Hr
Authors: Zhang Feng , Xia Haiou , Li Xia , Qin Ling , Gu Hongmei , Xu Xujuan , Shen Meiyun 
Published: March 2016

Objectives: To explore whether newborns born via Cesarean section have a weaker intraoral vacuum compared with those born vaginally and to determine whether a weaker intraoral vacuum is related to a delayed onset of lactation. Methods: For this prospective cohort study, 71 mother–infant dyads were enrolled and divided into birthing groups, vaginal or Cesarean. The newborn intraoral vacuum was measured via a tube placed alongside the nipple and connected to a pressure sensor during a breast-feeding session within the first 24 hr after birth. Onset of lactation was confirmed by maternal perception of breast fullness. The intraoral vacuum and its relationship with the onset of lactation were analyzed. Results: After adjustment for confounding factors, the peak intraoral vacuum was −19.50 kPa in the vaginal group, which was significantly stronger than the −13.78 kPa in the Cesarean group ( p = .005). Additionally, the baseline intraoral vacuum in the vaginal group (−2.35 kPa) was significantly stronger than that in the Cesarean group (−1.18 kPa; p = .022). Strength of the newborn intraoral vacuum was associated with the time of onset of maternal lactation. Conclusion: Cesarean section may weaken newborns’ intraoral vacuum within the first 24 hr after birth. Stronger intraoral vacuum was related to earlier onset of lactation. Early intervention aimed at the weaker intraoral vacuum should be provided to promote the onset of lactation.
Recent language experience influences cross-language activation in bilinguals with different scripts
Authors: Li Chuchu , Wang Min , Lin Candise Y 
Published: March 2016

Purpose: This study aimed to examine whether the phonological information in the non-target language is activated and its influence on bilingual processing. Approach: Using the Stroop paradigm, Mandarin-English bilinguals named the ink color of Chinese characters in English in Experiment 1 and named the Chinese characters in addition to the color naming in English in Experiment 2. Twenty-four participants were recruited in each experiment. In both experiments, the visual stimuli included color characters (e.g. 红, hong2, red), homophones of the color characters (e.g. 洪, hong2, flood), characters that only shared the same syllable segment with the color characters (S+T-, e.g. 轰, hong1, boom), characters that shared the same tone but differed in segments with the color characters (S-T+, e.g. 瓶, ping2, bottle), and neutral characters (e.g. 牵, qian1, leading through). Data and analysis: Planned t-tests were conducted in which participants’ naming accuracy rate and naming latency in each phonological condition were compared with the neutral condition. Findings: Experiment 1 only showed the classic Stroop effect in the color character condition. In Experiment 2, in addition to the classic Stroop effect, the congruent homophone condition (e.g. 洪 in red) showed a significant Stroop interference effect. These results suggested that for bilingual speakers with different scripts, phonological information in the non-target language may not be automatically activated even though the written words in the non-target language were visually presented. However, if the phonological information of the non-target language is activated in advance, it could lead to competition between the two languages, likely at both the phonological and lemma levels. Originality and significance: This study is among the first to investigate whether the translation of a word is phonologically encoded in bilinguals using the Stroop paradigm. The findings improve our understanding of the underlying mechanism of bilingual processing.