bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlates of Stigma Severity Among Persons Seeking Opioid Detoxification
Authors: Bozinoff Nikki , Anderson Bradley J. , Bailey Genie L. , Stein Michael D. 
Published: September 2017

Introduction:
Among people with opioid use disorder (OUD), stigma is a known barrier to accessing treatment and has negative impacts on physical and mental health. The purpose of this study was to understand the factors associated with self-stigma and perceived stigma severity among people with OUD entering an inpatient detoxification program.

Methods:
Between December 2015 and August 2016, consecutive persons seeking inpatient opioid detoxification were asked to complete a survey that included sociodemographic, drug use, treatment variables, an 8-item General Self-Stigma scale, and a 3-item Treatment Stigma scale. Correlates of stigma severity were estimated using ordinary least squares regression.

Results:
The 407 participants had an average age of 32.4 (±8.79) years, with 72.2% male and 84.5% non-Hispanic White. Two-thirds had ever received medication-assisted treatment for OUD and 323 (79.4%) had ever been admitted to a detoxification program. Adjusted mean General Self-Stigma scores were positively and significantly associated with recent injection drug use (b = 0.262, P = 0.032), and having previously entered detoxification programs (b = 0.330, P = 0.016). Adjusted mean Treatment Stigma scores were positively and significantly associated with years of education (b = 0.142, P = 0.002), having ever been prescribed naltrexone (b = 0.277, P = 0.025) and having previously entered detoxification programs (b = 0.389, P = 0.007).

Conclusion:
People with OUD presenting for inpatient detoxification struggle with experiences of self and perceived stigma. Strikingly, people with previous detoxification program admission had higher levels of stigma on both scales. Our findings suggest an opportunity for targeted intervention in this group.
Long-Acting Reversible Contraception Initiation With a 2- to 3-Week Compared With a 6-Week Postpartum Visit
Authors: Chen Melissa J. , Hou Melody Y. , Hsia Jennifer K. , Cansino Catherine D. , Melo Juliana , Creinin Mitchell D. 
Published: September 2017

OBJECTIVE:
To evaluate whether a department policy changing the scheduling of the postpartum visit from 6 weeks to 2–3 weeks after delivery is associated with higher long-acting reversible contraception initiation at the postpartum visit.

METHODS:
We conducted a quasiexperimental before–after study to evaluate long-acting reversible contraception initiation, specifically an intrauterine device or contraceptive implant, at the postpartum visit between women scheduled for follow-up at 6 weeks (before policy change) and 2–3 weeks after delivery (after policy change). Secondary outcomes included postpartum visit completion, overall contraception initiation at the postpartum visit, overall contraceptive use at 6 months after delivery, and repeat pregnancies by 6 months postpartum. We obtained delivery and postpartum information using the electronic medical record and contacted participants 3 and 6 months after delivery to assess contraception use and repeat pregnancies.

RESULTS:
We enrolled 586 participants between December 2014 and November 2015, of whom 512 women (256 in each cohort) continued to meet eligibility criteria after delivery. Long-acting reversible contraception initiation rates at the postpartum visit were lower in the 2- to 3-week (16.5%, 95% CI 12.2–21.8) compared with the 6-week group (31.1%, 95% CI 25.2–37.7, P<.01), primarily as a result of patient and health care provider preferences for delaying intrauterine device insertion to a later visit. More women completed a scheduled 2- to 3-week postpartum visit (90.2%, 95% CI 86.0–93.3) compared with a 6-week visit (81.6%, 95% CI 76.4–85.9, P<.01). Deferral of any contraception initiation was higher in the 2- to 3-week group (27.3%, 95% CI 21.9–33.4) compared with the 6-week group (15.8%, 95% CI 11.5–21.4, P<.01), but there were no differences in overall contraceptive use patterns at 6 months postpartum. No intrauterine device perforations or expulsions were observed in women who underwent insertion at 2–3 weeks postpartum. Five pregnancies were reported in each cohort by 6 months after delivery.

CONCLUSION:
Scheduling a visit at 2–3 weeks after delivery was not associated with increased long-acting reversible contraception initiation at this visit despite higher postpartum visit attendance.
Association of Nonsteroidal Antiinflammatory Drugs and Postpartum Hypertension in Women With Preeclampsia With Severe Features
Authors: Viteri Oscar A. , England Joey A. , Alrais Mesk A. , Lash Kayla A. , Villegas Maria I. , Ashimi Balogun Olaide A. , Chauhan Suneet P. , Sibai Baha M. 
Published: September 2017

OBJECTIVE:
To estimate whether nonsteroidal antiinflammatory drugs (NSAIDs) are associated with persistent postpartum hypertension in a cohort of women with preeclampsia and severe features.

METHODS:
We conducted a retrospective cohort study at a single, tertiary center from January 2013 to December 2015. All women diagnosed with severe preeclampsia who remained hypertensive for greater than 24 hours after delivery were included. The primary outcome was the rate of persistent postpartum hypertension, defined as systolic blood pressure 150 mm Hg or greater or diastolic 100 mm Hg or greater (or both), on two occasions, at least 4 hours apart. Secondary outcomes included severe maternal morbidity: pulmonary edema, renal dysfunction, stroke, eclampsia, and intensive care unit admission. Additional outcomes included length of postpartum hospital stay, receipt of narcotics, and hospital readmission. Multivariable logistic regression was performed to adjust for confounders. Adjusted odds ratios (ORs) are reported for applicable study outcomes.

RESULTS:
Of the 399 women with severe preeclampsia, 324 (81%) remained hypertensive 24 hours after delivery. Two hundred forty-three (75%) received NSAIDs (either ibuprofen or ketorolac) and 81 (25%) did not. After multivariable logistic regression, the likelihood of reaching a blood pressure of 150 mm Hg systolic or 100 mm Hg diastolic (or both), on two occasions, at least 4 hours apart, was similar between those who received NSAIDs compared with those who did not (70% compared with 73%; adjusted OR 1.1, 95% CI 0.6–2.0). Similarly, puerperal occurrence of pulmonary edema (3% compared with 10%; OR 4.4, 95% CI 1.5–13.1), renal dysfunction (5% compared with 8%; OR 1.7, 95% CI 0.6–4.8), eclampsia (1% compared with 0%; P=.34), or intensive care unit admission (3% compared with 8%; OR 2.4, 95% CI 0.8–7.1) was similar between the groups. There were no differences in the rate of narcotic use (89% compared with 75%; adjusted OR 0.6 95% CI 0.18–1.70).

CONCLUSION:
In this cohort of women with preeclampsia and severe features before delivery, NSAIDs were not associated with increased rates of persistent postpartum hypertension.
Longitudinal Changes in Electrically Evoked Auditory Event-Related Potentials in Children With Auditory Brainstem Implants: Preliminary Results Recorded Over 3 Years
Authors: He Shuman , Teagle Holly F. B. , McFayden Tyler C. , Ewend Matthew , Henderson Lillian , He Nancy , Buchman Craig A. 
Published: September 2017

Objectives:
This preliminary study aimed (1) to assess longitudinal changes in electrically evoked auditory event-related potentials (eERPs) in children with auditory brainstem implants (ABIs) and (2) to explore whether these changes could be accounted for by maturation in the central auditory system of these patients.

Design:
Study participants included 5 children (S1 to S5) with an ABI in the affected ear. The stimulus was a train of electrical pulses delivered to individual ABI electrodes via a research interface. For each subject, the eERP was repeatedly measured in multiple test sessions scheduled over up to 41 months after initial device activation. Longitudinal changes in eERPs recorded for each ABI electrode were evaluated using intraclass correlation tests for each subject.

Results:
eERPs recorded in S1 showed notable morphological changes for five ABI electrodes over 41 months. In parallel, signs or symptoms of nonauditory stimulation elicited by these electrodes were observed or reported at 41 months. eERPs could not be observed in S2 after 9 months of ABI use but were recorded at 12 months after initial stimulation. Repeatable eERPs were recorded in S3 in the first 9 months. However, these responses were either absent or showed remarkable morphological changes at 30 months. Longitudinal changes in eERP waveform morphology recorded in S4 and S5 were also observed.

Conclusions:
eERP responses in children with ABIs could change over a long period of time. Maturation of the central auditory system could not fully account for these observed changes. Children with ABIs need to be closely monitored for potential changes in auditory perception and unfavorable nonauditory sensations. Neuroimaging correlates are needed to better understand the emergence of nonauditory stimulation over time in these children.
Increasing Body Mass Index is Associated With Worse Perioperative Outcomes and Higher Costs in Adult Spinal Deformity Surgery
Authors: Amin Raj M. , Raad Micheal , Jain Amit , Sandhu Kevin P. , Frank Steven M. , Kebaish Khaled M. 
Published: September 2017

Study Design.
Retrospective review.

Objective.
To investigate associations of obesity with outcomes and costs of adult spinal deformity (ASD) surgery.

Summary of Background Data.
Increasing body mass index (BMI) is a risk factor for complications after nondeformity spine surgery, but its effect on ASD surgery is unknown.

Methods.
We reviewed records of 244 ASD patients who underwent spinal arthrodesis of ≥5 levels from 2010 to 2014 and categorized them by World Health Organization BMI groups: BMI < 30, nonobese (64%); BMI = 30–34.99, class-I obese (21%); and BMI ≥ 35, class-II/III obese (15%). We used multivariate logistical regression to determine odds of transfusion, inpatient complications, prolonged intensive care unit (ICU) stay (>2 days), prolonged total length of hospital stay (LOS) (>1 week), and high episode-of-care costs (>$80,000).

Results.
Preoperative characteristics were similar among groups, except sex, preoperative hemoglobin concentration, and performance/type of osteotomy (all, P = 0.01). On univariate analysis, the groups differed in rates of prolonged ICU stay (P < 0.001), prolonged total LOS (P = 0.016), and high episode-of-care costs (P = 0.013). Inpatient complication rates were similar among groups (P = 0.218). On multivariate analysis, compared with nonobese patients, class I obese patients had greater odds of prolonged ICU stay (odds ratio [OR] = 2.24, 95% confidence interval [CI]: 1.06, 4.71). Class II/III obese patients also had greater odds of prolonged total LOS (OR = 2.21, 95% CI: 1.03, 4.71), and high episode-of-care costs (OR = 2.91, 95% CI: 1.31, 6.50).

Conclusion.
In ASD surgery, BMI ≥35 is associated with significantly worse perioperative outcomes and higher costs compared with those of nonobese patients.

Level of Evidence: 3
Compassionate Nitric Oxide Adjuvant Treatment of Persistent Mycobacterium Infection in Cystic Fibrosis Patients
Authors: Yaacoby-Bianu Karin , Gur Michal , Toukan Yazeed , Nir Vered , Hakim Fahed , Geffen Yuval , Bentur Lea 
Published: September 2017

Background:

Mycobacterium abscessus is one of the most antibiotic-resistant pathogens in cystic fibrosis (CF) patients. Nitric oxide (NO) has broad-spectrum antimicrobial activity. Clinical studies indicated that it is safe and tolerable when given as 160 ppm intermittent inhalations.

Methods:
A prospective compassionate adjunctive inhaled NO therapy in 2 CF patients with persistent Mycobacterium abscessus infection.

Results:
No adverse events were reported. Both subjects showed significant reduction in quantitative polymerase chain reaction results for Mycobacterium abscessus load in sputum during treatment; estimated colony forming unit decreased from 7000 to 550 and from 3000 to 0 for patient 1 and patient 2, respectively.

Conclusions:
Intermittent inhalations with 160 ppm NO are well tolerated, safe and result in significant reduction of Mycobacterium abscessus load. It may constitute an adjuvant therapeutic approach for CF patients with Mycobacterium abscessus lung disease. Further studies are needed to define dosing, duration and long-term clinical outcome.
Opioid prescription levels and postoperative outcomes in orthopedic surgery
Authors: Cozowicz Crispiana , Olson Ashley , Poeran Jashvant , Mörwald Eva E. , Zubizarreta Nicole , Girardi Federico P. , Hughes Alexander P. , Mazumdar Madhu , Memtsoudis Stavros G. 
Published: September 2017

Abstract
Given the basic need for opioids in the perioperative setting, we investigated associations between opioid prescription levels and postoperative outcomes using population-based data of orthopedic surgery patients. We hypothesized that increased opioid amounts would be associated with higher risk for postoperative complications. Data were extracted from the national Premier Perspective database (2006-2013); N = 1,035,578 lower joint arthroplasties and N = 220,953 spine fusions. Multilevel multivariable logistic regression models measured associations between opioid dose prescription and postoperative outcomes, studied by quartile of dispensed opioid dose. Compared to the lowest quartile of opioid dosing, high opioid prescription was associated with significantly increased odds for deep venous thrombosis and postoperative infections by approx. 50%, while odds were increased by 23% for urinary and more than 15% for gastrointestinal and respiratory complications (P < 0.001 respectively). Furthermore, higher opioid prescription was associated with a significant increase in length of stay (LOS) and cost by 12% and 6%, P < 0.001 respectively. Cerebrovascular complications risk was decreased by 25% with higher opioid dose (P = 0.004), while odds for myocardial infarction remained unaltered. In spine cases, opioid prescription was generally higher, with stronger effects observed for increase in LOS and cost as well as gastrointestinal and urinary complications. Other outcomes were less pronounced, possibly because of smaller sample size. Overall, higher opioid prescription was associated with an increase in most postoperative complications with the strongest effect observed in thromboembolic, infectious and gastrointestinal complications, cost, and LOS. Increase in complication risk occurred stepwise, suggesting a dose–response gradient.
Leveraging multiple datasets for deep leaf counting
Authors: Dobrescu Andrei , Giuffrida Mario Valerio , Tsaftaris Sotirios A 
Published: September 2017

AbstractThe number of leaves a plant has is one of the key traits (phenotypes) describing its development and growth. Here, we propose an automated, deep learning based approach for counting leaves in model rosette plants. While state-of-the-art results on leaf counting with deep learning methods have recently been reported, they obtain the count as a result of leaf segmentation and thus require per-leaf (instance) segmentation to train the models (a rather strong annotation). Instead, our method treats leaf counting as a direct regression problem and thus only requires as annotation the total leaf count per plant. We argue that combining different datasets when training a deep neural network is beneficial and improves the results of the proposed approach. We evaluate our method on the CVPPP 2017 Leaf Counting Challenge dataset, which contains images of Arabidopsis and tobacco plants. Experimental results show that the proposed method significantly outperforms the winner of the previous CVPPP challenge, improving the results by a minimum of 50% on each of the test datasets, and can achieve this performance without knowing the experimental origin of the data (i.e. “in the wild” setting of the challenge). We also compare the counting accuracy of our model with that of per leaf segmentation algorithms, achieving a 20% decrease in mean absolute difference in count (|DiC|).
Fibroblast-derived HGF drives acinar lung cancer cell polarization through integrin-dependent RhoA-ROCK1 inhibition
Authors: Datta Anirban , Sandilands Emma , Mostov Keith E. , Bryant David M. 
Published: September 2017

AbstractThe formation of lumens in epithelial tissues requires apical-basal polarization of cells, and the co-ordination of this individual polarity collectively around a contiguous lumen. Signals from theExtracellularMatrix (ECM) instruct epithelia as to the orientation of where basal, and thus consequently apical, surfaces should be formed. We report that this pathway is normally absent in Calu-3 human lung adenocarcinoma cells in 3-Dimensional culture, but that paracrine signals from MRC5 lung fibroblasts can induce correct orientation of polarity and acinar morphogenesis. We identify HGF, acting through the c-Met receptor, as the key polarity-inducing morphogen, which acts to activate β1-integrin-dependent adhesion. HGF and ECM-derived integrin signals co-operate via a c-Src-dependent inhibition of the RhoA-ROCK1 signalling pathway via p190A RhoGAP. This occurred via controlling localization of these signalling pathways to the ECM-abutting surface of cells in 3-Dimensional culture. Thus, stromal derived signals can influence morphogenesis in epithelial cells by controlling activation and localization of cell polarity pathways.
Dynamic Spatiotemporal Organization of Exocytosis During Cellular Shape Change
Authors: Urbina Fabio , Gomez Shawn , Gupton Stephanie L. 
Published: September 2017

AbstractMorphological elongation of developing neurons requires plasmalemma expansion, hypothesized to occur primarily via exocytosis. We posited that exocytosis in developing neurons and non-neuronal cells exhibit distinct spatiotemporal organization. We exploited TIRF microscopy to image VAMP-pHluorin mediated exocytosis in murine embryonic cortical neurons and interphase melanoma cells, and developed computer-vision software and statistical tools to uncover spatiotemporal aspects of exocytosis. Vesicle fusion behavior differed between vesicle types, cell types, developmental stage, and extracellular environment. Experiment-based mathematical calculations indicated that VAMP2-mediated vesicle fusion supplied excess material for the plasma membrane expansion that occurred early in neuronal morphogenesis, which was balanced in part by clathrin-mediated endocytosis. Spatial statistics uncovered distinct spatiotemporal regulation of exocytosis in the soma and neurites of developing neurons that was modulated by developmental stage, exposure to the guidance cue netrin-1, and the brain-enriched ubiquitin ligase TRIM9. In melanoma cells, exocytosis occurred less frequently with distinct spatial clustering patterns.
Editing of the Human TRIM5 Gene to Introduce Mutations with the Potential to Inhibit HIV-1
Authors: Dufour Caroline , Claudel Alix , Joubarne Nicolas , Merindol Natacha , Maisonnet Tara , Plourde Mélodie B. , Berthoux Lionel 
Published: September 2017

ABSTRACTThe type I interferon (IFN-I)-inducible human restriction factor TRIM5α inhibits the infection of human cells by specific nonhuman retroviruses, such as N-MLV and EIAV, but does not generally target HIV-1. However, the introduction of two aminoacid substitutions, R332G and R355G, in the human TRIM5α (huTRIM5α) domain responsible for retroviral capsid recognition leads to efficient HIV-1 restriction. Using a DNA transfection-based CRISPR-Cas9 genome editing protocol, we successfully mutated TRIM5 to its HIV-1-restrictive version by homology-directed repair (HDR) in HEK293T cells. Nine clones bearing at least one HDR-edited TRIM5 allele containing both mutations were isolated (5.6% overall efficiency), whereas another one contained only the R332G mutation. Of concern, several of these HDR-edited clones contained on-target undesired mutations, and none had all the alleles corrected. We observed a lack of HIV-1 restriction in the cell clones generated, even when cells were stimulated with IFN-I prior to infection. This, however, was partly explained by the unexpectedly low potential for TRIM5α-mediated restriction activity in this cell line. Our study demonstrates the feasibility of editing the TRIM5 gene to in human cells and identifies the main challenges to be addressed in order to use this approach to confer protection from HIV-1.
Emerging hybridity: comparing UK healthcare regulatory arrangements
Authors: Furnival Joy , Walshe Kieran , Boaden Ruth 
Published: September 2017

Purpose
Healthcare regulation is one means to address quality challenges in healthcare systems and is carried out using compliance, deterrence and/or improvement approaches. The four countries of the UK provide an opportunity to explore and compare different regulatory architecture and models. The purpose of this paper is to understand emerging regulatory models and associated tensions.

Design/methodology/approach
This paper uses qualitative methods to compare the regulatory architecture and models. Data were collected from documents, including board papers, inspection guidelines and from 48 interviewees representing a cross-section of roles from six organisational regulatory agencies. The data were analysed thematically using an a priori coding framework developed from the literature.

Findings
The findings show that regulatory agencies in the four countries of the UK have different approaches and methods of delivering their missions. This study finds that new hybrid regulatory models are developing which use improvement support interventions in parallel with deterrence and compliance approaches. The analysis highlights that effective regulatory oversight of quality is contingent on the ability of regulatory agencies to balance their requirements to assure and improve care. Nevertheless, they face common tensions in sustaining the balance in their requirements connected to their roles, relationships and resources.

Originality/value
The paper shows through its comparison of UK regulatory agencies that the development and implementation of hybrid models is complex. The paper contributes to research by identifying three tensions related to hybrid regulatory models; roles, resources and relationships which need to be managed to sustain hybrid regulatory models.
Trade openness, financial liberalization and economic growth
Authors: Adeel-Farooq Rana Muhammad , Abu Bakar Nor Aznin , Raji Jimoh Olajide 
Published: September 2017

PurposeThe purpose of this paper is to empirically examine the effects of financial liberalization and trade openness on the economic growth of two countries, namely, Pakistan and India for the period 1985-2014.Design/methodology/approachThis study uses the autoregressive distributed lag technique, which allows mixed order of integration. In addition, it uses the principal component method to create an index for financial liberalization to examine how it affects the economic growth of the selected countries.FindingsThe findings reveal that in the short and long run, trade openness has positive effect on the Pakistan’s economic growth while the financial liberalization has positive impact only in the long run. In the case of India, both financial liberalization and trade openness positively and significantly influence the economic growth in the short and long run.Practical implicationsBy comparing the results of both countries, trade openness and financial liberalization increase the economic growth of India more than that of Pakistan. These results suggest that Pakistan should consider appropriate positive policies regarding financial liberalization and trade openness to achieve high and stable economic growth in the future.Originality/valueThis study creates financial liberalization index by using the principal component analysis method to explain the role of financial liberalization in the economic growth of Pakistan and India. In addition, it makes comparison of the results based on which country benefits most from the liberalization of trade and financial sectors. Only very few studies have examined these countries, yet their results have remained inconclusive as well.