bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective study on how primary care providers manage specialists’ recommendations after an e-consultation
Authors: Pecina Jennifer L , Frank Jennifer M , North Frederick 
Published: March 2017

Introduction: E-consultations are asynchronous text-based consultations between providers which can facilitate patient access to timely specialty care. In contrast to traditional face-to-face consults, conveying and completing recommendations of the specialist is the responsibility of the referring provider. This presents a new workflow for primary care providers who have multiple options (face-to-face, telephone, letter, secure message) to communicate the e-consultation recommendations. This study examines how primary care providers are managing this new workflow. Methods: We performed a retrospective random sampling of e-consultations with individual medical record review and classified e-consultations by type of recommendation, how recommendations were communicated to patients, and whether recommendations were carried out. Results: We randomly selected 220 e-consultations in 13 different specialties for review. In all, 85% of e-consultations contained recommendations for referring providers. Recommendations on medication(s) were most common (35%) followed by recommendations on ordering laboratory tests (29%). In all, 25% of the time e-consultants gave multiple possible courses of action for referring providers to choose from. Patient notification of recommendations was found for 192 (87%) of e-consultations with providers performing the notification 63% of the time and nursing staff performing the notification 37% of the time. The communication back to the patients included communication via nurse telephone calls (37%), provider telephone calls (23%), secure messages (24%), face-to-face visits (11%), and by written correspondence (5%). Discussion: Managing recommendations from e-consultations results in a new workflow for primary care providers. Healthcare institutions that utilize e-consults should be aware of this new workflow. Further study is needed to determine best practices for this task that is now increasing in primary care.
A multimodal approach to improving human papillomavirus vaccination in a community pharmacy setting
Authors: Hohmeier Kenneth C , Randolph Donna D , Smith Cindy Taliaferro , Hagemann Tracy M 
Published: March 2017

Background: Community pharmacy has become a major access point for several types of vaccinations. Despite the success of vaccination programs like influenza, pneumococcal, and herpes zoster, the rates of human papillomavirus vaccination continue to lag. Objectives: The primary objective is to describe and report on the impact of a multimodal series of pharmacist-led educational interventions on human papillomavirus vaccination rates in a community pharmacy setting. The primary outcome of this study was change in pharmacist-delivered human papillomavirus vaccination throughout a corresponding 8-week period in 2014 and 2015. Methods: A single-center, quasi-experimental interrupted time series mixed-methods pilot study was used to investigate a pharmacist-led, multimodal educational intervention approach to improve human papillomavirus vaccination rates in the community. Results: During the 2014 control period, there were no human papillomavirus vaccines dispensed or administered according to the internal prescription dispensing software. In 2015, a total of 10 patients indicated that they were vaccinated, with 9 patients receiving their first dose and 1 patient receiving his or her second dose at the pharmacy. Pharmacist recommendation was the most reported education method for increasing patient awareness of the human papillomavirus vaccine (n = 10). Conclusion: This study demonstrates pharmacist designed, educational interventions may impact human papillomavirus vaccination rates in the community. Further community-based research with larger sample sizes is warranted to verify these results. Due to the unique barriers to human papillomavirus vaccination, a multimodal and inter-professional approach such as the one presented here is warranted.
Assessment of postgraduate skin lesion education among Iowa family physicians
Authors: Goetsch Nicholas J , Hoehns James D , Sutherland John E , Ulven Matthew E , Shiyanbola Olayinka O , Rauch Monica K 
Published: March 2017

Background: Family medicine physicians play a pivotal role in the prevention and early detection of skin cancer. Our objective was to evaluate how family physicians believe their postgraduate training in skin cancer screening and prevention has prepared them for independent practice and to assess the need for enhanced skin lesion teaching in a family medicine residency setting. Methods: A descriptive, cross-sectional survey investigating provider demographics, confidence in providing dermatological care, residency training, current medical practice, and skin cancer prevention beliefs was mailed to all family medicine physicians in the state of Iowa as listed in the Iowa Academy of Family Physicians annual directory in 2006 (N = 1069). Results: A total of 575 family medicine physicians completed the survey for an overall response rate of 53.8%. Overall, family medicine physicians reported feeling confident in their ability to diagnose skin lesions (83.2%), differentiate between benign and malignant lesions (85.3%), and perform a biopsy of a lesion (94.3%). Only 65% of surveyed physicians felt that their residency program adequately trained them in diagnosing skin lesions and 65.7% of physicians agree that they could have benefited from additional training on skin lesions during residency training. Nearly 90% of clinicians surveyed believe that skin cancer screenings are the standard of care; however, only 51.8% perform skin cancer screening examinations during adult health maintenance visits more than 75% of the time. The primary reason listed by respondents who said they do not routinely perform skin cancer screenings was inadequate time (68.2%). Conclusion: Family medicine physicians in the state of Iowa are confident in evaluating skin lesions. However, they reported a need for additional enhanced, targeted skin lesion education in family medicine residency training programs. Physicians believe that skin cancer screening examination is the standard of care, but find that inadequate time increasingly hinders skin cancer screening during routine health maintenance examinations.
Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills
Authors: Toy Serkan , McKay Robert SF , Walker James L , Johnson Scott , Arnett Jacob L 
Published: March 2017

Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001). Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t(23) = −2.92, P < .001, and arterial line placement, t(23) = −2.75, P < .001. Procedural performance scores for intubation ( t(23) = −17.29, P < .001), arterial line placement ( t(23) = −19.75, P < .001), lumbar puncture ( t(23) = −16.27, P < .001), and central line placement ( t(23) = −17.25, P < .001) showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.
A fully recombinant human IgG1 Fc multimer (GL-2045) inhibits complement-mediated cytotoxicity and induces iC3b
Authors: Zhou Hua , Olsen Henrik , So Edward , Mérigeon Emmanuel , Rybin Denis , Owens Jane , LaRosa Gregory , Block David S. , Strome Scott E. , Zhang Xiaoyu 
Published: March 2017

Key PointsGL-2045, a recombinant human IgG1-based Fc multimer, binds C1q and inhibits complement-dependent cytotoxicity. GL-2045 induces self-limited complement activation that is governed by both factors H and I and results in the generation of iC3b.
Associations of FoxP3 gene polymorphisms with severe recurrent respiratory papillomatosis in Korean patients
Authors: Kwon Tack-Kyun , Chung Eun Jae , Lee Nuri , Roh Eun Youn , Song Eun Young 
Published: March 2017

Background FoxP3 is the most dependable marker for regulatory T cells which play a major role in immune tolerance. Foxp3 gene polymorphisms were associated with various autoimmune diseases and clearance of viral infections. We studied the association of Foxp3 polymorphisms in severe RRP patients. Methods A total of 30 Korean severe RRP patients and 195 healthy controls were enrolled. Foxp3 polymorphisms (rs5902434 del/ATT, rs3761548 C/A, rs3761549 C/T, and rs2232365 G/A) were determined by PCR and sequencing. Results Genotype frequencies (GF) of rs5902434 ATT/ATT and rs2232365 GG were significantly decreased in female RRP patients than controls (0.0% vs 23.0%, p = 0.039, OR = 9.4 for both). Conclusions We showed that Foxp3 polymorphism of rs5902434 and rs2232365 could be an important protective factor in the susceptibility of severe RRP in female Koreans. Further studies on larger number of patients and other ethnic groups are needed to clarify the association.
Three-Year Follow-Up of an Alectinib Phase I/II Study in ALK-Positive Non–Small-Cell Lung Cancer: AF-001JP
Authors: Tamura Tomohide , Kiura Katsuyuki , Seto Takashi , Nakagawa Kazuhiko , Maemondo Makoto , Inoue Akira , Hida Toyoaki , Yoshioka Hiroshige , Harada Masao , Ohe Yuichiro , Nogami Naoyuki , Murakami Haruyasu , Kuriki Hiroshi , Shimada Tadashi , Tanaka Tomohiro , Takeuchi Kengo , Nishio Makoto 
Published: March 2017

Purpose Alectinib is an anaplastic lymphoma kinase (ALK) –specific kinase inhibitor that seems to be effective against non–small-cell lung cancer (NSCLC) with a variety of ALK mutations. The primary analysis of AF-001JP reported a promising overall response rate. To assess progression-free survival (PFS) and overall survival (OS), patients from the phase II part of AF-001JP were followed up for approximately 3 years. Patients and Methods Oral alectinib 300 mg was administered twice per day to patients with ALK inhibitor–naïve, ALK-positive NSCLC who had progressed after one or more regimens of previous chemotherapy. In this long-term follow-up, efficacy (PFS, OS), correlation between tumor shrinkage and PFS, safety of alectinib, and relief of cancer symptoms were evaluated. Results At the updated data cutoff (September 10, 2015; first patient in August 30, 2011, last patient in April 18, 2012), 25 of 46 phase II patients were still receiving alectinib. Disease progression was confirmed in 18 patients (39%); median PFS was not reached (3-year PFS rate, 62%; 95% CI, 45 to 75). Fourteen patients had brain metastases at baseline; of these, 6 remained in the study without CNS and systemic progression. Tumor shrinkage and PFS showed no correlation. The 3-year OS rate was 78% (13 events). The most common treatment-related adverse event (all grades) was increased blood bilirubin (36.2%). Most cancer symptoms were relieved early, and medication for symptoms was dramatically decreased during alectinib therapy. Conclusion Alectinib was effective in this 3-year follow-up with a favorable safety profile over a long administration period in ALK-positive NSCLC without previous ALK inhibitor treatment.
Mutual interaction between endothelial cells and mural cells enhances BMP9 signaling in endothelial cells
Authors: Tachida Yuki , Izumi Nanae , Sakurai Toyo , Kobayashi Hideki 
Published: March 2017

ABSTRACTHereditary hemorrhagic telangiectasia is characterized by the formation of abnormal vascular networks and caused by the mutation of genes involved in BMP9 signaling. It is also known that the interaction between endothelial cells (ECs) and mural cells (MCs) is critical to maintain vessel integrity. However, it has not yet fully been uncovered whether the EC–MC interaction affects BMP9 signaling or not. To elucidate this point, we analyzed BMP9 signaling in a co-culture of several types of human primary culture ECs and MCs. The co-culture activated the Notch pathway in both types of cells in a co-culture- and BMP9-dependent manner. In HUVECs, the genes induced by BMP9 were significantly and synergistically induced in the presence of pericytes, fibroblasts or mesenchymal stem cells. The synergistic induction was greatly reduced in a non-contact condition. In fibroblasts, PDGFRB expression was potently induced in the presence of HUVECs, and BMP9 additively increased this response. Taken together, these results suggest that the EC–MC interaction potentiates BMP9 signaling both in ECs and MCs and plays a critical role in the maintenance of proper vessel functions.
Regulatory patterns of differentially expressed genes in Ebola and related viruses are critical for viral screening and diagnosis
Authors: Achinko Daniel , Dormer Anton , Narayanan Mahesh , Norman Elton , Abbas Muneer 
Published: March 2017

BackgroundViral detection techniques and applications are a critical first step to pathogen detection within a given population, especially during outbreaks. Common viral tests currently used are direct specimen examination, indirect examination and serological tests. Serological tests have gained intense interest because they are rapidly performed with patient blood samples for quick diagnosis and treatment. The diagnostic techniques developed around serology are often expensive, require expertise to use and cannot be afforded by developing countries with recurrent viral outbreaks. Therefore exploiting the huge amount of viral data available in various databases is critical to develop affordable and easy-to-use diagnostic tools.MethodsThis study obtained viral sample data from Gene Expression Omnibus database with focus on use of viral glycoprotein for host penetration. Gene relative mean across 34 obtained viral samples were extracted into data tables and used with edgeR statistical software in R version 3.3.1.ResultsThree clusters previously known to beLCKspecific (Ebola virus relative viral cluster, EBOVC),CD209specific (Mean differentiation cluster, MDC) and bothLCKandCD209specific (Kurtosis group cluster, KGC), expressed unique patterns of four proteins of interest (CD209, LCK, IL-2 and MYB). Differential expression analysis showed two cluster patterns on heatmaps, with differentially expressed proteins down-regulated in MDC but up-regulated in KGC and EBOVC for all pairwise cluster comparative analyses performed. Heatmaps showed two distinct immune related patterns, identifying MDC as B-lymphotropic while KGC and EBOVC as T-lymphotropic. Identified pathways were dominantly involved with homeostasis of immune cells and viral cell surface receptors involved in protein kinase activities.ConclusionsRegulatory proteomic variants identified in clusters suggest transcription repression of HLA class I alleles. This study identified viral expression patterns with screening and therapeutic applications. Given that the viral pathogenetic pathway for Ebola has not been clearly identified yet, assembling its components is vital for vaccine development.
ARAHAN PENGENDALIAN PERUBAHAN PENGGUNAAN LAHAN MENGGUNAKAN MARKOV - CELLULAR AUTOMATA DI KABUPATEN CIANJUR
Authors: Yudarwati Rani , Sitorus Santun R.P , Munibah Khursatul 
Published: March 2017

Controlling the rate of land use change is necessary due to maintaining environment sustainability. One of the efforts is studying the changes that occur in the past few years. These changes can be studied by Markov - Cellular Automata model.Cianjur is one of the regency that has a high risk of landslide hazard, so it is necessary to control land use change in order to realize environmental sustainability in accordance with the spatial plan of Cianjur regency (RTRW). The purpose of this study was to see land use changes that occurred and evaluated with the spatial plan (RTRW) and also to conduct controlling scenarios of land use changes. The analysis showed that Cianjur regency has drastically decreased in forest area up to 10,3% and landuse inconsistencyof 10,4%. The prediction results showed that landuse change without intervention would dramatically increase inconsistency up to 20,5%. Land use scenario of restoring forest could reduce inconsistency up to 16,6%.
Optical probing of gastrocnemius in patients with peripheral artery disease characterizes myopathic biochemical alterations and correlates with stage of disease
Authors: Becker Ryan A. , Cluff Kim , Duraisamy Nithyanandhi , Mehraein Hootan , Farhoud Hussam , Collins Tracie , Casale George P. , Pipinos Iraklis I. , Subbiah Jeyamkondan 
Published: March 2017

AbstractPeripheral artery disease (PAD) is a condition caused by atherosclerotic blockages in the arteries supplying the lower limbs and is characterized by ischemia of the leg, progressive myopathy, and increased risk of limb loss. The affected leg muscles undergo significant changes of their biochemistry and metabolism including variations in the levels of many key proteins, lipids, and nucleotides. The mechanisms behind these changes are poorly understood. The objective of this study was to correlate the severity of the PAD disease stage and associated hemodynamic limitation (determined by the ankle brachial index, ABI) in the legs of the patients with alterations in the biochemistry of chronically ischemic leg muscle as determined by ATR‐Fourier transform infrared micro‐spectroscopy. Muscle (gastrocnemius) biopsies were collected from 13 subjects including four control patients (ABI≥0.9), five claudicating patients (0.4 ≤ ABI<0.9), and four critical limb ischemia (CLI) patients (ABI<0.4). Slide mounted specimens were analyzed by ATR‐Fourier transform infrared micro‐spectroscopy. An analysis of variance and a partial least squares regression model were used to identify significant differences in spectral peaks and correlate them with the ABI. The spectra revealed significant differences (P < 0.05) across control, claudicating, and CLI patients in the fingerprint and functional group regions. Infrared microspectroscopic probing of ischemic muscle biopsies demonstrates that PAD produces significant and unique changes to muscle biochemistry in comparison to control specimens. These distinctive biochemical profiles correlate with disease progression and may provide insight and direction for new targets in the diagnosis and therapy of muscle degeneration in PAD.
Orai and TRPC channel characterization in FcεRI‐mediated calcium signaling and mediator secretion in human mast cells
Authors: Wajdner Hannah E. , Farrington Jasmine , Barnard Claire , Peachell Peter T. , Schnackenberg Christine G. , Marino Joseph P. , Xu Xiaoping , Affleck Karen , Begg Malcolm , Seward Elizabeth P. 
Published: March 2017

AbstractInappropriate activation of mast cells via the FcεRI receptor leads to the release of inflammatory mediators and symptoms of allergic disease. Calcium influx is a critical regulator of mast cell signaling and is required for exocytosis of preformed mediators and for synthesis of eicosanoids, cytokines and chemokines. Studies in rodent and human mast cells have identified Orai calcium channels as key contributors to FcεRI‐initiated mediator release. However, until now the role of TRPC calcium channels in FcεRI‐mediated human mast cell signaling has not been published. Here, we show evidence for the expression of Orai 1,2, and 3 and TRPC1 and 6 in primary human lung mast cells and the LAD2 human mast cell line but, we only find evidence of functional contribution of Orai and not TRPC channels to FcεRI‐mediated calcium entry. Calcium imaging experiments, utilizing an Orai selective antagonist (Synta66) showed the contribution of Orai to FcεRI‐mediated signaling in human mast cells. Although, the use of a TRPC3/6 selective antagonist and agonist (GSK‐3503A and GSK‐2934A, respectively) did not reveal evidence for TRPC6 contribution to FcεRI‐mediated calcium signaling in human mast cells. Similarly, inactivation of STIM1‐regulated TRPC1 in human mast cells (as tested by transfecting cells with STIM1‐KK684‐685EE ‐ TRPC1 gating mutant) failed to alter FcεRI‐mediated calcium signaling in LAD2 human mast cells. Mediator release assays confirm that FcεRI‐mediated calcium influx through Orai is necessary for histamine and TNFα release but is differentially involved in the generation of cytokines and eicosanoids.
Intact colonic KCa1.1 channel activity in KCNMB2 knockout mice
Authors: Larsen Casper K. , Praetorius Helle A. , Leipziger Jens , Sorensen Mads V. 
Published: March 2017

AbstractMammalian potassium homeostasis results from tightly regulated renal and colonic excretion, which balances the unregulated dietary K+ intake. Colonic K+ secretion follows the pump‐leak model, in which the large conductance Ca2+‐activated K+ channel (KCa1.1) is well established as the sole, but highly regulated apical K+ conductance. The physiological importance of auxiliary β and γ subunits of the pore‐forming α‐subunit of the KCa1.1 channel is not yet fully established. This study investigates colonic K+ secretion in a global knockout mouse of the KCa1.1‐β2‐subunit (KCNMB2−/−), which apparently is the only β‐subunit of the colonic enterocyte KCa1.1 channel. We can report that: (1) Neither KCa1.1 α‐ nor the remaining β‐subunits were compensatory transcriptional regulated in colonic epithelia of KCNMB2−/− mice. (2) Colonic epithelia from KCNMB2−/− mice displayed equal basal and ATP‐induced KCa1.1‐mediated K+ conductance as compared to KCNMB2+/+. (3) K+ secretion was increased in KCNMB2−/− epithelia compared to wild‐type epithelia from animals fed an aldosterone‐inducing diet. (4) Importantly, the apical K+ conductance was abolished by the specific blocker of KCa1.1 channel iberiotoxin in both KCNMB2+/+ and KCNMB2−/− mice. Recently a novel family of auxiliary γ‐subunits of the KCa1.1 channel has been described. (5) We detected the γ1‐subunit (LRRC26) mRNA in colonic epithelia. To investigate the physiological role of the γ1‐subunit of KCa1.1 channels in colonic K+ secretion, we acquired an LRRC26 knockout mouse. (6) Unexpectedly, LRRC26 mice had a perinatal lethal phenotype, thus preventing functional measurements. On this basis we conclude that colonic K+ secretion is intact or even increased in mice lacking the β2‐subunit of KCa1.1 channel complex despite no additional compensatory induction of KCa1.1 β‐subunits.