bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors and social consequences of daily pain expectancy among adults with chronic pain
Authors: Mun Chung Jung , Thummala Kirti , Davis Mary C. , Karoly Paul , Tennen Howard , Zautra Alex J. 
Published: March 2017

AbstractPrevious research suggests that for people living with chronic pain, pain expectancy can undermine access to adaptive resources and functioning. We tested and replicated the unique effect of pain expectancy on subsequent pain through 2 daily diary studies. We also extended previous findings by examining cognitive and affective antecedents of pain expectancy and the consequences of pain expectancy for daily social enjoyment and stress. In study 1, 231 individuals with rheumatoid arthritis completed 30 end-of-day diaries. Results of multilevel structural equation model showed that controlling for today's pain, pain expectancy predicted next day pain. In study 2, diary assessments of affective, cognitive, and social factors were collected during the morning, afternoon, and evening for 21 days from a sample of 220 individuals with fibromyalgia. Results showed that both positive affect and the extent to which pain interfered with daily activities in the afternoon predicted evening pain expectancy in the expected direction. However, negative affect and pain coping efficacy were not associated with pain expectancy. Consistent with study 1, more than usual evening pain expectancy was related to greater next morning pain. We also found that next morning pain predicted next afternoon social enjoyment but not social stress. The findings of these 2 studies point to the importance of promoting positive affect and reducing pain expectancy as a way of decreasing the detrimental effect of chronic pain on enjoyable social experiences.
A Single US Center Experience of Transbronchial Lung Cryobiopsy for Diagnosing Interstitial Lung Disease With a 2-Scope Technique
Authors: Sriprasart Thitiwat , Aragaki Alejandro , Baughman Robert , Wikenheiser-Brokamp Kathryn , Khanna Gaurav , Tanase Daniel , Kirschner Michelle , Benzaquen Sadia 
Published: March 2017

Background:
Transbronchial lung cryobiopsy (TBLC) has been used to establish the diagnosis of interstitial lung disease (ILD) in recent years. The technique and diagnostic yield vary among institutions. We report a new 2-scope technique and the results of TBLC in our institution.

Methods:
This is a retrospective chart review of patients who underwent TBLC for evaluation of ILD. Bronchoscopy with TBLC was performed by a board-certified interventional pulmonologist with a 2-scope technique under general anesthesia.

Results:
A total of 74 patients underwent TBLC with a 2-scope technique. Their mean age was 54±14 years. The mean tissue surface area was 63.54±6.76 mm2. The average anesthesia time was 80.66 minutes. The diagnostic yield was 87.84%. The most common diagnosis was sarcoidosis pneumothorax, which occurred in 5 cases (7%). There was 1 case with bronchoscopic-related respiratory failure associated with significant bleeding. Death occurred in 3 cases (4%), which is comparable to recent mortality data for “elective” surgical lung biopsy for ILD (1.7% to 4.2%).

Conclusion:
TBLC with a 2-scope technique could be an alternative method for diagnosing various types of ILD in patients unfit for surgical lung biopsy. Further prospective studies should clarify its role in the diagnostic armamentarium for undiagnosed ILDs.
Febrile infant update
Authors: Dorney Kate , Bachur Richard G. 
Published: March 2017

Purpose of review
The approach to febrile young infants remains challenging. This review serves as an update on the care of febrile infants less than 90 days of age with a focus on the changing epidemiology of serious bacterial infection (SBI), refinement of management strategies based on biomarkers, and the development of novel diagnostics.

Recent findings
There is high variability in the emergency department management of febrile young infants without significant differences in outcomes. C-reactive protein (CRP) and procalcitonin have emerged as valuable risk-stratification tests to identify high-risk infants. When interpreting automated urinalyses for suspected urinary tract infection (UTI), urine concentration influences the diagnostic value of pyuria. Novel diagnostics including RNA biosignatures and protein signatures show promise in better identifying young febrile infants at risk of serious infection.

Summary
The majority of febrile infants with an SBI will have a UTI but the diagnosis of invasive bacterial infection in infants continues to be challenging. The use of procalcitonin and CRP as biomarkers in prediction algorithms facilitates identification of low-risk infants.
Suicidal Ideation and Psychological Strain Among Patients Diagnosed With Stomach Cancer
Authors: Zhang Xuekun , Zhang Jie , Procter Nicholas , Chen Xiaoyun , Su Yonggang , Lou Fenglan , Cao Fenglin 
Published: March 2017

Abstract
Patients with stomach cancer are at high risk to experience suicidal ideation. Strain theory of suicide assumes that suicide is preceded by psychological strain. Despite wide international acceptance of the theory, its use with a sample of patients with stomach cancer has not previously been reported. The aims were to examine the relationship between psychological strain and suicidal ideation among patients with stomach cancer and to determine whether psychopathological factors act as mediators. A cross-sectional study was undertaken involving subjects with no history of mental disorder, and questionnaires were administered by face-to-face interview. Patients who experienced more psychological strain, especially coping strain, are more likely to experience suicidal ideation. The mediation effects of hopelessness and psychological distress are significant. Psychological strain, hopelessness, and psychological distress may be the vital factors among patients with stomach cancer in the suicide-risk assessment interview and for care planning and psychological intervention.
Factors Associated With Discharge Home After Transfer to a Pediatric Emergency Department
Authors: Peebles Erin R. , Miller Michael R. , Lynch Tim P. , Tijssen Janice A. 
Published: March 2017

Objectives
The transfer of children from community emergency departments (EDs) to tertiary care pediatric EDs for investigations, interventions, or a second opinion is common. In order to improve health care system efficiency, we must have a better understanding of this population and identify areas for education and capacity building.

Methods
We conducted a retrospective chart review of all patients (aged 0–17 years) who were transferred from community ED to a pediatric ED from November 2013 to November 2014. The primary outcome was the frequency of referred patients who were discharged home from the pediatric ED.

Results
Two hundred four patients were transferred from community EDs in the study period. One hundred thirteen children (55.4%) were discharged home from the pediatric ED. Presence of inpatient pediatric services (P = 0.04) at the referral hospital and a respiratory diagnosis (P = 0.03) were independently associated with admission to the children’s hospital. In addition, 74 patients (36.5%) had no critically abnormal vital signs at the referral hospital and did not require any special tests, interventions, consultations, or admission to the children’s hospital. Younger age (P = 0.03), lack of inpatient pediatric services (P = 0.04), and a diagnosis change (P = 0.03) were independently associated with this outcome.

Conclusions
More than half of patients transferred to the pediatric tertiary care ED did not require admission, and more than one third did not require special tests, interventions, consults, or admission. Many of these patients were likely transferred for a second opinion from a pediatric emergency medicine specialist. Education and real-time videoconferencing consultations using telemedicine may help to reduce the frequency of transfers for a second opinion and contribute to cost savings over the long term.
Experience With a Care Process Model in the Evaluation of Pediatric Musculoskeletal Infections in a Pediatric Emergency Department
Authors: Patel Lina , Michael Jeff , Allen Nancy , Schroeder Lisa , Berglund Lisa , Newland Jason G. 
Published: March 2017

Objectives
Care process models (CPMs) for certain conditions have improved clinical outcomes in children. This study describes the implementation and impact of a CPM for the evaluation of musculoskeletal infections in a pediatric emergency department (ED).

Methods
A retrospective pre-post intervention study was performed to analyze the impact of a musculoskeletal infection CPM. Patients were identified retrospectively through electronic order history for imaging of an extremity or joint and recommended laboratory tests. Clinical outcomes evaluated included hospital length of stay (LOS), time to magnetic resonance imaging (MRI), time to administration of antibiotics, hospital admission rate, and 30-day readmission rate.

Results
Musculoskeletal infection evaluations completed in the ED were reviewed from 1 year before implementation (n = 383) and 2 years after implementation (n = 1219) of the CPM. A significant improvement in the time to antibiotic administration for all patients (4.3 vs 3.7 hours, P < 0.05) and for patients with confirmed musculoskeletal infections (9.5 vs 4.9 hours, P < 0.05) was observed after the implementation of the CPM. The overall time to MRI (13.2 vs 10.3 hours, P = 0.29) and hospital LOS (4.7 vs 3.7 days, P = 0.11) were improved for all patients but were not statistically significant. The admission rate and 30-day readmission were similar before and after the implementation of the CPM.

Conclusions
The implementation of a musculoskeletal infection CPM has standardized the approach to the evaluation and diagnosis of musculoskeletal infections resulting in a significant decrease in the time to administer antibiotics and a downward trend in time to MRI and hospital LOS.
Acute Painless Lower Gastrointestinal Bleed That Mimics Meckel Diverticulum
Authors: Gourishankar Anand , Tsao KuoJen 
Published: March 2017

Objective
We describe a case of gastrointestinal duplication cyst with heterotopic gastric mucosa presenting with hematochezia.

Case
The patient was a previously healthy 2-month-old girl presenting with passing fresh blood in the diaper without distress or abdominal discomfort. She was evaluated for colic prior to this episode and discharged home. Meckel scan was positive, and surgeons performed an exploratory laparotomy to identify a jejunal duplication cyst. The infant had an uneventful recovery and was discharged home.

Conclusions
Gastrointestinal duplication cyst is an uncommon condition and can rarely present with lower gastrointestinal bleed with heterotopic gastric mucosa.
Mindfulness Meditation Training and Executive Control Network Resting State Functional Connectivity: A Randomized Controlled Trial
Authors: Taren Adrienne A. , Gianaros Peter J. , Greco Carol M. , Lindsay Emily K. , Fairgrieve April , Brown Kirk Warren , Rosen Rhonda K. , Ferris Jennifer L. , Julson Erica , Marsland Anna L. , Creswell J. David 
Published: March 2017

ABSTRACT

Objective
Mindfulness meditation training has been previously shown to enhance behavioral measures of executive control (e.g., attention, working memory, cognitive control), but the neural mechanisms underlying these improvements are largely unknown. Here, we test whether mindfulness training interventions foster executive control by strengthening functional connections between dorsolateral prefrontal cortex (dlPFC)—a hub of the executive control network—and frontoparietal regions that coordinate executive function.

Methods
Thirty-five adults with elevated levels of psychological distress participated in a 3-day randomized controlled trial of intensive mindfulness meditation or relaxation training. Participants completed a resting state functional magnetic resonance imaging scan before and after the intervention. We tested whether mindfulness meditation training increased resting state functional connectivity (rsFC) between dlPFC and frontoparietal control network regions.

Results
Left dlPFC showed increased connectivity to the right inferior frontal gyrus (T = 3.74), right middle frontal gyrus (MFG) (T = 3.98), right supplementary eye field (T = 4.29), right parietal cortex (T = 4.44), and left middle temporal gyrus (T = 3.97, all p < .05) after mindfulness training relative to the relaxation control. Right dlPFC showed increased connectivity to right MFG (T = 4.97, p < .05).

Conclusions
We report that mindfulness training increases rsFC between dlPFC and dorsal network (superior parietal lobule, supplementary eye field, MFG) and ventral network (right IFG, middle temporal/angular gyrus) regions. These findings extend previous work showing increased functional connectivity among brain regions associated with executive function during active meditation by identifying specific neural circuits in which rsFC is enhanced by a mindfulness intervention in individuals with high levels of psychological distress.

Clinical Trial Registration

Clinicaltrials.gov, NCT01628809.
Characterization of HIV Seroconverters in a TDF/FTC PrEP Study: HPTN 067/ADAPT
Authors: Sivay Mariya V. , Li Maoji , Piwowar-Manning Estelle , Zhang Yinfeng , Hudelson Sarah E. , Marzinke Mark A. , Amico Rivet K. , Redd Andrew , Hendrix Craig W. , Anderson Peter L. , Bokoch Kevin , Bekker Linda-Gail , van Griensven Frits , Mannheimer Sharon , Hughes James P. , Grant Robert , Eshleman Susan H. 
Published: March 2017

Background:
HIV Prevention Trials Network (HPTN) 067/ADAPT evaluated tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) pre-exposure prophylaxis (PrEP) in women (South Africa) and men who have sex with men (Thailand, US). Participants received once-weekly directly observed therapy (DOT) of TDF/FTC, and were then randomized to daily, time-driven, or event-driven PrEP. This report describes characterization of 12 HIV seroconversion events in this trial.

Methods:
HIV rapid testing was performed at study sites. Retrospective testing included fourth generation assays, HIV RNA testing, Western blot, an HIV-1/2 discriminatory assay, resistance testing, and antiretroviral drug testing.

Results:
Six of the 12 seroconverters received TDF/FTC in the DOT phase, but were not randomized (3 were acutely infected at enrollment; 2 were infected during the DOT phase; 1 was not randomized because of pregnancy). One of the 6 randomized participants had acute infection at randomization but was not diagnosed for 3–4 months because HIV rapid tests were nonreactive; continued daily PrEP use was associated with false-negative antibody tests and low HIV RNA levels. The 5 participants infected after randomization included 4 with low adherence to the PrEP regimen, and one who reported a 7-day period without dosing before infection. Three participants had TDF/FTC resistance (M184I, K65R), including 2 who received only 4 once-weekly TDF/FTC doses; most TDF/FTC mutations were detected by next generation sequencing only.

Conclusions:
In HPTN 067/ADAPT, participants who acquired HIV infection had infrequent PrEP dosing or low/suboptimal adherence. Sensitive assays improved detection of HIV infection and drug resistance. Drug resistance was observed with limited PrEP exposure.
Determinants of HIV Phylogenetic Clustering in Chicago Among Young Black Men Who Have Sex With Men From the uConnect Cohort
Authors: Morgan Ethan , Nyaku Amesika N. , D'Aquila Richard T. , Schneider John A. 
Published: March 2017

Introduction:
Phylogenetic analysis determines similarities among HIV genetic sequences from persons infected with HIV, identifying clusters of transmission. We determined characteristics associated with both membership in an HIV transmission cluster and the number of clustered sequences among a cohort of young black men who have sex with men (YBMSM) in Chicago.

Methods:
Pairwise genetic distances of HIV-1 pol sequences were collected during 2013–2016. Potential transmission ties were identified among HIV-infected persons whose sequences were ≤1.5% genetically distant. Putative transmission pairs were defined as ≥1 tie to another sequence. We then determined demographic and risk attributes associated with both membership in an HIV transmission cluster and the number of ties to the sequences from other persons in the cluster.

Results:
Of 86 available sequences, 31 (36.0%) were tied to ≥1 other sequence. Through multivariable analyses, we determined that those who reported symptoms of depression and those who had a higher number of confidants in their network had significantly decreased odds of membership in transmission clusters. We found that those who had unstable housing and who reported heavy marijuana use had significantly more ties to other individuals within transmission clusters, whereas those identifying as bisexual, those participating in group sex, and those with higher numbers of sexual partners had significantly fewer ties.

Conclusions:
This study demonstrates the potential for combining phylogenetic and individual and network attributes to target HIV control efforts to persons with potentially higher transmission risk, as well as suggesting some unappreciated specific predictors of transmission risk among YBMSM in Chicago for future study.
Pediatric multiple sclerosis
Authors: Yeshokumar Anusha K. , Narula Sona , Banwell Brenda 
Published: March 2017

Purpose of reviewThis review discusses the epidemiologic factors involved in the pathogenesis of pediatric multiple sclerosis (MS), which have been the focus of numerous studies in the last several years. We also review the clinical features (including diagnostic evaluation and differential diagnosis) of, treatment approach to, and prognosis of pediatric MS.Recent findingsUp to 10% of patients with MS have their initial demyelinating before the age of 18 years. Over the past 15 years, international and collaborative studies have identified an increasing number of genetic and environmental risk factors for pediatric MS. Identification of these risks and their interplay allow for better understanding of the pathophysiology of pediatric MS, which may inform subsequent treatment and disease management. Careful attention to the management of relapses and chronic symptoms, including implementation of lifestyle modifications and pharmacologic interventions, enables improved school performance and quality of life.SummaryOngoing research in the field of pediatric MS aims to better understand the epidemiologic factors involved in the pathobiology, safety and efficacy of disease-modifying treatments, and long-term prognosis, particularly of cognitive development and academic potential. Collaborative, multinational studies will enable the advancements needed to truly optimize clinical care for this population.
Shifting Spatial Neglect With Repeated Line Bisections: Possible Role of Lateralized Attentional Fatigue
Authors: Woods Mary , Williamson John B. , White Keith D. , Maitland Charles G. , Heilman Kenneth M. 
Published: March 2017

Background and Objective:
Many patients who have signs of neglect immediately after a right hemisphere stroke remain disabled even when they improve on tests of neglect. Few patients are tested for attentional persistence and fatigue despite their importance in many instrumental activities. To investigate whether stimulus repetition might alter the allocation of attention, we repeatedly tested a patient 16 weeks after she developed hemispatial neglect from a right hemisphere stroke.

Methods:
During each of three testing sessions given in 1 day, we asked the patient to bisect 90 lines of two lengths, presented in 30-trial blocks in three locations: left, center, and right of her midsagittal plane, partially counterbalanced across sessions. We adjusted multiple regression analyses and analysis of variance as well as post hoc regression and t tests for persistence in the repeated measures using variance-sample size analysis to estimate self-similarity, a measure related to the fractal correlation dimension.

Results:
In each session, the patient’s line bisections revealed transient leftward bias in her left peripersonal space, and constant rightward bias in her right peripersonal space. Her leftward bias shifted to a rightward bias over repeated trials in her left space.

Conclusions:
The patient’s left-to-right shift with repeated trials suggests either fatigue from an attempted compensation for leftward inattention or habituation of a contralesional spatial attentional attraction, revealing contralesional left-sided neglect in both the left and right spaces. Future studies are needed to learn if other patients show similar or different deficits with repetition, and how best to treat them.
Predictors That a Diagnosis of Mild Cognitive Impairment Will Remain Stable 3 Years Later
Authors: Clem Matthew A. , Holliday Ryan P. , Pandya Seema , Hynan Linda S. , Lacritz Laura H. , Woon Fu L. 
Published: March 2017

Background and Objective:In half to two thirds of patients who are diagnosed with mild cognitive impairment (MCI), the diagnosis neither converts to dementia nor reverts to normal cognition; however, little is known about predictors of MCI stability. Our study aimed to identify those predictors.Methods:We obtained 3-year longitudinal data from the National Alzheimer’s Coordinating Center Uniform Data Set for patients with a baseline diagnosis of MCI. To predict MCI stability, we used the patients’ baseline data to conduct three logistic regression models: demographics, global function, and neuropsychological performance.Results:Our final sample had 1059 patients. At the end of 3 years, 596 still had MCI and 463 had converted to dementia. The most reliable predictors of stable MCI were higher baseline scores on delayed recall, processing speed, and global function; younger age; and absence of apolipoprotein E4 alleles.Conclusions:Not all patients with MCI progress to dementia. Of the protective factors that we identified from demographic, functional, and cognitive data, the absence of apolipoprotein E4 alleles best predicted MCI stability. Our predictors may help clinicians better evaluate and treat patients, and may help researchers recruit more homogeneous samples for clinical trials.
Exploring the role of competition induced by non-vaccine serotypes for herd protection
Authors: Masala G. L. , Lipsitch M. , Bottomley C. , Flasche S. 
Published: March 2017

AbstractThe competitive pressure from non-vaccine serotypes may have helped pneumococcal conjugate vaccines (PCVs) to limit vaccine serotype (VT) prevalence. We aim to investigate if, consequently, the indirect protection of higher valency vaccines could fall short of the profound effects of current formulations.We compare three previously described pneumococcal models harmonized to simulate 20 serotypes with a combined pre-vaccination prevalence in <5y old children of 40%. We simulate vaccines of increasing valency by adding serotypes in order of their competitiveness and explore their ability to reduce VT carriage by 95% within 10 years after introduction.All models predict that additional valency will reduce indirect vaccine effects and hence the overall vaccine impact on carriage both in children and adults. Consequently, the minimal effective coverage (efficacy against carriage * vaccine coverage) needed to eliminate vaccine type carriage increases with increasing valency. One model predicts this effect to be modest while the other two predict that high-valency vaccines may struggle to eliminate VT pneumococci unless vaccine efficacy against carriage can be substantially improved. Similar results were obtained when settings of higher transmission intensity and different PCV formulations were explored.Failure to eliminate carriage as a result of increased valency could lead to overall decreased impact of vaccination if the disease burden caused by the added serotypes is low. Hence a comparison of vaccine formulations of varying valency, and pan-valent formulations in particular, should consider the invasiveness of targeted serotypes, as well as efficacy against carriage.