bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dorsal root ganglion neurons become hyperexcitable and increase expression of voltage-gated T-type calcium channels (Cav3.2) in paclitaxel-induced peripheral neuropathy
Authors: Li Yan , Tatsui Claudio Esteves , Rhines Laurence D. , North Robert Y. , Harrison Daniel S. , Cassidy Ryan M. , Johansson Caj A. , Kosturakis Alyssa K. , Edwards Denaya D. , Zhang Hongmei , Dougherty Patrick M. 
Published: November 2016

Abstract
Here, it is shown that paclitaxel-induced neuropathy is associated with the development of spontaneous activity (SA) and hyperexcitability in dorsal root ganglion (DRG) neurons that is paralleled by increased expression of low-voltage–activated calcium channels (T-type; Cav3.2). The percentage of DRG neurons showing SA and the overall mean rate of SA were significantly higher at day 7 in rats receiving paclitaxel treatment than in rats receiving vehicle. Cav3.2 expression was increased in L4-L6 DRG and spinal cord segments in paclitaxel-treated rats, localized to small calcitonin gene-related peptide and isolectin B4 expressing DRG neurons and to glial fibrillary acidic protein–positive spinal cord cells. Cav3.2 expression was also co-localized with toll-like receptor 4 (TLR4) in both the DRG and the dorsal horn. T-type current amplitudes and density were increased at day 7 after paclitaxel treatment. Perfusion of the TLR4 agonist lipopolysaccharide directly activated DRG neurons, whereas this was prevented by pretreatment with the specific T-type calcium channel inhibitor ML218 hydrochloride. Paclitaxel-induced behavioral hypersensitivity to mechanical stimuli in rats was prevented but not reversed by spinal administration of ML218 hydrochloride or intravenous injection of the TLR4 antagonist TAK242. Paclitaxel induced inward current and action potential discharges in cultured human DRG neurons, and this was blocked by ML218 hydrochloride pretreatment. Furthermore, ML218 hydrochloride decreased firing frequency in human DRG, where spontaneous action potentials were present. In summary, Cav3.2 in concert with TLR4 in DRG neurons appears to contribute to paclitaxel-induced neuropathy.
Health utilities in people with chronic pain using a population-level survey and linked health care administrative data
Authors: Hogan Mary-Ellen , Taddio Anna , Katz Joel , Shah Vibhuti , Krahn Murray 
Published: November 2016

Abstract
Health utilities are a preference-based measure of health-related quality of life that facilitates comparison of disease burden across conditions. We estimated utilities using a population-based, matched sample of adolescents and adults with and without chronic pain, controlling for comorbidity. Ontarians aged ≥12 years with and without chronic pain were identified from the Canadian Community Health Survey (CCHS) 2000-2001 and 2009-2010 and linked to their provincial health care administrative data. Individuals with chronic pain were matched to those without using age, sex, survey year, and a propensity score for having chronic pain estimated from a rurality index, income quintile, and comorbidity. The Health Utilities Index Mark 3 instrument, included in the Canadian Community Health Survey, was used. Mean utilities were calculated for each group. Utility decrement for chronic pain was also calculated for each matched pair. A total of 65,246 responses were available for analysis. After matching, there were 12,146 matched pairs with and without pain. In the matched cohort, mean age was 54 years (SD 12); 61% were female. The matched cohort with chronic pain had a mean utility of 0.59 (95% confidence interval 0.58-0.59), and the decrement associated with chronic pain was 0.32 (95% confidence interval 0.31-0.32). Utilities in people with chronic pain were lower than, and decrements larger than, those seen with most other chronic diseases including heart disease, diabetes, and chronic obstructive pulmonary disease. These data will be useful to inform priorities and future strategies for the prevention and control of chronic pain.
Preprotachykinin A is expressed by a distinct population of excitatory neurons in the mouse superficial spinal dorsal horn including cells that respond to noxious and pruritic stimuli
Authors: Gutierrez-Mecinas Maria , Bell Andrew M. , Marin Alina , Taylor Rebecca , Boyle Kieran A. , Furuta Takahiro , Watanabe Masahiko , Polgár Erika , Todd Andrew J. 
Published: November 2016

Abstract
The superficial dorsal horn, which is the main target for nociceptive and pruritoceptive primary afferents, contains a high density of excitatory interneurons. Our understanding of their roles in somatosensory processing has been restricted by the difficulty of distinguishing functional populations among these cells. We recently defined 3 nonoverlapping populations among the excitatory neurons, based on the expression of neurotensin, neurokinin B, and gastrin-releasing peptide. Here we identify and characterise another population: neurons that express the tachykinin peptide substance P. We show with immunocytochemistry that its precursor protein (preprotachykinin A, PPTA) can be detected in ∼14% of lamina I-II neurons, and these are concentrated in the outer part of lamina II. Over 80% of the PPTA-positive cells lack the transcription factor Pax2 (which determines an inhibitory phenotype), and these account for ∼15% of the excitatory neurons in this region. They are different from the neurotensin, neurokinin B, or gastrin-releasing peptide neurons, although many of them contain somatostatin, which is widely expressed among superficial dorsal horn excitatory interneurons. We show that many of these cells respond to noxious thermal and mechanical stimuli and to intradermal injection of pruritogens. Finally, we demonstrate that these cells can also be identified in a knock-in Cre mouse line (Tac1Cre), although our findings suggest that there is an additional population of neurons that transiently express PPTA. This population of substance P–expressing excitatory neurons is likely to play an important role in the transmission of signals that are perceived as pain and itch.
Analysis of Hospital Readmission Patterns in Medicare Fee-for-Service and Medicare Advantage Beneficiaries
Authors: Oh Joobong June Park 
Published: November 2016

Purpose of Study:
The study was conducted to examine the hospital readmission patterns of two groups of Medicare beneficiaries—those covered by traditional Medicare (Medicare fee-for-service [FFS]) and those enrolled in a Medicare risk plan (Medicare Advantage [MA])—and to determine the characteristics that significantly increase the likelihood of multiple hospital readmissions.

Primary Practice Setting:
The study setting is the Hospital of the University of Pennsylvania (HUP) located in Philadelphia, PA.

Methodology and Sample:
A retrospective descriptive study design was used to analyze the electronic data from the HUP information technology system for Medicare beneficiaries, 65 years and older, who had an index hospital admission at the HUP during 2012 (January 1, 2012, through December 31, 2012), and were subsequently readmitted one or more times to the HUP during the observation period.

Results:
FFS and MA beneficiaries were hospitalized an average of 1.5 (±1.0) times; 69% were rehospitalized once and 30% were rehospitalized two or more times. Characteristics that increased the likelihood of multiple hospital readmissions included being discharged on a weekend, admitted through the emergency department with a diagnosis of injury and poisoning, being diagnosed with a new problem of the circulatory system, having an exacerbation of a circulatory system illness, and having an infection related to a previous admission. Characteristics that decreased the likelihood of multiple hospital readmissions included being discharged to a skilled nursing facility and being discharged home with home health services.

Implications for Case Management Practice:
Identification of the risk factors and characteristics that increase the likelihood of multiple hospital readmissions will permit early interventions in discharge planning, as evidenced by decreasing the rate of hospital readmissions and the length of hospital stays, increasing in time to hospital readmission, and preventing the first readmission and a subsequent return to the hospital.
Implementing Huddles Improves Care Coordination in an Academic Health Center
Authors: Townsend Carolyn S. , McNulty Mary , Grillo-Peck Adria 
Published: November 2016

Purpose of the Study:
To determine whether routinely scheduled, organized interdisciplinary huddles result in decreased length of stay and readmissions.

Primary Practice Setting:
The study was conducted in an academic health center (AHC) that also fills a community hospital need for a diverse inner-city population. Results are applicable in other care settings.

Methodology and Sample:
Daily interdisciplinary huddles were piloted on 5 medical/surgical units. The 2015 readmission and length of stay data were compared with the 2013 baseline.

Results:
There was a mean readmission reduction of 0.56%. A paired t test comparing the 2013 and 2015 readmission rates of the 5 units was significant (p < .05). There was a 0.42-day increase in the mean LOS between the 2013 baseline and the 2015 follow-up. A paired t test comparing 2013 and 2015 readmission rates of the 5 units was not significant at the .05 level.

Implications for Case Management Practice:
Daily interdisciplinary sessions can result in reduced readmissions. Long-lasting positive outcomes related to enhanced communication are possible. Requirements for success include consistency in the standard huddle content reviewed. Data should be followed closely throughout an extended period of time to identify trends and support sustainment. Creative means to obtain input from services that cover multiple units and not be able to attend huddles may be necessary. Staff turnover will impact success. Variation in physician engagement can be addressed by frequent communication on the “why” behind the significance of the huddles, as well as sharing of change data highlighting success stories.
Sexually Transmitted Infections and Associated Risk Factors Among Street-Based and Residence-Based Female Sex Workers in Dhaka, Bangladesh
Authors: Khanam Rasheda , Reza Masud , Ahmed Dilruba , Rahman Mustafizur , Alam M. Shah , Sultana Salima , Alam Anadil , Khan Sharful I. , Mayer Kenneth H. , Azim Tasnim 
Published: November 2016

Background
Female sex workers (FSWs) in Bangladesh remain at elevated risk of sexually transmitted infections (STIs) although the human immunodeficiency virus (HIV) prevalence among them is low. Recent information on the burden and etiological diagnosis of STIs among them has been lacking. This study examines prevalence and risk behaviors of selected STIs among FSWs in Dhaka in 2014.

Methods
Between August and October 2014, a cross-sectional study was conducted among street-based and residence-based FSWs receiving HIV prevention services at 24 drop in centers in Dhaka. Participants underwent behavioral interview, clinical examination, and laboratory testing for selected STIs using cervical swabs and blood.

Results
The sample consisted of 371 streets and 329 residence FSWs. Prevalence of gonorrhea, chlamydia, and active syphilis were 5.1%, 4.6%, 1.3% in street FSWs and were 5.8%, 8.2%, and 0.6% for residence FSWs which are lower compared with the previously reported rates. The following factors were associated with having any STI: being ≤5 years in sex trade (odds ratio, 2.2; 95% confidence interval, 1.2–3.9; P < 0.01), and having a cervical discharge (odds ratio, 2.6, 95% confidence interval, 1.5–4.6; P < 0.01). Resistance to cefixime and azithromycin was observed for 1 and 3 Neisseria gonorrhoeae strains, respectively.

Conclusions
Despite receiving HIV/STI prevention services, bacterial STIs remain prevalent among FSWs suggesting the need for more effective management of STIs. The guidelines for management of STIs need revision in view of the emerging resistance.
Single-Dose Compared With Multidose Metronidazole for the Treatment of Trichomoniasis in Women: A Meta-Analysis
Authors: Howe Katharine , Kissinger Patricia J 
Published: November 2016

Background

Trichomonas vaginalis is the most common curable sexually transmitted infection worldwide. Although the Centers for Disease Control and Prevention and the World Health Organization recommend a single 2-g dose of metronidazole for the first line of treatment for T. vaginalis among human immunodeficiency virus (HIV) negative women, high rates of repeat infections are found. The purpose of this meta-analysis was to compare treatment failure between single versus multidose metronidazole for the treatment of T. vaginalis.

Methods
A systematic literature search was performed using search terms including metronidazole AND trichomoniasis AND women. Embase, MEDLINE, and Clinicaltrials.gov were used to search for relevant studies as well as hand searching relevant articles. These databases were last searched on January 25, 2016. To be included in this meta-analysis, the study had to be a clinical trial, evaluate T. vaginalis, use oral metronidazole, and compare single dose metronidazole to multidose metronidazole.

Results
There were 487 articles that were assessed for relevance and quality. Of these articles, 6 met the eligibility criteria and were included in the final results. The pooled risk ratio indicated higher treatment failure for single dose compared to multidose 1.87 (95% confidence interval, 1.23–2.82; P < 0.01). When the one study that included HIV+ women was excluded from analysis, the findings were similar with a pooled risk ratio of 1.80 (95% confidence interval, 1.07–3.02; P < 0.03).

Conclusions
Centers for Disease Control and Prevention recently changed treatment recommendations for HIV+ women to multidose rather than single-dose. These data suggest that those recommendations should be considered for all women.
Factors Associated With Primary Care Physician Knowledge of the Recommended Regimen for Treating Gonorrhea
Authors: Bornstein Marta , Ahmed Faruque , Barrow Roxanne , Risley Jami Fraze , Simmons Sheena , Workowski Kimberly A. 
Published: November 2016

Background
The recommended regimen for treating uncomplicated gonorrhea has changed over time, due to the emergence of antimicrobial resistance. We assessed physician knowledge of the recommendation for treating uncomplicated urogenital gonorrhea in adolescents and adults using ceftriaxone and azithromycin dual therapy.

Methods
We analyzed DocStyles 2015 survey data from 1357 primary care physicians practicing for at least 3 years who provided screening, diagnosis, or treatment for sexually transmitted diseases to one or more patients in an average month. Logistic regression and χ2 analyses were used to identify factors associated with knowledge of dual therapy.

Results
Among the options of treatment with ceftriaxone alone, azithromycin alone, both of these, or spectinomycin plus levofloxacin, 64% of physicians correctly preferred ceftriaxone plus azithromycin. Knowledge of the recommended dual therapy decreased with increasing years of practice, ranging from 74% among physicians with 3–9 years of practice to 57% among those practicing for ≥24 years (adjusted odds ratio, ORa, for ≥24 vs 3–9 years of practice, 0.50; 95% confidence interval [CI], 0.35–0.70). Knowledge of dual therapy decreased with higher socioeconomic status of patients (ORa for high income vs poor/lower middle income patients, 0.47; 95% CI, 0.32–0.69). Physicians who pursued continuing medical education using journals, podcasts, and government health agencies were more likely to report dual therapy than those who did not use these sources (ORa, 2.09; 95% CI, 1.31–3.33).

Conclusions
Knowledge of the recommended regimen for treating gonorrhea decreased with increasing years of practice and with higher socioeconomic status of patients.
Improving Physician Recommendations for Human Papillomavirus Vaccination: The Role of Professional Organizations
Authors: Hswen Yulin , Gilkey Melissa B. , Rimer Barbara K. , Brewer Noel T. 
Published: November 2016

Background
To address low human papillomavirus (HPV) vaccination coverage, the American Academy of Family Physicians (AAFP) and the American Academy of Pediatrics (AAP) have launched national campaigns encouraging physicians to deliver strong HPV vaccine recommendations. We surveyed family physicians and pediatricians to examine the impact of these efforts on physicians’ recommendation practices.

Methods
A national sample of family physicians and pediatricians (n = 776) completed our online survey in 2014. The survey assessed reach, content, and influence of AAFP and AAP communications about HPV vaccination. The survey also assessed quality of physicians' communication practices for recommending HPV vaccination.

Results
Forty-seven percent of family physicians reported receiving information on HPV vaccination from AAFP, whereas 62% of pediatricians reported receiving information from AAP. Among physicians reached by AAFP or AAP, most reported receiving the message to give strong recommendations to adolescent boys (71%) and girls (78%). Although receiving information was not associated with HPV vaccine recommendation quality, receiving the message to give strong recommendations correlated with delivering higher-quality recommendations for boys (odds ratio, 4.19, 95% confidence interval, 2.64–6.64) and girls (odds ratio, 3.15, 95% confidence interval, 1.91–5.18). Over half of physicians reported improving their HPV vaccine communication after receiving information from AAFP (69%) or AAP (53%).

Conclusions
Our findings suggest that it is important for AAFP and AAP to communicate the need for strong HPV vaccine recommendations. Given that many physicians reported improving their recommendation practices, professional organizations stand to contribute to increasing HPV vaccination coverage, but they will likely need to increase the intensity of quality improvement efforts to do so.
Point-of-Care Thoracic Ultrasonography in the Diagnosis and Management of Kaposiform Lymphangiomatosis
Authors: Raam Manu S. , Festekjian Ara , Elkhunovich Marsha A. 
Published: November 2016

Abstract
Kaposiform lymphangiomatosis is a generalized lymphatic disorder complicated by consumptive coagulopathy and pericardial and pleural effusions. We present the case of a 13-year-old female adolescent given a diagnosis of a large pleural effusion by point-of-care thoracic ultrasonography, which led to further evaluation and diagnosis of this rare disorder. We review the use of point-of-care thoracic ultrasonography for the diagnosis of pleural effusion.
Mobile Health Technology to Communicate Discharge and Follow-Up Information to Adolescents From the Emergency Department
Authors: Ray Margaret , Dayan Peter S. , Pahalyants Vartan , Chernick Lauren S. 
Published: November 2016

Objective
Adolescents are the largest users of mobile technology; yet, there are little data regarding their receptivity to the use of mobile health technology (mHealth) from the emergency department (ED). The objective of this study was to determine adolescents' preferences for receiving ED discharge and follow-up information via mHealth and factors associated with those preferences.

Methods
We administered an anonymous self-reporting survey to patients aged 14 to 19 years discharged from an urban pediatric ED. We conducted exploratory bivariate analyses to evaluate differences in communication preferences based on patient characteristics. We used multivariable logistic regression to determine whether preference for health information via mHealth is associated with frequent information technology (IT) use, adjusting for age, sex, ethnicity, and insurance status.

Results
Four hundred thirty-nine adolescents completed the survey. Most were female (n = 279, 64%), 14 to 17 years old (n = 247, 57%), Hispanic (n = 359, 86%), and insured (n = 388, 88%). Adolescents used IT often, texting more than 30 times a day (58%) and emailing more than once a day (61%). Most (n = 335, 78%) were interested in electronic communication from the ED. Teens expressed particular interest in using email for discharge instructions (n = 196, 47%), physician referrals (n = 197, 48%), and test results (n = 201, 48%) and using texting for medication (n = 155, 38%) and appointment reminders (n = 170, 41%). Individuals tended to prefer communication with IT modes that they typically used, although only email was independently associated with preference for this mode (adjusted odds ratio, 2.8; 95% confidence interval, 1.5-5.3).

Conclusions
Adolescent patients are interested in receiving health information from the ED, mainly via email and texting. Future ED interventions should evaluate the effectiveness of these modalities to communicate with patients after discharge.
Using an Implementation Research Framework to Identify Potential Facilitators and Barriers of an Intervention to Increase HPV Vaccine Uptake
Authors: Selove Rebecca , Foster Maya , Mack Raquel , Sanderson Maureen , Hull Pamela C. 
Published: November 2016

Background:
Although the incidence of cervical cancer has been decreasing in the United States over the last decade, Hispanic and African American women have substantially higher rates than Caucasian women. The human papillomavirus (HPV) is a necessary, although insufficient, cause of cervical cancer. In the United States in 2013, only 37.6% of girls 13 to 17 years of age received the recommended 3 doses of a vaccine that is almost 100% efficacious for preventing infection with viruses that are responsible for 70% of cervical cancers. Implementation research has been underutilized in interventions for increasing vaccine uptake. The Consolidated Framework for Implementation Research (CFIR), an approach for designing effective implementation strategies, integrates 5 domains that may include barriers and facilitators of HPV vaccination. These include the innovative practice (Intervention), communities where youth and parents live (Outer Setting), agencies offering vaccination (Inner Setting), health care staff (Providers), and planned execution and evaluation of intervention delivery (Implementation Process).

Methods:
Secondary qualitative analysis of transcripts of interviews with 30 community health care providers was conducted using the CFIR to code potential barriers and facilitators of HPV vaccination implementation.

Results:
All CFIR domains except Implementation Process were well represented in providers' statements about challenges and supports for HPV vaccination.

Conclusion:
A comprehensive implementation framework for promoting HPV vaccination may increase vaccination rates in ethnically diverse communities. This study suggests that the CFIR can be used to guide clinicians in planning implementation of new approaches to increasing HPV vaccine uptake in their settings. Further research is needed to determine whether identifying implementation barriers and facilitators in all 5 CFIR domains as part of developing an intervention contributes to improved HPV vaccination rates.