bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “Everything About the Existence” Experiences of Turkish Women With Infertility: Solicited Diaries in Qualitative Research
Authors: Boz İlkay , Okumuş Hülya 
Published: July 2016

ABSTRACT

Background:
Infertility as a gynecological illness causes many psychological problems. In Turkey, only a limited number of studies have used qualitative methods to explore the experiences of infertile women.

Purpose:
The aims of this study are to investigate the infertility experiences of women using Watson’s Theory of Human Caring as a guide and to sensitize healthcare professionals to the importance of the personal stories of these women.

Methods:
A phenomenological approach was used to guide our exploration of the stories of infertile women during their treatment for infertility. This study involved 18 infertile women in Turkey. Data were collected using solicited diaries and were evaluated using thematic analysis.

Results:
The findings identified the following themes: (a) losing control of everything, (b) facing up to the angst, (c) living with the unknown, (d) alienation from the fertile world, (e) existential faith and hope, and (f) nonhealing environment.

Conclusions/Implications for Practice:
This study identified “existentialist philosophy” as the most important aspect of the infertility experience. Participant experiences highlighted that they lived with a despair that was brought about by losses resulting from the infertility diagnosis and its treatment. Nurses should help infertile women reorganize the meaning of infertility to reach a healthy interpretation of infertility.
Length of endoscopic workup in gastrointestinal bleeding
Authors: Woodward Zibing , Williams J. Lucas , Sonnenberg Amnon 
Published: July 2016

Background
The number of procedures utilized in the general management of gastrointestinal bleeding (GIB) has not been investigated previously. We used the National Endoscopic Database of the Clinical Outcomes Research Initiative for an observational study to analyze the average length of workup in GIB.

Methods
The electronic database was queried for all patients aged 18 years and older who underwent an endoscopic evaluation for any bleeding indication between 2000 and 2014. Data were stratified by indication, type, and number of endoscopies per patient, and length of workup.

Results
A total of 603 807 endoscopic procedures among 451 470 individual patients were used in the workup of GIB, with 152 337 procedures among 113 030 patients (25%) being performed as a secondary procedure. The average length was 2.4±0.9 procedures per workup in procedural sequences involving multiple endoscopies. The length of workup was independent of the initial type of GIB. An esophago-gastro-duodenoscopy (EGD), followed by a colonoscopy or a colonoscopy, followed by an EGD were the most frequent combinations. In another substantial fraction of two consecutive procedures, the first and the second procedure were identical. This pattern applied not only to EGD and colonoscopy but also to flexible sigmoidoscopy, enteroscopy, and video capsule endoscopy.

Conclusion
The majority of patients with GIB require only one type of endoscopy to manage their bleeding. However, in a quarter of patients, on average, 2.4 procedures are needed. Previous trials assessing the outcomes of individual types of endoscopy may have exaggerated their overall success rates in diagnosing and treating GIB.
Impact of ACA Insurance Coverage Expansion on Perforated Appendix Rates Among Young Adults
Authors: Scott John W. , Rose John A. , Tsai Thomas C. , Zogg Cheryl K. , Shrime Mark G. , Sommers Benjamin D. , Salim Ali , Haider Adil H. 
Published: July 2016

Background:
The 2010 Dependent Coverage Provision (DCP) of the Affordable Care Act allowed young adults to remain on their parents’ health insurance plans until age 26 years. Although the provision improved coverage and survey-reported access to care, little is known regarding its impact on timely access for acute conditions. This study aims to assess changes in insurance coverage and perforation rates among young adults with acute appendicitis—an established metric for population-level health care access—after the DCP.

Methods:
The National Inpatient Sample and difference-in-differences linear regression were used to assess prepolicy/postpolicy changes for policy-eligible young adults (aged 19–25 y) compared with a slightly older, policy-ineligible comparator group (aged 26–34 y).

Results:
After adjustment for covariates, 19–25 year olds experienced a 3.6-percentage point decline in the uninsured rate after the DCP (baseline 22.5%), compared with 26–34 year olds (P<0.001). This coincided with a 1.4-percentage point relative decline in perforated appendix rate for 19–25 year olds (baseline 17.5%), compared with 26–34 year olds (P=0.023). All subgroups showed significant reductions in uninsured rates; however, statistically significant reductions in perforation rates were limited to racial/ethnic minorities, patients from lower-income communities, and patients presenting to urban teaching hospitals.

Conclusions:
Reductions in uninsured rates among young adults after the DCP were associated with significant reductions in perforated appendix rates relative to a comparator group, suggesting that insurance expansion could lead to fewer delays in seeking and accessing care for acute conditions. Greater relative declines in perforation rates among the most at-risk subpopulations hold important implications for the use of coverage expansion to mitigate existing disparities in access to care.
Comorbidity Correlates of Death Among New Veterans of Iraq and Afghanistan Deployment
Authors: Copeland Laurel A. , Finley Erin P. , Bollinger Mary J. , Amuan Megan E. , Pugh Mary Jo V. 
Published: July 2016

Background:
Veterans of the wars in Iraq and Afghanistan who receive care in the Veterans Health Administration (VA) have high disease burden. Distinct comorbidity patterns have been shown to be differentially associated with adverse outcomes, including death. This study determined correlates of 5-year mortality.

Materials and Methods:
VA demographic, military, homelessness, and clinical measures informed this retrospective analysis. Previously constructed comorbidity classifications over 3 years of care were entered into a Cox proportional hazards model of death.

Results:
There were 164,933 veterans in the cohort, including African Americans (16%), Hispanics (11%), and whites (65%). Most were in their 20s at baseline (60%); 12% were women; 4% had attempted suicide; 4% had been homeless. Having clustered disorders of pain, posttraumatic stress disorder, and traumatic brain injury was associated with death [hazard ratio (HR)=2.0]. Mental disorders including substance abuse were similarly associated (HR=2.1). Prior suicide attempt (HR=2.2) or drug overdose (HR=3.0) considerably increased risk of death over 5 years.

Conclusions:
As congressional actions such as Veterans Choice Act offer more avenues to seek care outside of VA, coordination of care, and suicide prevention outreach for recent veterans may require innovative approaches to preserve life.
Antithrombotic potential of the contact activation pathway
Authors: Schmaier Alvin H. 
Published: July 2016

Purpose of review
This report examines the mechanism(s) by which each protein of the contact activation system – factor XII (FXII), high-molecular-weight kininogen, and prekallikrein – influences thrombosis risk.

Recent findings
FXII generates thrombin through contact activation via interaction with artificial surfaces as on medical instruments such as indwelling catheters, mechanical valves, stents, and ventricular assist devices. Inhibition of FXIIa-mediated contact activation prevents thrombosis under contact activation circumstances without affecting hemostasis. Current studies suggest that high-molecular-weight kininogen deficiency parallels that of FXII and inhibits contact activation. Prekallikrein inhibition contributes to thrombosis prevention by contact activation inhibition in the nylon monofilament model of transient middle cerebral artery occlusion. However, in arterial thrombosis models where reactive oxygen species are generated, prekallikrein deficiency results in downregulation of vessel wall tissue factor generation with reduced thrombin generation. Exploiting this latter prekallikrein pathway for thrombosis risk reduction provides a general, overall reduced tissue factor, antithrombotic pathway without risk for bleeding.

Summary
These investigations indicate that the proteins of the contact activation and kallikrein/kinin systems influence thrombosis risk by several mechanisms and understanding of these pathway provides insight into several novel targets to prevent thrombosis without increase in bleeding risk.
Management and reconstruction of blast wounds of the head and neck
Authors: Stevens Jayne R. , Brennan Joseph 
Published: July 2016

Purpose of review
The purpose of this review is to highlight recent literature related to the initial management and reconstruction of blast injuries to the head and neck.

Recent findings
An increasing percentage of combat-related injuries are caused by blast trauma. Management of blast trauma over the last 10 years has improved understanding of the unique nature of these injuries and the importance of thoughtful management and reconstruction. Blast trauma is associated with an increased need for definitive airway management. As a result, initial triage principles of airway management and hemorrhage control are extremely important in the acute setting. Blast trauma results in high-velocity injuries that can lead to extensive soft tissue damage, which has important implications for reconstruction. Staging reconstruction is an important consideration for more extensive injuries.

Summary
Experience on the battlefield with blast injuries over the last decade has led to efficient triage with focus on hemorrhage and airway control. The lessons learned in Iraq and Afghanistan with the unique physiology of blast trauma have improved the casualty care of service members and can be used both in future military conflicts and in civilian trauma care.
Current state of stem cell-mediated therapies for facial nerve injury
Authors: Wang Tiffany V. , Delaney Sean , Pepper Jon-Paul 
Published: July 2016

Purpose of review
Interest in the application of stem cell therapy to nerve injury has grown exponentially in recent years, as the armamentarium of potential stem cell sources has increased. This article reviews literature on the recent developments in the application of stem cell therapy for facial nerve injury.

Recent findings
Current stem cell therapy for the treatment of peripheral nerve injury can be generalized into those that either enhance native neural regeneration via an anti-inflammatory effect or growth factor secretion, replace Schwann cells, or replace motor neurons. Animal studies have shown that nerve conduits seeded with stem cells (either undifferentiated or differentiated into Schwann-like cells) in sciatic and facial nerve injury models can promote nerve regeneration with similar efficacy to autologous nerve autografts. In-vivo studies have also shown that induced pluripotent stem cell-derived motor neurons, when transplanted into transected mouse tibial nerves, can form functional neuromuscular junctions with the denervated mouse triceps surae.

Summary
The authors believe that induced pluripotent stem cells have significant therapeutic potential. This source of human stem cells can be harvested with little morbidity, is isogenic to the donor, and has fewer ethical concerns compared with embryonic cellular sources. Further research is required to determine stem cell efficacy and safety. Questions of stem cell fate unpredictability and possible tumorigenesis must be addressed prior to human trials.
Double Lumen Polyamide Tube‐stent for the Treatment of Recurrent Postcorrosive Esophageal Stenosis
Authors: Woynarowski Marek , Dądalski Maciej , Wojno Violetta , Teisseyre Mikołaj , Hurkała Leszek , Płowiecki Emil 
Published: July 2016

ABSTRACTThis article presents the results of endoscopic treatment for recurrent postcorrosive esophageal stenosis with a tube‐stent developed at our institution. The tube‐stent was implanted in 5 children with corrosive esophageal injury at the age of 2 to 8.5 years after 7 to 64 dilatation sessions during 5 to 118 months. In total, 13 tube‐stents were implanted. One patient had undergone 9 procedures during 2.5 years and the tube‐stent remained in place for 14 to 250 days. This patient was tube‐stent–dependent due to the lack of any possibility of surgical reconstruction. Two patients had the tube‐stent removed after 150 to 205 days and they remain free from esophageal restenosis. One patient did not tolerate the tube‐stent, evacuated it after 1 day and was referred for surgical esophagus replacement. One patient is currently still being treated with the tube‐stent. Tube‐stent was well tolerated and it may be effective in children with recurrent critical postcorrosive esophageal stenosis.
Outcome of Nephroblastoma Treatment According to the SIOP-2001 Strategy at a Single Institution in Argentina
Authors: Cafferata Constanza , Cacciavillano Walter , Galluzzo María L. , Flores Paula , Rose Adriana , Zubizarreta Pedro 
Published: July 2016

Objective:
Wilms tumor (WT) is a disease with a good prognosis. The aim of this study was to evaluate the outcome of patients with WT, treated according to the SIOP-2001 strategy.

Methods:
A retrospective analysis of 141 consecutive patients with WT diagnosed at our institution between December 2001 and 2013 was performed.

Results:
A total of 114 patients, median age 38.8 months (3 to 155 mo), were assessable for analysis. Fine-needle aspiration was initially performed in 88 patients (84.6%). Stage distribution was: I: 33%, II: 9.6%, III: 28%, IV: 14%, V: 14.9%. Six patients were stage III because of tumor spillage. The remaining patients received preoperative chemotherapy. Adjuvant chemotherapy was given without randomization, using vincristine-actinomycin for stage II and vincristine-doxorubicin-actinomycin plus radiotherapy for stage III. After a median follow-up of 52 months, 5-year overall survival and event-free survival were 91% and 85%, respectively. Overall survival according to stage was: I: 96%, II: 99%, III: 88%, IV: 78%, V: 90% (P=0.16). There was no significant difference in event-free survival (P=0.7). Seventy-eight (85.7%) were intermediate-risk and 11 (12%) were high-risk patients. Seventeen patients (14.9%) relapsed within 2 to 99 months (median 29.9 mo). Eight patients (7%) died of progressive disease. There were no treatment-related deaths.

Conclusions:
The SIOP-01 protocol proposes a treatment strategy that is feasible in our institution, achieving good results.
Prevalence and Characteristics of Body Dysmorphic Disorder Among Patients in a Partial Hospital Program
Authors: Bjornsson Andri , Magnusdottir Soffia , Wessman Inga , Beard Courtney , Lee Josephine , Hearon Bridget A. , Björgvinsson Thröstur 
Published: July 2016

Abstract
Body dysmorphic disorder (BDD) is a common disorder that is usually associated with impaired functioning and high levels of suicidality. The current study is the first to assess prevalence of BDD among patients in a partial hospital program and compare patients with and without BDD on demographic and clinical variables. Participants were 207 patients with a variety of Axis I diagnoses. Prevalence of current BDD was 7.2%, and a diagnosis of BDD did not predict worse treatment outcome in the program. Patients with current BDD were more likely to be female and younger and have more comorbid diagnoses than patients without current BDD. No other significant differences were found at baseline between patients with and without current BDD. Results indicate that BDD is relatively common among patients in partial hospital programs and that such programs may be as beneficial to patients with BDD as to other patients.
Parental Divorce or Death During Childhood and Adolescence and Its Association With Mental Health
Authors: Tebeka Sarah , Hoertel Nicolas , Dubertret Caroline , Le Strat Yann 
Published: July 2016

Abstract
Despite the severity of the loss of a parent and the frequency of parental divorce, few studies compared their impact on mental health in the general adult population. The aim of this study was to estimate the prevalence, sociodemographic correlates, and psychiatric comorbidity of parental loss and parental divorce during childhood and adolescence. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults (n = 43,093). Of the 43,093 participants, parental divorce during childhood or adolescence was reported by 5776 participants, whereas 3377 experienced parental death during childhood or adolescence. Participants reporting a history of parental divorce present a significantly higher prevalence of psychiatric disorders, particularly alcohol and drug use disorders compared with control subjects. While participants experiencing the death of a parent reported a poorer overall health, the prevalence of psychiatric disorder after 17 years of age was not significantly higher than that of the control subjects.
Cluster B Personality Disorder Traits as a Predictor of Therapeutic Alliance Over Time in Residential Treatment for Substance Use Disorders
Authors: Olesek Kyle L. , Outcalt Jared , Dimaggio Giancarlo , Popolo Raffaele , George Sunita , Lysaker Paul H. 
Published: July 2016

Abstract
While poor therapeutic alliance is a robust predictor of poor outcome in substance abuse treatment, less is known about the barriers to therapeutic alliances in this group. To explore this issue, this study examined whether the severity of cluster B personality disorders predicted therapeutic alliances concurrently and prospectively in a residential substance treatment program for homeless veterans. Participants were 48 adults with a substance abuse disorder. Personality disorder traits were assessed using the Structured Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Personality Disorders, whereas therapeutic alliance was assessed at baseline using the Working Alliance Inventory. Partial correlations controlling for overall symptom severity measured with the Symptom Checklist 90 and education, revealed cluster B traits at baseline predicted all 4 assessments of therapeutic alliance even after controlling for initial levels of therapeutic alliance. Results suggest that higher levels of cluster B traits are a barrier to the formation of working alliances in residential substance treatment.
Perceived Risk Among Human Immunodeficiency Virus Serodiscordant Couples in East Africa Taking Oral Pre-Exposure Prophylaxis
Authors: Carroll Jennifer J. , Heffron Renee , Mugo Nelly , Ngure Kenneth , Ndase Patrick , Asiimwe Stephen , Celum Connie , Baeten Jared M. 
Published: July 2016

Objectives
Perceived risk of human immunodeficiency virus (HIV) infection is thought to drive low adherence in pre-exposure prophylaxis (PrEP) trials. We explored the level of perceived risk of incident HIV infection in the Partners PrEP Study, in which adherence was generally high.

Methods
A cross-sectional questionnaire assessed perceived risk of HIV at 12 months after enrollment. Logistic regression was used to analyze the relationship between perceived risk and other demographic and behavioral variables.

Results
Three thousand two hundred twenty-six couples from the Partners PrEP Study were included in this analysis. Only 15.4% of participants reported high or moderate perceived risk. Participants at high risk of acquiring HIV were slightly more likely to report high perceived risk (odds ratio, 1.60; 95% confidence interval, 1.30–1.95; P < 0.001); nevertheless, only 20% of participants with high-risk reported high perceived risk.

Conclusions
Participants reported low perceived risk of HIV but were adherent to PrEP. Perceptions of risk are likely socially determined and more complex than Likert scale questionnaires capture.
Anal Dysplasia Screening and Treatment in a Southern Human Immunodeficiency Virus Clinic
Authors: Willeford Wesley G. , Barroso Luis , Keller Jennifer , Fino Nora , Bachmann Laura H. 
Published: July 2016

Background
Persistent human papillomavirus infection in human immunodeficiency virus (HIV)-infected individuals has been strongly associated with anal squamous cell carcinoma. The incidence of anal squamous cell carcinoma continues to increase in this population despite advances in HIV therapy. There are few studies describing the prevalence of anal cancer precursors, treatment outcomes, and associated factors among HIV-infected populations in the southern United States.

Methods
A retrospective chart review was performed on 355 HIV-infected patients from a Southern HIV clinic who were 18 years or older and had received at least one anal Pap smear. Demographic and clinical variables were collected. Descriptive statistics, single variable, and multivariate logistic regression analysis were performed to evaluate for predictors of high-grade squamous intraepithelial lesion (HSIL). Odds ratios and 95% confidence intervals were constructed for independent measures.

Results
After the first anal Pap smear, 38.3% (70/183) of patients with abnormal results were lost to follow-up. Comparing patients with biopsy proven HSIL versus low-grade squamous intraepithelial lesions, patients were less likely to have HSIL if they had a higher CD4 count (odds ratio, 0.81; 95% confidence interval, 0.72–0.93; P = 0.0022). Treatment success after the first round of treatment for topical and infrared coagulation therapy was 36.7% (18/49, all therapy types), and of those who achieved biopsy proven treatment success at follow-up screening, 94.4% (17/18) required subsequent therapy.

Conclusions
Patients with a higher CD4 count were less likely to have HSIL. CD4 nadir, number of sexual partners, and race/ethnicity were not significantly associated with the presence of HSIL.
Molecular Typing of Treponema pallidum in Ocular Syphilis
Authors: Oliver Sara , Sahi Sharon K. , Tantalo Lauren C. , Godornes Charmie , Neblett Fanfair Robyn , Markowitz Lauri E. , Lukehart Sheila A. , Marra Christina M. 
Published: July 2016

Background
Syphilis can have many clinical manifestations, including eye involvement, or “ocular syphilis.” In 2015, an increase in reported cases of ocular syphilis and potential case clusters raised concern for an oculotropic strain of Treponema pallidum, the infectious agent of syphilis. Molecular typing was used to examine strains found in cases of ocular syphilis in the United States.

Methods
In 2015, after a clinical advisory issued by the Centers for Disease Control and Prevention, pretreatment clinical specimens from US patients with ocular syphilis were sent to a research laboratory for molecular analysis of T. pallidum DNA. Molecular typing was conducted on these specimens, and results were compared with samples collected from Seattle patients diagnosed with syphilis, but without ocular symptoms.

Results
Samples were typed from 18 patients with ocular syphilis and from 45 patients with syphilis, but without ocular symptoms. Clinical data were available for 14 ocular syphilis patients: most were men, human immunodeficiency virus–infected, and had early syphilis. At least 5 distinct strain types of Treponema pallidum were identified in these patients, and 9 types were identified in the Seattle nonocular patients. 14d/g was the most common type in both groups. An unusual strain type was detected in a small cluster of ocular syphilis patients in Seattle.

Conclusions
Ocular syphilis is a serious sequela of syphilis. In this preliminary study, clear evidence of a predominant oculotropic strain causing ocular syphilis was not detected. Identification of cases and prompt treatment is critical in the management of ocular syphilis.