bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Screening Methods for Hepatitis C Among People Who Inject Drugs: Findings from the HepTLC Initiative, 2012–2014
Authors: Blackburn Natalie A. , Patel Rajiv C. , Zibbell Jon E. 
Published: June 2016

Objective. People who inject drugs (PWID) are at increased risk for hepatitis C virus (HCV) infection. We examined HCV testing outcomes among PWID through CDC's Hepatitis Testing and Linkage to Care initiative, which promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites during 2012–2014. Ten grantees in nine geographically diverse cities conducted HCV testing among PWID. Methods. Among those testing positive for HCV antibody (anti-HCV), we calculated the proportion who were offered a confirmatory HCV ribonucleic acid (RNA) test, positively diagnosed, and referred to a specialist for care. We stratified anti-HCV-positive people who completed each step by same-day testing (i.e., an HCV RNA test administered on the same date as an anti-HCV test) vs. person not receiving same-day testing to evaluate whether the need for follow-up testing affected diagnosis of chronic infection and linkage to care. Results. A total of 15,274 people received an anti-HCV test at 84 testing sites targeting PWID. Of those, 11,159 (73%) reported having injected drugs in their lifetime, 7,789 (51%) reported injecting drugs in the past 12 months, and 3,495 (23%) tested anti-HCV positive. A total of 1,630 people received testing for HCV RNA, of whom 1,244 (76%) were HCV RNA positive. When not receiving both tests on the same day, 601 of 2,465 (24%) anti-HCV-positive people received an HCV RNA test. Conclusion. Strategies to diagnose PWID for HCV infection are needed to reduce associated morbidity and mortality. Agencies can substantially increase the number of PWID who are diagnosed and informed of their HCV infection by administering both anti-HCV and HCV RNA tests during a single testing event.
Hepatitis C Virus Testing and Linkage to Care in North Carolina and South Carolina Jails, 2012–2014
Authors: Schoenbachler Ben T. , Smith Bryce D. , Seña Arlene C. , Hilton Alison , Bachman Sallie , Lunda Mulamba , Spaulding Anne C. 
Published: June 2016

Objective. We evaluated a hepatitis C virus (HCV) testing and linkage-to-care post-release program among detainees of small- to medium-sized jails in North Carolina and South Carolina as part of the Hepatitis Testing and Linkage to Care initiative. Methods. An HCV testing and linkage-to-care program was implemented in selected jails in North Carolina and South Carolina from December 2012 to March 2014. Health-care workers not affiliated with the jails conducted HCV antibody (anti-HCV) and HCV ribonucleic acid (RNA) testing and linkage-to-care activities. The North Carolina jail provided universal opt-out testing for HCV; South Carolina jails initially targeted high-risk individuals before expanding to routine testing. Results. Of 669 detainees tested for HCV in North Carolina, 88 (13.2%) tested anti-HCV positive, of whom 81 (92.0%) received an HCV RNA test, 66 (81.5%) of whom tested HCV RNA positive (i.e., currently infected). Of the 66 detainees with current HCV infection, 18 were referred to HCV medical care post-release and 10 attended their first appointment. Of 224 detainees tested for HCV in South Carolina, 18 (8.0%) tested anti-HCV positive, of whom 13 received an HCV RNA test. Nine of 13 detainees tested HCV RNA positive, seven detainees were referred to post-release medical care, and two detainees attended their first appointment. Overall, 106 of 893 (11.9%) detainees were anti-HCV positive. Conclusion. This study demonstrated that HCV testing, identification of infection, and linkage to care are feasible among jail populations. The rate of anti-HCV positivity was lower than that found in national studies of incarcerated populations, suggesting that HCV infection prevalence in jails may vary across U.S. states or regions.
Impact of the Hepatitis Testing and Linkage to Care (HepTLC) Initiative on Linkage to Care for Minnesota Refugees with Hepatitis B, 2012–2014
Authors: Linde Ann C. , Sweet Kristin A. , Nelson Kailey , Mamo Blain , Chute Sara M. 
Published: June 2016

Objective. The Hepatitis Testing and Linkage to Care (HepTLC) initiative promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites from 2012 to 2014. Through the HepTLC initiative, the Minnesota Department of Health (MDH) and clinic partners began conducting linkage-to-care activities with hepatitis B-positive refugees in October 2012. This intervention provided culturally appropriate support to link refugees to follow-up care for hepatitis B. Methods. MDH refugee health and viral hepatitis surveillance programs, along with clinics that screened newly arrived refugees in Hennepin and Ramsey counties in Minnesota, collaborated on the project, which took place from October 1, 2012, through September 30, 2014. Bilingual care navigators contacted refugees to provide education, make appointments, and arrange transportation. We compared the linkage-to-care rate for participants with the rates for refugees screened the year before project launch using a two-sample test of proportions. Results. In the year preceding the project (October 2011 through September 2012), 87 newly arrived refugees had a positive hepatitis B surface antigen (HBsAg) test. Fifty-six (64%) refugees received follow-up care, 12 (14%) refugees did not receive follow-up care, and 19 (22%) refugees could not be located and had no record of follow-up care. During the project, 174 HBsAg-positive, newly arrived refugees were screened. Of those 174 refugees, 162 (93%) received follow-up care, seven (4%) did not receive follow-up care, and five (3%) could not be located and had no record of follow-up care. The one-year linkage-to-care rate for project participants (93%) was significantly higher than the rate for refugees screened the previous year (64%) ( p<0.001). Conclusion. In the context of a strong screening and surveillance infrastructure, a simple intervention improved the linkage-to-care rate for HBsAg-positive refugees.
Academic and Behavioral Design Parameters for Cluster Randomized Trials in Kindergarten
Authors: Hedberg E. C. 
Published: June 2016

Background: There is an increased focus on randomized trials for proximal behavioral outcomes in early childhood research. However, planning sample sizes for such designs requires extant information on the size of effect, variance decomposition, and effectiveness of covariates. Objectives: The purpose of this article is to employ a recent large representative sample of early childhood longitudinal study kindergartners to estimate design parameters for use in planning cluster randomized trials. A secondary objective is to compare the results of math and reading with the previous kindergartner cohort of 1999. Research Design: For each measure, fall–spring gains in effect size units are calculated. In addition, multilevel models are fit to estimate variance components that are used to calculate intraclass correlations (ICCs) and R2 statistics. The implications of the reported parameters are summarized in tables of required school sample sizes to detect small effects. Measures: The outcomes include information about student scores regarding learning behaviors, general behaviors, and academic abilities. Results: Aside from math and reading, there were small gains in these measures from fall to spring, leading to effect sizes between about .1 and .2. In addition, the nonacademic ICCs are smaller than the academic ICCs but are still nontrivial. Use of a pretest covariate is generally effective in reducing the required sample size in power analyses. The ICCs for math and reading are smaller for the current sample compared with the 1999 sample.
Muscle Tension Dysphagia
Authors: Kang Christina H. , Hentz Joseph G. , Lott David G. 
Published: June 2016

ObjectiveTo identify symptoms, common diagnostic findings, pattern of treatments and referrals offered, and their efficacy in a group of patients with idiopathic functional dysphagia in an otolaryngology setting with multiple providers.Study DesignCase series with chart review.SettingTertiary academic center.Subjects and MethodsFollowing Mayo Clinic Institutional Review Board approval, a retrospective chart review was conducted of patients with dysphagia who had a videofluoroscopic swallow study between January 1, 2013, and April 30, 2015. Each patient’s dysphagia symptomology, videofluoroscopic swallow study, flexible laryngoscopy, and medical chart were reviewed to identify the treatment paradigms that were utilized.ResultsSixty‐seven adult patients met the inclusion criteria. Abnormal laryngeal muscle tension was present in 97% of patients. Eighty‐two percent of patients also demonstrated signs of laryngeal hyperresponsiveness. Nonspecific laryngeal inflammation was evident in 52% of patients. Twenty‐seven patients were referred to speech‐language pathology for evaluation. Thirteen patients completed a course of voice therapy directed toward unloading muscle tension. All 13 patients self‐reported resolution of dysphagia symptoms.ConclusionThe study results suggest that laryngeal muscle tension may be a factor in the underlying etiology in patients with idiopathic functional dysphagia. We propose the diagnostic term muscle tension dysphagia to describe a subset of patients with functional dysphagia. Further prospective studies are needed to better evaluate potential gastroesophageal confounders in this group of patients and to identify an effective paradigm for treatment. In our limited series, speech‐language pathology intervention directed toward unloading muscle tension appears effective.
Successful Implementation of a Clinical Care Pathway for Management of Epistaxis at a Tertiary Care Center
Authors: Vosler Peter S. , Kass Jason I. , Wang Eric W. , Snyderman Carl H. 
Published: June 2016

ObjectiveWe compare the management of patients with severe epistaxis before and after the implementation a clinical care pathway (CCP) to standardize care, minimize hospital stay, and decrease cost.Study DesignSingle prospective analysis with historical control.SettingTertiary academic hospital.Subjects and MethodsPatients treated for epistaxis between October 2012 to December 2013 were compared with a prospective analysis of patients treated for severe epistaxis after implementation of a CCP from June 2014 to February 2015. Severe epistaxis was defined as nasal bleeding not able to be controlled with local pressure, topical vasoconstrictors, or simple anterior packing.ResultsSevere epistaxis was similar in the pre‐ and post‐CCP cohorts: 24.7% (n = 42) vs 18.9% (n = 22), respectively. Implementation of early sphenopalatine artery ligation resulted in decreased number of days packed (3.2 ± 1.6 to 1.4 ± 1.6; P =. 001), decreased hospital stay (5.2 ± 3.9 to 2.1 ± 1.3 days; P <. 001), an increased percentage of sphenopalatine artery ligations (31.0% vs 54.5%; P =. 035), admission to an appropriate hospital location with access to key resources (41.7% vs 83.3%; P =. 007), and decreased overall cost of hospitalization by 66% ($9435 saved). No patients received embolization after the CCP was implemented.ConclusionsImplementation of a CCP decreased hospital stay and days of packing, facilitated definitive care in patients with severe epistaxis, improved patient safety, and decreased cost. The results of this study can serve as a model for the management of severe epistaxis and for future quality improvement measures.
Amylin alters human brain pericyte viability and NG2 expression
Authors: Schultz Nina , Byman Elin , Fex Malin , Wennström Malin 
Published: June 2016

Amylin, a pancreatic β-cell-derived peptide hormone, forms inclusions in brain microvessels of patients with dementia who have been diagnosed with type 2 diabetes and Alzheimer’s disease. The cellular localization of these inclusions and the consequences thereof are not yet known. Using immunohistochemical staining of hippocampus and parahippocampal cortex from patients with Alzheimer’s disease and non-demented controls, we show that amylin cell inclusions are found in pericytes. The number of amylin cell inclusions did not differ between patients with Alzheimer’s disease and controls, but amylin-containing pericytes displayed nuclear changes associated with cell death and reduced expression of the pericyte marker neuron-glial antigen 2. The impact of amylin on pericyte viability was further demonstrated in in vitro studies, which showed that pericyte death increased in presence of fibril- and oligomer amylin. Furthermore, oligomer amylin increased caspase 3/7 activity, reduced lysate neuron-glial antigen 2 levels and impaired autophagy. Our findings contribute to increased understanding of how aggregated amylin affects brain vasculature and highlight amylin as a potential factor involved in microvascular pathology in dementia progression.
Ownership, Board Compensation and Company Performance in Sub-Saharan African Countries
Authors: Munisi Gibson Hosea , Mersland Roy 
Published: June 2016

In countries with weak institutions, board governance becomes more important. This study uses a unique dataset from listed sub-Saharan African companies to examine the relationship between ownership composition and board compensation. It further analyses the association between board compensation and company performance. The findings indicate that board ownership and chief executive officer ownership are positively associated, whereas state ownership and concentrated ownership are negatively associated with board compensation. There is no evidence of a significant association between chairperson ownership or foreign ownership and board compensation. Finally, there is a negative but not significant relationship between board compensation and company performance. JEL Classification: G32, G34
Conceptualizing the key processes of Mindful Parenting and its application to youth mental health
Authors: Townshend Kishani 
Published: June 2016

Objective: Youth mental health disorders are rising across the world. Mindful Parenting could be a potential tool to promote youth mental health. The primary distinction between Mindful Parenting programs and other behavioral parenting programs is the focus on emotional literacy and compassion. However, this emerging field has gaps in its theory and evidence. In order to objectively evaluate the impact of Mindful Parenting, it is important to identify how it promotes change. This theoretical paper aims to articulate the key change processes of Mindful Parenting that promote positive outcomes. Method: A literature review was conducted to synthesize the change processes outlined by different authors in the field. Results: Key processes argued to promote Mindful Parenting were aligned with five main categories, namely attention, intention, attitude, attachment and emotion. More specifically the change processes were listening, emotional awareness, emotional regulation, attentional regulation, attunement, attention to variability, intentionality, reperceiving, compassion and non-judgmental acceptance. Conclusions: This preliminary analysis attempted to understand how Mindful Parenting fosters change and transformation. Whilst there are numerous change processes, the essence of Mindful Parenting appears to be the ability to be responsive to a child’s needs.
Mannitol for the prevention of cisplatin-induced nephrotoxicity: A retrospective comparison of hydration plus mannitol versus hydration alone in inpatient and outpatient regimens at a large academic medical center
Authors: Williams Robert P , Ferlas Brandon W , Morales Paul C , Kurtzweil Andy J 
Published: June 2016

Background Cisplatin-induced nephrotoxicity is a dose limiting adverse effect that occurs in nearly one-third of patients. Mannitol administration has been used as a means to negate this toxicity. Data regarding the efficacy of mannitol use in this context are conflicting and limited. Objective The aim of this study is to evaluate the effect of mannitol on renal function and describe the incidence of cisplatin-induced nephrotoxicity. Methods This study is a quasi-experimental retrospective analysis approved by the Institutional Review Board of inpatient and outpatient adults receiving cisplatin doses ≥40 mg/m2. The primary outcome was mean change in serum creatinine from baseline. Secondary outcomes included incidences of various grades of nephrotoxicity. Results A total of 313 patients (95 treated with mannitol and 218 without) were evaluated. The average increase in serum creatinine (mg/dL) was lower in patients who received mannitol versus those who did not (0.30 vs. 0.47; 95% confidence interval for difference, 0.03 to 0.31; P = 0.02). Grade 2 or higher nephrotoxicity occurred less frequently in patients who received mannitol versus those who did not (8% vs. 17%; P = 0.04). Non-gynecologic regimens and those who received doses ≥70 mg/m2 of cisplatin had lower rates of grade 2 or higher nephrotoxicity with mannitol (6% vs. 23%; P = 0.001, and 7% vs. 22%; P = 0.03, respectively). Conclusion The use of mannitol reduces the incidence and severity of nephrotoxicity in patients treated with cisplatin. The results of the study suggest mannitol may be most effective when used with non-gynecologic regimens and with cisplatin doses ≥70 mg/m2.
Featured Article: Alterations of lecithin cholesterol acyltransferase activity and apolipoprotein A-I functionality in human sickle blood
Authors: Soupene Eric , Borja Mark S , Borda Mauricio , Larkin Sandra K , Kuypers Frans A 
Published: June 2016

In sickle cell disease (SCD) cholesterol metabolism appears dysfunctional as evidenced by abnormal plasma cholesterol content in a subpopulation of SCD patients. Specific activity of the high density lipoprotein (HDL)-bound lecithin cholesterol acyltransferase (LCAT) enzyme, which catalyzes esterification of cholesterol, and generates lysoPC (LPC) was significantly lower in sickle plasma compared to normal. Inhibitory amounts of LPC were present in sickle plasma, and the red blood cell (RBC) lysophosphatidylcholine acyltransferase (LPCAT), essential for the removal of LPC, displayed a broad range of activity. The functionality of sickle HDL appeared to be altered as evidenced by a decreased HDL–Apolipoprotein A-I exchange in sickle plasma as compared to control. Increased levels of oxidized proteins including ApoA-I were detected in sickle plasma. In vitro incubation of sickle plasma with washed erythrocytes affected the ApoA-I-exchange supporting the view that the RBC blood compartment can affect cholesterol metabolism in plasma. HDL functionality appeared to decrease during acute vaso-occlusive episodes in sickle patients and was associated with an increase of secretory PLA2, a marker for increased inflammation. Simvastatin treatment to improve the anti-inflammatory function of HDL did not ameliorate HDL–ApoA-I exchange in sickle patients. Thus, the cumulative effect of an inflammatory and highly oxidative environment in sickle blood contributes to a decrease in cholesterol esterification and HDL function, related to hypocholesterolemia in SCD.
Use of varenicline for more than 12 months for smoking cessation in heavy chronic obstructive pulmonary disease smokers unmotivated to quit: a pilot study
Authors: Sansores Raúl H. , Ramírez-Venegas Alejandra , Arellano-Rocha Rosario , Noé-Díaz Valeri , García-Gómez Leonor , Pérez Bautista Oliver , Velázquez Uncal Mónica 
Published: June 2016

Introduction: Use of varenicline for as long as necessary to achieve abstinence has not been studied. The aim of this study was to test whether smokers with mild-to-moderate chronic obstructive pulmonary disease (COPD) are able to quit if they use varenicline for a sufficient length of time. Methods: A total of 30 heavy smokers with COPD took varenicline for sufficiently long enough for smoking cessation. Smokers were allowed to smoke without a fixed quit date. The main endpoints were the time of voluntary abstinence (VA) and the continuous abstinence rate (CAR) at 12 and 18 months. Results: Of 28 subjects, eight subjects continued to smoke and 20 subjects stopped smoking, demonstrating a CAR up to 18 months (71%). Median time of treatment was 6 (range 3–24) and 2 (range 1–8) months for abstainers and non-abstainers, respectively, and the median time of VA for abstainers was 4 (range 1–21) months. Conclusions: Use of varenicline for more than the traditional 12 recommended weeks may be a good strategy to increase the cessation rate in heavy smokers with mild COPD.
Poor reproducibility of breath hydrogen testing: Implications for its application in functional bowel disorders
Authors: Yao Chu K , Tuck Caroline J , Barrett Jacqueline S , Canale Kim EK , Philpott Hamish L , Gibson Peter R 
Published: June 2016

BackgroundLimited data are available regarding the reproducibility of lactulose and fructose breath testing for clinical application in functional bowel disorders.ObjectivesThe purpose of this study was to investigate the reproducibility of lactulose and fructose breath hydrogen testing and assess symptom response to fructose testing.MethodsResults were analysed from 21 patients with functional bowel disorder with lactulose breath tests and 30 with fructose breath tests who completed another test >2 weeks later. Oro‐caecal transit time, hydrogen responses, both qualitatively (positive/negative) and quantitatively (area under the curve (AUC) for hydrogen), were compared between tests. In another 36 patients, data scores for overall abdominal symptoms, abdominal pain, bloating, wind, nausea and fatigue were collected during the fructose test and compared to hydrogen responses.ResultsNo correlations were found for lactulose AUC (linear regression, p  = 0.58) or transit time (Spearman's p  = 0.54) between tests. A significant proportion (30%) lost the presence of fructose malabsorption (p  < 0.01). Hydrogen AUC for fructose did not correlate between tests, (r  = 0.28, p  = 0.17) independent of time between testing (p  = 0.82). Whilst patients with fructose malabsorption were more likely to report symptoms than those without (56% vs 17%; p  = 0.04), changes in symptom severity were not different (p  > 0.05).ConclusionsRoutine use of lactulose and fructose breath tests in functional bowel disorder patients is not supported due to its poor reproducibility and low predictive value for symptom responses.
Unscheduled Pediatric Intensive Care Unit Admissions in Patients With Cardiovascular Disease
Authors: Coro Melinda D. , Spaeder Michael C. , Penk Jamie S. , Levin Amanda B. , Futterman Craig 
Published: June 2016

Background: An unscheduled readmission to the intensive care unit (ICU) is associated with increased morbidity and mortality in children. There is a paucity of data examining the impact of unscheduled admissions on outcomes in children with specific disease processes such as cardiovascular disease. We investigated the impact of scheduled versus unscheduled ICU admission on clinical outcomes and differences in patient characteristics in children with cardiovascular disease. Methods: This was a retrospective analysis of contemporaneously collected clinical data using the Virtual PICU Systems database. All consecutive admissions at 102 participating pediatric ICUs in patients with cardiovascular disease were collected from October 2010 to September 2012. Results: There were 48,653 admissions included in the analysis (44% scheduled and 56% unscheduled). The median patient age was 31 months. Unscheduled admissions were associated with longer ICU length of stay and increased mortality (both P < .001). Adjusting for age, weight, and primary ICU admission diagnosis (cardiovascular vs noncardiovascular), patients with unscheduled admissions had an increased odds of mortality (odds ratio = 4.8, P < .001). Conclusions: Unscheduled ICU admissions were associated with worse clinical outcomes including increased mortality. Efforts targeted at reducing unscheduled admissions in at-risk patients are warranted.