bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Single Center, Prospective, Randomized, Sham-Controlled, Double-Blinded, Split-Face Trial Using Microinjections of Transparent Hyaluronic Acid Gel for Cheek Rejuvenation
Authors: Jones Isabela T. , Vanaman Wilson Monique J. , Bolton Joanna , Zaleski-Larsen Lisa , Wu Douglas C. , Goldman Mitchel P. 
Published: January 2018

BACKGROUND
“Skin boosting” with injections of hyaluronic acid has been demonstrated to improve aged skin.

OBJECTIVE
The aim of this study was to determine the efficacy and safety of small-particle hyaluronic acid with lidocaine (SP-HAL) microaliquots for the correction of fine lines of the cheeks.

MATERIALS AND METHODS
Twenty subjects with mild to moderate static mid to lower cheek rhytides were enrolled. The right or left cheek was randomized to receive 1 mL of SP-HAL using a microdroplet technique, with the contralateral cheek treated with sham injection of sterile normal saline. The degree of cheek wrinkling and elastosis based on the Fitzpatrick-Goldman Wrinkle and Elastosis Scale was assessed at baseline and 7, 14, 30, 90, and 180 days after treatment. Subjects rated their satisfaction at days 90 and 180.

RESULTS
Fourteen patients completed the study. There were no statistically significant improvements in wrinkling or elastosis of the SP-HAL–treated cheek or control cheek at any time point. In addition, there were no significant differences in wrinkling, elastosis, or patient satisfaction between the treatment cheek and control cheek.

CONCLUSION
One treatment of intradermal microdroplet injections of SP-HAL to the mid to lower cheek failed to show superiority over normal saline in improving clinical signs of skin wrinkling and elastosis.
The Effects of Postoperative Intralesional Corticosteroids in the Prevention of Recurrent Earlobe Keloids: A Multispecialty Retrospective Review
Authors: Gold Daniel A. , Sheinin Renee , Jacobsen Gordon , Jones Lamont R. , Ozog David M. 
Published: January 2018

BACKGROUND
Effective treatment of keloids is challenging because the recurrence rate after surgical excision is high. Data on the best treatment practices are lacking.

OBJECTIVE
To investigate the recurrence rate after surgical excision of earlobe keloids based on a postoperative intralesional corticosteroid injection protocol.

MATERIALS AND METHODS
Retrospective chart review was performed from January 1, 2005, to March 31, 2016, of patients who had excision of ear keloids within the departments of dermatology, otorhinolaryngology, and plastic surgery. The number of postoperative injections was recorded, recurrence was reported by the patient, and the efficacy of an injection protocol was evaluated.

RESULTS
There were 277 charts reviewed. Appropriate data were available for 184 patients. A statistically significant difference was found with recurrence associated with a lower number of injections (p < .001). Keloids were more likely to recur if they were not treated with a planned serial injection protocol (p < .001) or if they were treated outside the department of dermatology (p < .001).

CONCLUSION
Intralesional corticosteroid injection after surgical excision of earlobe keloids statistically minimizes the risk of recurrence.
Association between HIV status and psychological symptoms in perimenopausal women
Authors: Looby Sara E. , Psaros Christina , Raggio Greer , Rivard Corinne , Smeaton Laura , Shifren Jan , Grinspoon Steven , Joffe Hadine 
Published: January 2018

Abstract

Objective:
HIV-infected women are burdened by depression and anxiety, which may impact adherence to antiretroviral therapy and overall quality of life. Yet, little is known about the scope of psychological symptoms in the growing number of HIV-infected women reaching menopause, when affective symptoms are more prevalent in the general population. We conducted a longitudinal study to compare affective symptoms between perimenopausal HIV-infected and non-HIV-infected women.

Methods:
The Center for Epidemiologic Studies Depression Scale (CES-D), and the Generalized Anxiety Disorder scale (GAD-7) were completed at baseline and 12 months among 33 HIV-infected and 33 non-HIV-infected perimenopausal women matched by race, age, menstrual patterns, and BMI. Linear regression models estimated the relationship of baseline GAD-7 and CES-D scores with clinical factors.

Results:
All women were perimenopausal at baseline, and the vast majority remained perimenopausal throughout follow-up. HIV status was associated with higher baseline CES-D scores (median [interquartile range] 21 [12, 29] vs 10 [5, 14]; P = 0.03) and GAD-7 scores (7 [5, 15] vs 2 [1, 7]; P = 0.01), controlling for smoking, substance use, and antidepressant use. Depressive symptoms and anxiety remained significantly higher in the HIV-infected women at 12 months (P ≤ 0.01). Significant relationships of depressive symptoms (P = 0.048) and anxiety (P = 0.02) with hot flash severity were also observed.

Conclusions:
Perimenopausal HIV-infected women experienced a disproportionately high level of affective symptom burden over a 12-month observation period. Given the potential for these factors to influence adherence to HIV clinical care and quality of life, careful assessment and referral for treatment of these symptoms is essential.
Hormone therapy and urine protein excretion: a multiracial cohort study, systematic review, and meta-analysis
Authors: Kattah Andrea G. , Suarez Maria L.G. , Milic Natasa , Kantarci Kejal , Zeydan Burcu , Mosley Thomas , Turner Stephen T. , Ware Erin B. , Kardia Sharon L.R. , Garovic Vesna D. 
Published: January 2018

Abstract

Objective:
Experimental models suggest estrogen has a renoprotective effect, but human studies show variable results. Our objective was to study the association of hormone therapy (HT) and albuminuria in postmenopausal women and to synthesize the results with outcomes from prior studies.

Methods:
We analyzed data from postmenopausal women who participated in the second study visit (2000-2004) of the Genetic Epidemiology Network of Arteriopathy (GENOA) study. The exposure was self-reported HT use and the outcome was albuminuria (urine albumin-to-creatinine ratio >25 mg/g creatinine). We also conducted a systematic review and meta-analysis on the association of HT and urine protein in postmenopausal women. Continuous and dichotomous measures of protein excretion were converted to a standardized mean difference (SMD) for each study.

Results:
In the GENOA cohort (n = 2,217), there were fewer women with albuminuria among HT users than nonusers (9% vs 19%, P < 0.001). HT use was associated with decreased odds of albuminuria (odds ratio 0.65, 95% confidence interval (CI), 0.45-0.95), after adjusting for significant differences in age, race, education, comorbidities, and the age at and cause of menopause. The SMD of the effect of HT on urine proteinuria/albuminuria in the randomized control trials (n = 3) was 0.02 (95% CI, −0.29 to 0.33) and −0.13 (95% CI, −0.31 to 0.05) in the observational studies (n = 9). There was significantly less albuminuria among HT users (SMD −0.15, 95% CI, −0.27 to −0.04) in the 9 studies that only reported albuminuria as an outcome and in the 10 studies with a comparator arm (SMD −0.15, 95% CI, −0.26 to −0.04).

Conclusions:
HT is associated with decreased odds of albuminuria, but some of the observed benefits may be related to reported outcomes, the presence of a comparator arm, and the type of study design.
What's in a name: are menopausal “hot flashes” a symptom of menopause or a manifestation of neurovascular dysregulation?
Authors: Miller Virginia M. , Kling Juliana M. , Files Julia A. , Joyner Michael J. , Kapoor Ekta , Moyer Ann M. , Rocca Walter A. , Faubion Stephanie S. 
Published: January 2018

Abstract
Hot flashes have typically been classified as “symptoms of menopause” that should be tolerated or treated until they resolve. However, mounting evidence points to hot flashes as a manifestation of one or several underlying pathophysiological processes. Associations exist between the presence, timing of onset, severity, and duration of hot flashes, and the risk of several neurological (affecting sleep, mood, and cognition) and cardiovascular conditions. In addition, four consistent patterns of vasomotor disturbances have been identified across different countries, making it unlikely that these patterns are solely explained by socioeconomic or cultural factors. The changing hormonal environment of menopause may unmask differences in the autonomic neurovascular control mechanisms that put an individual woman at risk for chronic conditions of aging. These differences may have a genetic basis or may be acquired across the life span and are consistent with the variability of the clinical manifestations of aging observed in women after bilateral oophorectomy. It is time to investigate the pathophysiological mechanisms underlying the four patterns of vasomotor symptoms more closely, and to shift from describing hot flashes as symptoms to be tolerated to manifestations of an underlying autonomic neurovascular dysregulation that need to be addressed.
Abdominal prehospital ultrasound impacts treatment decisions in a Dutch Helicopter Emergency Medical Service
Authors: Ketelaars Rein , Holtslag Jasper J.M. , Hoogerwerf Nico 
Published: January 2018

Objective
The aim of this study was to determine the impact of abdominal prehospital ultrasound (PHUS) on patient care in a Dutch physician-staffed Helicopter Emergency Medical Service (HEMS) and to determine its diagnostic performance.

Patients and methods
We carried out a retrospective analysis of abdominal ultrasound (US) examinations performed by the HEMS of Nijmegen, the Netherlands, from January 2007 until December 2016. Data including patient demographics, type of incident, abdominal US findings, impact on treatment decisions, and the physicians’ narrative report were retrieved from the HEMS database and analyzed. PHUS diagnostic performance was compared with computed tomography scan or laparotomy.

Results
Of 17 077 recorded scrambles and 8699 patients treated, 1583 underwent 1631 abdominal US examinations. After eliminating missing data, 251 impacts on treatment in 194 out of 1539 PHUS examinations were identified (12.6%, 95% confidence interval: 10.9–14.3). This affected 188 out of 1495 (12.6%) patients. The four main categories of treatment decisions impacted by PHUS were information provided to the destination hospital (45.4%); mode of transportation (23.5%); choice of destination hospital (13.1%); and fluid management (11.6%). The sensitivity of prehospital abdominal US for hemoperitoneum was 31.3%, specificity was 96.7%, and accuracy was 82.1%.

Conclusion
Abdominal PHUS in our setting impacts treatment decisions significantly. Therefore, it is a valuable tool in the Dutch HEMS setting and probably beyond.
Predictors of Caregiver Distress in the Community Setting Using the Home Care Version of the Resident Assessment Instrument
Authors: Pauley Tim , Chang Byung Wook , Wojtak Anne , Seddon Gayle , Hirdes John 
Published: January 2018

Purpose of Study:
The purpose of this study was to identify factors predictive of new onset and improved caregiver distress among informal caregivers providing assistance for clients receiving home care.

Primary Practice Settings:
Home care.

Methodology and Sample:
The sample included 323,409 clients receiving home care from a Community Care Access Centre between March 2002 and March 2015 for whom data were available from two subsequent Resident Assessment Instrument-Home Care (RAI-HC) assessments. Separate multivariate logistic regression models were created for onset of and improvement in caregiver distress.

Results:
Variables that increase the odds in onset of caregiver distress included primary caregiver is not satisfied with support received from family and friends; client lives with primary caregiver; 65 years and older; has Alzheimer and other related dementia; has condition or disease that makes cognition, activities of daily living, mood, or behavior patterns unstable; took sedatives in the last 7 days; Method for Assigning Priority Levels (MAPLe) score 4 or more; demonstrates persistent anger; has difficulty using the telephone; is married; requires 20 hr or more of informal help weekly; and Clinical Risk Scale score 4 or more. Variables that increased the odds of improved caregiver distress include client now lives with other persons (as compared with 90 days ago); demonstrates good prospects for recovery; treatment changes in last 30 days; surgical wound; female; one or more hospital visits in last 90 days; greater number of months between RAI-HC assessments; and two or more hours of physical activities in the last 3 days. Variables that decreased the odds of improved caregiver distress (i.e., persistent distress) include MAPLe score 4 or more; persistent anger; difficulty using telephone; Alzheimer, related dementia; requires interpreter; and lives with primary caregiver.

Implications for Case Management Practice:
Informal caregivers provide essential support for home care clients. Factors predictive of new onset and improved caregiver distress can be used by case managers for comprehensive care planning that addresses the collective needs of the client–caregiver dyad.
Appointment Reminders to Decrease 30-Day Readmission Rates to Inpatient Psychiatric Hospitals
Authors: Habit Nicole F. , Johnson Emily , Edlund Barbara J. 
Published: January 2018

Purpose of Project:
The purpose of this quality improvement project was to reduce 30-day readmission rates to inpatient psychiatric hospitals by standardizing discharge processes by including scheduling outpatient psychiatric appointments for all patients at discharge and also to include the mailing postal reminders to prompt patients to attend their first outpatient mental health appointment following treatment.

Primary Practice Setting:
Inpatient psychiatric hospital.

Methodology and Sample:
The project design was an analysis of readmission data obtained both 3 months before and after implementation of the postal reminder letters. This project took place at a 50-bed inpatient psychiatric hospital in the southeastern United States that accepts male and female adult patients with mental health and substance abuse disorders.

Results:
The implementation of an appointment reminder letter resulted in a slight decrease in 30-day readmission rates. The average readmission rate 3 months prior to implementation was 10%. The average readmission rate 3 months postdischarge was 9%. December 2015 was included in the postimplementation data. December historically has higher rates of 30-day readmissions at this facility. If this month had been excluded, more dramatic decrease in 30-day readmission rates could be observed.

Implications for Case Management Practice:
Future implications for case management practice could include the usage of reminder prompts via telephone communication or text messaging in conjunction with postal reminders. The psychiatric population can be particularly challenging when considering increased risk for readmission within 30 days and also the impending pay-for-performance quality measures, which are soon to be implemented. Measures should be taken now to ensure that readmission rates decrease, not only to promote better patient outcomes, but also as a cost-saving measure. Although many variables may contribute to the risk for 30-day readmission rates including medication noncompliance, lack of proper follow-up, as well as seasonal trends, the postal appointment reminder letters may further decrease 30-day readmission rates. Other care management strategies combined with reminder letters may further address barriers that may exist to not only improve patient outcomes, but also to further reduce readmission rates. It is also important to mention that there are further implications that could be directly contributed to specific social determinants of health specific to the psychiatric population. For example, access to prescribed medications and transportation to appointments should be addressed to further reduce readmission rates for this vulnerable population.
Simulated Interprofessional Education Discharge Planning Meeting to Improve Skills Necessary for Effective Interprofessional Practice
Authors: Smith Leslie M. , Keiser Megan , Turkelson Carman , Yorke Amy M. , Sachs Benjamin , Berg Karen 
Published: January 2018

Purpose of Study:
The purpose of this study was to evaluate the use of a simulation-enhanced interprofessional education (Sim-IPE) discharge planning learning experience using simulated patients (SPs), to explore the ability for students to communicate with each other and to a patient/caregiver, and to use clinical thinking to make a safe and appropriate interprofessional discharge recommendation.

Primary Practice Setting(s):
Educational institution; university simulation center.

Methodology and Sample:
A Sim-IPE was performed with students from physical therapy (N = 46), nursing (N = 25), and social work (N = 11). Students were placed into interprofessional teams. Presimulation, each student was expected to complete a survey and review several items including the patient case, a communication strategy, and community resources. The team then interacted with SPs portraying the patient and the family member. Postsimulation, facilitators led a debriefing session and students completed a post-IPE survey. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was completed pre- and postexperience.

Results:
Most students reported that they strongly or somewhat agreed that the experience improved their clinical thinking skills (67%; n = 55), improved awareness of the patient voice in shared decision-making (72.8%; n = 59), improved ability to prioritize patient's list of impairments (75.3%; n = 61), and improved confidence with discharge planning (69.1%; n = 56).

Implications for Case Management Practice:
Discharge planning is inherently an interprofessional process. Utilizing a simulation as a method to practice discharge planning may have a positive impact on future clinical practice. Completing the ICCAS may not be the appropriate assessment when evaluating change before and after an IPE experience based on the high scores noted preexperience. The use of a simulated discharge planning meeting may improve skills necessary for effective interprofessional practice.
Hospital Discharge and Selecting a Skilled Nursing Facility
Authors: Sorkin Dara H. , Amin Alpesh , Weimer David L. , Sharit Joseph , Ladd Heather , Mukamel Dana B. 
Published: January 2018

Purpose of Study:
A currently proposed rule by the Centers for Medicare & Medicaid Services would require providers to devote more resources to discharge planning from hospitals to ensure the prioritization of patient preferences and goals in the discharge planning process. Annually, more than 3 million persons enter a nursing home in the United States, with the vast majority of patients coming directly from hospitals. Although early evidence suggests more family involvement than patient involvement in the discharge process, most of this work has relied on retrospective reports of the decision-making process postplacement. This article seeks to examine and compare the experiences and perspectives of patients and others involved in the selection of the nursing home (predominately adult children and spouses).

Primary Practice Setting:
Large academic medical hospital with patients being discharged to a skilled nursing facility.

Methodology and Sample:
A total of 225 patients or their family members and involved others who completed an exit survey assessing their experiences and perspectives in selecting a skilled nursing home and in experiencing the discharge process more generally.

Results:
Patients were the primary decision makers about 23% of the time but were often involved in the decision even when family members/involved others were primarily making decisions in the discharge process. Although patients were involved in the selection of the nursing home to a lesser degree than involved others, their level of satisfaction with the decision to be discharged to a skilled nursing home and their level of satisfaction with their personal level of involvement with the selection of the specific nursing home did not differ from the satisfaction ratings of the involved others. Furthermore, their confidence in the decision and their satisfaction with the decision did not differ from ratings provided by family members/involved others.

Implications for Case Management Practice:
Recommendations for case management practice include (1) encouraging patients and their families to take an active role in the discharge process; (2) incorporating technology into the discharge process that promotes this active level of engagement; and (3) facilitating access to data to promote discharge to the highest quality nursing homes available.
The coming of age of EvoMPMI: evolutionary molecular plant-microbe interactions across multiple timescales
Authors: Upson Jessica L , Zess Erin K , Białas Aleksandra , Wu Chih-hang , Kamoun Sophien 
Published: January 2018

AbstractPlant-microbe interactions are great model systems to study co-evolutionary dynamics across multiple timescales, ranging from multimillion year macroevolution to extremely rapid evolutionary adaptations. However, mechanistic research on plant-microbe interactions has often been conducted with little consideration of the insights that can be gained from evolutionary concepts and methods. Conversely, evolutionary research has rarely integrated the diverse range of molecular mechanisms and models that continue to emerge from the molecular plant-microbe interactions field. These trends are changing. In recent years, the incipient field of evolutionary molecular plant-microbe interactions (EvoMPMI) has emerged to bridge the gap between mechanistic molecular research and evolutionary approaches. Here, we report on recent advances in EvoMPMI. In particular, we highlight new systems to study microbe interactions with early diverging land plants, and new findings from studies of adaptive evolution in pathogens and plants. By linking mechanistic and evolutionary research, EvoMPMI promises to add a new dimension to our understanding of plant-microbe interactions.