bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Pain Relief in Elder Patients (I‐PREP): An Emergency Department Education and Quality Intervention
Authors: Hogan Teresita M. , Howell Michael D. , Cursio John F. , Wong Alexandra , Dale William 
Published: November 2016

ObjectivesTo assess the effectiveness of a novel combined education and quality improvement (QI) program for management of pain in older adults in the emergency department (ED).DesignControlled pre/postintervention examination.SettingAn academic urban ED seeing 60,000 adult visits annually.ParticipantsIndividuals aged 65 and older experiencing moderate to severe pain.InterventionLinked standardized education and continuous QI for multidisciplinary staff in an urban, academic ED from January 2012 to January 2014.MeasurementsPain intensity, percentage receiving and time to pain assessment and reassessment, percentage receiving and time to delivery of analgesic.ResultsThe percentage of participants with final pain score of 4 or less (out of 10) increased 47.5% (95% confidence interval (CI) = 41.8–53.2%). Median decrease in pain intensity improved significantly, from 0.0 to 5.0 points (P < .001). Median final pain score decreased from 7.0 to 4.0 points (P < .001). The percentage of participants with any pain improvement increased 43.7% (95% CI = 37.1–50.3%, P < .001). Pain reassessments increased significantly (from 51.9% to 82.5%, P < .001). The percentage receiving analgesics increased significantly (from 64.1% to 84.8%, P < .001). After the intervention, participants had 3.1 (95% CI = 2.1–4.4, P < .001) greater odds of receiving analgesics and 4.7 (95% CI = 3.5–6.5, P < .001) greater odds of documented pain reassessment.ConclusionThe I‐PREP intervention substantially improved pain management in older adults in the ED with moderate to severe musculoskeletal or abdominal pain. Significant reductions in pain intensity were achieved, the timing of pain assessments and reassessments was improved, and analgesics were delivered faster. Tightly linking education to targeted QI improved pain management of older adults in the ED.
Effect of the Interplay Between Genetic and Behavioral Risks on Survival After Age 75
Authors: Rizzuto Debora , Keller Lina , Orsini Nicola , Graff Caroline , Bäckman Lars , Bellocco Rino , Wang Hui‐Xin , Fratiglioni Laura 
Published: November 2016

ObjectivesTo explore the association between genes that may be related to human mortality, taking into account the possible contribution of morbidity, and investigate whether lifestyle behaviors may attenuate genetic risk.DesignTwenty‐five‐year population‐based cohort study.SettingKungsholmen cohort, Stockholm, Sweden.ParticipantsIndividuals aged 75 and older (N = 1,229).MeasurementsThe associations between single‐nucleotide variations in 14 genes (previously associated with mortality or to diseases linked to mortality), relevant lifestyle risk behaviors (smoking; mental, physical, or social inactivity; moderate or poor social network), and mortality were estimated using Cox regression.ResultsPeople with allelic variation in four genes related to cardiovascular diseases and metabolism were more likely to die: apolipoprotein (APO)C1 GG and AG carriers, APOE ɛ4 carriers, insulin‐degrading enzyme (IDE) TC carriers, and phosphatidylinositol 3‐kinase (PI3KCB) GG carriers. Individuals with multiple adverse alleles had 62% higher mortality rate than those with none. In contrast, people with no risk behaviors (low‐risk profile) had 65% lower mortality rate than people with all examined risk behaviors (high‐risk profile). Combining the genetic and environmental factors, it was found that, independent of genetic profile, individuals with a low‐risk profile had up to 64% lower mortality rate than those with a moderate high– or high‐risk profile and at least one genetic risk factor.ConclusionThis study supports and expands evidence that genetic variations in APOE, IDE, and PI3KCB are associated with lower mortality rate, although lifestyle behaviors can modulate their effects.
Willingness to Pay for a Maternity Waiting Home Stay in Zambia
Authors: Vian Taryn , White Emily E. , Biemba Godfrey , Mataka Kaluba , Scott Nancy 
Published: November 2016

IntroductionComplications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource‐poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes‐residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability.MethodsWe conducted a mixed‐methods study to estimate willingness to pay for maternity waiting home services based on a survey of 167 women, men, and community elders. We also collected qualitative data from 16 focus group discussions to help interpret our findings in context.ResultsThe maximum willingness to pay was 5.0 Zambian kwacha or $0.92 US dollars per night of stay. Focus group discussions showed that willingness to pay is dependent on higher quality of services such as food service and suggested that the pricing policy (by stay or by night) could influence affordability and use.DiscussionWhile Zambians seem to value and be willing to contribute a modest amount for maternity waiting home services, planners must still address potential barriers that may prevent women from staying at the shelters. These include cash availability and affordability for the poorest households.
Improving Utilization of the Family History in the Electronic Health Record
Authors: Hickey Kathleen T. , Katapodi Maria C. , Coleman Bernice , Reuter‐Rice Karin , Starkweather Angela R. 
Published: November 2016

AbstractPurposeThe purpose of this article is to provide an overview of Family History in the Electronic Health Record and to identify opportunities to advance the contributions of nurses in obtaining, updating and assessing family history in order to improve the health of all individuals and populations.Organizing ConstructThe article presents an overview of the obstacles to charting Family History within the Electronic Health Record and recommendations for using specific Family History tools and core Family History data sets.MethodsOpportunities to advance nursing contributions in obtaining, updating, and assessing family history in order to improve the health of all individuals were identified. These opportunities are focused within the area of promoting the importance of communication within families and between healthcare providers to obtain, document, and update family histories.FindingsNurses can increase awareness of existing resources that can guide collection of a comprehensive and accurate family history and facilitate family discussions. In this paper, opportunities to advance nursing contributions in obtaining, updating, and assessing family history in order to improve the health of all individuals were identified.ConclusionsAligned with the clinical preparation of nurses, family health should be used routinely by nurses for risk assessment and to help inform patient and family members on screening, health promotion, and disease prevention. The quality of family health information is critical in order to leverage the use of genomic healthcare information and derive new knowledge about disease biology, treatment efficacy, and drug safety. These actionable steps need to be performed in the context of promoting evidence‐based applications of family history that will be essential for implementing personalized genomic healthcare approaches and disease prevention efforts.Clinical RelevanceFamily health history is one of the most important tools for identifying the risk of developing rare and chronic conditions, including cardiovascular disease, cancer, and diabetes, and represents an integration of disease risk from genetic, environmental, and behavioral/lifestyle factors. In fact, family history has long been recognized as a strong independent risk factor for disease and is the current best practice used in clinical practice to guide risk assessment.
Rethinking the Use of Neutral Faces as a Baseline in fMRI Neuroimaging Studies of Axis‐I Psychiatric Disorders
Authors: Filkowski Megan M. , Haas Brian W. 
Published: November 2016

ABSTRACTMajor Axis‐I disorders including major depressive disorder (MDD), bipolar disorder (BD), anxiety disorder, and schizophrenia are associated with a host of aberrations in the way social stimuli are processed. Face perception tasks are often used in neuroimaging research of emotion processing in both healthy and patient populations, and to date, there exists a mounting body of evidence, both behavioral and within the brain, indicating that emotional faces compared to neutral faces are processed abnormally by those with Axis‐I disorders relative to healthy control (HC) groups. The use of neutral faces as a “baseline control condition” is predicated on the assumption that neutral faces are processed in the same way HCs and individuals with major Axis‐I disorders. In this paper, existing fMRI studies examining the way neutral faces are processed in groups with Axis‐I disorders involving socioaffective perception are reviewed. In reviewing available studies, a consistent pattern of results demonstrated that these disorders are associated with abnormal frontolimbic activity in response to neutral faces and in particular within the amygdala and prefrontal regions such as the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) compared to HC groups. Specifically, increased amygdala activation was consistently reported in response to neutral faces in anxiety disorders and schizophrenia. Abnormal medial PFC activity was reported in patients with MDD, and patients with BD exhibit decreased activity in the DLPFC and ACC relative to HCs. In addition, specific suggestions to overcome these obstacles with new research and additional analyses are discussed.
Root hemiparasitic plants are associated with high diversity in temperate grasslands
Authors: Fibich Pavel , Lepš Jan , Chytrý Milan , Těšitel Jakub 
Published: November 2016

AbstractQuestionsIs the incidence of root hemiparasitic plants in non‐forest vegetation associated with high diversity? Are root hemiparasites more associated with species‐rich vegetation than other species?LocationCzech Republic.MethodsPlot size‐corrected species richness, Shannon diversity and Pielou's evenness were computed for a representative set of 18 101 vegetation plots representing all main types of terrestrial open (non‐forest) habitats of the country. Null models of species richness assuming occurrence of a random species with given occurrence frequency, reflecting higher incidence probability in species‐rich plots, were constructed for 16 common root hemiparasitic species. The null model distribution of species richness was subsequently compared with the actual mean species richness of plots containing the respective root hemiparasites. Median values of plot Shannon diversity and evenness were computed for each species in the database. Values obtained for plots containing individual root hemiparasites were compared with distribution of values for other species in the database.ResultsThe occurrence of 11 of 16 root hemiparasites studied was associated with high species richness significantly more than under random expectations; three species were negatively associated. Three root hemiparasites were among the top 5% of all species associated with high species richness and Shannon diversity, and eight were among the top 25%. Almost 50% of the top 1% most species‐rich plots contained at least one root hemiparasitic species.ConclusionsWe demonstrated a positive association between the incidence of most root hemiparasites and diversity of non‐forest terrestrial plant communities at a broad landscape scale. This finding scales up the results of experimental studies that showed some root hemiparasites act as ecosystem engineers, increasing vegetation diversity. Root hemiparasites should be regarded as important biodiversity indicators and potential drivers of biodiversity. As such, conserving their wild populations or promoting their establishment should become a goal of nature conservation and ecological restoration.
Replacement of Soybean Meal with Fermented Jatropha curcas Kernel Meal in the Diet of Labeo rohita Fingerlings: Effect on Hemato‐biochemical and Histopathological Parameters
Authors: Phulia Vikas , Sardar Parimal , Sahu Narottam Prasad , Shamna N. , Fawole Femi John , Gupta Subodh , Gadhave P. D. 
Published: November 2016

AbstractJatropha kernel meal was detoxified through the process of solid‐state fermentation using Aspergillus niger fungus. A 60‐d feeding trial was conducted to evaluate the effects of replacing soybean meal (SBM) with fermented Jatropha kernel meal (FJKM) on the hemato‐biochemical and histopathological parameters in Labeo rohita fingerlings (average weight 6.05 ± 0.04 g). A total of 180 fish were randomly distributed in 12 experimental tanks in four dietary groups, namely control (SBM‐based diet), T1 (10% FJKM replacing 33.3% SBM), T2 (20% FJKM replacing 66.7% SBM), and T3 (30% FJKM replacing 100% SBM). There was no significant difference in the red blood cell, white blood cell, hemoglobin, total protein, albumin, globulin, and respiratory burst activity among the various groups, but significantly higher hematocrit value and albumin/globulin ratio were observed in the T2‐fed group compared with the control. No statistical difference was found in serum glucose level of the control and FJKM‐fed groups. Histopathological examination of the intestine and liver indicated no adverse effects in the control and FJKM‐fed groups. Our findings revealed that FJKM can replace 100% SBM protein in the diets of L. rohita fingerlings, without any adverse effects on fish health.
Polymyxin‐B immobilized column–direct hemoperfusion for adolescent toxic shock syndrome
Authors: Nanishi Etsuro , Hirata Yuichirou , Lee Sooyoung , Kaku Noriyuki , Momii Kenta , Kubota Kensuke , Nishio Hisanori , Maehara Yoshihiko , Hara Toshiro 
Published: November 2016

AbstractToxic shock syndrome (TSS) is a critical illness associated with toxin from Staphylococcus aureus. Despite recent advances in critical care, mortality remains high and additional effective therapy is required. We report an adolescent case of TSS successfully treated with direct hemoperfusion using polymyxin‐B immobilized fiber (PMX‐DHP). The patient with spina bifida also had ischial pressure ulcer, and developed TSS associated with methicillin‐resistant S. aureus. Despite conventional treatment, the patient developed refractory shock, which was immediately improved with PMX‐DHP. PMX‐DHP has been widely used for the treatment of sepsis to remove circulating endotoxins produced by Gram‐negative bacteria, but beneficial effects have also been reported for Gram‐positive bacterial infection. To our knowledge, this is the first report on PMX‐DHP for TSS in an adolescent patient, and we propose that PMX‐DHP could be a new treatment strategy for severe TSS in children as well.
Accuracy and safety of ward based pleural ultrasound in the Australian healthcare system
Authors: Hammerschlag Gary , Denton Matthew , Wallbridge Peter , Irving Louis , Hew Mark , Steinfort Daniel 
Published: November 2016

ABSTRACT
Background and objectiveUltrasound has been shown to improve the accuracy and safety of pleural procedures. Studies to date have been performed in large, specialized units, where pleural procedures are performed by a small number of highly specialized physicians. There are no studies examining the safety and accuracy of ultrasound in the Australian healthcare system where procedures are performed by junior doctors with a high staff turnover.MethodsWe performed a retrospective review of the ultrasound database in the Respiratory Department at the Royal Melbourne Hospital to determine accuracy and complications associated pleural procedures.ResultsA total of 357 ultrasounds were performed between October 2010 and June 2013. Accuracy of pleural procedures was 350 of 356 (98.3%). Aspiration of pleural fluid was successful in 121 of 126 (96%) of patients. Two (0.9%) patients required chest tube insertion for management of pneumothorax. There were no recorded pleural infections, haemorrhage or viscera puncture.ConclusionWard‐based ultrasound for pleural procedures is safe and accurate when performed by appropriately trained and supported junior medical officers. Our findings support this model of pleural service care in the Australian healthcare system.
The feasibility of office‐based propofol sedation for dental care in patients with intellectual disability by sedation practitioners
Authors: Vaessen Hermanus H. B. , Schouten Antonius N. J. , van der Hoeve Henriette , Knape Johannes T. A. 
Published: November 2016

ABSTRACTBackgroundThe quality of oral health care for intellectually disabled patients is a significant challenge due to behavioral issues. Intravenous propofol sedation may be useful to relieve the anxiety and fear, and make dental procedures more acceptable. The aim of this study was to evaluate the safety and effectiveness of propofol sedation, by trained nonmedical sedation practitioners, during dental treatments in an office‐based setting.MethodsIntellectually disabled patients (124) were subjected to restorative dental procedures and moderately sedated using intravenous propofol. Vital signs, cooperation of the patient, and sedation depth were continuously assessed.ResultsPropofol sedation was effective for dental treatment. All procedures resulted in a sufficient level of sedation without moderate or severe complications.ConclusionPropofol sedation can be safely and effectively performed in an office‐based setting by sedation practitioners, who have experience in propofol sedation and are trained in the care of patients with disabilities.
Inactivation of Middle East respiratory syndrome coronavirus (MERS‐CoV) in plasma products using a riboflavin‐based and ultraviolet light‐based photochemical treatment
Authors: Keil Shawn D. , Bowen Richard , Marschner Susanne 
Published: November 2016

BACKGROUNDMiddle East respiratory syndrome coronavirus (MERS‐CoV) has been identified as a potential threat to the safety of blood products. The Mirasol Pathogen Reduction Technology System uses riboflavin and ultraviolet (UV) light to render blood‐borne pathogens noninfectious while maintaining blood product quality. Here, we report on the efficacy of riboflavin and UV light against MERS‐CoV when tested in human plasma.STUDY DESIGN AND METHODSMERS‐CoV (EMC strain) was used to inoculate plasma units that then underwent treatment with riboflavin and UV light. The infectious titers of MERS‐CoV in the samples before and after treatment were determined by plaque assay on Vero cells. The treatments were initially performed in triplicate using pooled plasma (n = 3) and then repeated using individual plasma units (n = 6).RESULTSIn both studies, riboflavin and UV light reduced the infectious titer of MERS‐CoV below the limit of detection. The mean log reductions in the viral titers were ≥4.07 and ≥4.42 for the pooled and individual donor plasma, respectively.CONCLUSIONRiboflavin and UV light effectively reduced the titer of MERS‐CoV in human plasma products to below the limit of detection, suggesting that the treatment process may reduce the risk of transfusion transmission of MERS‐CoV.
Who Supports the ECB? Evidence from Eurobarometer Survey Data
Authors: Farvaque Etienne , Hayat Muhammad Azmat , Mihailov Alexander 
Published: November 2016

AbstractThis paper studies the determinants of the support for the European Central Bank (ECB) in the member countries of the European Monetary Union (EMU) and their evolution from 1999 to 2015. Our contribution is to examine micro‐level sociodemographic characteristics from the Eurobarometer surveys jointly with macroeconomic indicators of trust in a central bank in order to evaluate econometrically their relative importance over time. Pseudo‐panel logit estimates reveal that the former have a dynamically stable, and generally stronger influence taken altogether, when compared with the latter. Interestingly, we find that while expected inflation becomes a positive determinant of trust in the ECB after the global financial crisis (GFC), actual inflation gets no statistical significance. Having taken centre stage in the monetary policy debate in the Euro‐area post‐GFC and especially since 2013, excessive disinflation and risk of deflation attracted strong attention by the public and have consequently affected its perceptions about the ECB. Accordingly, our results emphasise forward lookingness of the EMU population with regard to ‘deflation scares’ in determining trust in the ECB, in addition to disentangling the contributions of the key individual‐level sociodemographic factors, and can duly inform ECB's communication strategy.
Cerebral haemodynamic response to somatosensory stimulation in near‐term fetal sheep
Authors: Nakamura S. , Walker D. W. , Wong F. Y. 
Published: November 2016

Key points
Cerebral haemodynamic response to neural stimulation has been extensively investigated in animal and clinical studies, in both adult and paediatric populations, but little is known about cerebral haemodynamic functional response in the fetal brain.
The present study describes the cerebral haemodynamic response measured by near‐infrared spectroscopy to somatosensory stimulation in fetal sheep.
The cerebral haemodynamic response in the fetal sheep brain changes from a positive (increase in oxyhaemoglobin (oxyHb)) response pattern to a negative or biphasic response pattern when the duration of somatosensory stimulation is increased, probably due to cerebral vasoconstriction with prolonged stimulations.
In contrast to adult studies, we have found that changes in fetal cerebral blood flow and oxyHb are positively increased in response to somatosensory stimulation during hypercapnia. We propose this is related to reduced vascular resistance and recruitment of cerebral vasculature in the fetal brain during hypercapnia.
AbstractFunctional hyperaemia induced by a localised increase in neuronal activity has been suggested to occur in the fetal brain owing to a positive blood oxygen level‐dependent (BOLD) signal recorded by functional magnetic resonance imaging following acoustic stimulation. To study the effect of somatosensory input on local cerebral perfusion we used near‐infrared spectroscopy (NIRS) in anaesthetised, partially exteriorised fetal sheep where the median nerve was stimulated with trains of pulses (2 ms, 3.3 Hz) for durations of 1.8, 4.8 and 7.8 s. Signal averaging of cerebral NIRS responses to 20 stimulus trains repeated every 60 s revealed that a short duration of stimulation (1.8 s) increased oxyhaemoglobin in the contralateral cortex consistent with a positive functional response, whereas longer durations of stimulation (4.8, 7.8 s) produced more variable oxyhaemoglobin responses including positive, negative and biphasic patterns of change. Mean arterial blood pressure and cerebral perfusion as monitored by laser Doppler flowmetry always showed small, but coincident increases following median nerve stimulation regardless of the type of response detected by the NIRS in the contralateral cortex. Hypercapnia significantly increased the baseline total haemoglobin and deoxyhaemoglobin, and in 7 of 8 fetal sheep positively increased the changes in contralateral total haemoglobin and oxyhaemoglobin in response to the 7.8 s stimulus train, compared to the response recorded during normocapnia. These results show that activity‐driven changes in cerebral perfusion and oxygen delivery are present in the fetal brain, and persist even during periods of hypercapnia‐induced cerebral vasodilatation.