bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Hepatitis C Infection Rate among Baby Boomers in an Urban Primary Care Clinic: Results from the HepTLC Initiative
Authors: Geboy Alexander G. , Mahajan Sandeep , Daly Allison P. , Sewell Candice F. , Fleming Ike C. , Cha Hyun A. , Perez Idene E. , Cole Carmella A. , Ayodele Adebisi A. , Fishbein Dawn A. 
Published: June 2016

Objective. CDC recommends that all people born between 1945 and 1965 be tested for hepatitis C virus (HCV). We hypothesized that HCV testing in a large, urban primary care clinic would reveal higher rates of HCV infection than previously published. Methods. Through the Hepatitis Testing and Linkage to Care initiative, the primary care clinic at MedStar Washington Hospital Center in Washington, DC, provided HCV antibody (anti-HCV) testing and linkage to care from October 2012 through September 2013 for patients born between 1945 and 1965 without previously noted risk factors. We collected data on age, race/ethnicity, sex, anti-HCV and HCV ribonucleic acid (RNA) results, risk factors in those who tested anti-HCV positive, and health insurance type and made comparisons using χ2 and Student's t-tests. Results. Of 1,123 patients tested, the mean age was 57 years, 742 (66.1%) were women, 969 (86.3%) were black/African American, and 654 (58.2%) had public health insurance. Of the 99 (8.8%) patients who tested anti-HCV positive, the mean age was 58 years, 54 were men, and 93 were black/African American; 41 of 74 anti-HCV-positive patients were intravenous drug users. Of 82 anti-HCV-positive patients, 51 were HCV RNA positive. Of the black/African American patients tested, 49 of 317 men (15.5%) and 44 of 652 women (6.7%) were anti-HCV positive ( p<0.001). The HCV prevalence rate in the birth cohort (8.8%) was significantly higher than the U.S. (3.3%) and DC (2.5%) rates ( p<0.001), and the HCV prevalence rate among black/African American men in DC (15.5%) was substantially higher than the prevalence rate reported by CDC (8.1%). Conclusion. Testing initiatives in primary care settings need to be more rigorously upheld, and internal champions are needed to advocate for increased screening to ensure linkage to care and engagement in the HCV care cascade.
Integrating Routine HCV Testing in Primary Care: Lessons Learned from Five Federally Qualified Health Centers in Philadelphia, Pennsylvania, 2012–2014
Authors: Coyle Catelyn , Kwakwa Helena , Viner Kendra 
Published: June 2016

Objective. An estimated 2.7–3.9 million Americans are infected with hepatitis C virus (HCV). Despite being the most common blood-borne virus in the United States, routine HCV testing is not commonly practiced. To address this gap, we measured the impact of integrated routine HCV testing on patient care. Methods. As part of 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, National Nursing Centers Consortium integrated a routine opt-out HCV testing and linkage-to-care model at five federally qualified health centers in Philadelphia, Pennsylvania, from October 1, 2012, to June 30, 2014. The model included medical assistant-initiated testing, reflex laboratory-based HCV tests, and electronic health record modifications to prompt, track, and facilitate reimbursement for tests performed on uninsured patients. Results. During the study period, 4,207 unique patients received HCV antibody (anti-HCV) testing, of whom 488 (11.6%) tested anti-HCV positive. Of those testing positive, 433 (88.7%) received a confirmatory HCV RNA test; of these 433 recipients, 313 (72.3%) were diagnosed with current infection (overall prevalence = 7.4%), of which 243 (77.6%) received their HCV RNA-positive results, 184 (58.8%) were referred to an HCV care provider, and 121 (38.7%) were linked to care. The highest rates of current infection were among non-Hispanic white patients (18.1%, 90/496); patients from the Public Health Management Corporation Care Clinic, which treats HIV and HCV patients on-site (14.3%, 200/1,394); and patients aged 50–69 years (10.7%, 189/1,767). Conclusion. Our model successfully integrated HCV testing and linkage to care into routine primary care. This study also identified potential successes and barriers that may be experienced by other primary care health centers that are integrating HCV testing.
Results of fibre and toner flotation depending on oleic acid dosage
Authors: Trumic Maja S , Trumic Milan Z , Vujic Bogdana , Andric Ljubisa , Bogdanovic Grozdanka 
Published: June 2016

The literature was reviewed with respect to deinking flotation methods with toner samples, specifically emphasizing the speciation of copy machine and laser printing, which produce an increasing quantity of paper that is difficult to recycle. Speciation here refers to the physical-chemical characteristics of the toner, which change because of the polymerization (fusion) and oxidation process, due to exposure to heat, light and oxygen (air) during the printing process. To simulate the deinking flotation, after the ideal disintegration process, samples of toner were prepared in order to provide free toner particles. Synthetic toner has iron content and the same physical-chemical features as free disintegrated printed toner particles. We report the toner ( I) and fibre ( Y) recovery and the brightness ( B) of laboratory filter pads formed of deinked product as deinking efficiencies. The application of oleic acid as the collector in the flotation stage gives a better flotation recovery in alkaline than in acidic conditions. The highest brightness ( BF = 93.66%) and flotation recoveries ( I = 90, Y = 92.82%) were achieved during testing at an oleic acid concentration of 3.38·10−6 mol l−1, which is the lowest dose used. This makes the use of oleic acid economical and environmentally friendly.
Grey matter atrophy is associated with disability increase in natalizumab-treated patients
Authors: Ciampi Ethel , Pareto Deborah , Sastre-Garriga Jaume , Vidal-Jordana Angela , Tur Carmen , Río Jordi , Tintoré Mar , Auger Cristina , Rovira Alex , Montalban Xavier 
Published: June 2016

Background: Brain volume loss (BVL) is a key outcome in multiple sclerosis (MS) trials. Natalizumab is highly effective on inflammation with moderate impact on atrophy. Objective: To explore BVL in patients receiving natalizumab with an emphasis on grey matter (GM). Methods: We performed a retrospective post hoc analysis of BVL in 38 patients receiving natalizumab for 3 years using longitudinal voxel-based morphometry (VBM) and FreeSurfer. Results: Significant BVL was observed during first year: brain parenchymal fraction (BPF): −1.12% ( p < 0.001); white matter fraction (WMF): −0.9% ( p = 0.001); grey matter fraction (GMF): −1.28% ( p = 0.002). GM loss was found using VBM in bilateral cerebellum, cingulum, left > right fronto-parietal cortex, right > left hippocampus and left caudate. FreeSurfer showed significant volume losses in subcortical GM, brainstem and cerebellum, and cortical thinning in the left insula. In the second year, only WMF decrease (−0.6%; p = 0.015) was observed with no VBM changes, although FreeSurfer detected significant volume loss in thalamus, hippocampus and cerebellum. Baseline gadolinium enhancement influenced WMF and BPF changes during the first year, but not GMF. Patients with confirmed Expanded Disability Status Scale (EDSS) worsening at 3 years had lower baseline GMF and left thalamus volume and greater BVL over follow-up. Conclusion: BVL develops mainly during the first year of natalizumab therapy. GM changes are independent of baseline inflammation and correlate with disability.
Working memory network dysfunction in relapse-onset multiple sclerosis phenotypes: A clinical-imaging evaluation
Authors: Vacchi Laura , Rocca Maria A , Meani Alessandro , Rodegher Mariaemma , Martinelli Vittorio , Comi Giancarlo , Falini Andrea , Filippi Massimo 
Published: June 2016

Objectives: We investigated clinical, behavioural and functional magnetic resonance imaging (fMRI) correlates of working memory load in relapse-onset multiple sclerosis (MS) patients. Methods: In total, 12 clinically isolated syndromes (CIS) patients at risk of MS, 38 relapsing-remitting multiple sclerosis (RRMS), 22 secondary progressive multiple sclerosis (SPMS) and 24 healthy controls (HC) performed an N-back fMRI task. Correlations between fMRI abnormalities and clinico-behavioural and structural magnetic resonance imaging (MRI) measures were assessed. Results: Participants activated brain regions of the working memory network, especially in fronto-parietal lobes and cerebellum, and deactivated areas of the default mode network (DMN). During the N-back load contrast, compared to HC, the three groups of MS patients had a common pattern of decreased activation of the right superior parietal lobule, left inferior parietal lobule and left middle frontal gyrus. Areas specifically more active in CIS patients compared to the other study groups were found in the left medial superior frontal gyrus and right anterior cingulate cortex, whereas SPMS patients selectively activated the left parahippocampal gyrus and left superior temporal pole (STP). Worse accuracy and global cognitive scores correlated with increased STP activation. Conclusion: Load-dependent alterations of working memory network recruitment occur in MS. Frontal hyperactivation is maintained in CIS and lost in SPMS. Abnormal recruitment of DMN areas is related to worse cognitive and behavioural outcomes.
Innominate Artery Stenosis Presenting With Migratory Digital Ischemia
Authors: Juo Yen-Yi , Ramirez Lisbi Rivas , Ruben Garry 
Published: June 2016

Background: Atherosclerotic lesions of the supra-aortic trunk vessels, including the innominate artery, subclavian artery, or the common carotid artery, tend to present either as low-flow state distal to the lesion or as embolic events. The risk of embolic cerebrovascular event complicates the management of this condition via a pure endovascular approach. A combined operative–endovascular intervention may be a valuable approach in order to reduce the risk of intraoperative stroke and prevent future embolic events. Case Presentation: An 84-year-old female presented at the emergency department (ED) with a 4-month history of migratory digital cyanotic lesions across various fingers on her right hand. The lesion eventually progressed into dry gangrene on her right middle finger. Selective angiography of the aortic arch vessels demonstrated significant atherosclerotic plaque burden throughout her supra-aortic vessels and a segmental stenosis at the proximal innominate artery. A right carotid cut down was performed to allow clamping of the carotid artery so as to minimize the risk of intraoperative stroke from plaque manipulation. Retrograde balloon angioplasty was performed, and stent was placed across the stenotic segment. The patient tolerated the procedure well and had an uneventful postoperative course. She was discharged on postoperative day 3. At 2-week follow-up, she has had no progression of her digital ischemia nor other focal cranial nerve deficits. Conclusion: Migratory digital ischemia is a rare presentation of atherosclerotic disease of the supra-aortic vessels. It represents a challenging situation for endovascular intervention due to concern about plaque dislodgment during the procedure. A retrograde balloon-stent angioplasty following distal carotid control with an open approach may be safe and effective in selected patients.
Critical review of bariatric surgery, medically supervised diets, and behavioural interventions for weight management in adults
Authors: Beaulac Julie , Sandre Daniella 
Published: June 2016

Aims: Patient selection of weight management treatment option is often guided by a variety of factors. Currently, there is no comprehensive tool to facilitate informed decision-making for patients and clinicians. This article aims to synthesise evidence on the treatment effectiveness, health benefits, risks, and patient experiences of treatment options presently available at the Weight Management Clinic at The Ottawa Hospital (TOH), as a first step towards developing a decision aid. Methods: Narrative and systematic reviews published in English between 1999 and 2014 were included that focused on one or more of the following weight management treatments in adults aged 18 years and over: roux-en-y gastric bypass (RYGB), sleeve gastrectomy (SG), medically supervised meal replacement, and behavioural or lifestyle intervention. Results: Overall, bariatric surgeries have received the greatest research attention and have been associated not only with greater weight loss and health benefit but also with greater risks, complications, and financial cost. Dietary programmes demonstrated weight loss and health benefits to a lesser extent than with surgery but were associated with lower and shorter-term risks and complications. Behavioural and lifestyle interventions have been studied less yet have shown significant, albeit small, weight loss outcomes alone and in combination with dietary or surgical options; they also appear to be the lowest risk interventions. Patient experiences of weight management options are mixed and not well understood. Conclusion: Further research is needed; however, this review identified some general trends related to weight loss outcomes, benefits, risks, and barriers for weight management options that have implications for shared treatment decision-making.
Clinicians’ Adherence to Guidelines on Evaluation of Hypertension in Children and Adolescents
Authors: Hartz Jacob , Li Jennifer S. , Akintoye Ololade O. , Hornik Christoph P. 
Published: June 2016

Background: Hypertension is increasingly prevalent among children. We sought to review provider adherence to the National High Blood Pressure Education Program (NHBPEP) recommendations at a single academic medical center. Methods: We identified children 3-18 years of age with hypertension based on outpatient visit International Classification of Diseases, Ninth Edition, Clinical Modification codes from 2006 to 2012. We calculated the odds of individual tests administration for ten recommended tests, adjusting for demographic characteristics. Results: We identified 3,588 (1.7%) of 216,855 children diagnosed with hypertension at a median age of 14 years (25th and 75th percentile 10 and 16, respectively). No child received all ten recommended tests. The median number of tests administered was 2 (1, 4) but varied significantly by race and age. Urine drug screen (<1%) and renin levels (1%) were the least common, whereas serum creatinine (49%) and echocardiogram (40%) were the most common tests. Male children were more likely to receive an echocardiogram (odds ratio 1.43; 95% confidence interval: 1.24-1.64), and black children and those ≥11 years old were less likely to have their serum creatinine checked. Adherence to the guidelines did not improve over time ( P = .24). Conclusion: Children evaluated for hypertension in the outpatient setting infrequently receive the diagnostic tests recommended in the NHBPEP’s report. Test administration frequency varies by patient demographics but has not improved significantly over time.
Disparities in Emergency Department Pain Treatment for Toothache
Authors: Lee H.H. , Lewis C.W. , McKinney C.M. 
Published: June 2016

Racial disparities in how pain is treated in the emergency department (ED) for toothache have not been reported. Due to increasing reliance on EDs for dental care, the authors investigated whether race/ethnicity and insurance type are associated with treatment for toothache pain. The authors conducted a nationally representative cross-sectional study of ED toothache visits by adults (19 to 64 y old), using the 2008–2010 National Hospital Ambulatory Medical Care Survey. Multinomial regression models accounted for the complex survey design. Outcomes were pain medicines received: none, nonopioid only, or opioids. After adjusting for sociodemographic factors, black patients had 1.99 greater odds ( P < 0.005) than white patients of receiving only a nonopioid pain medicine for toothache. Visits made by patients on Medicare, Medicaid, uninsured, or “other” insurance status had greater odds than the privately insured of receiving only a nonopioid pain medicine rather than an opioid (odds ratios, respectively: 4.8, P < 0.001; 2.1, P ≤ 0.001; 2.3, P < 0.01; and 4.1, P < 0.001). Blacks are less likely than whites to receive opioids in the ED for a toothache, even with similar levels of pain. Nonprivately insured patients have lower odds than the privately insured to receive opioids for toothache pain. A better understanding of the etiology of these disparities could lead to directed interventions. Knowledge Transfer Statement: This study presents findings novel to the body of pain and oral health care literature. Because there is an increasing reliance on the emergency department to address dental pain, disparities in how toothache pain is treated will be of great interest to a growing number of Americans, clinicians, and policy makers.
Ectopic Adrenocorticotropic Hormone–Secreting Pituitary Adenomas: An Underestimated Entity
Authors: Knappe Ulrich J. , Jaspers Christian , Buschsieweke Desirée , Reinbold Wolf-Dieter , Alomari Ali , Saeger Wolfgang , Ehlenz Klaus , Mann W. Alexander , Kann Peter Herbert , Feldkamp Joachim 
Published: June 2016

Abstract

BACKGROUND: The diagnosis of Cushing disease is based on endocrinological pa-rameters, with no single test being specific. In some patients, dynamic thin-slice sellar magnetic resonance imaging fails to detect a pituitary tumor.

OBJECTIVE: The purpose of this study is to investigate the role of ectopic pituitary adenoma in this situation.

METHODS: In a retrospective chart review, 5 patients (6%) with ectopic adenomas were identified in 83 consecutive patients undergoing transsphenoidal surgery for adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas by 1 surgeon.

RESULTS: In all 5 patients (all female, 32-41 years of age), an exclusively extrasellar ACTH-secreting adenoma was excised. Three adenomas were located in the cavernous sinus, 1 in the sphenoid sinus, and 1 in the ethmoidal cells. Histologically, none of the tumors showed signs of aggressiveness. Three of the 5 adenomas specifically expressed somatostatin receptor 5. In 4 patients with Cushing disease, postoperative remission was obtained, with 1 recurrence after 14 months. In the patient with Nelson syndrome, ACTH decreased from >800 to <80 pg/mL. Three patients underwent previous surgery elsewhere, including 1 hypophysectomy. In this case, the ectopic adenoma (positive for somatostatin receptor 5) in the ethmoidal cells turned out to be positive on gallium 68 DOTATATE positron emission tomography/computed tomography.

CONCLUSION: The incidence of primarily ectopic ACTH-secreting adenomas in this series was 6%. In cases of negative MRI findings, an ectopic ACTH-secreting adenoma should be taken into account. 68Ga DOTATATE positron emission tomography/computed tomography may identify ectopic pituitary adenomas. Hypophysectomy should always be avoided in primary surgery for CD.
Εκπαιδευτικά ιστολόγια: Η δυνατότητα χρήσης τους ως αποτελεσματικά εργαλεία επίτευξης μη τυπικής μάθησης.
Authors: ΑΝΤΩΝΙΟΥ Παναγιώτης , ΜΑΧΑΙΡΙΔΟΥ Μαρία 
Published: June 2016

<p>Στην παρούσα εργασία διερευνάται η εκπαιδευτική χρήση των ιστολογίων, με στόχο την κατάθεση του προβληματισμού σχετικά με την αποτελεσματικότητά τους ως εκπαιδευτικά εργαλεία, στα πλαίσια της μη τυπικής εκπαίδευσης των συμμετεχόντων σε αυτά. Επίσης, αξιολογείται το περιεχόμενο κάποιων υπαρχόντων εκπαιδευτικών ιστολογίων στο διεθνή και τον ελληνικό χώρο. </p>
Η μαθησιακή αυτονομία κατά την εκπόνηση γραπτών εργασιών
Authors: ΦΑΝΑΡΙΤΗ Μαρία , ΣΠΑΝΑΚΑ Αδαμαντία 
Published: June 2016

<p>Σκοπός της παρούσας έρευνας είναι η διερεύνηση του συσχετισμού ανάμεσα στην εκπόνηση γραπτών εργασιών, την εξάσκηση της μεταγνωστικής σκέψης και δράσης και την εξάσκηση της μαθησιακής αυτονομίας. Πιο αναλυτικά, διερευνήθηκαν οι αντιλήψεις μεταπτυχιακών φοιτητών στο ΕΑΠ ως προς το ρόλο τους κατά την εκπόνηση γραπτών εργασιών, καθώς και τις μεταγνωστικές στρατηγικές σχεδιασμού, παρακολούθησης και ελέγχου που εφαρμόζουν κατά την εκπόνηση γραπτών εργασιών. Μέσα από την ανταπόκριση έξι μεταπτυχιακών φοιτητών σε συνέντευξη διαπιστώθηκε ότι υπάρχουν περιθώρια διεύρυνσης και επέκτασης των ορίων της μεταγνωστικής τους δράσης στο μαθησιακό περιβάλλον της εξ αποστάσεως εκπαίδευσης. Καθοριστική ως προς αυτό είναι η συμβολή του καθηγητή-συμβούλου ως προς την κατεύθυνση της εξοικείωσης και εμπλοκής των φοιτητών σε δραστηριότητες που αναπτύσσουν το μεταγνωστικό προβληματισμό και στοχασμό.</p><p><strong> </strong></p>
Ανιχνεύοντας την πορεία του E-learning στα «Χρονικά της Εκπαίδευσης» και εφαρμόζοντας το σε μια πρόταση για την επιμόρφωση στη Μουσειακή Εκπαίδευση
Authors: ΓΚΙΡΤΖΗ Μαρία 
Published: June 2016

<p>Το e-learning εισβάλει δυναμικά στη ζωή μας κατακλύζοντας όλο και περισσότερο εκπαιδευτικές και επιμορφωτικές δράσεις. Στην παρούσα εισήγηση δίνεται καταρχήν συνοπτικά το ιστορικό της εμφάνισης του e-learning και οι προϋποθέσεις για την δημιουργία τέτοιων περιβαλλόντων μάθησης. Στη συνέχεια αναλύονται οι σημαντικότερες μορφές e-learning (ασύγχρονη και σύγχρονη τηλεκπαίδευση) και το σε ποιους τομείς χρησιμοποιούνται οι εφαρμογές τους σήμερα (πρωτοβάθμια, δευτεροβάθμια, τριτοβάθμια εκπαίδευση και επιμόρφωση-κατάρτιση). Τέλος κατατίθεται μια πρόταση επιμόρφωσης στη Μουσειακή Εκπαίδευση με το μοντέλο της υβριδικής μάθησης (blended learning), για την οποία κατασκευάστηκε πλατφόρμα ασύγχρονης τηλεκπαίδευσης. </p>
Επίδραση της τηλεδιάσκεψης στη μαθησιακή διαδικασία του Ε.Α.Π. Απόψεις φοιτητών και ΣΕΠ των ΘΕ ΕΚΠ 65 –ΕΚΕ 50
Authors: ΜΗΛΙΩΡΙΤΣΑΣ Ευάγγελος , ΓΕΩΡΓΙΑΔΗ Ειρήνη 
Published: June 2016

<p>Στην εισήγηση αυτή επιχειρείται να σκιαγραφηθεί η αξιοποίηση της τηλεδιάσκεψης στην εξ αποστάσεως εκπαιδευτική διαδικασία. Η διερεύνηση των απόψεων των φοιτητών και των ΣΕΠ του ΕΑΠ, υλοποιήθηκε ποιοτικά και σχεδιάστηκε να απαντήσει στο καίριο ερώτημα: <em>«πώς η τηλεδιάσκεψη μπορεί, ως εργαλείο επικοινωνίας και μάθησης, να προσθέσει αξία στην εκπαιδευτική διαδικασία του ΕΑΠ;» </em>Για το σκοπό της έρευνας πραγματοποιήθηκαν 14 συνεντεύξεις 7 από φοιτητές/φοιτήτριες και 7 από καθηγητές /καθηγήτριες Συμβούλους (ΣΕΠ) των ΘΕ ΕΚΠ 65 &amp; ΕΚΕ 50 και η στοχευμένη επιλογή της ποιοτικής διερεύνησης αποσκοπούσε μέσα από την αμεσότητα της επικοινωνίας του συνεντευκτή με τα ερωτώμενα πρόσωπα. Η τηλεδιάσκεψη ως δυναμικό και ευέλικτο μαθησιακό σύστημα μπορεί να τοποθετηθεί παράλληλα με τα υπάρχοντα και είναι δυνατόν να αξιοποιηθεί μεταξύ φοιτητών, ανάμεσα σε φοιτητές-καθηγητές και για συνεργασίες ΣΕΠ. Επιπλέον η συμπληρωματική της χρήση δρα ενισχυτικά στη λειτουργία των ομαδικών συμβουλευτικών συναντήσεων. Από την έρευνα και σύμφωνα με τις απόψεις του δείγματος που συμμετέχει σε αυτή, προκύπτει, ότι για τους εμπλεκόμενους στη διδακτική πράξη και τη μαθησιακή πορεία, η τηλεδιάσκεψη ως μορφή αμφίδρομης επικοινωνίας, μπορεί να ενισχύει την επικοινωνία και τη μάθηση προς όφελος του διδασκομένου και να υποστηρίξει το καθοδηγητικό έργο του διδάσκοντα. Ο ρόλος του καθηγητή-συμβούλου γίνεται πιο απαιτητικός και είναι ο ρυθμιστής του μέσου με τις προϋποθέσεις οι οποίες απαιτούνται. Η τηλεδιάσκεψη έρχεται να λειτουργήσει συμπληρωματικά με τις ΟΣΣ και προς όφελος των απόντων αυτής.</p>