Publications by authors named "Steven Crane"

A shortcut review of the literature was conducted to examine whether administering a sphenopalatine ganglion (SPG) block provides symptomatic relief in adult patients with acute migraine. 381 papers were found of which 4 included data on patients relevant to the specific clinical question, these are discussed in the paper. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated.

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Article Synopsis
  • - A literature review was conducted to explore whether neuron-specific enolase (NSE) could indicate the absence of spinal cord or nerve root compression, examining a total of 132 papers.
  • - Only 4 studies provided relevant data on the use of NSE as a clinical marker, which were analyzed for authors, publication details, patient demographics, outcomes, and study limitations.
  • - The conclusion is that there is currently no evidence supporting the use of NSE measurements in clinical settings to rule out significant spinal compression.
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Access to scientific data can enable independent reuse and verification; however, most data are not available and become increasingly irrecoverable over time. This study aimed to retrieve and preserve important datasets from 160 of the most highly-cited social science articles published between 2008-2013 and 2015-2018. We asked authors if they would share data in a public repository-the Data Ark-or provide reasons if data could not be shared.

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Positive social experiences may induce oxytocin release. However, previous studies of moral elevation have generally utilized cross-sectional and simple modeling approaches to establish the relationship between oxytocin and emotional stimuli. Utilizing a cohort of 30 non-lactating women (aged 23.

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Introduction/objectives: Coaching is emerging as a form of facilitation in health professions education. Most studies focus on one-on-one coaching rather than team coaching. We assessed the experiences of interprofessional teams coached to simultaneously improve primary care residency training and interprofessional practice.

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Background: Patient boarding in the emergency department (ED) is a significant issue leading to increased morbidity/mortality, longer lengths of stay, and higher hospital costs. We examined the impact of boarding patients on the ED waiting room. Additionally, we determined whether facility type, patient acuity, time of day, or hospital occupancy impacted waiting rooms in 18 EDs across a large healthcare system.

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Introduction: Patients suspected of having venous thromboembolism (VTE), with a low pretest probability, undergo D-dimer testing. A negative D-dimer, in a low-risk patient rules out VTE with a high degree of certainty because of its high sensitivity. It is, however, a poorly specific test, and the absolute value increases with age.

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Introduction: Patients presenting to emergency departments (EDs) with suspected pulmonary embolism (PE) can be risk stratified and those who are deemed to be at low risk for PE usually undergo D-dimer testing. A negative D-dimer in this low-risk group rules out PE with a high degree of certainty because of its high sensitivity. The D-dimer is, however, a poorly specific test and positive results often lead to unnecessary radiological imaging (notably computed tomography pulmonary angiography).

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Adenosine derivatives developed to activate adenosine receptors (ARs) revealed micromolar activity at serotonin 5HT and 5HT receptors (5HTRs). We explored the structure-activity relationship at 5HTRs and modeled receptor interactions in order to optimize affinity and simultaneously reduce AR affinity. Depending on N substitution, small 5'-alkylamide modification maintained 5HTR affinity, which was enhanced upon ribose substitution with rigid bicyclo[3.

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Small molecule screening libraries cover only a small fraction of the astronomical number of possible drug-like compounds, limiting the success of ligand discovery efforts. Computational screening of virtual libraries representing unexplored chemical space could potentially bridge this gap. Drug development for adenosine receptors (ARs) as targets for inflammation and cardiovascular diseases has been hampered by the paucity of agonist scaffolds.

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Purine (N)-methanocarba-5'-N-alkyluronamidoriboside A3 adenosine receptor (A3AR) agonists lacking an exocyclic amine resulted from an unexpected reaction during a Sonogashira coupling and subsequent aminolysis. Because the initial C6-Me and C6-styryl derivatives had unexpectedly high A3AR affinity, other rigid nucleoside analogues lacking an exocyclic amine were prepared. Of these, the C6-Me-(2-phenylethynyl) and C2-(5-chlorothienylethynyl) analogues were particularly potent, with human A3AR Ki values of 6 and 42 nM, respectively.

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2-Arylethynyl derivatives of (N)-methanocarba adenosine 5'-uronamides are selective AAR (adenosine receptor) agonists. Here we substitute a 1,2,3-triazol-1-yl linker in place of the rigid, linear ethynyl group to eliminate its potential metabolic liability. Docking of nucleosides containing possible short linker moieties at the adenine C2 position using a hybrid molecular model of the AAR (based on the AAR agonist-bound structure) correctly predicted that a triazole would maintain the AAR selectivity, due to its ability to fit a narrow cleft in the receptor.

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Substitution of rigidified A3 adenosine receptor (AR) agonists with a 2-((5-chlorothiophen-2-yl)ethynyl) or a 2-(4-(5-chlorothiophen-2-yl)-1H-1,2,3-triazol-1-yl) group provides prolonged protection in a model of chronic neuropathic pain. These agonists contain a bicyclo[3.1.

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Purpose: Near-miss events represent an opportunity to identify and correct errors that jeopardize patient safety. This study was undertaken to assess the feasibility of a near-miss reporting system in primary care practices and to describe initial reports and practice responses to them.

Methods: We implemented a web-based, anonymous near-miss reporting system into 7 diverse practices, collecting and categorizing all reports.

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Background: Redesign in the health care delivery system creates a need to reorganize resident education. How residency programs fund these redesign efforts is not known.

Methods: Family medicine residency program directors participating in the Preparing Personal Physicians for Practice (P(4)) project were surveyed between 2006 and 2011 on revenues and expenses associated with training redesign.

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In response to adenosine 5'-diphosphate, the P2Y1 receptor (P2Y1R) facilitates platelet aggregation, and thus serves as an important antithrombotic drug target. Here we report the crystal structures of the human P2Y1R in complex with a nucleotide antagonist MRS2500 at 2.7 Å resolution, and with a non-nucleotide antagonist BPTU at 2.

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A shortcut review was carried out to establish whether a higher age related threshold can be used when using d-dimer as a rule out test for pulmonary embolism. 29 papers were found of which 13 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated.

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Background: Patients with complex behavioral health and medical problems can have a disproportionate impact on emergency departments.

Methods: We identified a cohort of 255 low-income, uninsured patients who had used inpatient or emergency department services more than 6 times in the previous 12 months. Between July 2010 and June 2011 we enrolled 36 of these high-risk patients to participate in a twice-weekly drop-in group medical appointment staffed by an interdisciplinary team of a family physician, behavioral health professional, and nurse case manager.

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To attract new physicians to rural primary care, new models of care are needed that are more effective, more sustainable, and replicable in smaller communities. This commentary provides a brief description of preliminary findings associated with a radically redesigned, low-overhead patient-centered medical-home practice model in North Carolina.

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Background: In North Carolina, nearly one-fourth of persons with asthma visit an emergency department (ED) or urgent care center at least once a year because of an exacerbation of asthma symptoms. The Emergency Department Asthma Program was a quality-improvement initiative designed to better understand the population of patients who use the ED for asthma care in rural western North Carolina and to demonstrate whether EDs at small hospitals could, by implementing National Asthma Education and Prevention Program treatment guidelines, improve asthma care and reduce subsequent asthma-related ED visits.

Methods: Eight hospitals in western North Carolina participated in the project, which lasted from November 2003 through December 2007.

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