scholarly journals Time series-based bibliometric analysis of a systematic review of multidisciplinary care for opioid dose reduction: exploring the origins of the North American opioid crisis

2021 ◽  
Author(s):  
Abhimanyu Sud ◽  
Darren K. Cheng ◽  
Rahim Moineddin ◽  
Erin Zlahtic ◽  
Ross Upshur
Keyword(s):  
Chronic Pain ◽  
Time Series ◽  
North American ◽  
Scientific Literature ◽  
Relevant Literature ◽  
Multidisciplinary Care ◽  
Opioid Overdose ◽  
Opioid Dose ◽  
Opioid Crisis ◽  
The North

AbstractBibliometric analyses of systematic reviews offer unique opportunities to explore the character of specific scientific fields. In this time series-based analysis, dynamics of multidisciplinary care for chronic pain and opioid prescribing are analyzed over a forty-four year time span. Three distinct periods are identified, each defined by distinct research areas, as well as priorities regarding the use of opioids and the appropriate management of chronic pain. These scientometrically defined periods align with timelines identified previously by narrative historical accounts. Through cross-correlation with a mortality time series, a significant two-year lag between opioid overdose mortality and citation dynamics is identified between 2004 and 2019. This analysis demonstrates a bidirectional relationship between the scientific literature and the North American opioid overdose crisis, suggesting that the scientific literature is both reflective and generative of an important health and social phenomenon. A scientometric phenomenon of memory lapse, namely an overt and prolonged failure to cite older relevant literature, is identified using a metric of mean time to citation. It is proposed that this metric can be used to analyze changes in emerging literature and thus predict the nature of clinical and policy responses to the opioid crisis, and thus potentially to other health and social phenomena.

scholarly journals Evaluating the agreement between measurements and models of net ecosystem exchange at different times and timescales using wavelet coherence: an example using data from the North American Carbon Program Site-Level Interim Synthesis

2013 ◽  
Vol 10 (11) ◽  
pp. 6893-6909 ◽  
Author(s):  
P. C. Stoy ◽  
M. C. Dietze ◽  
A. D. Richardson ◽  
R. Vargas ◽  
A. G. Barr ◽  
...  
Keyword(s):  
Time Series ◽  
Data Fusion ◽  
North American ◽  
Net Ecosystem Exchange ◽  
Wavelet Coherence ◽  
Environmental Drivers ◽  
Model Data ◽  
Foliar Nitrogen ◽  
The North ◽  
Model Parameterization

Abstract. Earth system processes exhibit complex patterns across time, as do the models that seek to replicate these processes. Model output may or may not be significantly related to observations at different times and on different frequencies. Conventional model diagnostics provide an aggregate view of model–data agreement, but usually do not identify the time and frequency patterns of model–data disagreement, leaving unclear the steps required to improve model response to environmental drivers that vary on characteristic frequencies. Wavelet coherence can quantify the times and timescales at which two time series, for example time series of models and measurements, are significantly different. We applied wavelet coherence to interpret the predictions of 20 ecosystem models from the North American Carbon Program (NACP) Site-Level Interim Synthesis when confronted with eddy-covariance-measured net ecosystem exchange (NEE) from 10 ecosystems with multiple years of available data. Models were grouped into classes with similar approaches for incorporating phenology, the calculation of NEE, the inclusion of foliar nitrogen (N), and the use of model–data fusion. Models with prescribed, rather than prognostic, phenology often fit NEE observations better on annual to interannual timescales in grassland, wetland and agricultural ecosystems. Models that calculated NEE as net primary productivity (NPP) minus heterotrophic respiration (HR) rather than gross ecosystem productivity (GPP) minus ecosystem respiration (ER) fit better on annual timescales in grassland and wetland ecosystems, but models that calculated NEE as GPP minus ER were superior on monthly to seasonal timescales in two coniferous forests. Models that incorporated foliar nitrogen (N) data were successful at capturing NEE variability on interannual (multiple year) timescales at Howland Forest, Maine. The model that employed a model–data fusion approach often, but not always, resulted in improved fit to data, suggesting that improving model parameterization is important but not the only step for improving model performance. Combined with previous findings, our results suggest that the mechanisms driving daily and annual NEE variability tend to be correctly simulated, but the magnitude of these fluxes is often erroneous, suggesting that model parameterization must be improved. Few NACP models correctly predicted fluxes on seasonal and interannual timescales where spectral energy in NEE observations tends to be low, but where phenological events, multi-year oscillations in climatological drivers, and ecosystem succession are known to be important for determining ecosystem function. Mechanistic improvements to models must be made to replicate observed NEE variability on seasonal and interannual timescales.

scholarly journals Understanding Buprenorphine for Use in Chronic Pain: Expert Opinion

Pain Medicine ◽  
2020 ◽  
Vol 21 (4) ◽  
pp. 714-723 ◽  
Author(s):  
Lynn Webster ◽  
Jeffrey Gudin ◽  
Robert B Raffa ◽  
Jay Kuchera ◽  
Richard Rauck ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Opioid Receptor ◽  
Receptor Agonist ◽  
Relevant Literature ◽  
Analgesic Efficacy ◽  
Chronic Pain Management ◽  
Opioid Dose ◽  
Opioid Receptor Agonist ◽  
Clinical Scenarios

Abstract Objective An expert panel convened to reach a consensus on common misconceptions surrounding buprenorphine, a Schedule III partial µ-opioid receptor agonist indicated for chronic pain. The panel also provided clinical recommendations on the appropriate use of buprenorphine and conversion strategies for switching to buprenorphine from a full µ-opioid receptor agonist for chronic pain management. Methods The consensus panel met on March 25, 2019, to discuss relevant literature and provide recommendations on interpreting buprenorphine as a partial µ-opioid receptor agonist, prescribing buprenorphine before some Schedule II, III, or IV options, perioperative/trauma management of patients taking buprenorphine, and converting patients from a full µ-opioid receptor agonist to buprenorphine. Results The panel recommended that buprenorphine’s classification as a partial µ-opioid receptor agonist not be clinically translated to mean partial analgesic efficacy. The panel also recommended that buprenorphine be considered before some Schedule II, III, or IV opioids in patients with a favorable risk/benefit profile on the basis of metabolic factors, abuse potential, and tolerability and that buprenorphine be continued during the perioperative/trauma period. In addition, switching patients from a full µ-opioid receptor agonist to buprenorphine should be considered with no weaning period at starting doses that are based on the previous opioid dose. Conclusions These recommendations provide a framework for clinicians to address most clinical scenarios regarding buprenorphine use. The overall consensus of the panel was that buprenorphine is a unique Schedule III opioid with favorable pharmacologic properties and a safety profile that may be desirable for chronic pain management.

scholarly journals Addressing the Opioid Problem

2018 ◽  
Vol 12 (4) ◽  
Author(s):  
Mitch Levine
Keyword(s):  
Annual Meeting ◽  
North American ◽  
Plenary Session ◽  
Opioid Dependency ◽  
Opioid Crisis ◽  
The North

At the recent CSIM annual meeting in Toronto the opening plenary session was “The North American Opioid Crisis.” This is a fundamentally important topic for internists. We frequently encounter patients in our clinics and hospitals who have opioid dependency issues and we need to have a compassionate and medically sound strategy to manage the problems before us. We also have the opportunity to help prevent a problem that is often started with a physician’s prescription.  

1588: The Bicalutamide Early Prostate Cancer Program: Findings of the North American Trial at 7.7 Years' Median Follow-Up

2006 ◽  
Vol 175 (4S) ◽  
pp. 511-512
Author(s):  
David G. McLeod ◽  
Ira Klimberg ◽  
Donald Gleason ◽  
Gerald Chodak ◽  
Thomas Morris ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
North American ◽  
Early Prostate Cancer ◽  
The North ◽  
Cancer Program
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