bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Attribution and Explanation
Authors: Hilton Denis
Published: May 2017

Attribution processes appear to be an integral part of human visual perception, as low-level inferences of causality and intentionality appear to be automatic and are supported by specific brain systems. However, higher-order attribution processes use information held in memory or made present at the time of judgment. While attribution processes about social objects are sometimes biased, there is scope for partial correction. This chapter reviews work on the generation, communication, and interpretation of complex explanations, with reference to explanation-based models of text understanding that result in situation models of narratives. It distinguishes between causal connection and causal selection, and suggests that a factor will be discounted if it is not perceived to be connected to the event and backgrounded if it is perceived to be causally connected to that event, but is not selected as relevant to an explanation. The final section focuses on how interpersonal explanation processes constrain causal selection.
Mental Models and Causation
Authors: Johnson-Laird P. N. , Khemlani Sangeet S.
Published: May 2017

The theory of mental models accounts for the meanings of causal relations in daily life. They refer to seven temporally-ordered deterministic relations between possibilities, which include causes, prevents, and enables. Various factors—forces, mechanisms, interventions—can enter into the interpretation of causal assertions, but they are not part of their core meanings. Mental models represent only salient possibilities, and so they are identical for causes and enables, which may explain failures to distinguish between their meanings. Yet, reasoners deduce different conclusions from them, and distinguish between them in scenarios, such as those in which one event enables a cause to have its effect. Neither causation itself nor the distinction between causes and enables can be captured in the pure probability calculus. Statistical regularities, however, often underlie the induction of causal relations. The chapter shows how models help to resolve inconsistent causal scenarios and to reverse engineer electrical circuits.
The Development of Causal Reasoning
Authors: Muentener Paul , Bonawitz Elizabeth
Published: May 2017

Research on the development of causal reasoning has broadly focused on accomplishing two goals: understanding the origins of causal reasoning, and examining how causal reasoning changes with development. This chapter reviews evidence and theory that aim to fulfill both of these objectives. In the first section, it focuses on the research that explores the possible precedents for recognizing causal events in the world, reviewing evidence for three distinct mechanisms in early causal reasoning: physical launching events, agents and their actions, and covariation information. The second portion of the chapter examines the question of how older children learn about specific causal relationships. It focuses on the role of patterns of statistical evidence in guiding learning about causal structure, suggesting that even very young children leverage strong inductive biases with patterns of data to inform their inferences about causal events, and discussing ways in which children’s spontaneous play supports causal learning.
The Inferential Reasoning Theory of Causal Learning
Authors: Boddez Yannick , Houwer Jan De , Beckers Tom
Published: May 2017

Chapter 4 describes the inferential reasoning theory of causal learning and discusses how thinking about this theory has evolved in at least two important ways. First, the authors argue that it is useful to decouple the debate about different possible types of mental representations involved in causal learning (e.g., propositional or associative) from the debate about processes involved therein (e.g., inferential reasoning or attention). Second, at the process level inferential reasoning is embedded within a broad array of mental processes that are all required to provide a full mechanistic account of causal learning. Based on those insights, the authors evaluate five arguments that are often raised against inferential reasoning theory. They conclude that causal learning is best understood as involving the formation and retrieval of propositional representations, both of which depend on multiple cognitive processes (i.e., the multi-process propositional account).
Causal Invariance as an Essential Constraint for Creating a Causal Representation of the World
Authors: Cheng Patricia W. , Lu Hongjing
Published: May 2017

This chapter illustrates the representational nature of causal understanding of the world and examines its implications for causal learning. The vastness of the search space of causal relations, given the representational aspect of the problem, implies that powerful constraints are essential for arriving at adaptive causal relations. The chapter reviews (1) why causal invariance—the sameness of how a causal mechanism operates across contexts—is an essential constraint for causal learning in intuitive reasoning, (2) a psychological causal-learning theory that assumes causal invariance as a defeasible default, (3) some ways in which the computational role of causal invariance in causal learning can become obscured, and (4) the roles of causal invariance as a general aspiration, a default assumption, a criterion for hypothesis revision, and a domain-specific description. The chapter also reviews a puzzling discrepancy in the human and non-human causal and associative learning literatures and offers a potential explanation.
Precaution in the Governance of Technology
Authors: Stirling Andy
Published: May 2017

Strong political pressures mean that few issues in international governance of science and technology are more misunderstood than the precautionary principle. Often accused of being ‘anti-science’, precaution simply acknowledges that not all uncertainties can be artificially aggregated to ‘risk’. ‘Real-world’ imperatives for justification, acceptance, trust, and blame management unscientifically suppress the indeterminacies, complexities, and variabilities of the ‘real’ real world—and so reinforce attachments to whichever innovation trajectories are most powerfully backed by default. Resisting these pressures for circumscribed ‘risk assessment’, precaution explicitly emphasizes health and environment—and challenges pretence that technology choices can be value-free. Additionally, precaution points to a host of normally-excluded methods that allow greater rigour, balance, completeness, transparency, and accountability in evaluating priorities and interpreting evidence. This chapter reviews key associated issues in technology governance, and highlights practical ways to help more deliberate social steering of the directions taken by science and technology.
Economics of Criminal Law
Authors: Ehrlich Isaac
Published: May 2017

This chapter discusses the economic approach to crime. By applying the tools of economic analysis and econometric methodology, it serves as a unified approach for understanding illegal behaviour as part of human behaviour in general. It offers new insights about the relative efficiency and desirability of means of crime control and components of the law enforcement system. The economic approach, and the “market model” linking it to the general methodology used by economists to study and interpret the general economy, remains a work in progress, because the data are not available to the degree they are collected and reported in other areas of economic inquiry. It is still too early to assess the degree to which the various econometric studies have produced accurate estimates of critical behavioral relationships underlying variations and conflicting trends of crime. Progress depends on better data and more complete implementations of the comprehensive model of crime.
Economics of Ancient Legal Systems
Authors: Miller Geoffrey Parsons
Published: May 2017

The economic analysis of ancient legal systems is fundamentally similar to the economic analysis of modern law. The researcher observes a data set of legal materials and seeks to explain its features based on a model of human action. If the analysis is successful, it could enhance the understanding of phenomena that are poorly explained by other approaches. Certain features of ancient legal materials, however, constrain economic analysis and require modifications to the methodology. Three differences are most salient: the sources of data available to the researcher; the assumptions that the researcher brings to bear in analyzing the data; and the techniques of validation available to confirm or disconfirm theoretical hypotheses. This chapter discusses how economic analysis is conducted subject to these constraints as well as applications of economic analysis of ancient legal systems.
Critiques of Law and Economics
Authors: Driesen David , Malloy Robin Paul
Published: May 2017

This article summarizes leading critiques of law and economics. These critiques are grouped into three categories. The article first addresses concerns about the normative value of economic efficiency as a leading goal for law. It then addresses methodological criticisms, which often call into question the coherence of the allocative efficiency concept. Finally, it discusses the interpretive criticisms of law and microeconomics, which view law and economics as a rhetorical form and raises questions based on that view. Scholars have questioned the normative value of economic efficiency as a central goal of law. They have also challenged the coherence and objectivity of the methods used to assess economic efficiency. They have questioned the claim of economics as somehow providing a scientific justification for law, arguing instead that it constitutes a rhetorical form shifting the terms of legal argument and changing its outcomes.
Syriac
Authors: Witakowski Witold
Published: May 2017

This chapter presents a sketch of early Syriac literature during the Roman/Byzantine period, before the Arab conquests. Although its beginnings were pre-Christian, the bulk of Syriac writings is made up of typically Christian compositions, belonging mainly to the literary genres such as exegetical, dogmatic, polemical, ascetic, monastic, as well as canon law, etc. Much of the output of the epoch is religious poetry, in which Syriac authors excelled, having become renowned even outside the Syriac sphere, as is the case with Ephrem’s poems that reached Greek and other Christian Oriental literatures. Short accounts of the Syriac Bible translations are provided, and of the compositions of the most important authors, such as BarDaisan, Jacob of Serum, Isaac of Antioch, Philoxenos of Mabbogh, and others, as well as accounts of two genres: historiography and biography/hagiography.
History of Epilepsy Neuropsychology
Authors: Loring David W. , Hermann Bruce P.
Published: May 2017

This article reviews the shared history of epilepsy and neuropsychology and highlights the clinical and scientific progress in both disciplines. It considers the role of neuropsychology in understanding the impact of the epilepsies and how cognitive studies of epilepsy and epilepsy surgery helped elucidate human brain function. It begins by focusing on the late 1800s/early 1900s, when intelligence testing became available and widely used in epilepsy and neuropsychology, before turning to the 1920s–1950s, when a clearer picture of the different epilepsy syndromes and their associated EEG and clinical seizure features emerged. It then examines surgical treatment of the epilepsies in the period beginning in the late 1940s, along with the conflict between the eugenics movement and the goal of providing better care of people with epilepsy within specialized epilepsy institutions. It also looks at the risk factors for cognitive impairment and the effects of EEG abnormalities on neuropsychological function.
Halstead Reitan Battery
Authors: Goldstein Gerald
Published: May 2017

This chapter reviews the history of the Halstead-Reitan Neuropsychological Battery from the factor analytic study of its component tests published in 1947 by Ward Halstead to the present time. It discusses the initial work of Halstead and the contributions of Ralph Reitan, Reitan’s collaborators, and independent researchers. It describes various versions of the battery and discusses issues regarding so-called fixed batteries, use of quantitative versus qualitative procedures in neuropsychological assessment, interpretation with or without knowledge of the case history, and the status of the battery with regard to forming brain-behavior relationships. The HRNB remains in common use and has been the major force in forming clinical neuropsychology by providing a comprehensive, valid, and sensitive way of assessing brain-damaged patients based upon research supporting neuropsychological inferences made by clinicians. Specific contributions include the impairment index, comparison between right and left hemispheres, type-locus interaction, and multiple methods of inference.
Ancient Greek and Roman Sport
Authors: Kyle Donald G.
Published: May 2017

To demonstrate the growth and sophistication of ancient sport studies, this chapter surveys Greek athletics and Roman spectacles from their origins to their overlap in the Roman Empire. It notes trends, debates, and new discoveries (e.g., of victory epigrams, agonistic inscriptions, gladiator burials). Revisionists are exposing traditional ideologies of sport and spectacle rooted in Victorian idealism and moralism. Challenging the traditional amateurist scenario of early athletic glory and tragic decline, they suggest continuities, transitions, and cultural discourse. Questioning Olympocentrism and the “exceptionalism” of Greece and Rome, studies now favor broader chronological, geographical, comparative, and inclusive approaches. Scholars are rethinking the significance of sport and spectacle for society, identity, spectatorship, violence, gender, and the body. Forgoing sensationalistic approaches to the shows of the Roman arena, scholars now suggest that gladiators were professional performers whose preparations, combats, and rewards had “sporting” aspects.
Patterns of Police, Fire, and Ambulance Calls-for-Service: Scanning the Spatio-Temporal Intersection of Emergency Service Problems
Authors: Clare Joseph , Townsley Michael , Birks Daniel J. , Garis Len
Published: May 2017

Independent analysis of police, fire, and ambulance calls for service demonstrates common patterns in emergency service activity. Targeted, place-focused interventions have been demonstrated to prevent future problems for emergency services. This research builds on these findings to examine the spatial and temporal intersection of police, fire, and ambulance incidents to explore the potential utility of enhanced collaboration between emergency-first responders. Using police and fire data from Surrey, BC, Canada, from 2011 to 2013, spatial and temporal patterns of police-, fire-, and ambulance-related incidents were examined. Initial analyses demonstrate that 36% of the City’s area experienced 72% of incidents responded to over this 3-year study period. Focusing on this high-volume area, the spatial and temporal intersection of these incident types was explored. Spatially, lattices of varying cell sizes (250 m, 500 m, and 1,000 m) were placed over the study area. Temporally, incident volume was examined across the entire 3-year study period, and at yearly and monthly intervals. Incidents were placed within these spatial and temporal frameworks and visual inspection was utilized to assess the convergence of service demand. Regardless of the cell grid size, police, fire, and ambulance incidents were spatially and temporally concentrated, with the top 10% of cells accounting for approximately 50% of all incidents across all services. Furthermore, there was considerable spatio-temporal convergence in cells which account for the top decile of call volume for all incident types. A 2 × 2 typology is proposed to classify locations (in this case grid cells) based on (1) the frequency at which they generate high demand for services (sporadic versus persistent), and (2) the combination of agencies required to respond to high demand problems (single versus convergent). The spatial and temporal convergence of emergency service problems observed in this study suggests that an interagency approach to problem identification will enhance problem analysis processes. Working in conjunction with established problem-focused intervention strategies (such as problem-oriented policing), the volume-service typology provides a framework that can contribute to the development of appropriate problem-responses. This, we hope, will support emerging efforts to increase the extent to which emergency-first responder agencies collaborate to maximize efficiency and effectiveness, and reduce harm.
National Institutes of Health Research Plan on Rehabilitation
Authors:   NIH Medical Rehabilitation Coordinating Committee, O’Mara Ann , Rowland Julia H. , Greenwell Thomas N. , Wiggs Cheri L. , Fleg Jerome , Joseph Lyndon , McGowan Joan , Panagis James S. , Washabaugh Charles , Peng Grace C. Y. , Bray Rosalina , Cernich Alison N. , Cruz Theresa H. , Marden Sue , Michel Mary Ellen , Nitkin Ralph , Quatrano Louis , Spong Catherine Y. , Shekim Lana , Jones Teresa L. Z. , Juliano-Bult Denise , Panchinson David M. , Chen Daofen , Jakeman Lyn , Knebel Ann , Tully Lois A. , Chan Leighton , Damiano Diane , Tian Biao , McInnes Pamela , Khalsa Partap , Reider Eve , Shurtleff David , Elwood William , Ballard Rachel , Ershow Abby G. , Begg Lisa
Published: May 2017

One in five Americans experiences disability that affects their daily function because of impairments in mobility, cognitive function, sensory impairment, or communication impairment. The need for rehabilitation strategies to optimize function and reduce disability is a clear priority for research to address this public health challenge. The National Institutes of Health (NIH) recently published a Research Plan on Rehabilitation that provides a set of priorities to guide the field over the next 5 years. The plan was developed with input from multiple Institutes and Centers within the NIH, the National Advisory Board for Medical Rehabilitation Research, and the public. This article provides an overview of the need for this research plan, an outline of its development, and a listing of six priority areas for research. The NIH is committed to working with all stakeholder communities engaged in rehabilitation research to track progress made on these priorities and to work to advance the science of medical rehabilitation.

This article is being published almost simultaneously in the following six journals: American Journal of Occupational Therapy, American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Neurorehabilitation and Neural Repair, Physical Therapy, and Rehabilitation Psychology. Citation information is as follows: NIH Medical Rehabilitation Coordinating Committee. Am J Phys Med Rehabil. 2017;97(4):404—407.
“What About the Next Generation That's Coming?”
Authors: Hoffman Sarah J. , Robertson Cheryl L. , Tierney Jessica Dockter
Published: May 2017

The purpose of this analysis was to explore the recontextualization of mothering in Karen refugees from Burma. We collected ethnographic data over an 11-month period with a cohort of 12 Karen women postresettlement. Using Spradley's and tools of critical discourse analysis, we interpreted the migration narratives of women, in particular, experiences they shared as mothers. These narratives were grounded in the space of cultural difference; thus, we engaged hybridity as a theoretical frame. Findings reflect the negotiation of mothering practices within the norms, structures, and policies of the country of resettlement. We identified the spaces of transformation a woman constructed to usher change while sustaining a connection between herself, her culture, and her children.
Antihypertensive Drugs Aliskiren, Nebivolol, and Olmesartan Reduce Hypertension by Reducing Endothelial Microparticles and Regulating Angiogenesis
Authors: Jain Moon , Bhosale Vivek , Tripathi Dipti , Singh Himalaya , Pal Niharika , Hanif Kashif , Jagavelu Kumaravelu
Published: May 2017

The accelerated generation of endothelial microparticles (EMPs) and impaired angiogenesis are the markers of vascular pathology during various cardiovascular and inflammatory conditions including hypertension. Because studies comparing the effects of antihypertensive agents on these 2 parameters are limited, this study was designed to compare the effects of 3 antihypertensive agents: aliskiren, nebivolol, and olmesartan, on the EMP generation and angiogenesis. Changes in the hemodynamic parameters and serum EMP count were determined after 3 weeks of the drug treatments [aliskiren (30 mg/kg), nebivolol (10 mg/kg), or olmesartan (5 mg/kg) per orally] in l-NAME–induced rat model of hypertension. The 3 drugs prevented the rise in blood pressure and EMP count to a similar extent. Furthermore, nebivolol was found to possess more potent and concentration-dependent antiangiogenic activity compared with aliskiren, whereas olmesartan was devoid of such an effect. The EMPs generated by virtue of the respective drug treatments were found to be involved in mediating the antiangiogenic effect of nebivolol and aliskiren. In addition, olmesartan treatment also resulted in the increased eNOS expression. The results of this study show that the antihypertensive drugs, viz. aliskiren, nebivolol, and olmesartan, regulate the vascular health by their differential effects on the EMP generation and angiogenesis.
A PROSPECTIVE, RANDOMIZED TRIAL COMPARING PLAIN GUT TO POLYGLACTIN 910 (VICRYL) SUTURES FOR SCLEROTOMY CLOSURE AFTER 23-GAUGE PARS PLANA VITRECTOMY
Authors: Sridhar Jayanth , Kasi Sundeep , Paul Joshua , Shahlaee Abtin , Rahimy Ehsan , Chiang Allen , Spirn Marc J. , Hsu Jason , Garg Sunir J. ,   on behalf of the Retina Service of Wills Eye Hospital Vitrectomy Study Group
Published: May 2017

Purpose:

To report a prospective, randomized comparative study assessing clinical outcomes of plain gut versus polyglactin 910 (PG910) sutures for sclerotomy closure after 23-gauge pars plana vitrectomy.

Methods:

A single-masked, randomized, prospective study was undertaken with 49 eyes of 49 patients undergoing 23-gauge pars plana vitrectomy randomized to sclerotomy closure with either plain gut suture, PG910 (Vicryl) suture or a combination of the two. Assessment was based on both a postoperative pain scale and a standardized assessment of scleral inflammation at each suture site.

Results:

No wound leakage was noted postoperatively in any patient. Across all groups, scleral inflammation was significantly higher at the PG910 suture sites compared with the plain gut suture sites at both the 1-week (P = 0.04) and 1-month postoperative visits (P < 0.001). Patients with PG910 sutures reported greater pain at the 1-month postoperative visit than those with plain gut sutures (P = 0.018).

Conclusion:

This prospective study suggests improved tolerability and reduced inflammation using plain gut suture compared with an 8-0 PG910 suture to close 23-gauge sclerotomies.
THREE-DIMENSIONAL ANALYSIS OF SUBMACULAR PERFORATING SCLERAL VESSELS BY ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY
Authors: Rothenbuehler Simon P. , Maloca Peter , Scholl Hendrik P. N. , Gyger Cyrill , Schoetzau Andreas , Kuske Lorenz , Mosimann Nathanael , Zweifel Sandrine A. , Barthelmes Daniel , Tufail Adnan , Hasler Pascal W.
Published: May 2017

Purpose:

To analyze submacular perforating scleral vessels (PSVs) using enhanced depth imaging spectral domain optical coherence tomography (EDI-SDOCT).

Methods:

Twenty-two eyes of 11 healthy women were included in this retrospective study. Central EDI-SDOCT scans (3 × 4.5 × 1.9 mm, 13.5 mm2 scan area) were acquired and postprocessed by denoising, manual sclera segmentation, and PSV investigated by five graders.

Results:

Mean age was 22.4 ± 6.2 years. Mean refractive error was −0.44 ± 0.8 diopters. Mean axial length was 23.08 ± 0.63 mm. The coefficient of agreement for grading was good. Mean number of submacular PSVs was 0.33 ± 0.2 per mm2 (range from 0 to 9 per eye). Subfield analysis showed 0.2 ± 0.5 (range 0–2) and 2.1 ± 1.8 (range 0–7) vessels, respectively, for central 1-mm diameter and 3-mm diameter. Quadrant analysis showed 0.7 ± 0.9, 0.5 ± 0.9, 0.3 ± 0.6, and 0.4 ± 0.6 vessels, respectively for superior, inferior, nasal, and temporal quadrants. Total number of PSV showed no significant side difference (median difference 0.5, confidence interval −3.0 to 3.0, P = 0.94) or an influence of axial length (P = 0.16).

Conclusion:

This is the first description of three-dimensional EDI-SDOCT visualization of submacular PSV in healthy eyes. This method allows for in vivo imaging of a critical component of outer retinal perfusion at the posterior pole.
Incorporating Alternative Care Site Characteristics Into Estimates of Substitutable ED Visits
Authors: Trueger Nathan Seth , Chua Kao-Ping , Hussain Aamir , Liferidge Aisha T. , Pitts Stephen R. , Pines Jesse M.
Published: May 2017

Background:

Several recent efforts to improve health care value have focused on reducing emergency department (ED) visits that potentially could be treated in alternative care sites (ie, primary care offices, retail clinics, and urgent care centers). Estimates of the number of these visits may depend on assumptions regarding the operating hours and functional capabilities of alternative care sites. However, methods to account for the variability in these characteristics have not been developed.

Objective:

To develop methods to incorporate the variability in alternative care site characteristics into estimates of ED visit “substitutability.”

Research Design, Subjects, and Measures:

Our approach uses the range of hours and capabilities among alternative care sites to estimate lower and upper bounds of ED visit substitutability. We constructed “basic” and “extended” criteria that captured the plausible degree of variation in each site’s hours and capabilities. To illustrate our approach, we analyzed data from 22,697 ED visits by adults in the 2011 National Hospital Ambulatory Medical Care Survey, defining a visit as substitutable if it was treat-and-release and met both the operating hours and functional capabilities criteria.

Results:

Use of the combined basic hours/basic capabilities criteria and extended hours/extended capabilities generated lower and upper bounds of estimates. Our criteria classified 5.5%–27.1%, 7.6%–20.4%, and 10.6%–46.0% of visits as substitutable in primary care offices, retail clinics, and urgent care centers, respectively.

Conclusions:

Alternative care sites vary widely in operating hours and functional capabilities. Methods such as ours may help incorporate this variability into estimates of ED visit substitutability.
Identifying Increased Risk of Readmission and In-hospital Mortality Using Hospital Administrative Data
Authors: Moore Brian J. , White Susan , Washington Raynard , Coenen Natalia , Elixhauser Anne
Published: May 2017

Objective:

We extend the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The Elixhauser measures are commonly used in research as an adjustment factor to control for severity of illness.

Data Sources:

We used a large analysis file built from all-payer hospital administrative data in the Healthcare Cost and Utilization Project State Inpatient Databases from 18 states in 2011 and 2012.

Methods:

The final models were derived with bootstrapped replications of backward stepwise logistic regressions on each outcome. Odds ratios and index weights were generated for each Elixhauser comorbidity to create a single index score per record for mortality and readmissions. Model validation was conducted with c-statistics.

Results:

Our index scores performed as well as using all 29 Elixhauser comorbidity variables separately. The c-statistic for our index scores without inclusion of other covariates was 0.777 (95% confidence interval, 0.776–0.778) for the mortality index and 0.634 (95% confidence interval, 0.633–0.634) for the readmissions index. The indices were stable across multiple subsamples defined by demographic characteristics or clinical condition. The addition of other commonly used covariates (age, sex, expected payer) improved discrimination modestly.

Conclusions:

These indices are effective methods to incorporate the influence of comorbid conditions in models designed to assess the risk of in-hospital mortality and readmission using administrative data with limited clinical information, especially when small samples sizes are an issue.
Acute Kidney Injury After Pediatric Cardiac Surgery: A Secondary Analysis of the Safe Pediatric Euglycemia After Cardiac Surgery Trial*
Authors: Blinder Joshua J. , Asaro Lisa A. , Wypij David , Selewski David T. , Agus Michael S. D. , Gaies Michael , Ferguson Michael A.
Published: May 2017

Objectives:

To understand the effect of tight glycemic control on cardiac surgery–associated acute kidney injury.

Design:

Secondary analysis of data from the Safe Pediatric Euglycemia after Cardiac Surgery trial of tight glycemic control versus standard care.

Setting:

Pediatric cardiac ICUs at University of Michigan, C.S. Mott Children’s Hospital, and Boston Children’s Hospital.

Patients:

Children 0–36 months old undergoing congenital cardiac surgery.

Interventions:

None.

Measurements and Main Results:

Cardiac surgery–associated acute kidney injury was assigned using the Acute Kidney Injury Network criteria with the modification that a greater than 0.1 mg/dL increase in serum creatinine was required to assign cardiac surgery–associated acute kidney injury. We explored associations between cardiac surgery–associated acute kidney injury and tight glycemic control and clinical outcomes. Of 799 patients studied, cardiac surgery–associated acute kidney injury occurred in 289 patients (36%), most of whom had stage II or III disease (72%). Cardiac surgery–associated acute kidney injury rates were similar between treatment groups (36% vs 36%; p = 0.99). Multivariable modeling showed that patients with cardiac surgery–associated acute kidney injury were younger (p = 0.002), underwent more complex surgery (p = 0.005), and had longer cardiopulmonary bypass times (p = 0.002). Cardiac surgery–associated acute kidney injury was associated with longer mechanical ventilation and ICU and hospital stays and increased mortality. Patients at University of Michigan had higher rates of cardiac surgery–associated acute kidney injury compared with Boston Children’s Hospital patients (66% vs 15%; p < 0.001), but University of Michigan patients with cardiac surgery–associated acute kidney injury had shorter time to extubation and ICU and hospital stays compared with Boston Children’s Hospital patients.

Conclusions:

Tight glycemic control did not reduce the cardiac surgery–associated acute kidney injury rate in this trial cohort. We observed significant differences in cardiac surgery–associated acute kidney injury rates between the two study sites, and there was a differential effect of cardiac surgery–associated acute kidney injury on clinical outcomes by site. These findings warrant further investigation to identify causal variation in perioperative practices that affect cardiac surgery–associated acute kidney injury epidemiology.
Epinephrine Auto-Injector Versus Drawn Up Epinephrine for Anaphylaxis Management: A Scoping Review*
Authors: Chime Nnenna O. , Riese Victoria G. , Scherzer Daniel J. , Perretta Julianne S. , McNamara LeAnn , Rosen Michael A. , Hunt Elizabeth A.
Published: May 2017

Objective:

Anaphylaxis is a life-threatening event. Most clinical symptoms of anaphylaxis can be reversed by prompt intramuscular administration of epinephrine using an auto-injector or epinephrine drawn up in a syringe and delays and errors may be fatal. The aim of this scoping review is to identify and compare errors associated with use of epinephrine drawn up in a syringe versus epinephrine auto-injectors in order to assist hospitals as they choose which approach minimizes risk of adverse events for their patients.

Data Sources:

PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library were searched using terms agreed to a priori.

Study Selection:

We reviewed human and simulation studies reporting errors associated with the use of epinephrine in anaphylaxis. There were multiple screening stages with evolving feedback.

Data Extraction:

Each study was independently assessed by two reviewers for eligibility. Data were extracted using an instrument modeled from the Zaza et al instrument and grouped into themes.

Data Synthesis:

Three main themes were noted: 1) ergonomics, 2) dosing errors, and 3) errors due to route of administration. Significant knowledge gaps in the operation of epinephrine auto-injectors among healthcare providers, patients, and caregivers were identified. For epinephrine in a syringe, there were more frequent reports of incorrect dosing and erroneous IV administration with associated adverse cardiac events. For the epinephrine auto-injector, unintentional administration to the digit was an error reported on multiple occasions.

Conclusions:

This scoping review highlights knowledge gaps and a diverse set of errors regardless of the approach to epinephrine preparation during management of anaphylaxis. There are more potentially life-threatening errors reported for epinephrine drawn up in a syringe than with the auto-injectors. The impact of these knowledge gaps and potentially fatal errors on patient outcomes, cost, and quality of care is worthy of further investigation.
Reevaluating Antidepressant Selection in Patients With Bruxism and Temporomandibular Joint Disorder
Authors: RAJAN ROYCE , SUN YE-MING
Published: May 2017

Temporomandibular joint disorder (TMD) is a broad pain disorder that refers to several conditions affecting the temporomandibular joint of the jaw and the muscles of mastication. As with most pain disorders, a high prevalence of depression and anxiety is associated with TMD. Research has shown that selective serotonin reuptake inhibitors (SSRIs), the first-line drug therapy for major depressive disorder, may not be suitable for TMD patients because SSRIs can induce teeth-grinding, otherwise known as bruxism. This is problematic because bruxism is believed to further exacerbate TMD. Therefore, the purpose of this literature review is to better understand the mechanism of SSRI-induced bruxism, as well as discuss alternative antidepressant options for treating depression and anxiety in patients with bruxism and TMD. Alternative classes of antidepressants reviewed include serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, atypical antidepressants, and monoamine oxidase inhibitors. Findings indicate that dopamine agonists and buspirone are currently the most effective medications to treat the side effects of SSRI-induced bruxism, but results regarding the effectiveness of specific antidepressants that avoid bruxism altogether remain inconclusive.
Synthetic Cannabinoids Use in Elderly Patients
Authors: MAHGOUB NAHLA , YOUNG ROBERT C.
Published: May 2017

Synthetic cannabinoids are becoming a public health concern. No data are apparently available concerning use of synthetic cannabinoids in the elderly. We report two cases of elderly individuals who used synthetic cannabinoids and were admitted to a psychiatric hospital.
Performance Validity Testing in Neuropsychology: Methods for Measurement Development and Maximizing Diagnostic Accuracy
Authors: WODUSHEK THOMAS R. , GREHER MICHAEL R.
Published: May 2017

In the first column in this 2-part series, Performance Validity Testing in Neuropsychology: Scientific Basis and Clinical Application—A Brief Review, the authors introduced performance validity tests (PVTs) and their function, provided a justification for why they are necessary, traced their ongoing endorsement by neuropsychological organizations, and described how they are used and interpreted by ever increasing numbers of clinical neuropsychologists. To enhance readers’ understanding of these measures, this second column briefly describes common detection strategies used in PVTs as well as the typical methods used to validate new PVTs and determine cut scores for valid/invalid determinations. We provide a discussion of the latest research demonstrating how neuropsychologists can combine multiple PVTs in a single battery to improve sensitivity/specificity to invalid responding. Finally, we discuss future directions for the research and application of PVTs.
Increasing Patient-Clinician Concordance About Medical Error Disclosure Through the Patient TIPS Model
Authors: Martinez William , Browning David , Varrin Pamela , Sarnoff Lee Barbara , Bell Sigall K.
Published: May 2017

Objective

To test whether an educational model involving patients and family members (P/F) in medical error disclosure training for interprofessional clinicians can narrow existing gaps between clinician and P/F views about disclosure.

Method

Parallel presurveys/postsurveys using Likert scale questions for clinicians and P/F.

Results

Baseline surveys were completed by 91% (50/55) of clinicians who attended the workshops and 74% (65/88) of P/F from a hospital patient and family advisory council. P/F’s baseline views about disclosure were significantly different from clinicians’ in 70% (7/10) of the disclosure expectation items and 100% (3/3) of the disclosure vignette items. For example, compared with clinicians, P/F more strongly agreed that “patients want to know all the details of what happened” and more strongly disagreed that “patients find explanation(s) more confusing than helpful.” In the medication error vignette, compared with clinicians, P/F more strongly agreed that the error should be disclosed and that the patient would want to know and more strongly disagreed that disclosure would do more harm than good (all P < 0.05). After the workshop, P/F and clinician views about information sharing, fallibility, truth telling, and threshold for disclosure showed greater concordance, with significant differences remaining in less than half of the expectation items and none of the vignette responses.

Discussion

Even with self-selecting clinicians, collaborative learning with P/F highlights important differences in patient and clinician baseline perspectives about medical error disclosure and brings patient and clinicians views closer together.
Description of Malignancy Rates in Childhood- and Adult-Onset Systemic Lupus Erythematous by Proportional Meta-analysis
Authors: Aoki Priscila Rodrigues da Silva , El Dib Regina , Silva Clovis Artur Almeida , Magalhaes Claudia Saad
Published: May 2017

Objective

Describe malignancy rates in childhood onset and adult onset systemic lupus erythematous (SLE) by proportional meta-analysis.

Methods

Two reviewers screened data from PubMed (1966–2015), EMBASE (1980–2015), and LILACS (1982–2015) for SLE-associated malignancy. Proportional meta-analysis with a random-effects model and 95% confidence intervals (CIs) were calculated according to SLE onset age and mean follow-up time. Statistical difference was defined by 95% CI overlap.

Results

Overall the malignancy rate reported in 30 case series with 96,578 subjects was 3.4% (95% CI, 0.0260–0.0442; I
2 = 97.6%; P < 0.0001). The malignancy rate was 4.2% (95% CI, 0.0318–0.0531; I
2 = 98%; P < 0.0001) in 25 adult-onset SLE series, compared with 0.5% (95% CI, 0.0003–0.0154; I
2 = 62.6%; P = 0.03) in 5 childhood-onset SLE series. Overall, in those with less than 5 years’ follow-up, the malignancy rate was 2.8% (95% CI, 0.013–0.047; I
2 = 91%; P < 0.0001) compared with 3.6% (95% CI, 0.0226–0.0531; I
2 = 98.3%; P < 0.0001) in those with more than 5 years’ follow-up, which was not significant, with 95% CI overlap.

Conclusions

The meta-analysis indicated lower malignancy rates in pediatric-onset SLE compared with adult-onset SLE, but accrued data from childhood-onset SLE are still needed.
Disentangling the causes for faster-X evolution in aphids
Authors: Jaquiéry J , Peccoud J , Ouisse T , Legeai F , Prunier-Leterme N , Gouin A , Nouhaud P , Brisson JA , Bickel R , Purandare S , Poulain J , Battail C , Lemaitre C , Mieuzet L , Le Trionnaire G , Simon JC , Rispe C
Published: May 2017

Faster evolution of X chromosomes has been documented in several species and results from the increased efficiency of selection on recessive alleles in hemizygous males and/or from increased drift due to the smaller effective population size of X chromosomes. Aphids are excellent models for evaluating the importance of selection in faster-X evolution, because their peculiar life-cycle and unusual inheritance of sex-chromosomes lead to equal effective population sizes for X and autosomes. Because we lack a high-density genetic map for the pea aphid whose complete genome has been sequenced, we assigned its entire genome to the X and autosomes based on ratios of sequencing depth in males and females. Unexpectedly, we found frequent scaffold misassembly, but we could unambiguously locate 13,726 genes on the X and 19,263 on autosomes. We found higher non-synonymous to synonymous substitutions ratios(dN/dS) for X-linked than for autosomal genes. Our analyses of substitution rates together with polymorphism and expression data showed that relaxed selection is likely to contribute predominantly to faster-X as a large fraction of X-linked genes are expressed at low rates and thus escape selection. Yet, a minor role for positive selection is also suggested by the difference between substitution rates for X and autosomes for male-biased genes (but not for asexual female-biased genes) and by lower Tajima’s D for X-linked than for autosomal genes with highly male-biased expression patterns. This study highlights the relevance of organisms displaying alternative inheritance of chromosomes to the understanding of forces shaping genome evolution.
High Resolution Epigenomic Atlas of Early Human Craniofacial Development
Authors: Wilderman Andrea , Kron Jeffrey , VanOudenhove Jennifer , Noonan James P. , Cotney Justin
Published: May 2017

Defects in embryonic patterning resulting in craniofacial abnormalities are common birth defects affecting up to 1 in 500 live births worldwide, and are mostly non-syndromic. The regulatory programs that build and shape the craniofacial complex are thought to be controlled by information encoded in the genome between genes and within intronic sequences. Early stages of human craniofacial development have not been interrogated with modern functional genomics techniques, preventing systematic analysis of genetic associations with craniofacial-specific regulatory sequences. Here we describe a comprehensive resource of craniofacial epigenomic annotations and systematic, integrative analysis with a variety of human tissues and cell types. We identified thousands of novel craniofacial enhancers and provide easily accessible genome annotations for craniofacial researchers and clinicians. We demonstrate the utility of our data to find likely causal variants for craniofacial abnormalities and identify a large enhancer cluster that interacts with HOXA genes during craniofacial development.
De novoassembly and annotation of the eastern fence lizard (Sceloporus undulatus) transcriptome
Authors: Grizante Mariana B. , Tollis Marc , Rodriguez Juan J. , Levy Ofir , Angilletta Michael J. , Kusumi Kenro
Published: May 2017

Background

The eastern fence lizard (Sceloporus undulatus) has been a model species for ecological and evolutionary research. Genomic and transcriptomic resources for this species would promote investigation of genetic mechanisms that underpin plastic responses to environmental stress, such as climate warming. Moreover, such resources would aid comparative studies of complex traits at the molecular level, such as the transition from oviparous to viviparous reproduction, which happened at least four times withinSceloporus.

Findings

Ade novotranscriptome assembly forSceloporus undulatus, Sund_v1.0, was generated using over 179 million Illumina reads obtained from three tissues (whole brain, skeletal muscle, and embryo) as well as previously reported liver sequences. The Sund_v1.0 assembly had an average contig length of 782 nucleotides and an E90N50 statistic of 2,550 nucleotides. ComparingS. undulatustranscripts with the benchmarking universal single-copy orthologs (BUSCO) for tetrapod species yielded 97.2% gene representation. A total of 13,422 protein-coding orthologs were identified in comparison to the genome of the green anole lizard,Anolis carolinensis, which is the closest related species with genomic data available.

Conclusions

The multi-tissue transcriptome ofS. undulatusis the first for a member of the family Phrynosomatidae, offering an important resource to advance studies of adaptation in this species and genomic research in reptiles.
Inferring relevant cell types for complex traits using single-cell gene expression
Authors: Calderon Diego , Bhaskar Anand , Knowles David A. , Golan David , Raj Towfique , Fu Audrey Q. , Pritchard Jonathan K.
Published: May 2017

Previous studies have prioritized trait-relevant cell types by looking for an enrichment of GWAS signal within functional regions. However, these studies are limited in cell resolution by the lack of functional annotations from difficult-to-characterize or rare cell populations. Measurement of single-cell gene expression has become a popular method for characterizing novel cell types, and yet, hardly any work exists linking single-cell RNA-seq to phenotypes of interest. To address this deficiency, we presentRolyPoly, a regression-based polygenic model that can prioritize trait-relevant cell types and genes from GWAS summary statistics and single-cell RNA-seq. We demonstrateRolyPoly’s accuracy through simulation and validate previously known tissue-trait associations. We discover a significant association between microglia and late-onset Alzheimer’s disease, and an association between oligodendrocytes and replicating fetal cortical cells with schizophrenia. Additionally,RolyPolycomputes a trait-relevance score for each gene which reflects the importance of expression specific to a cell type. We found that differentially expressed genes in the prefrontal cortex of Alzheimer’s patients were significantly enriched for highly ranked genes byRolyPolygene scores. Overall, our method represents a powerful framework for understanding the effect of common variants on cell types contributing to complex traits.