bluuebunny/crossref_metadata_2025 huggingface dataset:
Do ‘blacheap’ and ‘subcheap’ both prime ‘cheap’? An investigation of morphemic status and position in early visual word processing
Authors: Heathcote Lauren , Nation Kate , Castles Anne , Beyersmann Elisabeth
Published: August 2017

Much research suggests that words comprising more than one morpheme are decomposed into morphemes in the early stages of visual word recognition. In the present masked primed lexical decision study, we investigated whether or not decomposition occurs for both prefixed and suffixed nonwords and for nonwords which comprise a stem and a non-morphemic ending. Prime–target relatedness was manipulated in three ways: (1) primes shared a semantically transparent morphological relationship with the target (e.g., subcheap-CHEAP, cheapize-CHEAP); (2) primes comprised targets and non-affixal letter strings (e.g., blacheap-CHEAP, cheapstry-CHEAP); and (3) primes were real, complex words unrelated to the target (e.g., miscall-CHEAP, idealism-CHEAP). Both affixed and non-affixed nonwords significantly facilitated the recognition of their stem targets, suggesting that embedded stems are activated independently of whether they are accompanied by a real affix or a non-affix. There was no difference in priming between stems being embedded in initial and final string positions, indicating that embedded stem activation is position-independent. Finally, more priming was observed in the semantically interpretable affixed condition than in the non-affixed condition, which points to a semantic licensing mechanism during complex novel word processing.
Tensor product of cyclic 𝐴_{∞}-algebras and their Kontsevich classes
Authors: Amorim Lino , Tu Junwu
Published: August 2017

Given two cyclic

A
∞

A_\infty

-algebras

A
A

and

B
B

, in this paper we prove that there exists a cyclic

A
∞

A_\infty

-algebra structure on their tensor product

A
⊗
B

A\otimes B

which is unique up to a cyclic

A
∞

A_\infty

-quasi-isomorphism. Furthermore, the Kontsevich class of

A
⊗
B

A\otimes B

is equal to the cup product of the Kontsevich classes of

A
A

and

B
B

on the moduli space of curves.
fastNGSadmix: admixture proportions and principal component analysis of a single NGS sample
Authors: Jørsboe Emil , Hanghøj Kristian , Albrechtsen Anders
Published: August 2017

Motivation

Estimation of admixture proportions and principal component analysis (PCA) are fundamental tools in populations genetics. However, applying these methods to low- or mid-depth sequencing data without taking genotype uncertainty into account can introduce biases.

Results

Here we present fastNGSadmix, a tool to fast and reliably estimate admixture proportions and perform PCA from next generation sequencing data of a single individual. The analyses are based on genotype likelihoods of the input sample and a set of predefined reference populations. The method has high accuracy, even at low sequencing depth and corrects for the biases introduced by small reference populations.

Availability and implementation

The admixture estimation method is implemented in C ++ and the PCA method is implemented in R. The code is freely available at http://www.popgen.dk/software/index.php/FastNGSadmix

Supplementary information

Supplementary data are available at Bioinformatics online.
Lep-MAP3: robust linkage mapping even for low-coverage whole genome sequencing data
Authors: Rastas Pasi
Published: August 2017

Motivation

Accurate and dense linkage maps are useful in family-based linkage and association studies, quantitative trait locus mapping, analysis of genome synteny and other genomic data analyses. Moreover, linkage mapping is one of the best ways to detect errors in de novo genome assemblies, as well as to orient and place assembly contigs within chromosomes. A small mapping cross of tens of individuals will detect many errors where distant parts of the genome are erroneously joined together. With more individuals and markers, even more local errors can be detected and more contigs can be oriented. However, the tools that are currently available for constructing linkage maps are not well suited for large, possible low-coverage, whole genome sequencing datasets.

Results

Here we present a linkage mapping software Lep-MAP3, capable of mapping high-throughput whole genome sequencing datasets. Such data allows cost-efficient genotyping of millions of single nucleotide polymorphisms (SNPs) for thousands of individual samples, enabling, among other analyses, comprehensive validation and refinement of de novo genome assemblies. The algorithms of Lep-MAP3 can analyse low-coverage datasets and reduce data filtering and curation on any data. This yields more markers in the final maps with less manual work even on problematic datasets. We demonstrate that Lep-MAP3 obtains very good performance already on 5x sequencing coverage and outperforms the fastest available software on simulated data on accuracy and often on speed. We also construct de novo linkage maps on 7-12x whole-genome data on the Red postman butterfly (Heliconius erato) with almost 3 million markers.

Availability and implementation

Lep-MAP3 is available with the source code under GNU general public license from http://sourceforge.net/projects/lep-map3.

Supplementary information

Supplementary data are available at Bioinformatics online.
Zero Counting and Invariant Sets of Differential Equations
Authors: Binyamini Gal
Published: August 2017

Consider a polynomial vector field $\xi$ in ${\mathbb C}^n$ with algebraic coefficients, and $K$ a compact piece of a trajectory. Let $N(K,d)$ denote the maximal number of isolated intersections between $K$ and an algebraic hypersurface of degree $d$. We introduce a condition on $\xi$ called constructible orbits and show that under this condition $N(K,d)$ grows polynomially with $d$.

We establish the constructible orbits condition for linear differential equations over ${\mathbb C}(t)$, for planar polynomial differential equations and for some differential equations related to the automorphic $j$-function.

As an application of the main result, we prove a polylogarithmic upper bound for the number of rational points of a given height in planar projections of $K$ following works of Bombieri–Pila and Masser.
Body Dysmorphic Disorder by Proxy
Authors: Greenberg Jennifer L. , Limoncelli Katherine E. , Wilhelm Sabine
Published: August 2017

This chapter reviews the literature on body dysmorphic disorder (BDD) by proxy, outlines its clinical presentation using a case example, and describes the currently recommended treatment approach. BDD by proxy is a variant of BDD characterized by a preoccupation with perceived defects or flaws in another person’s appearance. Preoccupations commonly involve a loved one, such as a child or significant other, although any person can be the focus of concern. BDD by proxy is associated with high levels of psychosocial impairment, distress, and shame. Research on BDD by proxy and its treatment is extremely limited. Cognitive-behavioral therapy (CBT) is the gold-standard psychosocial intervention for patients with BDD; however, CBT for BDD does not focus on other persons of concern, nor does it address the interpersonal impairment specific to BDD by proxy. There is some preliminary support for the use of a modified CBT for BDD by proxy, which is described in this chapter.
Body Dysmorphic Disorder in Children and Adolescents
Authors: Phillips Katharine A.
Published: August 2017

Body dysmorphic disorder (BDD) usually has its onset during childhood or adolescence. Prevalence studies indicate that BDD is common in adolescents. BDD symptoms in children and adolescents appear largely similar to those in adults, although BDD may be somewhat more severe in youth. Youth with BDD typically have poor psychosocial functioning and mental health–related quality of life. BDD often causes academic underachievement, social avoidance, and other types of psychosocial impairment; it may lead to school refusal and dropping out of school. Suicidal ideation and attempts, physical aggression behavior that is attributable to BDD symptoms, and substance use disorders are common risk behaviors in youth with BDD. BDD can derail the developmental trajectory, which makes appropriate treatment especially important during childhood and adolescence. Youth in mental health settings and cosmetic treatment settings, as well as youth who express suicidal ideation or have attempted suicide, should be screened for BDD.
Bipolar affective disorder
Authors: Burns Tom , Firn Mike
Published: August 2017

This chapter deals with the other major psychotic illness, bipolar affective disorder. Bipolar disorder poses a difficult question for outreach workers, as patients are often well recovered between episodes—so should persisting outreach be provided? We report very good results in severe bipolar disorder where continuity of care has paid off. The chapter also deals with theories of causation and classification. The section on treatment identifies the importance of early admission in hypomania, the use of mood stabilizers, and the value of identifying and agreeing on relapse signatures. It also confirms the value of working hard to strengthen the therapeutic relationship and of psychosocial interventions such as psycho-education. Long-term work with these patients brings home just how persistent and disabling the depressive phases can be.
Ventilator Control Parameters
Authors: Lei Yuan
Published: August 2017

‘Ventilator Control Parameters’ looks at the individual ventilator settings, which are largely used to quantitatively define the properties of mechanical breaths. Following on from the previous discussion of essential variables, this chapter describes their implementation in the form of controls. This chapter begins by discussing the confusing and non-standardized terminology used for control parameters, providing a list of controls used on major ventilators. Common controls include rate, pressure and flow triggers, inspiratory time, I:E ratio, peak flow, flow cycle, tidal volume, pressure control or pressure support, PEEP, FiO2, rise time, flow pattern, and specific controls for biphasic modes. The chapter includes normal values and uses of the controls.
Computed tomography angiography and other applications of computed tomography
Authors: de Graaf Michiel A , Scholte Arthur JHA , Kroft Lucia , Bax Jeroen J
Published: August 2017

Patients presenting with acute chest pain constitute a common and important diagnostic challenge. This has increased interest in using computed tomography for non-invasive visualization of coronary artery disease in patients presenting with acute chest pain to the emergency department; particularly the subset of patients who are suspected of having an acute coronary syndrome, but without typical electrocardiographic changes and with normal troponin levels at presentation. As a result of rapid developments in coronary computed tomography angiography technology, high diagnostic accuracies for excluding coronary artery disease can be obtained. It has been shown that these patients can be discharged safely. The accuracy for detecting a significant coronary artery stenosis is also high, but the presence of coronary artery atherosclerosis or stenosis does not imply necessarily that the cause of the chest pain is related to coronary artery disease. Moreover, the non-invasive detection of coronary artery disease by computed tomography has been shown to be related with an increased use of subsequent invasive coronary angiography and revascularization, and further studies are needed to define which patients benefit from invasive evaluation following coronary computed tomography angiography. Conversely, the implementation of coronary computed tomography angiography can significantly reduce the length of hospital stay, with a significant cost reduction. Additionally, computed tomography is an excellent modality in patients whose symptoms suggest other causes of acute chest pain such as aortic aneurysm, aortic dissection, or pulmonary embolism. Furthermore, the acquisition of the coronary arteries, thoracic aorta, and pulmonary arteries in a single computed tomography examination is feasible, allowing ‘triple rule-out’ (exclusion of aortic dissection, pulmonary embolism, and coronary artery disease). Finally, other applications, such as the evaluation of coronary artery plaque composition, myocardial function and perfusion, or fractional flow reserve, are currently being developed and may also become valuable in the setting of acute chest pain in the future.
Biomarkers in acute coronary syndromes
Authors: Giannitsis Evangelos , Katus Hugo A
Published: August 2017

Biomarker testing in the evaluation of a patient with acute chest pain is best established for cardiac troponins that allow the diagnosis of myocardial infarction, risk estimation of short- and long-term risk of death and myocardial infarction, and guidance of pharmacological therapy, as well as the need and timing of invasive strategy. Newer, more sensitive troponin assays have become commercially available and have the capability to detect myocardial infarction earlier and more sensitively than standard assays, but they are hampered by a lack of clinical specificity, i.e. the ability to discriminate myocardial ischaemia from myocardial necrosis not related to ischaemia such as myocarditis, pulmonary embolism, or decompensated heart failure. Strategies to improve clinical specificity (including strict adherence to the universal myocardial infarction definition and the need for serial troponin measurements to detect an acute rise and/or fall of cardiac troponin) will improve the interpretation of the increasing number of positive results. Other biomarkers of inflammation, activated coagulation/fibrinolysis, and increased ventricular stress mirror different aspects of the underlying disease activity and may help to improve our understanding of the pathophysiological mechanisms of acute coronary syndromes. Among the flood of new biomarkers, there are several novel promising biomarkers, such as copeptin that allows an earlier rule-out of myocardial infarction in combination with cardiac troponin, whereas MR-proANP and MR-proADM appear to allow a refinement of cardiovascular risk. GDF-15 might help to identify candidates for an early invasive vs conservative strategy. A multi-marker approach to biomarkers becomes more and more attractive, as increasing evidence suggests that a combination of several biomarkers may help to predict individual risk and treatment benefits, particularly among normal-troponin subjects. Future goals include the acceleration of rule-in and rule-out of patients with suspected acute coronary syndrome, in order to shorten lengths of stay in the emergency department, and to optimize patient management and the use of health care resources. New algorithms using high-sensitivity cardiac troponin assays at low cut-offs alone, or in combination with additional biomarkers, allow to establish accelerated rule-out algorithms within 1 or 2 hours.
Mechanical complications of myocardial infarction
Authors: López-Sendón José , López de Sá Esteban
Published: August 2017

Mechanical complications after an acute infarction include different forms of heart rupture, including free wall rupture, interventricular septal rupture, and papillary muscle rupture. Its incidence decreased dramatically with the widespread use of reperfusion therapies but may occur in 2–3% of ST-elevation myocardial infarction patients, and mortality is very high if not properly diagnosed, as surgery is the only effective treatment. Echocardiography is the most important tool for diagnosis that should be suspected in patients with hypotension, heart failure, or recurrent chest pain. Awareness and well-established protocols are crucial for an early diagnosis. Modern imaging techniques permit a more reliable and direct identification of left ventricular free wall rupture, which is almost impossible to identify with conventional echocardiography. Mitral regurgitation, secondary to papillary muscle ischaemia or necrosis or left ventricular dilatation and remodelling, without papillary muscle rupture, is frequent after myocardial infarction and is considered as an independent risk factor for outcomes. Revascularization to control ischaemia and surgical repair should be considered in all patients with severe or symptomatic mitral regurgitation in the absence of severe left ventricular dysfunction. Other mechanical complications include true aneurysms and thrombus formation in the left ventricle. Again, these complications have decreased with the use of early reperfusion therapies and, for thrombus formation, with aggressive antithrombotic treatment. In a single large randomized trial (STICH), surgical remodelling of the left ventricle failed to demonstrate a significant improvement in outcomes, although it still may be an option in selected patients.
Cardiac complications in trauma
Authors: Lam Lydia , Kobayashi Leslie , Demetriades Demetrios
Published: August 2017

Post-traumatic cardiac complications may occur after penetrating or blunt injuries to the heart or may follow severe extracardiac injuries. The majority of victims with penetrating injuries to the heart die at the scene and do not reach hospital care. For those patients who reach hospital care, an immediate operation, sometimes in the emergency room, cardiac injury repair, and cardiopulmonary resuscitation provide the only possibility of survival. Many patients develop perioperative cardiac complications such as acute cardiac failure, cardiac arrhythmias, coronary air embolism, and myocardial infarction. Some survivors develop post-operative functional abnormalities or anatomical defects, which may not manifest during the early post-operative period. It is essential that all survivors undergo detailed early and late cardiac evaluations. Blunt cardiac trauma encompasses a wide spectrum of injuries that includes asymptomatic myocardial contusion, arrhythmias, or cardiogenic shock to full-thickness cardiac rupture and death. Clinical examination, electrocardiograms, troponin measurements, and echocardiography are the cornerstone of diagnosis and monitoring of these patients. Lastly, some serious extracardiac traumatic conditions, such as traumatic pneumonectomy and severe traumatic brain injury, may result in cardiac complications. This may include tachyarrhythmias, cardiogenic shock, electrocardiographic changes, troponin elevations, heart failure, and cardiac arrest.
The Hyper Suprime-Cam software pipeline
Authors: Bosch James , Armstrong Robert , Bickerton Steven , Furusawa Hisanori , Ikeda Hiroyuki , Koike Michitaro , Lupton Robert , Mineo Sogo , Price Paul , Takata Tadafumi , Tanaka Masayuki , Yasuda Naoki , AlSayyad Yusra , Becker Andrew C , Coulton William , Coupon Jean , Garmilla Jose , Huang Song , Krughoff K Simon , Lang Dustin , Leauthaud Alexie , Lim Kian-Tat , Lust Nate B , MacArthur Lauren A , Mandelbaum Rachel , Miyatake Hironao , Miyazaki Satoshi , Murata Ryoma , More Surhud , Okura Yuki , Owen Russell , Swinbank John D , Strauss Michael A , Yamada Yoshihiko , Yamanoi Hitomi
Published: August 2017

In this paper, we describe the optical imaging data processing pipeline developed for the Subaru Telescope’s Hyper Suprime-Cam (HSC) instrument. The HSC Pipeline builds on the prototype pipeline being developed by the Large Synoptic Survey Telescope’s Data Management system, adding customizations for HSC, large-scale processing capabilities, and novel algorithms that have since been reincorporated into the LSST codebase. While designed primarily to reduce HSC Subaru Strategic Program (SSP) data, it is also the recommended pipeline for reducing general-observer HSC data. The HSC pipeline includes high-level processing steps that generate coadded images and science-ready catalogs as well as low-level detrending and image characterizations.
Wheelchair Shuttle Test for Assessing Aerobic Fitness in Youth With Spina Bifida: Validity and Reliability
Authors: Bloemen Manon A.T. , de Groot Janke F. , Backx Frank J.G. , Benner Joyce , Kruitwagen Cas L.J.J. , Takken Tim
Published: August 2017

Background

Testing aerobic fitness in youth is important because of expected relationships with health.

Objective

The purpose of the study was to estimate the validity and reliability of the Shuttle Ride Test in youth who have spina bifida and use a wheelchair for mobility and sport.

Design

Ths study is a validity and reliability study.

Methods

The Shuttle Ride Test, Graded Wheelchair Propulsion Test, and skill-related fitness tests were administered to 33 participants for the validity study (age = 14.5 ± 3.1 y) and to 28 participants for the reliability study (age = 14.7 ± 3.3 y).

Results

No significant differences were found between the Graded Wheelchair Propulsion Test and the Shuttle Ride Test for most cardiorespiratory responses. Correlations between the Graded Wheelchair Propulsion Test and the Shuttle Ride Test were moderate to high (r = .55–.97). The variance in peak oxygen uptake (VO2peak) could be predicted for 77% of the participants by height, number of shuttles completed, and weight, with large prediction intervals. High correlations were found between number of shuttles completed and skill-related fitness tests (CI = .73 to −.92). Intraclass correlation coefficients were high (.77–.98), with a smallest detectable change of 1.5 for number of shuttles completed and with coefficients of variation of 6.2% and 6.4% for absolute VO2peak and relative VO2peak, respectively.

Conclusions

When measuring VO2peak directly by using a mobile gas analysis system, the Shuttle Ride Test is highly valid for testing VO2peak in youth who have spina bifida and use a wheelchair for mobility and sport. The outcome measure of number of shuttles represents aerobic fitness and is also highly correlated with both anaerobic performance and agility. It is not possible to predict VO2peak accurately by using the number of shuttles completed. Moreover, the Shuttle Ride Test is highly reliable in youth with spina bifida, with a good smallest detectable change for the number of shuttles completed.
Relationships Between Reflection and Behavior Change in CME
Authors: Ratelle John T. , Wittich Christopher M. , Yu Roger C. , Newman James S. , Jenkins Sarah M. , Beckman Thomas J.
Published: August 2017

Introduction:

Reflection exposes performance gaps and is a step in the process of behavior change among adult learners. However, little is known about the relationships between reflection and behavior change in CME. Our objectives were to measure associations between validated reflection scores and behavior change among CME participants and to identify associations between reflection and characteristics of CME presentations.

Methods:

This was a cohort study of attendees at a national hospital medicine CME course. Participants provided reflection scores for each presentation and planned commitment-to-change (CTC) statements at the conclusion of the course. Reflection scores from 1 (strongly disagree) to 5 (strongly agree) were averaged for each presentation. CTC statements were linked to their accompanying presentations. A 3-month postcourse survey was conducted to assess if planned CTCs were successfully implemented.

Results:

In all, 223 of 281 participants (79.4%) returned evaluations. Of the 195 planned CTC statements available for postcourse analysis, 128 (65.6%) were implemented. Reflection scores correlated with the number of planned CTC statements across all presentations (Pearson correlation, 0.65; P < .001). In addition, higher reflection scores (mean [SD]) were associated with the presence of audience response opportunities (Yes: 4.13 [0.18] versus No: 3.96 [0.16]; P = .01) and the use of clinical cases (Yes: 4.09 [0.18] versus No: 3.86 [0.12]; P < .01).

Discussion:

To our knowledge, this is the first study to show a relationship between participant reflection and CTC in conference-based CME. Presentations that incorporate clinical cases and audience response systems seem to stimulate participant reflection and behavior change.
Pseudomelanomas Following Stevens–Johnson Syndrome
Authors: Ardakani Nima Mesbah , Tiwari Shevya M. , Wood Benjamin A.
Published: August 2017

In this report, we present a novel case of pseudomelanoma, similar to that seen in a recurrent/traumatized nevus, in pre-existing nevi in a 36-year-old man a few months after recovering from an episode of severe Stevens–Johnson syndrome. The mechanism responsible for the atypical transformation of these nevi is likely the release of cytokines and growth factors in the microenvironment during the repair/regeneration process. It is important to be aware of this phenomenon, and specific inquiry about potential recent blistering skin disorder in addition to the other causes of trauma should be made when dealing with cases of pseudomelanoma to avoid misdiagnosis.
Validation of Digital Pathology for Primary Histopathological Diagnosis of Routine, Inflammatory Dermatopathology Cases
Authors: Lee Jonathan J. , Jedrych Jaroslaw , Pantanowitz Liron , Ho Jonhan
Published: August 2017

Background:

Digital pathology (DP) systems have been validated for routine, histopathological diagnosis by several investigators. The diagnostic matter in previous studies is composed mostly of neoplasms. However, in dermatopathology, inflammatory diseases constitute a greater proportion of cases and have been under-represented in this literature. Herein, we report the results of a prospective, DP side-by-side validation study comparing the histologic assessment of routine, clinical inflammatory dermatopathology cases by whole slide imaging (WSI) and traditional light microscopy (LM).

Methods:

Glass slides were digitized at ×40 magnification. Two dermatopathologists rendered diagnoses digitally and immediately thereafter by light microscopy. Additional recuts, special, and immunohistochemical stains obtained during workup were scanned and evaluated similarly. Morphological features used to make diagnoses and appreciable differences in histology were recorded.

Results:

A total of 332 slides representing 93 cases were examined, including 157 hematoxylin & eosin sections, 132 special stains, and 43 immunohistochemical slides. In total, 333 microscopic features important for rendering inflammatory diagnoses were identified. Two discrepant instances were noted wherein Gram-positive cocci were identified using traditional microscopy but not by DP (×40 scan). Eosinophils, melanin granules, and mucin were identified on both modalities but were noted to have different appearances.

Conclusions:

Our findings indicate that DP is sufficient for primary diagnosis in inflammatory dermatopathology. Higher magnification scanning may be required to identify submicron features, such as microorganisms. Subtle differences in image quality between these 2 modalities may contribute to varied histologic interpretations of which pathologists should be aware when validating clinical DP systems.
Is outpatient hysteroscopy accurate for the diagnosis of endometrial pathology among perimenopausal and postmenopausal women?
Authors: Bar-On Shikma , Ben-David Alon , Rattan Gilad , Grisaru Dan
Published: August 2017

Objective:

To assess the histological and visual accuracy of outpatient hysteroscopy.

Methods:

This was a retrospective analysis of all women referred to a tertiary center outpatient hysteroscopy clinic between March 2011 and October 2016 for the following indications: postmenopausal bleeding, suspected polyp, and/or thick endometrium. Histological accuracy was evaluated by comparing specimens obtained in hysteroscopy with those obtained by hysterectomy, and visual accuracy was evaluated by comparing visual findings with those obtained by biopsies. Sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio were calculated to assess visual accuracy.

Results:

The mean age of participants was 54.14 (interquartile range 43.0-64.0). A total of 408 pathological specimens were obtained from outpatient hysteroscopies during the 712 visits recorded in the clinic log. Histological accuracy was evaluated in 15 participants who eventually underwent hysterectomy. Total percent of agreement between hysteroscopy biopsies and final pathology obtained by hysterectomy was 73% (kappa = 0.47). Overall visual accuracy was calculated with a 93.1% sensitivity, 52.1% specificity, 90.4% positive predictive value, and 61.0% negative predictive value. Visual accuracy for benign pathology was generally higher compared with that for pre and malignant lesions. Visual accuracy was satisfactory for the diagnosis of endometrial carcinoma with sensitivity and specificity of 71.4% and 98.9%, respectively, but poor for diagnosing hyperplasia with sensitivity and specificity of 25.0% and 96.6%, respectively.

Conclusions:

Outpatient hysteroscopy is an adequate and reliable tool for the evaluation of benign pathology in the uterine cavity. Visual findings may not suffice, and directed biopsies may be required to improve diagnostic accuracy.
Magnusiomyces capitatus Peritonitis in a Child With Acute Lymphocytic Leukemia as a Breakthrough Infection During Caspofungin Therapy
Authors: Bariş Ayşe , Gencer Haşim , Dalgiç Nazan , Şik Güntülü , Özakkaş Fatma , Aktaş Elif
Published: August 2017

Magnusiomyces capitatus is an emerging opportunistic fungal pathogen particularly in immunocompromised patients. We report a case of a M. capitatus peritonitis in child with acute lymphocytic leukemia as a breakthrough infection during caspofungin therapy. The possibility of breakthrough infections caused by M. capitatus must be taken into consideration, particularly in immunosupressed patients being treated for systemic fungal infections by caspofungin. Although there are no defined breakpoints for susceptibility testing of M.capitatus, minimal inhibitory concentration results can be helpful for therapy. Antifungal treatment with amphotericin B lipid complex plus flucytosine can be effective against infections caused by M. capitatus.
Suspected Pediatric Influenza Risk-Stratification Algorithm
Authors: Evers Patrick D. , Starr Michelle , McNeil Michael J. , O'Neill Laura , Posa Andrea , Savage Timothy , Migita Russell
Published: August 2017

Background and Objectives

Influenza causes significant annual burden among children. Current guidelines recommend empiric treatment for a broadly defined group of children at high risk for influenza complications, resulting in overtreatment or costly viral testing. This study creates an algorithm for clinicians to risk stratify children with influenza-like illness (ILI) according to likelihood of influenza infection.

Methods

A retrospective analysis was performed on 818 children seen in the emergency department from November 2012 to April 2013 for ILI. We reviewed medical records for symptoms, influenza risk factors, and viral assay results. Classification and regression tree analyses were performed separately for children older and younger than 2 years.

Results

In children younger than 2 years, populations likely to test positive were those with an influenza-positive contact, unimmunized children, and those presenting in high-incidence influenza periods. In this subgroup, immunized patients in low-incidence seasons and those with absence of cough are low risk for influenza infection. For children 2 years and older, high-risk populations were unimmunized children, those presenting in high-incidence influenza periods and those with myalgia or absence of diarrhea.

Conclusions

These risk-stratification analyses were summarized into Suspected Pediatric Influenza Risk-Stratification Algorithm (SPIRA). For those in whom influenza infection is likely, clinicians may consider empiric treatment. Conversely, patients whom SPIRA identifies as unlikely to be infected with influenza are candidates for viral testing and targeted treatment. In assessing children with ILI, SPIRA aids clinicians in determining who to test versus treat empirically, saving children from costly viral testing or unnecessary antiviral exposure.
Massive Pericardial Effusion and Tamponade Can Be a First Sign of Familial Mediterranean Fever
Authors: Yoldaş Tamer , Kayali Şeyma , Ertuğrul İlker , Doğan Vehbi , Örün Utku Arman , Karademir Selmin
Published: August 2017

Cardiac involvement is a rare initial presentation of familial Mediterranean fever (FMF). We described 2 children with massive pericardial effusion and cardiac tamponade, who were later diagnosed as having FMF based on clinical and laboratory findings. Therefore, in children presenting with massive pericardial effusion, FMF should be considered as one of the differential diagnoses. In addition, massive pericardial effusion is a serious clinical condition that requires emergency therapeutic approach including pericardiocenthesis. For medical treatment, colchicine is the first line therapy, but in resistant cases, other anti-inflammatory drugs can be used for extra anti-inflammatory effect.
Point-of-Care Ultrasound Diagnosis of Multiple Mandibular Fractures in an Adolescent Presenting to the Pediatric Emergency Department
Authors: Zapolsky Nathan , Zapolsky Ivan Joseph , Lim Czer Anthoney
Published: August 2017

We present a case of an adolescent patient with multiple mandibular fractures diagnosed by point-of-care ultrasound in the pediatric emergency department. Sonographic findings consistent with fracture were identified in our patient, and early consultation expedited interdepartmental coordination and disposition. The role of ultrasound in identifying various traumatic orthopedic and maxillofacial injuries is discussed.
Improving Outreach and Surveillance Efforts Following a Large-Scale Carbon Monoxide Poisoning in Wisconsin
Authors: Creswell Paul D. , Vogt Christy M. , Wozniak Ryan J. , Camponeschi Jenny , Werner Mark A. , Meiman Jonathan G.
Published: August 2017

Objective:

In December 2014, the largest carbon monoxide (CO) poisoning in Wisconsin's history occurred at an ice arena. Following this event, the Wisconsin Environmental Public Health Tracking (WI EPHT) Program sought to improve outreach and surveillance efforts.

Methods:

WI EPHT designed and distributed educational materials on CO poisoning prevention and surveyed stakeholders to gauge the effectiveness of outreach efforts. To enhance surveillance, WI EPHT utilized data from the Wisconsin Poison Center (WPC) to generate real-time alerts of anomalous numbers of CO-related calls.

Results:

WI EPHT found that 42% of stakeholders reviewed the outreach materials, and 1 ice arena had installed a CO detector as a result. CO alerts were developed using WPC data and are now routinely used in statewide public health surveillance.

Conclusion:

WI EPHT staff improved CO poisoning prevention outreach and saw a positive response among stakeholders. This work demonstrates ways that health agencies can improve outreach and surveillance for CO poisoning. Improvements in these areas can bolster public health response and may prevent CO-related illness and injury.
Addressing Data Inequities in American Indian Communities Through an Environmental Public Health Tracking Pilot Project
Authors: Lucas-Pipkorn Samantha , Tuomi Ashley
Published: August 2017

National and state surveillance systems identify American Indians/Alaska Natives inconsistently and often inaccurately within their data sets. Consequently, communities may not be represented with data at the level of geography needed. Collecting and presenting environmental and health-related data to the public are done by state Tracking Networks. Great Lakes Inter-Tribal Epidemiology Center (GLITEC) conducted a groundbreaking 2014 Tribal Environmental Health Tracking pilot project that engaged tribes, an urban Indian community, 3 state health departments, a Tribal Epidemiology Center (TEC), and a federal agency. Two other TECs—the Albuquerque Area Southwest Tribal Epidemiology Center (AASTEC) and Northwest Tribal Epidemiology Center (NW EpiCenter)—are now modeling GLITEC's project. They will forge active partnerships with at least one tribe and build relationships with state Tracking programs, explore environmental priorities, identify health outcomes of greatest concern for each community, and determine whether environmental or health inquiries can be addressed through state Tracking data. The Tribal Environmental Health Tracking pilot project provides an example of how state public health Tracking programs can be responsive to data inequities, build relationships between tribes/urban Indian communities, and increase their competency for working with indigenous communities.
Four Corners States Biomonitoring Consortium: Lessons Learned During Implementation
Authors: Chaudhuri Sanwat N. , Broekemeier Megan , Butler Carrie , Coyle Alexander , Iuliano Kayla , James Katherine A. , LeFevre Sam
Published: August 2017

Building on a history of collaboration in environmental public health and biomonitoring activities, laboratory and environmental epidemiology leaders in Arizona, Colorado, New Mexico, and Utah created the Four Corners States Biomonitoring Consortium, which is now in its third year of activities. In this article, we briefly highlight some lessons learned during the implementation phases of the consortium, including the processes of collaborating to identify common environmental exposure concerns, prioritizing those concerns, identifying cohorts and communities with potential risks of excessive exposure, developing a model for conducting exposure investigations, and the challenges presented during the implementation phases and early fieldwork activities. Detailed information on these topics can be found at www.4csbc.org. The advantages of collaborating with, and leveraging the resources of, state Environmental Public Health Tracking Networks and Public Health Emergency Preparedness programs are discussed. Using one example from the early stages of this work, we also discuss the potential of biomonitoring as a vehicle for empowering the public to make informed choices to control their exposures and to influence public health decisions, support science-based environmental health policy and program development, and respond to emerging environmental exposure concerns.
Health Impact Assessments and Extreme Weather—Challenges for Environmental Health
Authors: Kintziger Kristina , Ortegren Jason , DuClos Chris , Jordan Melissa , Smith Talia , Foglietti Rebecca , Merritt Robert , Donado Louviminda
Published: August 2017

Background:

The Florida Department of Health, Environmental Public Health Tracking Program, in collaboration with the Escambia County Health Department and the University of West Florida, used the Health Impact Assessment Framework to examine adverse health outcomes that may be related to an extreme flood event in Pensacola, Florida (Escambia County) during April 29 to May 3, 2014. In this 2014 flood event, portions of Pensacola received more than 15.5 in of rain in a single day. Infrastructure impacts from this extreme event included destroyed bridges and roads and the failure of many sewage lift stations.

Objective:

To determine whether there were associated increases in injury, illness, and death, data on reportable diseases, hospitalizations, emergency department (ED) visits, and deaths that occurred during the impact period in 2014 were compared with a control period in 2008.

Design:

We used an ecological design to compare impact and control periods and examined the proportion of hospitalizations, ED visits, and deaths potentially attributable to the extreme flood event.

Results:

The results of this comparison were mixed, with some Escambia County zip codes showing increased hospitalizations and ED visits, and some zip codes showing a decrease. However, countywide, there were increases in the proportion of both injury- and respiratory-related hospitalizations and ED visits during the impact period.

Conclusions:

It is challenging to characterize human health impacts from natural disasters such as extreme floods. Still, it is believed that specific policy changes could result in fewer health impacts during future flood events. For example, this study recommended raising the electric panels on lift stations above the flood elevation to keep them operational during extreme rainfall events. For more maps and tables, consult the complete project report available online at http://www.floridatracking.com/HealthTrackFL/document/Escambia_HIA_Report.pdf.
Spatial Surveillance of Childhood Lead Exposure in a Targeted Screening State: An Application of Generalized Additive Models in Denver, Colorado
Authors: Berg Kevin , Kuhn Stephanie , Van Dyke Mike
Published: August 2017

Context:

The targeted nature of Colorado's childhood lead screening program presents several analytical issues that complicate routine epidemiologic surveillance.

Objectives:

To analyze spatial patterns of childhood lead exposure among children younger than 6 years, identifying areas of increased risk along with associated covariates.

Methods:

We analyzed a spatial case-control data set of childhood lead poisoning using generalized additive models. Incident cases were represented by the residential locations of children younger than 6 years with confirmed elevated blood lead levels (EBLL) of 5 μg/dL or more recorded between calendar years 2010 and 2014, and controls were sampled from the population at risk. We modeled the effect of spatial location, adjusting for potential spatial confounders. We also adjusted for a number of covariates previously identified in the childhood lead poisoning literature to understand the ecologic-level drivers of spatial variation in risk.

Main Outcome Measure(s):

Crude and adjusted spatial odds ratios describing the relative frequency of lead poisoning among different locations in Denver, Colorado.

Results:

We found evidence of statistically significant spatial clustering in incident cases of lead poisoning even after adjustment for age, sex, year, season, and spatially smoothed screening rate. Spatial confounder-adjusted odds ratios in the Denver study area ranged from 0.22 to 2.7. Adjusting for additional ecologic-level covariates effectively accounted for the observed spatial variation. We found that ecologic-level indicators of low socioeconomic status, Hispanic ethnicity, Asian race, and older housing age were all positively and significantly associated with an increased EBLL risk.

Conclusion:

Housing and socioeconomic factors continue to be the primary ecologic risk factors associated with childhood lead exposure and can be used to predict risk at a fine spatial resolution in the Denver study area. Our analysis demonstrates how other targeted screening states can be proactive about childhood lead surveillance within their major population centers and enhance the spatial specificity of lead mitigation efforts.
Environmental Public Health Tracking Program Advances and Successes: Highlights From the First 15 Years
Authors: Wilson Holly R. , Charleston Alex E.
Published: August 2017

Over the past 15 years, the National Environmental Public Health Tracking Program (Tracking Program) has advanced technologically and programmatically, evolving from an abstract concept to a mature program. The Tracking Program, in collaboration with national, state, and local partners, uses data and expertise to identify and address environmental public health needs and improve public health capacity across the United States. Examples of the successful application of environmental public health tracking include informing health impact assessments and filling data gaps. The Tracking Program plans to continue working to direct innovative programs and solutions that protect and improve community health in years to come. With support from the Tracking Program, health departments can enhance their abilities to plan and conduct environmental public health activities.
The Balance Between Surgical Resident Education and Patient Safety in Laparoscopic Colorectal Surgery: Surgical Resident’s Performance has No Negative Impact
Authors: Homma Shigenori , Kawamata Futoshi , Yoshida Tadashi , Ohno Yosuke , Ichikawa Nobuki , Shibasaki Susumu , Kawamura Hideki , Takahashi Norihiko , Taketomi Akinobu
Published: August 2017

Objective:

This study aimed to evaluate the feasibility and effectiveness of a comprehensive theoretical and hands-on training program in performing laparoscopic colonic resections under supervision of an expert surgeon.

Materials and Methods:

Laparoscopic right colectomy was performed in 78 patients (10 with benign disease, 68 with carcinoma). Demographic, intraoperative, pathologic examination, and short-term outcome data were retrospectively compared between 25 patients operated by surgical residents (R group) and 53 patients operated by senior surgeons (S group). The residents who performed surgeries in the R group had between 1 and 6 years after graduation; no experience with open or laparoscopic colorectal surgery was necessary. The residents completed a training program under supervision of a single expert laparoscopic colorectal surgeon, which included 6 steps, from basic skills to certification.

Results:

There were no differences in patient age, sex, and body mass index between the R and S groups. Significantly more patients in the R group had early cancer and benign lesions (P<0.05). Thirteen of the 16 residents (81.2 %) had not had prior experience with colonic resection. The time of suturing and knot tying in the dry box did not differ between residents and senior surgeons (68 and 69 s, respectively). All the residents performed laparoscopic right colectomy without intraoperative complications. There were no significant differences in operating time (R group: 173±34 min, S group: 172±52 min), mean estimated blood loss (50±111 vs. 49±100 mL), number of lymph nodes dissected (20.8±12.8 vs. 17.1±9.0), and mean postoperative hospital stay (9.1±3.3 vs. 10.7±4.1 d). On the basis of the year of their residency period, all 3 residents at 6 years after graduation had far greater experience than the other residents and therefore performed the surgery with minor verbal support from the expert. However, residents with 1 or 2 years after graduation had to receive guidance provision by the expert during surgery.

Conclusions:

When supervised and led by an expert laparoscopic surgeon, surgical residents are capable of performing laparoscopic surgery without negative effects on outcomes.
Using Pretend Play to Promote Foundations for Text Comprehension
Authors: Westby Carol , Wilson Deborah
Published: August 2017

This review article starts with an overview of changing education paradigms and the literature on cognitive and linguistic relationships in imaginative play related to comprehension of oral and written texts. Strategies for developing the cognitive and linguistic foundations for text comprehension through play are described. A review of current literature on children who are deaf or hard of hearing (DHH) indicates that many of them are at risk for deficits in imaginative play and text comprehension related to deficits in language, cognition, theory of mind, and social–emotional skills. The article concludes with description of a play-based educational program that was implemented with preschool children who are DHH. It is an example of how play-based interventions could be implemented with other populations facing language and literacy challenges.