bluuebunny/crossref_metadata_2025_split huggingface dataset:
nIFTy galaxy cluster simulations VI: the dynamical imprint of substructure on gaseous cluster outskirts.
Authors: Power C , Elahi P J , Welker C , Knebe A , Pearce F R , Yepes G , Davé R , Kay S T , McCarthy I G , Puchwein E , Borgani S , Cunnama D , Cui W , Schaye J 
Published: November 2019

Abstract
Galaxy cluster outskirts mark the transition region from the mildly non-linear cosmic web to the highly non-linear, virialised, cluster interior. It is in this transition region that the intra-cluster medium (ICM) begins to influence the properties of accreting galaxies and groups, as ram pressure impacts a galaxy’s cold gas content and subsequent star formation rate. Conversely, the thermodynamical properties of the ICM in this transition region should also feel the influence of accreting substructure (i.e. galaxies and groups), whose passage can drive shocks. In this paper, we use a suite of cosmological hydrodynamical zoom simulations of a single galaxy cluster, drawn from the nIFTy comparison project, to study how the dynamics of substructure accreted from the cosmic web influences the thermodynamical properties of the ICM in the cluster’s outskirts. We demonstrate how features evident in radial profiles of the ICM (e.g. gas density and temperature) can be linked to strong shocks, transient and short-lived in nature, driven by the passage of substructure. The range of astrophysical codes and galaxy formation models in our comparison are broadly consistent in their predictions (e.g. agreeing when and where shocks occur, but differing in how strong shocks will be); this is as we would expect of a process driven by large-scale gravitational dynamics and strong, inefficently radiating, shocks. This suggests that mapping such shock structures in the ICM in a cluster’s outskirts (via e.g. radio synchrotron emission) could provide a complementary measure of its recent merger and accretion history.
The Effects of a Systemwide Diagnostic Stewardship Change on West Nile Virus Disease Ordering Practices
Authors: Karaba Andrew H , Blair Paul W , Martin Kevin , Saheed Mustapha O , Carroll Karen C , Borowitz Michael J 
Published: November 2019

Abstract
We report that removing the clinically insensitive West Nile virus CSF nucleic acid amplification test (NAAT) from the electronic health record (EHR) test menu decreased costs and may have improved diagnostic yield. Removing high-cost, low yield tests from the EHR can be an effective diagnostic stewardship intervention.
Vascular Transposition of the Superior Cerebellar Artery Using a Fenestrated Clip and Fibrin Glue in Trigeminal Neuralgia: 2-Dimensional Operative Video
Authors: Abi-Aad Karl R , Turcotte Evelyn , Patra Devi P , Welz Matthew E , Maiti Tanmoy , Hess Ryan , Kalen Brian , Krishna Chandan , Zimmerman Richard S , Bendok Bernard R 
Published: November 2019

Abstract
This is the case of an 86-yr-old gentleman who presented with left facial pain exacerbated by eating, drinking, chewing, and shaving (distribution: V2, V3). The patient was diagnosed with trigeminal neuralgia and was refractory to medications. Imaging showed a superior cerebellar artery (SCA) loop adjacent to the trigeminal nerve root entry zone and a decision to perform a microvascular decompression of the fifth nerve was presented to the patient. After patient informed consent was obtained, a standard 3 cm × 3 cm retrosigmoid craniotomy was performed with the patient in a supine head turned position and in reverse Trendelenburg. The arachnoid bands tethering the SCA to the trigeminal nerve were sharply divided. A slit was then made in the tentorium and a 3 mm fenestrated clip was then used to secure the transposed SCA away from the trigeminal nerve. The SCA proximal to this was slightly patulous in its course so a small amount of a fibrin glue was also used to secure the more proximal SCA to the tentorium. The patient was symptom-free postoperatively and no longer required medical therapy. Additionally, imaging was consistent with adequate separation of the nerve from adjacent vessels.
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Clinically Integrated Physical Therapist Practice in Cancer Care: A New Comprehensive Approach
Authors: Barnes Christopher A , Stout Nicole L , Varghese, Jr Thomas K , Ulrich Cornelia M , Couriel Daniel R , Lee Catherine J , Noren Christopher S , LaStayo Paul C 
Published: November 2019

Abstract
Best practice recommendations in cancer care increasingly call for integrated rehabilitation services to address physical impairments and disability. These recommendations have languished primarily due to a lack of pragmatic, generalizable intervention models. This perspective paper proposes a clinically integrated physical therapist (CI-PT) model that enables flexible and scalable services for screening, triage, and intervention addressing functional mobility. The model is based on (1) a CI-PT embedded in cancer care provider clinics, and (2) rehabilitation across the care continuum determined by the patient’s level of functional mobility. The CI-PT model includes regular screening of functional mobility in provider clinics via a patient-reported mobility measure—the Activity Measure for Post-Acute Care, a brief physical therapy evaluation tailored to the specific functional needs of the individual—and a tailored, skilled physical therapist intervention based on functional level. The CI-PT model provides a pragmatic, barrier-free, patient-centric, data-driven approach to integrating rehabilitation as part of standard care for survivors of cancer. The model standardizes CI-PT practice and may be sufficiently agile to provide targeted interventions in widely varying cancer settings and populations. Therefore, it may be ideal for wide implementation among outpatient oncological settings. Implementation of this model requires a shared approach to care that includes physical therapists, rehabilitation administrators, cancer care providers, and cancer center administrators.
A high-resolution fMRI investigation of BNST and centromedial amygdala activity as a function of affective stimulus predictability, anticipation, and duration
Authors: Pedersen Walker S , Muftuler L Tugan , Larson Christine L 
Published: November 2019

Abstract
Relative to the centromedial amygdala (CM), the bed nucleus of the stria terminalis (BNST) may exhibit more sustained activation toward threat, sensitivity to unpredictability and activation during anxious anticipation. These factors are often intertwined. For example, greater BNST (vs CM) activation during a block of aversive stimuli may reflect either more sustained activation to the stimuli or greater activation due to the anticipation of upcoming stimuli. To further investigate these questions, we had participants (19 females, 9 males) complete a task adapted from a study conducted by Somerville, Whalen and Kelly in 2013, during high-resolution 7-Tesla fMRI BOLD acquisition. We found a larger response to negative vs neutral blocks (sustained threat) than to images (transient) in the BNST, but not the CM. However, in an additional analysis, we also found BNST, but not CM, activation to the onset of the anticipation period on negative vs neutral trials, possibly contributing to BNST activation across negative blocks. Predictability did not affect CM or BNST activation. These results suggest a BNST role in anxious anticipation and highlight the need for further research clarifying the temporal response characteristics of these regions.
Suppression of Parvalbumin Interneuron Activity in the Prefrontal Cortex Recapitulates Features of Impaired Excitatory/Inhibitory Balance and Sensory Processing in Schizophrenia
Authors: Toader Oana , von Heimendahl Moritz , Schuelert Niklas , Nissen Wiebke , Rosenbrock Holger 
Published: November 2019

AbstractAccumulating evidence supports parvalbumin expressing inhibitory interneuron (PV IN) dysfunction in the prefrontal cortex as a cause for cognitive impairment associated with schizophrenia (CIAS). PV IN decreased activity is suggested to be the culprit for many of the EEG deficits measured in patients, which correlate with deficits in working memory (WM), cognitive flexibility and attention. In the last few decades, CIAS has been recognized as a heavy burden on the quality of life of patients with schizophrenia, but little progress has been made in finding new treatment options. An important limiting factor in this process is the lack of adequate preclinical models and an incomplete understanding of the circuits engaged in cognition. In this study, we back-translated an auditory stimulation protocol regularly used in human EEG studies into mice and combined it with optogenetics to investigate the role of prefrontal cortex PV INs in excitatory/inhibitory balance and cortical processing. We also assessed spatial WM and reversal learning (RL) during inhibition of prefrontal cortex PV INs. We found significant impairments in trial-to-trial reliability, increased basal network activity and increased oscillation power at 20–60 Hz, and a decreased signal-to-noise ratio, but no significant impairments in behavior. These changes reflect some but not all neurophysiological deficits seen in patients with schizophrenia, suggesting that other neuronal populations and possibly brain regions are involved as well. Our work supports and expands previous findings and highlights the versatility of an approach that combines innovative technologies with back-translated tools used in humans.
The Effect of Foregrounding Intended Use on Observers’ Ratings and Comments in the Assessment of Clinical Competence
Authors: Tavares Walter , Young Meredith , Gauthier Geneviève , St-Onge Christina 
Published: November 2019

Purpose
Some educational programs have adopted the premise that the same assessment can serve both formative and summative goals; however, how observers understand and integrate the intended uses of assessment may affect the way they execute the assessment task. The objective of this study was to explore the effect of foregrounding a different intended use (formative vs summative learner assessment) on observer contributions (ratings and comments).

Method
In this randomized, experimental, between-groups, mixed-methods study (May–September 2017), participants observed 3 prerecorded clinical performances under formative or summative assessment conditions. Participants rated performances using a global rating tool and provided comments. Participants were then asked to reconsider their ratings from the alternative perspective (from which they were originally blinded). They received the opportunity to alter their ratings and comments and to provide rationales for their decision to change or preserve their original ratings and comments. Outcomes included participant–observers’ comments, ratings, changes to each, and stated rationales for changing or preserving their contributions.

Results
Foregrounding different intended uses of assessment data for participant–observers did not result in differences in ratings, number or type of comments (both emphasized evaluative over constructive statements), or the ability to differentiate among performances. After adopting the alternative perspective, participant–observers made only small changes in ratings or comments. Participant–observers reported that they engage in the process in an evaluative manner despite different intended uses.

Conclusions
Foregrounding different intended uses for assessments did not result in significant systematic differences in the assessment data generated. Observers provided more evaluative than constructive statements overall, regardless of the intended use of the assessment. Future research is needed to explore whether these results hold in social/workplace-based contexts and how they might affect learners.
Seeking Inclusion Excellence: Understanding Racial Microaggressions as Experienced by Underrepresented Medical and Nursing Students
Authors: Ackerman-Barger Kupiri , Boatright Dowin , Gonzalez-Colaso Rosana , Orozco Regina , Latimore Darin 
Published: November 2019

Purpose
To describe how racial microaggressions may affect optimal learning for under-represented health professions students.

Method
The authors conducted focus groups and individual interviews from November 2017 to June 2018 with 37 students at University of California, Davis and Yale University who self-identified as underrepresented in medicine or nursing. Questions explored incidence, response to, and effects of racial microaggressions, as well as students’ suggestions for change. Data were organized and coded, then thematic analysis was used to identify themes and subthemes.

Results
The data showed consistent examples of microaggressions across both health professions and schools, with peers, faculty, preceptors, and structural elements of the curricula all contributing to microaggressive behavior. The 3 major themes were: students felt devalued by microaggressions; students identified how microaggressions affected their learning, academic performance, and personal wellness; and students had suggestions for promoting inclusion.

Conclusions
The data indicated that students perceived that their daily experiences were affected by racial microaggressions. Participants reported strong emotions while experiencing racial microaggressions including feeling stressed, frustrated, and angered by these interactions. Further, students believed microaggressions negatively affected their learning, academic performance, and overall well-being. This study shows the need for leadership and faculty of health professions schools to implement policies, practices, and instructional strategies that support and leverage diversity so that innovative problem-solving can emerge to better serve underserved communities and reduce health disparities.
Approaches to Measuring Trends in Interdisciplinary Research Publications at One Academic Medical Center
Authors: Weston Christine M. , Terkowitz Mia S. , Thompson Carol B. , Ford Daniel E. 
Published: November 2019

Purpose
To determine if interdisciplinary research has increased between 2005 and 2015, based on an analysis of journal articles containing at least 1 author from Johns Hopkins University, and to compare different methods for determining the disciplinarity of research articles.

Method
In 2017–2018, 100 peer-reviewed biomedical science articles were randomly selected from years 2005, 2010, and 2015 and classified as unidisciplinary or interdisciplinary based on Scopus author affiliation data (method 1). The corresponding authors of the 2010 and 2015 articles were sent a survey asking them to describe the disciplines involved in their research (method 2) and to define their research as unidisciplinary or interdisciplinary based on provided definitions (method 3).

Results
There was a statistically significant increase in the proportion of interdisciplinary articles in 2015 compared with both 2005 and 2010 (P = .02). Comparison of the 3 methods indicated that 45% of the articles were classified as interdisciplinary based on author affiliation data (method 1), 40% based on the corresponding author’s description of the disciplines involved in their research (method 2), and 71% based on the corresponding author’s definition of their article’s disciplinarity (method 3). There was a statistically significant difference in the proportion of articles classified as interdisciplinary between methods 1 and 3 (P < .001) and between methods 2 and 3 (P < .001).

Conclusions
This study found that interdisciplinary research increased at Johns Hopkins University over the past decade and highlights the difference between corresponding authors’ views of their own research and other methods for determining interdisciplinarity.
Opioid and Amphetamine Treatment Trends Among American Indians in the Great Plains
Authors: Mitton Julian A. , Jackson Sean , Ho J. Janet , Tobey Matthew 
Published: November 2019

Objectives:
Traditionally underserved populations in the United States, particularly rural and American Indian/Alaska Native (AI/AN) communities, are disproportionately impacted by the opioid and amphetamine epidemics and have a higher risk for substance use disorders. AI/AN communities in the American Great Plains face exceptional health risks. We aim to describe recent trends in opioid and amphetamine treatment admissions for AI/ANs living in the Great Plains relative to that of the general population.

Methods:
We used data from the 2014 to 2016 Substance Abuse and Mental Health Services Administration (SAMHSA) Drug and Alcohol Services Information System (DASIS) Treatment Episode Data Set (TEDS) for Admissions. We extracted opioid and amphetamine treatment admissions for self-identified AI/AN and non-AI/AN patients living in the Great Plains: North Dakota, South Dakota, Nebraska, and Iowa. Average annual admission rates were calculated and compared from 2014 to 2016 for AI/AN versus non-AI/AN populations.

Results:
While opioid and amphetamine treatment admissions from 2014 to 2016 increased in both AI/AN (49 vs 80 per 10,000) and non-AI/AN (20 vs 26 per 10,000) populations, the rate of increase was significantly greater among AI/ANs (64% vs 32%; P < 0. 01). These trends are largely reflective of increased amphetamine use treatment admissions observed in both AI/AN and non-AI/AN populations.

Conclusions:
Treatment admissions for opioid and amphetamine use have increased from 2014 to 2016 for both AI/AN and non-AI/AN individuals in the Great Plains, driven largely by amphetamine use. AI/AN individuals were observed to seek care at a much higher rate. This increase in treatment admissions suggests increasing demand for services, which, in turn, necessitates greater investment of resources into AI/AN health facilities to address opioid and amphetamine use disorder in this underserved population.
Light syringe barrel (external fixator) for phalangeal and metacarpal fractures: A case series
Authors: Abdallah Mahmoud M. , Nageeb Mahmoud Ahmed , Moharram Ashraf Nehad , Amin Sherif Nabil , Mansour Ayman 
Published: November 2019

Background:
External fixation is a well-established technique for management of displaced metacarpal and phalangeal fractures. External fixation can achieve adequate fixation with relatively low complications.

Methods:
This is a study of 45 patients (48 digits) with phalangeal and metacarpal fractures that were managed using a simple light external fixator system. Eighteen patients had a comminuted fracture pattern, sixteen had a transverse, ten had an oblique, and two had a spiral fracture pattern. Radiographic outcomes were reviewed on a regular basis after surgery. Functional outcomes were assessed using total active motion of the digit and plotted using the American Society for Surgery of the Hand (ASSH) score.

Results:
All the patients achieved radiographic fracture union at a mean duration of 6 wk (average 4-8 wk). As for functional outcomes according to the ASSH score, excellent results were achieved in 34, good results in three, fair results in nine, and poor in two. One patient had redisplacement that required revision internal fixation. Fair and poor results were found mainly in elderly and uncooperative patients due to noncompliance with postoperative hand mobility exercises.

Conclusions:
The light external fixator system provided a simple, easy, cheap, and adequate technique for management of displaced metacarpal and phalangeal fractures, with good radiographic and clinical outcomes. Strict adherence to hand motion exercises is mandatory to achieve favorable outcomes.

Level of Evidence:
Level IV.
Outcomes at Skeletal Maturity of 34 Children With Scoliosis Treated With a Traditional Single Growing Rod
Authors: Bouthors Charlie , Gaume Mathilde , Glorion Chistophe , Miladi Lotfi 
Published: November 2019

Study Design.
Retrospective case series.

Objectives.
To analyze the outcomes at skeletal maturity of patients treated with a single traditional growing rod (GR). To compare results of patients according to whether posterior spinal fusion (PSF) was performed at treatment completion.

Summary of Background Data.
Few studies examined the end results of GRs at skeletal maturity. There is no agreement on requirement of PSF at GR treatment completion.

Methods.
Clinical and radiological analysis of consecutive patients with severe and/or progressive scoliosis treated initially with traditional single GR. Group comparisons of patients with PSF and without fusion surgery at treatment completion.

Results.
Thirty-four patients underwent traditional single GR implantation at a median age of 11.7 years. Median follow-up was 6.5 years. At last follow-up, T1-S1 distance was increased by a median 116 mm (P < 0.001) and median major curve Cobb angle was changed from 55° preoperatively to 30° (P < 0.001). Complications included 26 rod fractures, 1 implant prominence, 4 proximal junctional kyphosis, 2 proximal hook dislodgments, and 2 wound infections. At the beginning our experience, PSF was performed systematically in 17 patients. Relying on spinal ankylosis, 17 patients were subsequently not fused at GR treatment completion (single GR removed N = 2, single GR retained N = 7, dual GR surgery N = 8). There were no statistical differences between groups in improvements of radiological parameters from preoperative GR insertion to last follow-up. No GR fracture occurred after dual GR surgery.

Conclusion.
Single GR allows curve control and promotes spinal growth. Dual GR is, however, recommended for rod fracture prevention and better correction maintenance. In patients with satisfactory deformity correction at skeletal maturity, one may consider retaining dual GR instead of performing PSF.

Level of Evidence: 4
Lower SRS Mental Health Scores are Associated With Greater Preoperative Pain in Patients With Adolescent Idiopathic Scoliosis
Authors: Hwang Steven W. , Pahys Joshua M. , Bastrom Tracey P. , Lonner Baron S. , Newton Peter O. , Samdani Amer F. 
Published: November 2019

Study Design.
Retrospective review of a prospectively collected multicenter database.

Objective.
The aim of this study was to investigate factors associated with low preoperative SRS pain scores.

Summary of Background Data.
The prevalence of preoperative pain in patients with adolescent idiopathic scoliosis (AIS) has become increasingly evident and is a primary concern for patients and families. Greater preoperative pain is associated with more postoperative pain; however, less is understood about what contributes to preoperative pain.

Methods.
A prospectively collected, multicenter database was queried for patients with AIS. Patients were divided into 2 cohorts based on preoperative SRS pain scores: ≤ 3 (Pain cohort), 4 to 5 (No Pain cohort). Univariate analysis was performed identifying which factors were associated with a low preoperative SRS score and used for a CART analysis.

Results.
Of 2585 patients total, 2141 (83%) patients had SRS pain scores of 4 to 5 (No Pain) and 444 (17%) had SRS pain scores ≤3 (Pain). Female sex, older age, greater % body mass index, larger lumbar curves, greater T5–12 kyphosis, and lower mental health scores were associated with greater preoperative pain. In multivariate CART analysis, lower mental health SRS scores (P = 0.04) and older age (P = 0.003) remained significant, with mental health scores having the greatest contribution. In subdividing the mental health component questions, anxiety-related questions appeared to have the greatest effect followed by mood/depression (SRS Question 13: OR 2.04; Q16: OR 1.35; Q7: OR 1.31; Q3: OR 1.20).

Conclusion.
Anxiety and mood are potentially modifiable risk factors that have the greatest impact on pre- and postoperative pain. These results can be used to identify higher-risk patients and develop preoperative therapeutic protocols to improve postoperative outcomes.

Level of Evidence: 3