bluuebunny/crossref_metadata_2025_split huggingface dataset:
P047 PARENT PERSPECTIVES ON COMPREHENSIVE CARE FOR CHILDREN WITH INFLAMATORY BOWEL DISEASES: BUILDING A CARE DELIVERY MODEL FROM THE FAMILY UP
Authors: Michel Hilary , Kim Sandra , Siripong Nalyn , Noll Robert 
Published: January 2020

Abstract

Background
Patients with Inflammatory Bowel Diseases (IBD) require life-long management by gastroenterology (GI) and primary care providers (PCP). Guidelines exist outlining recommended healthcare services, but it is unclear which provider is responsible for which tasks, and what parents prefer.

Aims
To understand perceptions of healthcare quality and delivery for children with IBD, describe barriers to receiving comprehensive healthcare, and elicit preferences for how care would ideally be delivered.

Methods
Cross-sectional survey of parents of children ages 2–17 with IBD at a large, free-standing children’s hospital, recruited via an institutional research registry. Surveys assessed patient medical history, family demographics, perceptions of health care quality and delivery, barriers to primary and GI care, and preferences for care receipt.

Results
217 parents were recruited, 214 consented, and 161 completed the survey (75% response). Mean patient age 14 years (SD 3); 51% male; 80% Crohn’s, 16% ulcerative colitis, and 4% indeterminate colitis. Most parents were Caucasian (94%), had a bachelor’s degree or higher (61%), and lived in a suburban setting (57%). Most had private insurance (43%) or private primary and public secondary insurance (34%). Most parents (N=149, 94%) thought the GI doctor was responsible for their child’s IBD care, and 8 (6%) reported shared responsibility by the GI doctor and PCP. 113 (71%) said their child’s PCP was responsible for primary care, 8 (5%) said GI doctor, and 37 (23%) said both. 95% of parents were confident in their GI doctor’s primary care knowledge, and 81% with their PCP’s IBD knowledge. 89% were satisfied with their communication with the PCP, and 98% were satisfied with their communication with the GI doctor. 53% did not know how well their PCP and GI doctors were communicating with each other. Only 4% of parents reported unmet healthcare needs, but those who did cited inadequate family support and mental health services. The greatest barriers to PCP care were lack of continuity with providers (22%) and scheduling (24%). The greatest barriers to GI care were scheduling (38%) and traveling to appointments (29%). Parent preferences for specific health care service delivery are found in Figure 1.

Conclusions
Parents of children with IBD are satisfied with provider knowledge and communication skills with them, though most are unaware how well their PCP and GI doctor are communicating with each other. Healthcare needs are being met for most patients in our cohort, but parents cite different barriers to primary vs. specialty care, and mental health services in particular are lacking. Parents seem to support co-management between their child’s PCP and GI provider. Understanding parent perspectives is essential to the development of family-centered healthcare delivery models for children with IBD.
P048 QUALITY OF LIFE AND OTHER PATIENT REPORTED OUTCOMES IN PATIENTS WITH POUCHITIS
Authors: Barnes Edward , Long Millie , Raffals Laura , Zhang Xian , Vyas Anuj , Kappelman Michael , Sandler Robert , Herfarth Hans 
Published: January 2020

Abstract

Background
While restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the preferred surgical approach in patients with medically refractory ulcerative colitis (UC) or UC-related dysplasia, a significant proportion of patients develop pouchitis and/or report decreased health related quality of life (HRQOL) at some point after IPAA. We designed this study to 1) evaluate the association between recently reported pouchitis and specific Patient-Reported Outcome Measurement Information System (PROMIS) domains (anxiety, depression, fatigue, pain interference, sleep disturbance, and social role satisfaction) and HRQOL as assessed by the Cleveland Global Quality of Life (CGQL) scale, and 2) describe the correlations between specific PROMIS domains and overall HRQOL.

Methods
IBD Partners is an internet-based cohort that collects patient reported survey data every 6 months. In patients who reported having an IPAA for UC, we performed cross sectional analyses to compare patient characteristics and patient reported outcomes among patients who reported pouchitis in the prior 6 months versus those without reported pouchitis. To identify the specific social, emotional, and physical domains most associated with HRQOL, we evaluated the correlations between PROMIS domains (measured in T-scores) and CGQL scores using Pearson’s test.

Results
Among 118 patients, 70 (59%) reported pouchitis in the prior 6 months. There were no significant differences in age, sex, race, or number of stages of IPAA between patients with and without recent pouchitis (Table 1). Patients with recent pouchitis were more likely to demonstrate higher levels of anxiety (53.8 vs. 48.5, p=0.005), depression (52.2 vs. 46.9, p=0.005), fatigue (55.8 vs. 47.8, p&lt;0.001), pain interference (54.4 vs. 48.1, p=0.001), sleep disturbance (54.3 vs. 48.8, p=0.001), and lower levels of social satisfaction (47.4 vs. 53.6, p=0.001). As assessed by the CGQL, patients with pouchitis demonstrated decreased Quality of Life (6.64 vs. 7.71, p=0.007), Quality of Health (6.31 vs. 7.63, p=0.001), and Quality of Energy (5.77 vs. 7.17, p=0.001). Social satisfaction was the PROMIS domain that most strongly correlated with Quality of Life among patients with recent pouchitis (r= 0.62, Table 2) while sleep demonstrated the strongest correlation among those without pouchitis (r= -0.74).

Conclusions
Patients with recent pouchitis demonstrated a significant reduction in overall HRQOL as well as decrements in specific areas of social, emotional, and physical health. Among patients without pouchitis, strong correlations between multiple PROMIS domains and HRQOL were also demonstrated. These findings indicate that the PROMIS measures may be useful in assessing these areas of health that are clinically important after IPAA, allowing for tailored interventions in this population.
P052 VALIDITY AND INTERPRETABILITY OF PROMIS PEDIATRIC PATIENT-REPORTED OUTCOMES FOR CHILDREN WITH INFLAMMATORY BOWEL DISEASE
Authors: Schuchard Julia , Forrest Christopher , Clegg Jennifer , Firestine Ann , Kappelman Michael 
Published: January 2020

Abstract

Introduction
Patient-Reported Outcome Measurement Information System (PROMIS) instruments were developed using rigorous psychometric methods to assess health and quality of life across the life course. In two studies, we aimed to evaluate the clinical validity of PROMIS measures for children with inflammatory bowel disease (IBD) and to increase the interpretability of scores on these measures.

Methods
Study 1 recruitment and clinical data collection took place within 14 pediatric gastroenterology practices located across the United States. PROMIS Pediatric measures of Pain Interference, Fatigue, Psychological Stress Experiences, Global Health, and Life Satisfaction were completed by 1,049 children and youth (8–24 years old) with IBD and linked to an IBD registry that included disease activity measures. Study 2 utilized baseline data from a large, multi-center clinical trial to compare the effectiveness of anti-TNF monotherapy versus combination therapy with methotrexate. A total of 199 participants (8–20 years old) across 35 sites completed PROMIS Pediatric measures of Pain Interference, Fatigue, and Positive Affect. PROMIS measures were scored on a T-score metric (mean = 50; standard deviation = 10). Scores on symptom measures were classified as “severe” if they were at or above the 95th percentile, and scores on positive health measures were classified as “poor” if they were at or below the 5th percentile, relative to the United States general population of children ages 8–17.

Results
For nearly all domains across both studies, PROMIS scores were significantly associated with clinical measures of IBD severity. PROMIS measures indicated worse health and/or functioning with corresponding increases in disease activity (inactive to mild to moderate/severe). Comparisons between inactive and mild IBD groups resulted in medium or large effect sizes (Cohen’s d = 0.5 – 0.96) for Pain Interference, Fatigue, Psychological Stress, Global Health, and Life Satisfaction (Table 1). Proportions of children with IBD who were classified as “severe” or “poor” were higher than in the general population and increased with increasing levels of IBD severity (Table 2).

Conclusions
These studies support the clinical validity of PROMIS instruments for assessing the lived experiences of children with IBD. Effect sizes associated with differences between inactive and mild IBD translate to 5–10 points on the PROMIS T-scale, suggesting that 5–10 points is a clinically important difference between group average scores. To aid interpretation of an individual’s score, percentiles derived from the general population may be used to determine whether the score falls within the range of severe/poor scores for the measure.
P053 VARIATIONS IN HEALTHCARE UTILIZATION PATTERNS AMONG HIGH RISK INFLAMMATORY BOWEL DISEASE PATIENTS ENROLLED IN HIGH DEDUCTIBLE HEALTH PLANS
Authors: Berinstein Jeffrey , Cohen-Mekelburg Shirley , Steiner Calen , Mcleod Megan , Noureldin Mohamed , Kullgren Jeffrey , Waljee Akbar , Higgins Peter 
Published: January 2020

Abstract

Background
High-deductible health plan (HDHP) enrollment has increased rapidly over the last decade. Patients with HDHPs are incentivized to delay or avoid necessary medical care. We aimed to quantify the out-of-pocket costs of Inflammatory Bowel Disease (IBD) patients at risk for high healthcare resource utilization and to evaluate for differences in medical service utilization according to time in insurance period between HDHP and traditional health plan (THP) enrollees. Variations in healthcare utilization according to time may suggest that these patients are delaying or foregoing necessary medical care due to healthcare costs.

Methods
IBD patients at risk for high resource utilization (defined as recent corticosteroid and narcotic use) continuously enrolled in an HDHP or THP from 2009–2016 were identified using the Truven Health MarketScan database. Median annual financial information was calculated. Time trends in office visits, colonoscopies, emergency department (ED) visits, and hospitalizations were evaluated using additive decomposition time series analysis. Financial information and time trends were compared between the two insurance plan groups.

Results
Of 605,862 with a diagnosis of IBD, we identified 13,052 patients at risk for high resource utilization with continuous insurance plan enrollment. The median annual out-of-pocket costs were higher in the HDHP group (n=524) than in the THP group (n=12,458) ($1,920 vs. $1,205, p&lt;0.001), as was the median deductible amount ($1,015 vs $289, p&lt;0.001), without any difference in the median annual total healthcare expenses (Figure 1). Time in insurance period had a greater influence on utilization of colonoscopies, ED visits, and hospitalization in IBD patients enrolled in HDHPs compared to THPs (Figure 2). Colonoscopies peaked in the 4th quarter, ED visits peaked in the 1st quarter, and hospitalizations peaked in the 3rd and 4th quarter.

Conclusion
Among IBD patients at high risk for IBD-related utilization, HDHP enrollment does not change the cost of care, but shifts healthcare costs onto patients. This may be a result of HDHPs incentivizing delays with a potential for both worse disease outcomes and financial toxicity and needs to be further examined using prospective studies.
What unmanaged fishing patterns reveal about optimal management: applied to the balanced harvesting debate
Authors: Burgess Matthew G , Plank Michael J 
Published: January 2020

Abstract
Balanced harvesting (BH)—the idea of harvesting all species and sizes in proportion to their production rate—has been a topic of recent debate. Developed world fisheries tend to fish more selectively, concentrating on certain species and sizes preferred in the market. However, fishing patterns in some developing countries, with a range of different fishing gears and more generalist markets, more closely resemble BH. The BH debate therefore hinges on whether selective fisheries should become more balanced, whether unselective fisheries should do the opposite, both, or neither. In this study, we use simple and general analytical theory to describe the ideal free distribution that should emerge in unmanaged fisheries, and we show that this ideal free distribution should approximately produce BH only when prices, catchabilities, and fishing costs are similar across species and sizes. We then derive general properties of yield and profit maxima subject to conservation constraints. We find that BH is unlikely to be optimal in any fishery but may be closer to optimal in fisheries in which it emerges without management. Thus, BH may be more useful as a heuristic for understanding differences between fisheries in locally appropriate management than as an exact management strategy.
Penetration of the ascending aorta and bronchus by a crossbow bolt
Authors: Futamura Yasuhiro , Watanuki Hirotaka , Okada Masaho , Matsuyama Katsuhiko 
Published: January 2020

Abstract
We report the successful repair in a 29-year-old man who experienced penetration of the ascending aorta and bronchus by a crossbow bolt. Imaging studies revealed the arrow penetrating the sternum, right lung, ascending aorta and right bronchus, with mediastinal emphysema. The top of the arrow (8 mm in diameter) was deeply embedded in the body of the thoracic vertebra. The arrow was successfully removed while maintaining a stable respiratory condition by performing differential lung ventilation. There was no need for cardiopulmonary bypass. To our knowledge, this is the first case of a through-and-through penetrating ascending aorta injury.
Serious games for smoking prevention and cessation: A systematic review of game elements and game effects
Authors: Derksen M E , van Strijp S , Kunst A E , Daams J G , Jaspers M W M , Fransen M P 
Published: January 2020

AbstractObjectiveSerious health games might have the potential to prevent tobacco smoking and its health consequences, depending on the inclusion of specific game elements. This review aimed to assess the composition of serious games and their effects on smoking initiation prevention and cessation and behavioral determinants.Materials and MethodsWe systematically searched MEDLINE, Embase, PsycINFO, and Web of Science for publications that evaluated serious games aimed at changing smoking behavior or behavioral determinants. A taxonomy by King et al was used to classify game elements.ResultsWe identified 15 studies, evaluating 14 unique serious games. All games combined multiple game elements (mean 5.5; range, 3-10). Most frequently used were general and intermittent rewards, theme and genre features, and punishments. Six studies on smoking prevention together assessed 20 determinants and found statistically significant positive effects for 8 determinants (eg, attitude, knowledge, intention). Of 7 studies on smoking cessation, 5 found positive, statistically significant effects on smoking cessation or status. These studies found statistically significant positive effects for 6 of 12 determinants (eg, self-efficacy, attitude, intention). The majority of included studies had poor or fair methodological quality, lacked follow-up measures, and had fixed (as opposed to free, on-demand) play sessions.ConclusionsSerious games included multiple types of game elements. The evidence from a number of studies suggests that games may have positive effects on smoking-related outcomes, particularly smoking cessation. However, as most studies had important methodological limitations, stronger designs are needed to demonstrate, quantify, and understand the effects of serious games.
Validated Chromatographic and Spectrofluorimetric Methods for Analysis of Silodosin: A Comparative Study with Application of RP-HPLC in the Kinetic Investigation of Silodosin Degradation
Authors: Boltia Shereen A , Abdelkawy Mohammed , Mohamed Taghreed A , Mostafa Nahla N 
Published: January 2020

Abstract

Background
Stability indicating determination of pharmaceuticals is crucial, especially for drugs which have few published official analytical methods. Silodosin (SLD) is an FDA approved α1A-adrenoceptor blocker.

Objective
Efficient analytical methods were suggested, based on different instrumental techniques for quantification of SLD, besides conducting kinetic investigation of its degradation.

Methods
The first method is based on Reversed Phase High Performance Liquid Chromatography with Photodiode Array Detector (RP-HPLC-PDAD). Detection is done at wavelength 225 nm. The second method is focused on using High Performance Thin Layer Chromatography (HPTLC) and eluting the drug by solvent mixture followed by scanning at wavelength 270 nm. The third method depends on the First Derivative Synchronous Fluorescence Spectroscopy (1DSFS) for analysis of solutions of SLD and its acid and oxidative induced degradation products at Δλ = 90 nm, then determining the first derivative of the spectra and measuring peak amplitudes at 360 nm.

Results
Acceptable linearities were found in the concentration range of 0.50–90 μg/mL, 0.10–3.0 μg/band, and 0.05–0.50 µg/mL, for RP-HPLC-PDAD, HPTLC, and spectrofluorimetric methods, respectively.

Conclusion
Statistical analysis showed no significant difference between the suggested and the reported method. In monitoring the kinetics of SLD degradation, the order of reactions was determined and effects of degrading agent concentration and temperature on reaction rate were studied.

Highlights
Three analytical methods were developed for the determination of SLD based on RP-HPLC-PDAD, HPTLC, and 1DSFS in bulk and capsule dosage form. In addition, kinetic investigation of SLD degradation was performed using the developed RP-HPLC-PDAD method.
Understanding the environmental impact of global dairy production
Authors: Holden Lisa A 
Published: January 2020

Abstract
Some popular press articles and social media discussions continue to cite the erroneous data presented in the “Livestock’s Long Shadow” publication (FAO, 2006). While this data has subsequently been shown to be incorrect (Pitesky et al, 2009), on-going discussions about the high level of impact of livestock on global GHG emissions continue to be shared as fact nearly 15 years later. There is inherent complexity in studying the biology of livestock for meat and milk production. Efforts to make this complexity more understandable can lead to incorrect assumptions and create an unfavorable and incorrect view of dairy and livestock production for the general public. An unfavorable image of animal production creates added challenge for dairy and livestock producers. If the general public is to believe information about the environmental impact of livestock production, it is critical that that information is both accurate and easily understood. The following paper that highlights sustainable animal science and practices by Capper and Cady (2020) provides a review using modeling techniques for more recent updates (2007–2017), GHG emissions and overall impact of dairy production on environmental sustainability. Additionally, the contribution of ruminants to overall GHG emissions has also been more recently been summarized by Mitloehner (2018.)
The crustacean Armadillidium vulgare (Latreille, 1804) (Isopoda: Oniscoidea), a new promising model for the study of cellular senescence
Authors: Depeux Charlotte , Samba-Louaka Ascel , Becking Thomas , Braquart-Varnier Christine , Moreau Jérôme , Lemaître Jean-François , Laverre Tiffany , Paulhac Hélène , Dechaume-Moncharmont François-Xavier , Gaillard Jean-Michel , Beltran-Bech Sophie 
Published: January 2020

AbstractSenescence, the decline of physiological parameters with increasing age, is a quasi-ubiquitous phenomenon in the living world. The observed patterns of senescence, however, can markedly differ across species and populations, between sexes, and even among individuals. To identify the drivers of this variation in senescence, experimental approaches are essential and involve the development of tools and new study models. Current knowledge of the senescence process is mostly based on studies on vertebrates and the main information about senescence in invertebrates is mostly limited to model organisms such as Caenorhabditis elegans or Drosophila melanogaster. In this context, we tested whether biomarkers of vertebrate ageing could be used to study senescence in a new invertebrate model: the common woodlouse Armadillidium vulgare (Latreille, 1804). More specifically, we looked for the effect of age in woodlouse on three well-established physiological biomarkers of ageing in vertebrates: immune cells (cell size, density, and viability), β-galactosidase activity, and the gene expression of telomerase reverse transcriptase (TERT), an essential subunit of telomerase protein. We found that the size of immune cells was higher in older individuals, whereas their density and viability decreased, and that the β-galactosidase activity increased with age, whereas the TERT gene expression decreased. These findings demonstrate that woodlouse displays age-related changes in biomarkers of vertebrate senescence, with different patterns depending on gender. The tools used in studies of vertebrate senescence can thus be successfully used in studies of senescence of invertebrates such as the woodlouse. The application of commonly used tools to new biological models offers a promising approach to assess the diversity of senescence patterns across the tree of life.
Supporting Accountability for Sexual Violence in the Syria and Iraq Conflicts
Authors: Barbour Stephanie 
Published: January 2020

Abstract
This article examines innovations in investigating sexual and gender-based violence (SGBV) through private investigations of international criminal and humanitarian law violations in Syria and Iraq. Drawing on the progress, challenges and lessons learned at the international level, a few notable initiatives have endeavoured to implement high-quality criminal investigations driven by local actors. The article first sets out the context in which private initiatives have moved to fill the gaps in the international response to crimes in Syria and Iraq through a shift to supporting national investigators engaged in evidence-gathering in their own countries and amid ongoing conflict. Next, the article explores efforts to build the capacity of national investigators to conduct safe and ethical evidence-gathering concerning sexual violence, often facing down socio-cultural barriers and other obstacles to effective investigations. Thirdly, the article examines the case-building strategy pursued by initiatives such as the Commission for International Justice and Accountability (CIJA), from ensuring a focus on demonstrating leadership responsibility for crimes of sexual violence by the Syrian military and security apparatus and Islamic State to feeding cases into viable avenues for prosecution. This section explores some of the innovations, good practices and lessons learned in such initiatives in response to challenges arising in sexual offence investigation. Such issues include socio-cultural barriers to effective investigation of SGBV, the risk of creating SGBV silos, and ensuring the safety and wellbeing of national investigators. Finally, the article offers a prognosis for these efforts’ successful contribution to future accountability for conflict-related sexual violence in Syria and Iraq, and concludes with wider lessons for the role of private criminal investigations of this category of criminality and beyond.