bluuebunny/crossref_metadata_2025_split huggingface dataset:
Techno-poetics in micro-stories of the digital age: The case of Alex Epstein
Authors: Levin Orna 
Published: May 2019

AbstractIn this study, I frame the concept of techno-poetics by analyzing Alex Epstein’s micro-stories and by examining the development of the micro-fiction genre throughout the world. Epstein is a contemporary Israeli author whose universal micro-stories have been translated into several languages (English, Spanish, French, and Russian). Epstein uses a dual language: given his career as a computer programmer in a high-tech company, the language of his thoughts is conveyed through the logic of technology, whereas, as an artist, he is loyal to the language of poetics. Is Epstein a “programmer” of micro-stories? Within the framework of this study, I analyze the dynamic relationship between the polar opposites of technology and poetics, as it is revealed in Epstein’s micro-stories, taking into account the genre’s characteristics as well as the unique features with which Epstein—as a contemporary author—imbues his works. More specifically, I analyze six categories that describe the relationship between digital technology and the world of art, a relationship that informs Epstein's micro-stories. Epstein's work was not created in a void; nevertheless, his micro-stories differ not only from the works of previous authors of the genre, but also from those of his contemporaries, whose work, likewise, deals with the tension between technology and poetics. A major difference is the methods of publication that Epstein uses, which form part of the techno-poetical process. In this sense, the themes, the conception of art, and the method of publication are all indications of a unique artistic phenomenon.
VoroMQA web server for assessing three-dimensional structures of proteins and protein complexes
Authors: Olechnovič Kliment , Venclovas Česlovas 
Published: May 2019

AbstractThe VoroMQA (Voronoi tessellation-based Model Quality Assessment) web server is dedicated to the estimation of protein structure quality, a common step in selecting realistic and most accurate computational models and in validating experimental structures. As an input, the VoroMQA web server accepts one or more protein structures in PDB format. Input structures may be either monomeric proteins or multimeric protein complexes. For every input structure, the server provides both global and local (per-residue) scores. Visualization of the local scores along the protein chain is enhanced by providing secondary structure assignment and information on solvent accessibility. A unique feature of the VoroMQA server is the ability to directly assess protein-protein interaction interfaces. If this type of assessment is requested, the web server provides interface quality scores, interface energy estimates, and local scores for residues involved in inter-chain interfaces. VoroMQA, the underlying method of the web server, was extensively tested in recent community-wide CASP and CAPRI experiments. During these experiments VoroMQA showed outstanding performance both in model selection and in estimation of accuracy of local structural regions. The VoroMQA web server is available at http://bioinformatics.ibt.lt/wtsam/voromqa.
Kazan Tatar Teacher School: The Global Entanglement of A Local Imperial Institution in The Late Russian Empire
Authors: Tuna Mustafa 
Published: May 2019

Abstract
This article examines the ‘global life’ of a teacher school that Russian imperial officials opened in 1876 to Russify the tsarist empire’s Turkic-speaking Muslim subjects in the Volga-Ural region. Interventions and transformations at the local, imperial and transregional scales over the next several decades altered the context in which this imperial institution the Kazan Tatar Teacher School operated. The school’s effectiveness in achieving its pedagogical goals turned into a political problem for the tsarist center as a result. A Berlin-born German Turkologist in Russian government service designed the school’s curriculum to offer European-inspired secular knowledge. He called it ‘Russian knowledge’ and introduced it to his superiors as a gateway to Russification. He also incorporated Islamic studies and some Muslim daily practices into the school programme to avoid a backlash from the local Muslim population. Over time, a small but vocal cohort of progressivist Muslims took advantage of this programme to acquire conversance in the language and culture of the empire’s evolving cosmopolitan public. As Eurocentric transregional movements from socialism to nationalism permeated that culture, however, the Kazan Tatar Teacher School served as an incubator for politicization among Russia’s Muslims to the ire of the tsarist regime’s centrist advocates and agents.
Cancer-Related Pain Is an Independent Predictor of In-Hospital Opioid Overdose: A Propensity-Matched Analysis
Authors: Onyeakusi Nnaemeka E , Mukhtar Fahad , Gbadamosi Semiu O , Oshunbade Adebamike , Adejumo Adeyinka C , Olufajo Olubode , Owoh Jude 
Published: May 2019

Abstract

Background
About 50% of patients with cancer who have undergone surgery suffer from cancer-related pain (CP). The use of opioids for postoperative pain management presents the potential for overdose, especially among these patients.

Objective
The primary objective of this study was to determine the association between CP and postoperative opioid overdose among inpatients who had undergone major elective procedures. The secondary objective was to assess the relationship between CP and inpatient mortality, total hospital charge, and length of stay in this population.

Methods
Data of adults 18 years and older from the National Inpatient Sample (NIS) were analyzed. Variables were identified using ICD-9 codes. Propensity-matched regression models were employed in evaluating the association between CP and outcomes of interest.

Results
Among 4,085,355 selected patients, 0.8% (N = 2,665) had CP, whereas 99.92% (N = 4,082,690) had no diagnosis of CP. We matched patients with CP (N = 2,665) and no CP (N = 13,325) in a 1:5 ratio. We found higher odds of opioid overdose (adjusted odds ratio [aOR] = 4.82, 95% confidence interval [CI] = 2.68–8.67, P &lt; 0.0001) and inpatient mortality (aOR = 1.39, 95% CI = 1.11–1.74, P = 0.0043) in patients with CP vs no CP. Also, patients with CP were more likely to stay longer in the hospital (12.76 days vs 7.88 days) with higher total hospital charges ($140,220 vs $88,316).

Conclusions
CP is an independent risk factor for opioid overdose, increased length of stay, and increased total hospital charges.
What Does He Think? A Pilot Study Examining Male Knowledge and Attitudes of Long Acting Reversible Contraception [2G]
Authors: George Jessica , Hussain Nuzhath , Hussein Nada 
Published: May 2019

INTRODUCTION:
Contraceptive counseling, especially regarding long acting reversible contraception (LARC), is generally directed at women. However, male partners and peers may influence contraceptive decision making. As there are no published studies examining male perceptions of LARC in the United States, this study investigates male knowledge and attitudes of LARC.

METHODS:
An anonymous electronic cross sectional survey was administered from May to September 2018 to males age 18 to 24 years old. Participants were recruited via university email listservs and in-person at a campus student organization fair. Qualitative and quantitative data were analyzed using SPSS.

RESULTS:
Participants (n=97) are predominantly heterosexual (83.5%) men. Of those who are sexually active (63.9%), 98.4% report female partners and trying to avoid pregnancy. The most commonly used methods of contraception are oral contraceptive pills (48.4%) and condoms (80.6%). The majority (76.3%) of participants have not heard of LARC. Prior LARC use is associated with knowledge of LARC (X2(1,97)=4.26, P<.05); however, this association is not seen with use of other contraceptive methods. Despite large confidence intervals (CI), the magnitude of association suggests prior sex is predictive of knowledge of LARC (OR 1.19 95% CI 0.45-3.11). Participants familiar with LARC are generally neutral to very supportive of LARC (87.0%). Additionally, 80.4% of participants are neutral to very interested in learning more about LARC.

CONCLUSION:
Males age 18 to 24 have limited knowledge of LARC, with an interest in learning more about LARC. This information can be used to shape interventions to bridge knowledge gaps, ultimately helping women make supported contraceptive choices.
Cervical Preparation and Dilation Prior to Second Trimester Abortion [8G]
Authors: Economou Nicole I. , Ihenacho Ugonna , Cortessis Victoria , Natavio Melissa Faith Q. 
Published: May 2019

INTRODUCTION:
Dilation and evacuation (D&E) is the most common method of second trimester abortion in the United States. Cervical preparation prior to the procedure is essential for its safety as inadequate dilation can result in complications including cervical laceration and uterine perforation. This research study explores the relationship between cervical preparation and achieving adequate cervical dilation at the time of D&E.

METHODS:
IRB-approved, retrospective cohort study of patients between 16w0d to 24w0d who underwent overnight cervical preparation with laminaria prior to D&E.

RESULTS:
265 patients met criteria for analysis. Increasing summed cross-sectional area of laminaria was associated with an increase in cervical dilation (as determined by digital exam) at the time of D&E. Cervical dilation of 2.5 cm was adequate to complete all procedures between 16w0d to 19w6d without needing mechanical dilation. Cervical dilation of 3 cm was adequate to complete the majority of procedures (98.2%) between 20w0d to 24w0d without needing mechanical dilation; at 3.5 cm dilation, all procedures were completed without mechanical dilation. Major complication rate was 4% overall and was not increased in those needing additional mechanical dilation, regardless of gestational age. All procedures were completed as scheduled; none were cancelled or delayed due to inadequate dilation.

CONCLUSION:
The goal of cervical preparation should be to achieve a dilation of at least 2.5-3 cm in order to complete the majority of D&E procedures without need for mechanical dilation. Data analysis is ongoing to determine the optimal number and size of laminaria needed to achieve these levels of cervical dilation.
An Evaluation of the Maternal and Neonatal Characteristics Associated With Preterm Birth in Haiti [24G]
Authors: Buckley Ayisha , Persad Malini D. , Milone Gina F. , Pardo Christina , Davilmar Inolson , Garretto Diana J. 
Published: May 2019

INTRODUCTION:
Haiti is an impoverished country with poor health infrastructure and pregnancy outcomes. In Haiti, a 2010 study estimated the preterm birth (PTB) rate to be 14.1%, similar to the United States. Few studies have assessed PTB in Haiti. We aim to characterize maternal and perinatal characteristics associated with PTB in Haiti.

METHODS:
IRB-approved, retrospective cohort study from January 2017 to May 2017 looking at all deliveries at St. Damien Hospital. 423 paper charts were reviewed. Patients were placed into 2 groups based on gestational age at time of delivery (<37 weeks defined as PTB). Parametric and non-parametric statistics were used to analyze the data, P-value <.05 was significant.

RESULTS:
The incidence of PTB was 24.3% (103/320). The average gestational age in the PTB group was 31.9 weeks, vs. 39.3 in the non-PTB group (P<.001). Patients with PTB were more likely to have chronic hypertension (6.8% vs. 2.2%, P<.02) or preeclampsia with severe features (33.0% vs. 8.8%, P<.001), and receive antenatal steroids (31.1% vs. 0.6%, P<.001) and magnesium sulfate (32.0% vs. 8.1%, P<.001). 13.5% of patients with PTB had oligohydramnios (P<.005) and 4.9% had fetal growth restriction (P<.02). PTB neonates were more likely to be small for gestational age (18.4% vs. 9.7%, P<.001), have lower 5-minute Apgar scores (P<.001), and respiratory distress syndrome (7.8% vs. 1.3%, P<.001).

CONCLUSION:
The incidence of PTB in Haiti was higher than previously estimated, although studies are lacking. This innovative study further characterizes PTB, its risk factors, outcomes and potential areas of intervention in the Haitian population.
Antenatal Ultrasound Compared to MRI Evaluation of Fetal Myelomeningocele: A Prenatal and Postnatal Evaluation [28G]
Authors: Munoz Jessian Louis , Bishop Elaine , Reider Mitchell , Singh Katherine 
Published: May 2019

INTRODUCTION:
Spina bifida affects 0.5-1 in 1000 pregnancies in the United States. Imaging has played a major role in pregnancies complicated by spinal defects. Our goal was to directly compare ultrasounds and MRI obtained antenatally in the diagnosis and localization of fetal myelomeningocele and compare these to the postnatal outcomes of these infants.

METHODS:
A retrospective analysis of patients referred to the Fetal Care Center at the Cleveland Clinic from 2005-2017. Ultrasounds and MRIs were obtained within the Cleveland Clinic electronic medical record. Infants were followed up at an interdisciplinary myelomeningocele pediatrics clinic.

RESULTS:
MRI and US varied in correlation with physical exam at time of birth and surgery. While no differences were detected in demographics, pregnancy outcomes or pediatric outcomes, it was noted the majority of patients developed neurogenic bladders irrespective of lesion level.

CONCLUSION:
MRI is not superior to US in the diagnosis of MMC. Pregnancies complicated by MMC do not vary in morbidity and pediatric outcomes remain similar regardless of level of lesion. This data provides additional information for the counseling of patients when faced with this antenatal diagnosis.
Are There Characteristics Associated With Hypertension Beyond the Fourth Trimester? [32G]
Authors: Weeks Corinne M. , Marcov Lauren J. , Lynch Kerry , Wiese Sarah L. , Leung Katherine , Leftwich Heidi Kay 
Published: May 2019

INTRODUCTION:
Literature reports women with hypertensive disorders of pregnancy are at threefold increased risk of having hypertension and twofold increased risk of developing cardiovascular disease later in life. We sought to identify characteristics associated with hypertension in the 12 weeks to 24 months postpartum period.

METHODS:
We performed an IRB approved, retrospective cohort study on postpartum hypertension from deliveries from 07/09 to 07/16. Inclusion criteria were delivery at our institution, presence of a hypertensive disorder of pregnancy, and a documented blood pressure between 12 weeks to 24 months postpartum. Exclusion criteria were discharge home on antihypertensive medication. Postpartum hypertension was defined as a systolic blood pressure ≥-140 or diastolic blood pressure ≥90. Chi-square test was used for categorical and Student T-test was used for continuous variables.

RESULTS:
697 women met inclusion and exclusion criteria. Of these women, 245 were identified as having hypertension 12 weeks to 24 months postpartum. Women with hypertension were more likely to be older (p=0.046), have a higher pre-pregnancy BMI (p<0.001), and be multiparous (p=0.002). There was a statistically significant difference in hypertension when comparing the hypertensive disorders of pregnancy (p<0.001). There were no differences amongst other study variables.

CONCLUSION:
Of the women who delivered at our institution with a hypertensive disorder of pregnancy, 35% had hypertension in the 12 weeks to 24 months postpartum period. Characteristics more likely associated with postpartum hypertension include older age, higher pre-pregnancy BMI, and multiparity. These characteristics may be important to consider when counseling patients on the importance of continued follow up beyond the fourth trimester.
Association Between Hemoglobin A1C and Hypertensive Disorders in Type 2 Diabetics [34G]
Authors: Holthaus Emily , Singh Katherine 
Published: May 2019

INTRODUCTION:
Pre-gestational type 2 diabetes is increasing in prevalence and is known to be associated with poor pregnancy outcomes. There is conflicting data about the association between hemoglobin A1c (HbA1c) and pregnancy outcomes, with very limited data specifically examining type 2 diabetics. This is a retrospective cohort study examining patients with pre-gestational type 2 diabetes who delivered within the Cleveland Clinic system between 2012 and 2018.

METHODS:
Type 2 diabetics were identified using ICD code extraction from pregnancy episodes. IRB approval was obtained. We examined the association between gestational HbA1c and a pooled hypertension outcome which included gestational hypertension, preeclampsia with and without severe features, eclampsia, and pregnancy induced hypertension. Odds ratios with 95% confidence intervals were calculated for first, second, and third trimester HbA1c values.

RESULTS:
We identified 611 pregnancy episodes with pre-gestational type 2 diabetes diagnoses. No differences in age, race, BMI, or parity were found between the two groups. Increased first trimester HbA1c was more likely to result in the pooled hypertension outcome (Odds ratio 1.25, 95% CI 1.03-1.52), while second trimester HbA1c (OR 1.25, 95% CI 0.97-1.61) and third trimester HbA1c (OR 1.23, 95% CI 0.96-1.57) were not found to have statistically significant associations with the pooled outcome.

CONCLUSION:
Our analysis show a positive association between first trimester HbA1c and our pooled hypertension outcome. Utilizing HbA1c may be of benefit in our rapidly growing patient population of type 2 diabetics, particularly in those presenting late to care or those diagnosed in early screening.
Evaluating the Impact of a Student-Run Clinic on Expanding Access to Gynecologic Care for Uninsured Patients [36G]
Authors: Kumar Natasha Raj , DuVernois Gabriele , Almeida-Monroe Valerie , Siegert Nicole , DeGroot Annie 
Published: May 2019

INTRODUCTION:
Significant disparities in access to gynecologic services persist for uninsured women, who are far less likely to obtain preventive screenings against breast or cervical cancer than insured women. Safety net institutions reduce health disparities, but gaps in service provision for gynecologic services remain. Student-run clinics, or clinics coordinated and staffed by medical students that are supervised by licensed physicians, provide preventive services at rates similar to other safety net institutions.

METHODS:
A retrospective chart review examined the prevalence of gynecologic issues addressed by a student-run women's clinic at a free clinic in Providence, Rhode Island and quantified the service provision provided to this population of uninsured, predominantly Latina women.

RESULTS:
Between May 2015 and 2017, the women's clinic saw 138 patients over 171 encounters during 48 clinics. Most visits included Pap smears or mammograms (85.2%). Other prevalent issues were abnormal uterine bleeding (23.9%), contraception (13.0%), abnormal vaginal discharge (12.3%), and infertility (11.6%). The clinic provided 83 Pap smears, 35 STI tests, 19 vaginitis screens and referrals for mammograms (n=42), colposcopy (n=7), and sub-specialists (n=14). Culturally sensitive interventions were designed to address linguistic and social barriers to care for patients seeking subspecialty care.

CONCLUSION:
Student-run clinics can effectively deliver gynecologic services to safety net populations. With their unique access to faculty preceptors and funding, medical students can play a significant role in expanding the specialty services available to uninsured patients. Safety net institutions should consider empowering medical students to create student-run specialized clinics under appropriate supervision to address the needs of their patient populations.
Impact of Sex Assessment Methodology on Natal Sex-Specific Condition Data: Pap Smears and Transmen [38G]
Authors: Crissman Halley P. , Berger Mitchell B. , Stroumsa Daphna 
Published: May 2019

INTRODUCTION:
Most surveys use a single question to assess sex. The recommended two-step process asks two questions, sex assigned at birth and current gender identity, which better identifies gender minority populations. We use Pap smear data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine the impact of single question sex assessment on natal sex-specific condition data.

METHODS:
We analyzed data among people eligible for Pap smears in the 2014-2016 BRFSS (n= 294,171). In 2014-2015 “sex” was determined by interviewers' perception with “clarification if necessary;” in 2016 respondents were asked, “Are you male or female?” “Females” were asked about Paps. Transgender status was determined by asking “Do you consider yourself to be transgender?” We analyzed the “sex” and transgender status of respondents that were and were not asked about Paps using design-adjusted chi-square tests.

RESULTS:
Half of transmen (48.7%), compared to two-thirds (69.8%) of ciswomen, were asked whether they ever had a Pap (p-value <0.001). Sex was coded “male” for 31.8% (24.9-43.0%) of transmen. Pap data was not collected for any individuals coded as “male”. Among transmen labeled “female” there was no difference in those asked about Paps (71.4%) compared to ciswomen (69.8%, p-value=0.709). Of those who were asked, 17.5% of transmen had never had a pap compared to 6.8% of ciswomen (p-value <0.001).

CONCLUSION:
Transmen are less likely to be asked about, or to have had, a Pap than ciswomen. With a single sex question, surveys fail to capture natal sex-specific conditions accurately in gender minority populations.
Implementation of a Standardized Integrated Screening Tool to Identify Behavioral Risks in Pregnancy [39G]
Authors: Dean Sara , Fox Karin , Denning Stacie , Jackson Aimee , Gandhi Manisha 
Published: May 2019

INTRODUCTION:
Pregnancy provides a unique opportunity to identify women exposed to risky behavior. Standardization has proven to decrease variability and improve quality of care across a breadth of disciplines. We aimed to increase screening and detection of behavioral health risks by introducing the standardized Integrated Screening Tool (IST). The IST uses 11 yes or no questions to screen for patient, peer and family substance use, domestic violence, and emotional health, and takes less than 3 minutes to complete.

METHODS:
We retrospectively reviewed 100 charts to evaluate baseline rates of screening. No standard tool was used at baseline. In January 2018, we launched universal screening using the IST at intake, 28-week, and 36-week visits within the Maternal-Fetal Medicine ambulatory clinic. Clinical staff instructed all patients to complete the IST while awaiting the provider. We reviewed 186 active patients' charts from January to July 2018.

RESULTS:
During the study period, 295 screening visits occurred. Chart review of these visits revealed 90% of opportunities to screen were completed compared to only 65% at baseline. Positive screens were significantly higher at intake and 28-week visits than when compared to baseline (33% vs 16% [P=.006], and 26% vs 11% [P=.017], respectively).

CONCLUSION:
Our data demonstrate a standardized, written tool increases screening in our patient population and significantly increases the detection of positive screens in pregnant patients. Identification of behavioral health risks in pregnancy can lead to potential interventions to mitigate the effect of these behaviors.