bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, Causes, and Timing of 30-Day Readmission following Total Hip Arthroplasty
Authors: Curtis Gannon L. , Jawad Michael , Samuel Linsen T. , Higuera-Rueda Carlos A. , Little Bryan E. , Darwiche Hussein L. 
Published: April 2019

AbstractUnplanned readmissions are associated with increased financial burdens. It is important to understand why they occur and how to reduce them. This study identifies incidences, trends, causes, and timing of 30-day readmissions after total hip arthroplasty (THA). Primary THA cases from 2012 to 2016 in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database were identified (n = 122,451). Fractures (n = 3,990), nonelective surgery (n = 1,715), and bilateral THA (n = 730) were excluded, leaving 116,016 cases. Linear regression analysis determined readmission trends overtime. The readmission rate after THA from 2012 to 16 was 3.32%, which significantly decreased during this time (p = 0.022). The top five causes of readmission included musculoskeletal complications (14.8%), deep surgical site infections (SSI; 11.1%), non-SSI infections (10.8%), gastrointestinal complications (GI; 7.5%), and cardiovascular complications (CV; 7.0%). The most common cause of readmission during week 1 was non-SSI infections (13.0%), week 2 was musculoskeletal complications (16%), week 3 was deep SSI (18.4%), and week 4 was deep SSI (18.6%). Causes of readmission that significantly decreased (p < 0.05) from week 1 to 4 include CV complications, GI complications, non-SSI infections, pain, and respiratory complications. In contrast, causes that significantly increased during this time included deep SSI, prosthesis complications, superficial SSI, and wound complications. Readmissions following THA significantly declined from 2012 to 2016. The most common causes of readmission were musculoskeletal complications, deep SSI, non-SSI infections, GI complications, and CV complications. Interestingly, the most common causes of readmission changed from week to week. These findings may help to develop policies to prevent readmissions following THA.
RAPID COMMUNICATION: Multi-breed validation study unraveled genomic regions associated with puberty traits segregating across tropically adapted breeds1
Authors: Melo Thaise P , Fortes Marina R S , Fernandes Junior Gerardo A , Albuquerque Lucia G , Carvalheiro Roberto 
Published: April 2019

Abstract
An efficient strategy to improve QTL detection power is performing across-breed validation studies. Variants segregating across breeds are expected to be in high linkage disequilibrium (LD) with causal mutations affecting economically important traits. The aim of this study was to validate, in a Tropical Composite cattle (TC) population, QTL associations identified for sexual precocity traits in a Nellore and Brahman meta-analysis genome-wide association study. In total, 2,816 TC, 8,001 Nellore, and 2,210 Brahman animals were available for the analysis. For that, genomic regions significantly associated with puberty traits in the meta-analysis study were validated for the following sexual precocity traits in TC: age at first corpus luteum (AGECL), first postpartum anestrus interval (PPAI), and scrotal circumference at 18 months of age (SC). We considered validated QTL those underpinned by significant markers from the Nellore and Brahman meta-analysis (P ≤ 10–4) that were also significant for a TC trait, i.e., presenting a P-value of ≤10–3 for AGECL, PPAI, or SC. We also considered as validated QTL those regions where significant markers in the reference population were at ±250 kb from significant markers in the validation population. Using this criteria, 49 SNP were validated for AGECL, 4 for PPAI, and 14 for SC, from which 5 were in common with AGECL, totaling 62 validated SNP for these traits and 30 candidate genes surrounding them. Considering just candidate genes closest to the top SNP of each chromosome, for AGECL 8 candidate genes were identified: COL8A1, PENK, ENSBTAG00000047425, BPNT1, ADAMTS17, CCHCR1, SUFU, and ENSBTAG00000046374. For PPAI, 3 genes emerged as candidates (PCBP3, KCNK10, and MRPS5), and for SC 8 candidate genes were identified (SNORA70, TRAC, ASS1, BPNT1, LRRK1, PKHD1, PTPRM, and ENSBTAG00000045690). Several candidate regions presented here were previously associated with puberty traits in cattle. The majority of emerging candidate genes are related to biological processes involved in reproductive events, such as maintenance of gestation, and some are known to be expressed in reproductive tissues. Our results suggested that some QTL controlling early puberty seem to be segregating across cattle breeds adapted to tropical conditions.
How Single Institutional Review Boards Manage Their Own Conflicts of Interest: Findings From a National Interview Study
Authors: Pivovarova Ekaterina , Klitzman Robert L. , Murray Alexandra , Stiles Deborah F. , Appelbaum Paul S. , Lidz Charles W. 
Published: April 2019

Purpose
Conflicts of interest (COIs) are important ethical concerns because they may affect scientific decision making, research integrity, and the safety and fairness of studies. No research to date has examined COIs of single institutional review boards (sIRBs), which are now mandated by the National Institutes of Health, and will be by the revised Common Rule in 2020, for all multisite research. This study investigated how different types of sIRBs manage their own COIs by documenting existing processes for and comparing commercial, government, and academic sIRBs.

Method
One hundred three personnel from 20 commercial, government, or academic sIRBs participated in semistructured interviews about their processes for and experiences with managing COIs when conducting multisite research review.

Results
Variability in COI management policies exist across types of sIRBs. Commercial sIRBs were aware of their own COIs given their for-profit model, and managed them by using firewalls, relying on external reviewers, and turning down potential clients. Government sIRBs described unique COIs stemming from the same agency funding the sIRB and the research being reviewed. They addressed these by discussing concerns about COIs, using firewalls, relying on nonaffiliated reviewers, and having broad COI policies. In contrast to commercial and government sIRBs, academic sIRBs did not report any specific policies to manage their COIs, which are similar to those of local IRBs.

Conclusions
As sIRBs become increasingly common, researchers will need to weigh the different COIs inherent to each type of sIRB. Additionally, academic sIRBs may consider implementing specific policies for managing their COIs.
Respiratory Physiology for the Anesthesiologist
Authors: Bigatello Luca , Pesenti Antonio 
Published: April 2019

Abstract
Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily actions of induction and maintenance of general anesthesia, delivery of mechanical ventilation, discontinuation of mechanical and pharmacologic support, and return to the preoperative state. The current work provides a review of classic physiology and emphasizes features important to the anesthesiologist. The material is divided in two main sections, gas exchange and respiratory mechanics; each section presents the physiology as the basis of abnormal states. We review the path of oxygen from air to the artery and of carbon dioxide the opposite way, and we have the causes of hypoxemia and of hypercarbia based on these very footpaths. We present the actions of pressure, flow, and volume as the normal determinants of ventilation, and we review the resulting abnormalities in terms of changes of resistance and compliance.
Atypical Hemolytic Uremic Syndrome With the p.Ile1157Thr C3 Mutation Successfully Treated With Plasma Exchange and Eculizumab: A Case Report
Authors: Saito Daiki , Watanabe Eizo , Ashida Akira , Kato Hideki , Yoshida Yoko , Nangaku Masaomi , Ohtsuka Yasufumi , Miyata Toshiyuki , Hattori Noriyuki , Oda Shigeto 
Published: April 2019

Objectives:
To describe a case of atypical hemolytic uremic syndrome induced by influenza A infection with the p.Ile1157Thr C3 mutation.

Data Sources:
Clinical observations of a patient.

Study Selection:
Case reports.

Data Extraction:
Data extracted from medical records, after patient’s consent.

Data Synthesis:
Four days prior to presentation to our hospital, a 16-year-old adolescent had a fever and arthralgia with hematuria. He was found to be positive for type A influenza and prescribed oseltamivir and acetaminophen by a primary-care physician. A bleeding tendency and purpura in the extremities and on the trunk developed; therefore, he was transferred to Chiba University Hospital. Hematology revealed severe thrombocytopenia, hyperbilirubinemia, and acute kidney injury. Aspartate aminotransferase, lactate dehydrogenase, and potassium could not be determined because of severe hemolysis. Highly elevated blood urea nitrogen and creatinine levels indicated acute kidney injury. A platelet count of 24,000/μL indicated thrombocytopenia, with low hemoglobin level. Peripheral blood profiling identified schistocytes. Continuous hemodiafiltration and plasma infusion were initiated immediately; however, he became oliguric. Plasma exchange was initiated on ICU day 3, but decreased urine output, hemolysis, and thrombocytopenia persisted. IV eculizumab therapy was initiated on day 7 and resulted in recovery of these symptoms and also successful discontinuation of renal support. The patient showed a stable condition without recurrence of hemolytic findings and acute kidney injury and is currently on maintenance therapy of eculizumab (1,200 mg, every other week) without any relapse of atypical hemolytic uremic syndrome symptoms. A plasma sample collected prior to initiation of plasma exchange showed an disintegrin-like and metalloprotease with thrombospondin type 1 motifs 13 activity level of 104.9%. The absence of both Shiga toxin-producing Escherichia coli in feces led to suspicion of atypical hemolytic uremic syndrome. Subsequent genetic analysis identified a mutation in C3 (p.Ile1157Thr), confirming the diagnosis of atypical hemolytic uremic syndrome.

Conclusions:
Although managing thrombocytopenia secondary to infection, inclusion of atypical hemolytic uremic syndrome in the differential diagnosis at an early stage is important in clinical practice.
Effect of Optisol Supplementation With 0.255 μg/mL Amphotericin B on Elimination of Yeast at 5°C
Authors: Tran Devin , Dhaliwal Deepinder , Kamyar Roheena , Jhanji Vishal , Kowalski Regis P. 
Published: April 2019

Purpose:
Fungal infections in lamellar keratoplasty are a growing concern. Optisol-GS does not contain an antifungal agent and supplementation with 0.255 μg/mL Amphotericin B (AmpB) has been considered. This study tested the ability of 0.255 μg/mL AmpB in Optisol-GS to eliminate yeast contamination of corneal tissue.

Methods:
Three isolates of Candida albicans, 1 of Candida parapsilosis, and 1 of Candida glabrata were tested in Optisol with and without AmpB. Corneoscleral rims stored at −80°C were thawed and placed in 10 multiwell plates (4 per plate). The rims were inoculated with 4 respective loads of yeast: 0, 101, 102, and 103 colony-forming units in 2 sets of 5 for 5 yeasts. One set was filled with Optisol plus AmpB and the other with Optisol only. All 10 plates were incubated at cold storage (2°C–8°C) for 48 hours. After 48 hours, all corneal rims were placed into 10 mL of yeast extract peptone dextrose medium; a swab culture of each well was plated onto Sabouraud plates; and all plates with the remaining Optisol were incubated at 30°C. Yeast growth was monitored for 10 days. Minimum inhibitory concentration and minimum fungicidal concentration were determined.

Results:
All corneoscleral specimens were positive regardless of fungal load or presence of AmpB. All controls remained negative. Minimum inhibitory concentrations and minimum fungicidal concentrations were equivalent and ranged between 0.5 and 2.0 μg/mL.

Conclusions:
AmpB at a concentration of 0.255 μg/mL in Optisol-GS at cold storage (2°C–8°C) over 48 hours did not eliminate yeast from corneal tissue.
Recovery After Campus Tragedy
Authors: Swanchak Lori E. , Bonavoglia Marie 
Published: April 2019

Abstract
School shootings are increasing nationally. In response, campus safety and security efforts have become a priority across the country. Most institutions have developed appropriate emergency response plans, and many have held practice drills. Preparedness typically involves safety during and in the minutes directly following the event. But in the wake of tragedy, long-term recovery is a journey that requires and deserves the same amount of deliberation. The ultimate goal is a return to learning and teaching; however, an intentional focus on full recovery in the aftermath of tragedy is vital.
Improvements in Students' Attitudes Toward People With Disabilities With or Without Semi-Structured Community-Based Interactions
Authors: Jimenez Liliana , Pechak Celia , Garrand Kiersten 
Published: April 2019

Introduction.
Repeated interactions with people with disabilities (PWD) in a Doctor of Physical Therapy (DPT) program could improve students' attitudes toward PWD. This study's purposes were to explore if: 1) a baseline first-year DPT curriculum improved DPT students' attitudes toward PWD; 2) an enhanced first-year DPT curriculum improved DPT students' attitudes toward PWD; and 3) there was a difference between the baseline and the enhanced DPT curriculum related to improving DPT students' attitudes toward PWD.

Methods.
Sixty-four students from 2 DPT cohorts participated in this study. The Attitudes Toward Disabled People (ATDP-A) and Multidimensional Attitudes Scale Toward Persons with Disabilities (MAS) were used. The authors compared the scores of 2 DPT cohorts: 1) a baseline group; and 2) an enhanced curriculum group that had repeated community-based interactions with PWD.

Results.
The baseline group only had improved attitudes according to the MAS (P = .02), whereas the enhanced group demonstrated improvements with bothATDP-A (P = .01) and MAS (P = .01). No significant difference in scores on the ATDP-A (P = .11) and MAS (P = .38) between the baseline and the enhanced curriculum cohort was found.

Discussion and Conclusion.
Regardless of being exposed to the baseline or the enhanced curriculum, DPT students' attitudes toward PWD improved. The baseline group showed improvements according to 1 scale, whereas the enhanced group demonstrated improvements with both scales. Perhaps longer or more frequent interactions with PWD may have produced a difference between the baseline and enhanced groups. Although future research is necessary, this study offers ideas on how to incorporate community-based interactions with PWD in a DPT curriculum.
Hearing Protection, Restoration, and Regeneration: An Overview of Emerging Therapeutics for Inner Ear and Central Hearing Disorders
Authors: Schilder Anne G. M. , Su Matthew P. , Blackshaw Helen , Lustig Lawrence , Staecker Hinrich , Lenarz Thomas , Safieddine Saaid , Gomes-Santos Carina S. , Holme Ralph , Warnecke Athanasia 
Published: April 2019

Objective:
To provide an overview of biotechnology and pharmaceutical companies active in the field of inner ear and central hearing disorders and their therapeutic approaches.

Methods:
Scientific and grey literature was searched using broad search terms to identify companies and their hearing-related therapeutic approaches. For each approach its lead indication, product, therapeutic modality, target, mechanism of action and current phase of clinical development was collated.

Results:
A total of 43 biotechnology and pharmaceutical companies have been identified that are developing therapeutics for inner ear and central hearing disorders. Their therapeutics include drug-, cell- and gene-based approaches to prevent hearing loss or its progression, restore hearing, and regenerate the inner ear. Their therapeutic targets and specific mechanisms of action are wide-ranging, reflecting the complexity of the hearing pathways and the diversity of mechanisms underlying inner ear disorders. While none of the novel products under investigation have yet made it to the clinical market, and a large proportion are still at preclinical phase, many therapeutics have already entered clinical testing with more expected to do so in the next few years.

Conclusion:
A wide range of novel therapeutics targeting different hearing, balance and tinnitus pathways, and patient populations are approaching the clinical domain. It is important that clinicians involved in the care of patients with hearing loss prepare for what may become a radically different approach to the management of hearing disorders, and develop a true understanding of the new therapies’ mechanisms of action, applications, and indications.
Development and Psychometric Evaluation of the Cancer Health Literacy Scale in Newly Diagnosed Cancer Patients
Authors: Chou Hsiu-Ling , Lo Yu-Ling , Liu Chieh-Yu , Lin Shih-Chiang , Chen Yu-Chi 
Published: April 2019

Background
Health literacy (HL) influences a patient’s comprehension and judgment of health-related information. A rigorous assessment tool is needed to screen for low HL in order to improve it.

Objective
The aim of this study was to develop and validate the Cancer Health Literacy Scale (C-HLS).

Methods
The framework of the C-HLS is based on the Levels of Prevention model. The scale items were developed according to Nutbeam’s 3 constructs of HL. We employed several procedures to develop the C-HLS, including focus group interviews, item generation, the expert Delphi process, and face validity. Various types of analysis, including reliability and split-half reliability testing, confirmatory factor analysis, and criterion-related validity testing, were performed; receiver operating characteristic curve analysis was also performed to confirm sensitivity and specificity.

Results
There were 33 items included in the C-HLS for validation; 360 newly diagnosed cancer patients completed the survey. The administration time is only 10 to 15 minutes. Results showed that C-HLS had good reliability, split-half reliability, and validity. All confirmatory factor analysis model fit indices reached acceptable thresholds. The receiver operating characteristic curve analyses suggested that the C-HLS had an adequate combination of sensitivity and specificity to distinguish between high and low HL.

Conclusions
The C-HLS is a reliable, valid tool capable of discriminating levels of HL in the assessment of cancer patients and does not have an excessive administration time.

Implications for Practice
This scale can aid our understanding of HL in newly diagnosed cancer patients and can serve as a basis for providing individual care interventions.
Fathering on Tenuous Ground
Authors: SmithBattle Lee , Phengnum Wisitsri , Shagavah Anne Winnie , Okawa Satoko 
Published: April 2019

Abstract

Background:
Although teen fathers are a vulnerable group of parents, they have received far less attention than teen mothers.

Purpose:
We conducted a systematic search of qualitative studies that examined their prenatal and postpartum experience to better understand teen fathers' concerns, strengths, and vulnerabilities.

Methods:
We searched nine electronic databases through September 2017; 29 studies represented in 30 articles met study criteria. All authors independently extracted data from each article. Coding decisions were reviewed weekly and differences were settled by consensus.

Results:
From pooling the results of 29 primary studies, we describe how a tenuous ground contributes to teen paternity and imperils young fathers' involvement with their children. In the best of circumstances, the ground begins to stabilize for teens who become involved parents despite significant challenges and hardships.

Clinical Implications:
Our results contribute to the visibility of teen fathers and the social disparities that imperil fathering. We provide clinical guidance for strengthening the ground for teen fathers and their families, recognizing that clinicians often encounter challenges such as interpersonal factors and sociocultural conditions that systematically erode fathers' ties to their children, partners, professional caregivers, and institutions.
Synergistic Interaction Increases Complication Rates following Microvascular Breast Reconstruction
Authors: Roy Mélissa , Sebastiampillai Stephanie , Zhong Toni , Hofer Stefan O. P. , O’Neill Anne C. 
Published: April 2019

Background:
Microvascular breast reconstruction is a complex procedure that can be associated with high complication rates. Although a number of individual predictors of perioperative complications have been identified, few studies have explored interaction between risk factors. Understanding the synergistic effects of multiple risk factors is central to accurate and personalized preoperative risk prediction.

Methods:
The authors conducted a retrospective cohort study of patients who underwent microvascular breast reconstruction at their institution between 2009 and 2017. All intraoperative and postoperative complications were recorded. A multivariable logistic regression exploratory model identified independent predictors of complications. Interactions between individual variables were then assessed using the relative excess risk index (RERI) and the synergy index (SI).

Results:
Nine hundred twelve patients were included in the study and 26.1 percent experienced at least one perioperative complication. Obesity (OR, 1.54; p = 0.009), immediate reconstruction (OR, 1.49; p = 0.028), and comorbidities (OR, 1.43; p = 0.033) were identified as independent predictors of complications. Obesity and comorbidities had significant synergistic interactions with immediate reconstruction (RERI, 0.86; SI, 2.35; p = 0.0002; and RERI, 0.54; SI, 1.78; p = 0.001), bilateral reconstruction (RERI, 0.12; SI, 1.15; p = 0.002; and RERI, 0.59; SI, 3.16; p = 0.005), and previous radiotherapy (RERI, 0.62; SI, 4.43; p = 0.01; and RERI, 0.11; SI, 1.23; p = 0.040). Patients undergoing immediate breast reconstruction who were both obese and smokers had a 12-fold increase in complication rates (OR, 12.68; 95 percent CI, 1.36 to 118.46; p = 0.026) with a very strong synergistic interaction between variables (RERI, 10.55; SI, 10.33).

Conclusion:
Patient- and treatment-related variables interact in a synergistic manner to increase the risk of complications following microvascular breast reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.