bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome Measurement Instruments for Provoked Vulvodynia: A Systematic Review
Authors: Davenport Rachael B. , Voutier Catherine R. , Veysey Emma C. 
Published: July 2018

Objective
The objective of this study was to detail the outcome measurement instruments used in randomized control trials and observational studies investigating therapeutic interventions for provoked vulvodynia.

Materials and Methods
We searched Ovid Medline, Embase, Emcare, and PyschINFO libraries from database inception through April 2017. We included randomized control trials and observational studies of provoked vulvodynia that used instruments to measure the outcome of therapeutic interventions.

Results
A total of 2299 articles were retrieved and 25 were eligible for inclusion in accordance with the selection criteria. The included studies measured 26 different outcomes, using 110 outcome measurement instruments. Patient-reported outcomes were most commonly measured (144/166, 86%), followed by physician-reported outcomes (20/166, 12%). The most commonly measured outcomes were patient-reported psychological impact of disease (27/166, 16%), patient-reported improvement in dyspareunia (25/166, 15%), and patient-reported reduction in pain (24/166, 14%). The Pain Catastrophizing Scale, the Beck Depression Inventory, and the State Trait Anxiety Questionnaire were the most commonly used instruments to measure psychological impact.
The most commonly measured clinician-rated outcome was an improvement in pain (17/166, 10%), which was most frequently assessed by the cotton swab test. Only 34 (31%) outcome measurement instruments were specific to vulvodynia (26/110, 23%) or sexual functioning (8/110, 7%).

Conclusions
There is a wide range of outcome measurement instruments used in provoked vulvodynia studies, resulting in inconsistency of reporting and difficulty in comparing and combining findings for systemic review. There is a pressing need for the development of validated, reliable instruments and consensus on a core outcome set for further research purposes.
Curricular Innovations for Teaching Undergraduate Nursing Students Care of Older Adults
Authors: Gray-Miceli Deanna , Morse Catherine 
Published: July 2018

Background
By 2030, 1 in 5 persons will be 65 years or older. To address the health care needs of the burgeoning elderly population, nursing faculty need to use curricular models that are poised to deliver age-appropriate nursing care to the specialized needs of the older adult population.

Problem
The lack of geriatric clinical experiences and clinical faculty who do not have expertise in geriatric nursing assessment create barriers to guide students in learning about care of older adults.

Approach
A new curricular approach to educate prelicensure nursing students about caring for older adults was created, which used 6 types of learning assignments during a 7-week clinical practicum. Students were exposed to interactive learning assignments based on competencies involving interviewing, performance-based assessment, clinical decision making, and problem-based learning.

Outcome
Prelicensure nursing students (n = 124) rated the interactive, performance-based functional evaluation assignment highest for perceived understanding and as the best type of learning experience.
Applying Artificial Intelligence to Identify Physiomarkers Predicting Severe Sepsis in the PICU*
Authors: Kamaleswaran Rishikesan , Akbilgic Oguz , Hallman Madhura A. , West Alina N. , Davis Robert L. , Shah Samir H. 
Published: July 2018

Objectives:
We used artificial intelligence to develop a novel algorithm using physiomarkers to predict the onset of severe sepsis in critically ill children.

Design:
Observational cohort study.

Setting:
PICU.

Patients:
Children age between 6 and 18 years old.

Interventions:
None.

Measurements and Main Results:
Continuous minute-by-minute physiologic data were available for a total of 493 critically ill children admitted to a tertiary care PICU over an 8-month period, 20 of whom developed severe sepsis. Using an alert time stamp generated by an electronic screening algorithm as a reference point, we studied up to 24 prior hours of continuous physiologic data. We identified physiomarkers, including sd of heart rate, systolic and diastolic blood pressure, and symbolic transitions probabilities of those variables that discriminated severe sepsis patients from controls (all other patients admitted to the PICU who did not meet severe sepsis criteria). We used logistic regression, random forests, and deep Convolutional Neural Network methods to derive our models. Analysis was performed using data generated in two windows prior to the firing of the electronic screening algorithm, namely, 2–8 and 8–24 hours. When analyzing the physiomarkers present in the 2–8 hours analysis window, logistic regression performed with specificity of 87.4% and sensitivity of 55.0%, random forest performed with 79.6% specificity and 80.0% sensitivity, and the Convolutional Neural Network performed with 83.0% specificity and 75.0% sensitivity. When analyzing physiomarkers from the 8–24 hours window, logistic regression resulted in 77.1% specificity and 39.3% sensitivity, random forest performed with 82.3% specificity and 61.1% sensitivity, whereas the Convolutional Neural Network method achieved 81% specificity and 76% sensitivity.

Conclusions:
Artificial intelligence can be used to predict the onset of severe sepsis using physiomarkers in critically ill children. Further, it may detect severe sepsis as early as 8 hours prior to a real-time electronic severe sepsis screening algorithm.
Efficacy and Safety of Hepatitis B Vaccination in Rheumatoid Arthritis Patients Receiving Disease-Modifying Antirheumatic Drugs and/or Biologics Therapy
Authors: Intongkam Samanan , Samakarnthai Parinya , Pakchotanon Rattapol , Narongroeknawin Pongthorn , Assavatanabodee Paijit , Chaiamnuay Sumapa 
Published: July 2018

Objectives
The aims of this study were to assess efficacy and safety of the hepatitis B vaccination in rheumatoid arthritis (RA) patients receiving conventional and/or biological disease-modifying antirheumatic drugs (DMARDs).

Methods
A longitudinal open-label study was conducted. Of 46 RA patients, 33 received only conventional synthetic DMARDs, and 13 received both conventional synthetic DMARDs and biological DMARDs, and 9 healthy age- and sex-matched control subjects were vaccinated with 20 μg recombinant hepatitis B vaccine (EuVax B) at weeks 0, 4, and 24. Hepatitis B surface antibody levels were measured 8 weeks after the last dose of vaccination. Seroprotection was defined as hepatitis B surface antibody level of 10 mIU/mL or greater. Disease Activity Score in 28 Joints scores were recorded at weeks 0, 4, and 32 in 46 RA patients who received hepatitis B vaccination and 47 treatment-matched RA patients who did not receive it. Adverse events were recorded at each visit.
Statistical analyses were performed using SPSS version 16.0.

Results
Seroprotection was lower in the RA patients than in the control subjects (64% vs. 100%, p = 0.045). Patients receiving biological DMARDs and conventional DMARDs had a lower proportion of seroprotection compared with the control group (50% vs. 100% [p = 0.02] and 69.7% vs. 100% [p = 0.09], respectively). Among RA patients, responders were younger than nonresponders with a mean age of 57.5 (SD, 9.0) years and 64.9 (SD, 10.9) years (p = 0.04) and less likely to be treated with rituximab (6.9% vs. 37.5%, p = 0.01). Overall, hepatitis B vaccination was well tolerated. The rate of RA flare was not increased after hepatitis B vaccination.

Conclusions
Patients with RA receiving DMARDs had less humoral response to hepatitis B vaccination as compared with control subjects. Aging and rituximab use were associated with impaired response to hepatitis B vaccination. Hepatitis B vaccination is safe and well tolerated in RA patients.
Practical Guidance on Biosimilars, With a Focus on Latin America
Authors: Azevedo Valderilio Feijó , Babini Alejandra , Caballero-Uribe Carlo V. , Castañeda-Hernández Gilberto , Borlenghi Cecilia , Jones Heather E. 
Published: July 2018

Background/Historical Perspective
Availability of biologic disease-modifying antirheumatic drugs (bDMARDs) has improved clinical outcomes in rheumatoid arthritis, but it also increased the cost of treatment. Biosimilars, the regulated copies of biologic products, have a potential to reduce health care costs and expand access to treatment. However, because of a complex development process, biosimilars can be considered only those noninnovator biologics with satisfactory supporting evidence (ranging from structural to clinical), as outlined in the recommendations by the World Health Organization (WHO). In Latin America, a heterogeneous regulatory landscape and nonconsistent approval practices for biosimilars create decision-making challenges for practicing rheumatologists.

Summary of Literature
Most Latin American countries either have adopted or are in the process of adopting guidelines for the approval of biosimilars. However, among several marketed bDMARDs in the region, currently there are only 2 products that could be considered true biosimilars, based on the WHO criteria. The rest can be considered only intended copies, whose safety and efficacy are not fully established. One such product had to be withdrawn from the market because of safety concerns.

Conclusions and Future Directions
Practicing rheumatologists in Latin America need to understand the regulatory situation for biosimilars in their countries. When considering bDMARDs that are not innovator products, clinicians should use only those that have been approved according to the WHO recommendations. For clarification, local health authorities or professional associations should be contacted.
Developing an In-house Interdisciplinary Three-Dimensional Service: Challenges, Benefits, and Innovative Health Care Solutions
Authors: Hatamleh Muhanad M. , Ong Juling , Hatamleh Zaydoon Mohammad , Watson Jason , Huppa Chrisopher 
Published: July 2018

Abstract
Three-dimensional printing (3DP) technologies have been employed in regular medical specialties. They span wide scope of uses, from creating 3D medical models to design and manufacture of Patient-specific implants and guidance devices which help to optimize medical treatments, patient education, and medical training. This article aims to provide an in-depth analysis of factors and aspects to consider when planning to setup a 3D service within a hospital serving various medical specialties. It will also describe challenges that might affect 3D service development and sustainability and describe representative cases that highlight some of the innovative approaches that are possible with 3D technology. Several companies can offer such 3DP service. They are often web based, time consuming, and requiring special call conference arrangements. Conversely, the establishment of in-house specialized hospital-based 3D services reduces the risks to personal information, while facilitating the development of local expertise in this technology. The establishment of a 3D facility requires careful consideration of multiple factors to enable the successful integration with existing services. These can be categorized under: planning, developing and sustaining 3D service; 3D service resources and networking workflow; resources and location; and 3D services quality and regulation management.
Individualized Treatment for Infantile Hemangioma
Authors: Xu Meng-nan , Zhang Min , Xu Yuan , Wang Min , Yuan Si-Ming 
Published: July 2018

Abstract
Infantile hemangioma can grow dramatically or typically locate on the face, which may lead to functional impairment, cosmetically disfiguring and exhibiting complications such as ulceration, bleeding, or infection. Early intervention is necessary. In this study, the authors chose individual treatment for different patients. From January 2012 to December 2016, 185 patients with hemangioma were enrolled into this study. Lesion area ranged from 0.5 cm × 0.5 cm to 9 cm × 12 cm. The initial treatment age ranged from 1 to 7 months with an average age of 3.9 months. Thirty-five children achieved the treatment of Intralesional Compound Betamethasone, 134 children achieved the treatment of oral propranolol, and 16 children achieved the treatment of topical carteolol. In the follow-up, the treatment could be repeated or switched to oral propranolol if the tumor tended to grow again. At the end of follow-up, 89% of the patients’ tumors shrinked or involuted completely, 5 patients switched to oral propranolol. The adverse effects included soft tissue atrophy, moon face, diarrhea, heart rate reduction, and liver enzyme abnormalities. All of the patients recovered in a short period. Early treatment for hemangioma can achieve good results and avoid functional impairment. For different patients, the authors suggest individualized treatment according to the tumors’ size and location.
Persistent Nasal Infantile Hemangioma: A Surgical Treatment Algorithm
Authors: Giugliano Carlos , Reculé Francisca , Guler Kenneth , Gantz José Tomás , Hasbún Trinidad 
Published: July 2018

Abstract
Treatment of infantile hemangioma is usually medical. The nose is one of the most important aesthetic and functional units of the face; therefore, surgical management is preferred in persistent lesions (fibro-fatty tissue component) that do not respond to medical treatment. Herein, the authors analyze the results of surgical nasal hemangioma treatment in their center, a literature review and propose an algorithm for surgical management. A retrospective analysis of 23 persistent nasal hemangioma operated between 1996 and 2014 at our institution was made. The authors recollected the following demographic and clinical data: hemangioma subtype, phase of evolution, affected aesthetic nasal subunit, previous treatment, surgery type, complications and follow-up period. The Strasser scale was chosen for assessment of postoperative photographic results. Surgical treatment was performed. Age average was 6.8 years old (range 2–19). Mixed hemangioma was the most common subtype (83%). Surgery was mainly performed in the involution phase (87%). The most affected aesthetic subunit was nasal tip (44%). All lesions received previous medical treatment. The most common surgical technique was open rhinoplasty approach. Follow-up was an average of 26.6 months. Aesthetic results according to the Strasser method included: 3 excellent scores, 15 good, 5 regular, and none poor. Surgery was performed on patients in order to correct nasal persistent hemangiomas sequel. The nose has serious psychosocial impact and mixed infantile hemangiomas appear to have a higher rate of persistent hemangioma requiring surgery, but further studies are needed. Aesthetic outcome with surgical procedures chosen were acceptable and no complications were reported.
22q11.2 Deletion: Surgical and Speech Outcomes of Patients With Velopharyngeal Insufficiency Treated With a Superiorly Based Pharyngeal Flap as the Primary Surgery
Authors: Álvarez Carvajal Drina C. , Palomares Aguilera Mirta M. , Geldres Meneses María B. , Bravo-Torres Sofía , Giugliano Villarroel Carlos 
Published: July 2018

Abstract
The most frequent palate diagnoses in patients with chromosome 22q11.2 deletion syndrome are a classic submucous cleft, occult, and velopharyngeal insufficiency without cleft, which generates alterations in speech that require surgery. Surgical protocols are controversial owing to syndrome characteristics that make their handling more complex. Pharyngeal flap pharyngoplasty is effective for this type of patient. The objective of this study is to examine the surgical management of velopharyngeal insufficiency in patients with chromosome 22 deletion, using a pharyngeal flap as the primary surgery. The clinical records of patients with chromosome 22 deletion and velopharyngeal insufficiency between 2015 and 2017 were analyzed retrospectively. Eight patients underwent pharyngeal flap pharyngoplasty as a primary surgery, including 1 with velopharyngeal insufficiency without a cleft, 1 with a classic submucous cleft, and 6 with occult submucous cleft. The pre- and postoperative protocol performed by speech therapists and surgeons included clinical evaluation of the oral cavity; perceptual, video recording, and nasometry speech evaluation; and videonasopharyngoscopy. All perceptual parameters and nasometry results significantly changed. Of the cases, 88% achieved a flap with the expected width and height and complete closure of the velopharyngeal sphincter. One patient required flap revision. Four of the 8 patients achieved normal resonance, and 2 of 8 showed mild hypernasality. Using the pharyngeal flap pharyngoplasty as a primary technique to correct velopharyngeal insufficiency in patients with chromosome 22 deletion provides satisfactory outcomes and decreases the number of surgeries. Preoperative planning must be conducted carefully and needs to be individualized to be successful.
Statewide Success of Staged Sacral Neuromodulation for the Treatment of Urinary Complaints in California (2005–2011)
Authors: Dobberfuhl Amy D. , Mahal Amandeep , Dallas Kai B. , Choi Katherine M. , Comiter Craig V. , Elliott Christopher S. 
Published: July 2018

Purpose
Sacral neuromodulation (SNS) is approved by the Food and Drug Administration as a third-line treatment for refractory overactive bladder, idiopathic urinary retention, and fecal incontinence. Prior to implantation of an implantable pulse generator, all patients undergo a trial phase to ensure symptom improvement. The published success rates of progression from the test phase to permanent implant vary widely (range, 24% to >90%). We sought to characterize success rates using a statewide registry.

Methods
Using nonpublic data, we identified SNS procedures using the California Office of Statewide Planning and Development ambulatory surgery database from 2005 to 2011. A successful trial was defined as receiving a stage 2 generator implantation after trial lead placement. Multivariable logistic regression was performed to identify factors associated with staged success.

Results
During the study period, 1396 patients underwent a staged SNS procedure, with 962 (69%) subsequently undergoing generator placement. Successful trial rates were 72% for overactive bladder wet, 69% for urgency/frequency, 68% for interstitial cystitis, 67% for neurogenic bladder, and 57% for urinary retention. On multivariate logistic regression, only male sex (odds ratio, 0.51) and urinary retention [odds ratio, 0.54) were significantly associated with lower odds of success, whereas age, race/ethnicity, medical insurance, and placement at an academic or high-volume institution had no association.

Conclusions
The “real world” success rates for staged SNS implantation in California are less than those observed by some academic centers of excellence but better than previously reported for Medicare beneficiaries. Successful trial rates for interstitial cystitis and neurogenic voiding dysfunction are similar to refractory overactive bladder.
Fungal Lumbosacral Osteomyelitis After Robotic-Assisted Laparoscopic Sacrocolpopexy
Authors: Boyd Brittni , Pratt Toya , Mishra Kavita 
Published: July 2018

Abstract
Sacral osteomyelitis is a rare complication after robotic sacrocolpopexy, with previous reports of enteric and skin flora as inciting organisms. We report a patient who presented with severe low back pain and fever 6 weeks after a robotic sacrocolpopexy, who was subsequently diagnosed as having lumbosacral discitis and osteomyelitis with thoracic intervertebral extension. Empiric antibiotic therapy was initially administered. After laparoscopic mesh excision and abdominal wash out, Candida albicans was isolated from the excised mesh. Postoperatively, the patient was treated with a 12-month course of oral fluconazole with significant clinical improvement. To our knowledge, this is the second reported case of fungal osteomyelitis, providing further recommendations for the management of postoperative sacral osteomyelitis using a minimally invasive surgical technique and guidance by a multidisciplinary team.
WEScover: selection of whole exome sequencing vs. gene panel testing
Authors: Alvarez William Jefferson , Lee In-Hee , Hernandez-Ferrer Carles , Mandl Kenneth D. , Kong Sek Won 
Published: July 2018

AbstractMotivationWhole exome sequencing (WES) is widely adopted in clinical and research settings. However, there is potential for false negatives due to incomplete breadth and depth of coverage for several exons in clinically implicated genes. In some cases, a targeted gene panel testing may be a dependable option to ascertain true negatives for genomic variants in known phenotype associated genes. We developed a tool for quickly gauging whether all genes of interest would be reliably covered by WES or whether targeted gene panel testing should instead be considered to minimize false negatives in candidate genes.ResultsWEScover is a novel web application that provides an interface for discovering breadth and depth of coverage across population scale WES datasets, searching either by phenotype, by targeted gene panels and by gene(s). Moreover, the application shows metrics from the Genome Aggregation Database to provide gene-centric view on breadth of coverage.ConclusionWEScover allows users to efficiently query genes and phenotype for exome coverage of associated exons, and recommends use of panel tests for genes that are potentially not well covered by WES.
The R package Rsubread is easier, faster, cheaper and better for alignment and quantification of RNA sequencing reads
Authors: Liao Yang , Smyth Gordon K. , Shi Wei 
Published: July 2018

AbstractThe first steps in the analysis of RNA sequencing (RNA-seq) data are usually to map the reads to a reference genome and then to count reads by gene, by exon or by exon-exon junction. These two steps are at once the most common and also typically the most expensive computational steps in an RNA-seq analysis. These steps are typically undertaken using Unix command-line or Python software tools, even when downstream analysis is to be undertaken using R.We present Rsubread, a Bioconductor software package that provides high-performance alignment and counting functions for RNA-seq reads. Rsubread provides the ease-of-use of the R programming environment, creating a matrix of read counts directly as an R object ready for downstream analysis. It has no software dependencies other than R itself. Using SEQC data and simulations, we compare Rsubread to the popular non-R tools TopHat2, STAR and HTSeq. We also compare to counting functions provided in the Bioconductor infrastructure packages. We show that Rsubread is faster, uses less memory and produces read count summaries that more accurately correlate with true values. The results show that users can adopt the R environment for alignment and quantification without suffering any loss of performance.