bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determination of Eligibility for Influenza Research: A Clinical Informatics Approach
Authors: Silveira Fernanda P , Saul Melissa , Nowalk Mary Patricia , Saul Sean , Sax Theresa M , Eng Heather , Zimmerman Richard K , Balasubramani Goundappa K 
Published: June 2019

Abstract

Background
A clinical informatics algorithm (CIA) was developed to systematically identify potential enrollees for a test-negative, case-control study to determine influenza vaccine effectiveness, to improve enrollment over manual records review. Further testing may enhance the CIA for increased efficiency.

Methods
The CIA generated a daily screening list by querying all medical record databases for patients admitted in the last 3 days, using specified terms and diagnosis codes located in admission notes, emergency department notes, chief complaint upon registration, or presence of a respiratory viral panel charge or laboratory result (RVP). Classification and regression tree analysis (CART) and multivariable logistic regression were used to refine the algorithm.

Results
Using manual records review, 204 patients (&lt;4/day) were approached and 144 were eligible in the 2014–2015 season compared with 3531 (12/day) patients who were approached and 1136 who were eligible in the 2016–2017 season using a CIA. CART analysis identified RVP as the most important indicator from the CIA list for determining eligibility, identifying 65%–69% of the samples and predicting 1587 eligible patients. RVP was confirmed as the most significant predictor in regression analysis, with an odds ratio (OR) of 4.9 (95% confidence interval [CI], 4.0–6.0). Other significant factors were indicators in admission notes (OR, 2.3 [95% CI, 1.9–2.8]) and emergency department notes (OR, 1.8 [95% CI, 1.4–2.3]).

Conclusions
This study supports the benefits of a CIA to facilitate recruitment of eligible participants in clinical research over manual records review. Logistic regression and CART identified potential eligibility screening criteria reductions to improve the CIA’s efficiency.
Imagining Insurance in Japanese High Schools during the Era of Rapid Modernisation: From ‘Distrust’ to the Japanese ‘Spirit’
Authors: WILLIAMSON Piers R , NAGASHIMA Miori 
Published: June 2019

AbstractIndividual private insurance is a risk-management practice that plays an important role in many people’s lives. Despite its prominence in industrialised countries, it remains an understudied area in Japan studies, where most work has focused on social insurance. Using insights from the governmentality literature, and in particular François Ewald’s concept of an ‘insurantial imaginary’, we examine the changing perceptions towards private non-life insurance during Japan’s period of high growth and rapid modernisation (1964–1992). While individual private insurance developed in Western Europe and the US over hundreds of years, it did not take off in Japan until the early postwar era. We argue that, like in Western Europe and the US, individual private insurance in Japan had to overcome normative resistance. The norms in Japan, however, were different. To illustrate this, we look at winning essays from an annual high school writing competition run by the Japanese insurance industry as part of a wide-ranging publicity campaign. We conclude that private insurance in Japan passed through four stages of moral understanding to successfully incorporate existing counter norms centred on ‘sincerity’ and ‘mutual aid’. What was initially viewed with ‘distrust’ ended up as a supposed manifestation of the Japanese ‘spirit’.
3Postcolonial Theory
Authors: Powell Edward 
Published: June 2019

Abstract
This chapter covers selected research in postcolonial theory published in 2018, beginning with books and edited collections before discussing journal special issues. Literary form features in many of these works, particularly as reconsiderations of ‘minor’ genres and their relationship to capitalism. Meanwhile, the place of postcolonial studies itself within capitalism came under new scrutiny, along with that of world literature.
Surgical Management of Fibroadipose Vascular Anomaly of the Lower Extremities
Authors: Wang Kemble K. , Glenn Rachel L. , Adams Denise M. , Alomari Ahmad I. , Al-Ibraheemi Alyaa , Anderson Megan E. , Chaudry Gulraiz , Fishman Steven J. , Greene Arin K. , Shaikh Raja , Trenor Cameron C. , Kozakewich Harry P. , Spencer Samantha A. 
Published: June 2019

Background:
Fibroadipose vascular anomaly (FAVA) is a recently-defined vascular malformation often involving the extremities and presenting in childhood. Patients may present to orthopaedic surgeons with pain, swelling, joint contractures, and leg length discrepancy. There is no established therapy or treatment paradigm. We report on outcomes following surgical excision for patients with this condition.

Methods:
Between 2007 and 2016, all 35 patients that underwent excision of lower-extremity FAVA were retrospectively reviewed using a combination of medical records, radiologic findings, and telemedicine reviews.

Results:
Mean age at initial presentation was 12.3±6.8 years. Mean follow-up from time of definitive diagnosis at our institution was 66 months (range: 12 to 161 mo). Mean follow-up after surgery was 35 months (range: 6 to 138 mo). Females were affected more than males (71% vs. 29%). The most common location of FAVA was in the calf (49%), followed by the thigh (40%). The most commonly involved muscle was gastrocnemius (29%), followed by the quadriceps (26%). At latest follow-up after surgery, there was an improvement in the proportion of patients with pain at rest (63% vs. 29%), pain with activity (100% vs. 60%), as well as analgesia use (94% vs. 37%). Fourteen patients (40%) had symptomatic residual disease or recurrence of FAVA requiring further treatment. Six patients (17%) required further surgery and 6 (17%) required further interventional radiologic procedures. Three patients (9%) required eventual amputation for intractable pain and loss of function. Lesions with direct nerve involvement were associated with persistent neuropathic symptoms at latest follow-up (P=0.002) as well as symptomatic residual disease and/or recurrence requiring further treatment (P=0.01). Seventeen patients (49%) had 19 preoperative joint contractures. Eighteen of the 19 contractures (95%) had sustained improvement at latest follow-up.

Conclusions:
In carefully selected patients, surgical excision of FAVA results in improvement of symptoms. However, symptomatic residual disease and/or recurrence are not uncommon. Direct nerve involvement is associated with a worse outcome.

Level of Evidence:
Level IV—case series.
Life, God, and Help
Authors: Lucas Denise , Bischof Janet , Resick Lenore 
Published: June 2019

ABSTRACT:
Women who work, yet remain poor and uninsured, struggle to live with limited resources. This phenomenological study interviewed 57 such women, hearing how they turned to God or other help to accomplish the major theme of life, with additional themes of God and help. Findings can guide nurses caring for these women to validate the importance of nonmonetary resources and assist in obtaining essential community resources to meet their needs.
Evangelism in Patient Care
Authors: Fowler Marsha D. 
Published: June 2019

ABSTRACT:
Evangelism has been present in modern nursing care from the days of Nightingale in the Crimea. Even so, there is little in the way of ethical analysis and guidance regarding evangelism in healthcare. This article examines Nightingale's concern about evangelism in nursing care; discusses the boundaries established by the 2015 American Nurses Association Code of Ethics for Nurses with Interpretive Statements; and analyzes ethical issues including vocation, power, vulnerability and voluntariness, religious diversity, spiritual care, harm, and the Great Commission. Within the context of ethical analysis, broad guidelines are provided for nurses in clinical practice.
Long-term Effects of Cumulative Average PM2.5 Exposure on the Risk of Hemorrhagic Stroke
Authors: Noh Juhwan , Sohn Jungwoo , Han Minkyung , Kang Dae Ryong , Choi Yoon Jung , Kim Hyeon Chang , Suh Il , Kim Changsoo , Shin Dong Chun 
Published: June 2019

Background:
Epidemiological studies have revealed associations between the fine particle (PM2.5; aerodynamic diameter <2.5 μm) exposure and cardiovascular disease. Researchers have also recently begun investigating the association between PM2.5 exposure and hemorrhagic stroke (HS) and identifying subpopulations vulnerable to PM2.5 exposure. Long-term cumulative average PM2.5 exposure may affect the risk of HS, and these effects may be modified by risk factors.

Methods:
This retrospective study evaluated the effects of PM2.5 on the time-to-first-diagnosis of HS among 62,676 Seoul metropolitan city residents with 670,431 total person-years of follow-up; this cohort is a subset from a nationally representative cohort of 1,025,340 individuals from the Korean National Health Insurance Service database (2002–2013). A time-dependent Cox proportional hazards model was used to adjust for age, sex, household income, insurance type, body mass index, smoking status, medical history, and family history. The annual mean PM2.5 concentrations for 25 districts were used as the time-dependent variable. Subgroup analyses of the traditional risk factors of HS were performed to evaluate potential effect modifications.

Results:
Each 10-μg/m3 increment in cumulative average PM2.5 exposure was noticeably associated with HS (hazard ratio [HR] = 1.43; 95% confidence interval [CI]: 1.09–1.88). The adverse effects of PM2.5 exposure were modified by ≥65 years of age (HR = 2.00; 95% CI = 1.32, 3.02) and obesity (body mass index ≥25 kg/m2; HR = 1.91; 95% CI = 1.28, 2.84).

Conclusions:
Cumulative average PM2.5 exposure might increase the risk of HS. Elderly (≥65 years) and obese individuals may be more vulnerable to the effects of PM2.5 exposure.
The Relationship Between Occupational Exposure to Low-dose Ionizing Radiation and Changes in Thyroid Hormones in Hospital Workers
Authors: Wong Yi-Sin , Cheng Ya-Yun , Cheng Tain-Junn , Huang Chien-Cheng , Yeh Jun-Jun , Guo How-Ran 
Published: June 2019

Background:
The effects of ionized radiation on the thyroid have been extensively studied. However, most studies have focused on high-dose radiation received accidentally or through therapy, and few were on low-dose occupational exposure.

Methods:
Using a retrospective cohort study design, we collected health examination reports from employees who worked on jobs with occupational exposure to radiation at a hospital to evaluate possible changes in the serum thyroid hormones and determine whether there is a dose-response effect. After excluding those with diseases that may affect thyroid function and who were pregnant at any given examination during the study periods we followed the remaining 326 workers for 12 years and evaluated the associations between radiation exposure and changes in serum thyroid hormones using the generalized estimating equation for repeated measures. Data from an external comparison cohort were used to adjust for changes over time.

Results:
We observed declines in triiodothyronine (T3) and thyroxine (T4) over the study period, but not in thyroid-stimulating hormone (TSH). In addition, we found negative dose-response relationships between exposure duration and declines in the serum levels of T3 (a change of −0.037 ng/ml/year after adjusting for sex and age at the beginning of follow-up; 95% confidence interval [CI] = −0.042, −0.032 ng/ml/year) and T4 (−0.115 µg/dl/year; 95% CI = −0.140, −0.091 µg/dl/year). We also observed an increase in the TSH level (0.683 µIU/ml/year; 95% CI = 0.151, 1.214 µIU/ml/year) after the ninth year of follow-up.

Conclusions:
We concluded that despite low exposure doses, occupational exposure to ionizing radiation in healthcare workers still may be associated with the declines in the serum levels of T3 and T4.
Closure of Intractable Enterocutaneous Fistula with a Rectus Abdominis Musculocutaneous Flap
Authors: Hashiguchi Shin-ichiro , Rikimaru Hideaki , Rikimaru-Nishi Yukiko , Ohmaru Youkou , Migita Hisashi , Morihisa Youichiro , Morinaga Keigo , Kiyokawa Kensuke 
Published: June 2019

Summary:
Large enterocutaneous fistulas of the small intestine are rare and difficult to close, particularly if the fistula is associated with massive leakage of digestive juice and the residual intestinal tract is too short for anastomosis. We present a patient who underwent small bowel resection and secondary anastomosis following massive necrosis of the small intestine due to superior mesenteric artery thrombosis. After resection of an enterocutaneous fistula and reanastomosis, the residual small bowel was only 70 cm long with a persistent fistula. We successfully closed the fistula by employing a hinged rectus abdominis musculocutaneous flap. Here, we report our procedure for treating a large enterocutaneous fistula without performing laparotomy and bowel resection.
DIFFERENCE BETWEEN PACHYCHOROID AND NONPACHYCHOROID POLYPOIDAL CHOROIDAL VASCULOPATHY AND THEIR RESPONSE TO ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY
Authors: Chang Yun-Chia , Cheng Cheng-Kuo 
Published: June 2019

Purpose:
Recent investigations have found a biphasic pattern of choroidal thickness within polypoidal choroidal vasculopathy (PCV) patients. This study aims to investigate the relationship between choroidal thickness and the clinical features of PCV eyes.

Method:
We investigated the correlation between various clinical features including subfoveal choroidal thickness (SFCT) and the response to 3-monthly anti–vascular endothelial growth factor (VEGF) treatments in 62 consecutive, treatment-naive PCV patients (66 eyes). After finding out SFCT as the only factor that was correlated with anti-VEGF treatment, we then set up to determine a best cutoff line for SFCT that could be used as a parameter to differentiate PCV patients into pachychoroid and nonpachychoroid groups using the Youden index for best combined specificity and sensitivity. We then compared the demographic features, clinical characteristics, and the response to anti-VEGF between both groups, to determine whether there is a difference between these two groups.

Results:
Subfoveal choroidal thickness was the only significant factor for the treatment effect. The SFCT of 267.5 µm is the best cutoff line. The pachychoroid group showed significant younger ages (64.1 ± 9.6 vs. 72.0 ± 8.2, P = 0.004), fewer age-related macular degeneration–like features (50.0 vs. 81.3%, P = 0.027), more central serous chorioretinopathy–like features (typical retinal pigment epithelial mottling [61.1 vs. 16.7%, P = 0.0014] and choroidal vascular hyperpermeability [88.9 vs. 37.5%, P = 0.0002]), and less response to 3-monthly anti-VEGF treatments (27.8 vs. 83.3%, P < 0.0001) as compared to the nonpachychoroid group.

Conclusion:
Polypoidal choroidal vasculopathy patients could be subclassified into pachychoroid and nonpachychoroid groups. The pachychoroid subtype of PCV has significantly younger ages, fewer age-related macular degeneration–like features, more central serous chorioretinopathy–like features, and less response to anti-VEGF treatment.
NONCONFOCAL ULTRA-WIDEFIELD SCANNING LASER OPHTHALMOSCOPY
Authors: Ajlan Radwan S. , Barnard Luke R. , Mainster Martin A. 
Published: June 2019

Purpose:
Bowtie-shaped polarization artifacts are often present in nonconfocal ultra-widefield scanning laser ophthalmoscope (SLO) images. We studied these artifacts and evaluated their potential value as clinical biomarkers in screening for center-involving diabetic macular edema (DME).

Methods:
We performed a retrospective, observational, cohort study on 78 diabetic adult patients (143 eyes) who had spectral domain optical coherence tomography and nonmydriatic nonconfocal ultra-widefield SLO testing on the same day. Scanning laser ophthalmoscope green-only (532 nm), red-only (635 nm), and composite pseudocolor (532 plus 635 nm) images were examined for the presence of a foveal bowtie polarization artifact.

Results:
Polarization artifacts were absent in all but one eye with center-involving DME (32 of 33 eyes). Polarization artifacts were also absent in many eyes without center-involving DME (49 of 110 eyes in pseudocolor images). As clinical biomarkers of center-involving DME, artifact absence has high specificity (99, 100, and 98% for green, red, and pseudocolor images, respectively) but poor sensitivity (49, 31, and 40% for green, red, and pseudocolor images, respectively).

Conclusion:
Foveal bowtie-shaped polarization artifacts occur routinely in nonconfocal ultra-widefield SLO images. Their presence indicates preserved foveal Henle fiber layer structure. Contemporary nonconfocal ultra-widefield SLO images lack the sensitivity for their bowtie artifacts to serve as reliable biomarkers in screening for center-involving DME.
Comparison of the Effects of Dovitinib and Bevacizumab on Reducing Neovascularization in an Experimental Rat Corneal Neovascularization Model
Authors: Sahan Berna , Ciftci Ferda , Eyuboglu Signem , Yaba Aylin , Yilmaz Bayram , Yalvac Belkıs Ilgaz 
Published: June 2019

Purpose:
To compare the inhibitory effects of dovitinib and bevacizumab for treatment of corneal neovascularization (CNV).

Methods:
Thirty-nine adult female Sprague Dawley rats weighing 180 to 250 g were used. CNV was induced by silver nitrate in the right eye of each rat. After the chemical burn, the animals were randomized into 5 groups. Group 1 did not receive any chemical substance. Group 2 received dimethyl sulfoxide, group 3 received bevacizumab 5 mg/mL, group 4 received dovitinib 5 mg/mL, and group 5 received bevacizumab 5 mg/mL + dovitinib 5 mg/mL topically administered twice daily for 14 days. On the 14th day, slit-lamp examination was performed, and anterior segment photographs were taken. The corneal neovascular area was measured on photographs as the percentage of the cornea's total area using computer imaging analysis. The corneal sections were stained with hematoxylin and eosin for histopathological examination.

Results:
A statistically significant decrease in the percentage of CNV was found in all treatment groups (group 3, group 4, and group 5) compared with the control group (group 1) (P < 0.01). A statistically significant difference in the percentage of CNV was found among group 3, group 4, and group 5 (P = 0.003). The percentage of CNV in group 4 was significantly higher than that in group 3 and group 5 (P
1 = 0.004; P
2 = 0.006). There was no statistically significant difference in the percentage of CNV between group 3 and group 5 (P = 0.228).

Conclusions:
Dovitinib is a newly developed multitargeted tyrosine kinase inhibitor. Topical administration of dovitinib effectively inhibited CNV, but this effect of dovitinib was found less than topical bevacizumab.
Successful Intrathecal Rituximab Administration in Refractory Nonteratoma Anti–N-Methyl-D-Aspartate Receptor Encephalitis: A Case Report
Authors: Casares Maritsa , Skinner Holly J. , Gireesh Elakkat D. , Wombles Christina , Schweitzer Josephine , Gwyn P. Gage , Newton Herbert B. , Makar Sherif M. , Lee Kihyeong , Westerveld Michael 
Published: June 2019

ABSTRACT

N-methyl-D-aspartate receptor (NMDA-R) antibody encephalitis is an immune-mediated disorder characterized by the presence of anti-NMDA antibody in serum and cerebrospinal fluid, with a characteristic combination of psychological and neurological signs and symptoms. The scientific knowledge pertaining to the management of anti–NMDA-R encephalitis is growing. It is important that neuroscience nurses be aware of treatments as well as the newest novel treatment options available. Early aggressive intervention is imperative to recovery. The first line of treatment often includes high-dose steroids, intravenous immunoglobulin, and therapeutic plasma exchange. Second-line therapy for refractory NMDA-R encephalitis includes intravenous rituximab and cyclophosphamide. Even with these treatments, up to 25% of patients may be left with severe deficits or have a fatal outcome.1 It is well known that penetration of monoclonal anti-CD20 antibody therapy (rituximab) into the cerebrospinal fluid is 0.1% of that in the serum.2 Therefore, efficacy of rituximab in the treatment of NMDA encephalitis may be improved by intrathecal administration in selected cases with a poor response to intravenous rituximab. We present a case of anti–NMDA-R encephalitis that was refractory to first- and second-line therapies, who responded to intrathecal rituximab, to highlight a novel treatment that may be able to prevent long-term disability and improve clinical outcomes.
Perinatal Posttraumatic Stress Disorder: A Review of Risk Factors, Diagnosis, and Treatment
Authors: Cirino Nicole H. , Knapp Jacqueline M. 
Published: June 2019

Importance
Perinatal posttraumatic stress disorder (P-PTSD) occurs in approximately 3% to 15% of women in the postpartum period. It is often underrecognized, poorly characterized, and undertreated. If untreated, it can lead to maternal and infant morbidity.

Objective
The aim of this review article is to discuss P-PTSD as it relates to the obstetrician gynecologist, focusing specifically on identifying perinatal risk factors, P-PTSD diagnostic tools, and treatment options.

Evidence Acquisition
PubMed, PsycINFO, Cochrane Library, and Scopus were searched on MeSH terms and free text for terms related specifically to P-PTSD. Because of the lack of data on treatment specifically for the perinatal population, a second search for general PTSD treatment guidelines was conducted and incorporated into this review.

Results
Risk factors have been identified in the literature in 4 major categories: obstetric, psychiatric, social, and subjective distress during delivery.
Two diagnostic tests, the general PTSD diagnostic tool, the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the specific diagnostic tool, the Perinatal Post-Traumatic Stress Disorder Questionnaire, can both be helpful for the clinician to diagnose patients who may have P-PTSD.
Individual trauma-focused psychotherapy is first line for treatment of P-PTSD. Immediate debriefing interventions and non–trauma-focused psychotherapy has not been shown to be helpful. If trauma-focused psychotherapy is not available or not preferred, selective serotonin reuptake inhibitors and non–trauma-focused psychotherapy can be used.

Conclusions and Relevance
Identifying and treating P-PTSD have important implications for maternal and neonatal health. Few treatment studies exist for P-PTSD specifically, so combining P-PTSD research with current guidelines for PTSD is necessary to inform clinical practice.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this CME activity, the participant should be better able to identify several risk factors for the development of PTSD in the perinatal period; describe 2 diagnostic tools to help diagnose and monitor P-PTSD; and compare effective and ineffective treatment options for perinatal PTSD, recognizing the importance of timing of interventions.
An Observational Study of Deep Learning and Automated Evaluation of Cervical Images for Cancer Screening
Authors: Hu Liming , Bell David , Antani Sameer , Xue Zhiyun , Yu Kai , Horning Matthew P. , Gachuhi Noni , Wilson Benjamin , Jaiswal Mayoore S. , Befano Brian , Long L. Rodney , Herrero Rolando , Einstein Mark H. , Burk Robert D. , Demarco Maria , Gage Julia C. , Rodriguez Ana Cecilia , Wentzensen Nicolas , Schiffman Mark 
Published: June 2019

(Abstracted from J Natl Cancer Inst 2019; doi: 10.1093/jnci/djy225)
Ninety-nine percent of cervical cancers cases are caused by infections with a human papillomavirus (HPV). This cancer can be prevented in most women by cervical cancer screening and HPV vaccination.