bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Causes the Onset of Psychosis in Individuals at Clinical High Risk? A Meta-analysis of Risk and Protective Factors
Authors: Oliver Dominic , Reilly Thomas J , Baccaredda Boy Ottone , Petros Natalia , Davies Cathy , Borgwardt Stefan , McGuire Philip , Fusar-Poli Paolo 
Published: March 2019

AbstractTwenty percent of individuals at clinical high risk for psychosis (CHR-P) develop the disorder within 2 years. Extensive research has explored the factors that differentiate those who develop psychosis and those who do not, but the results are conflicting.The current systematic review and meta-analysis comprehensively addresses the consistency and magnitude of evidence for non-purely genetic risk and protective factors associated with the risk of developing psychosis in CHR-P individuals. Random effects meta-analyses, standardized mean difference (SMD) and odds ratio (OR) were used, in combination with an established stratification of evidence that assesses the association of each factor and the onset of psychotic disorders (from class I, convincing evidence to class IV weak evidence), while controlling for several types of biases.A total of 128 original controlled studies relating to 26 factors were retrieved. No factors showed class I-convincing evidence. Two further factors were associated with class II-highly suggestive evidence: attenuated positive psychotic symptoms (SMD = 0.348, 95% CI: 0.280, 0.415) and global functioning (SMD = −0.291, 95% CI: −0.370, −0.211). There was class III-suggestive evidence for negative psychotic symptoms (SMD = 0.393, 95% CI: 0.317, 0.469). There was either class IV-weak or no evidence for all other factors.Our findings suggest that despite the large number of putative risk factors investigated in the literature, only attenuated positive psychotic symptoms, global functioning, and negative psychotic symptoms show suggestive evidence or greater for association with transition to psychosis. The current findings may inform the refinement of clinical prediction models and precision medicine in this field.
Global classification and evolution of brushlegged mayflies (Insecta: Ephemeroptera: Oligoneuriidae): phylogenetic analyses of morphological and molecular data and dated historical biogeography
Authors: Massariol Fabiana Criste , Takiya Daniela Maeda , Salles Frederico Falcão 
Published: March 2019

AbstractOligoneuriidae is a Pantropical family of Ephemeroptera, with 68 species described in 12 genera. Three subfamilies are recognized: Chromarcyinae, with a single species from East Asia; Colocrurinae, with two fossil species from Brazil; and Oligoneuriinae, with the remaining species distributed in the Neotropical, Nearctic, Afrotropical and Palaearctic regions. Phylogenetic and biogeographical analyses were performed for the family based on 2762 characters [73 morphological and 2689 molecular (COI, 16S, 18S and 28S)]. Four major groups were recovered in all analyses (parsimony, maximum likelihood and Bayesian inference), and they were assigned to tribal level, namely Oligoneuriini, Homoeoneuriini trib. nov., Oligoneuriellini trib. nov. and Elassoneuriini trib. nov. In addition, Yawari and Madeconeuria were elevated to genus level. According to Statistical Dispersal-Vicariance (S-DIVA), Dispersal Extinction Cladogenesis (DEC) and divergence time estimation analyses, Oligoneuriidae originated ~150 Mya in the Gondwanan supercontinent, but was probably restricted to the currently delimited Neotropical region. The initial divergence of Oligoneuriidae involved a range expansion to Oriental and Afrotropical areas, sometime between 150 and 118 Mya. At ~118 Mya, the family started its diversification, reaching the Nearctic through dispersal from the Neotropical region and the Palaearctic and Madagascar from the Afrotropical region.
Systems Perspective for Incivility in Academia
Authors: Stalter Ann M. , Phillips Janet M. , Ruggiero Jeanne S. , Wiggs Carol M. , Brodhead Josette , Swanson Kathleen 
Published: March 2019

Abstract

AIM
The purpose of this integrative review was to identify evidence of systems thinking on civility in academic settings.

BACKGROUND
Incivility is present in academic systems, including nursing education. What is learned in academia translates to the workplace. Systems-based solutions may promote quality and safety in health care.

METHOD
Whittemore and Knafl’s integrative approach guided this study.

RESULTS
Forty-nine articles were reviewed. Themes emerged describing incivility in nursing as embedded within layers of a performance-driven, oppressive hostile bureaucracy, trickling down, instilling fear, and reinforcing uncivil behavior among and between members. Other themes defined faculty-to-faculty and faculty-to-student incivilities, reasons for it, reactions to it, and suggestions for improved civility.

CONCLUSION
The systems awareness model is offered as a means of promoting civility in nursing education. A lack of evidence to support how incivility in academia transfers to quality and safety in practice settings is identified as a gap for future study.
Internet, Apps, and Tweets: Enhancing Clinical Learning Through Just-in-Time Training
Authors: Serembus Joanne Farley , Hunt-Kada Patricia , Lenahan Kerry , Lydon April 
Published: March 2019

Abstract
Students work in fast-paced environments that do not allow them the time to thumb through books for needed clinical information. At times such as these, just-in-time training using mobile technology comes to the rescue. Apps, tweets, and the Internet are all in the hands of nursing students and can decrease their cognitive load while enhancing clinical learning.
Working Together: Addressing Cultural Diversity, Patient Safety, and Quality Care Through an Interprofessional Health Care Course
Authors: Gambino Kathleen M. , Frawley Stacey , Lu Wei-Hsin 
Published: March 2019

Abstract
An interprofessional course was designed to augment the integration of practice and education in a large, public northeastern university. The schools of medicine, nursing, and social work, along with the associated hospital’s quality assurance team, worked together to design curricula aimed at improving quality of care, communication, collaboration, and teamwork. Development and implementation of the elective course resulted in extended discussions among the schools, complementing the university’s overall initiative to develop a formal interprofessional educational program. Evaluations indicated that participants developed a greater appreciation for the roles of fellow health care professionals and a desire to better utilize their services.
The Effects of Racism in Medical Education on Students’ Decisions to Practice in Underserved or Minority Communities
Authors: Phelan Sean M. , Burke Sara Emily , Cunningham Brooke A. , Perry Sylvia P. , Hardeman Rachel R. , Dovidio John F. , Herrin Jeph , Dyrbye Liselotte N. , White Richard O. , Yeazel Mark W. , Onyeador Ivuoma N. , Wittlin Natalie M. , Harden Kristin , van Ryn Michelle 
Published: March 2019

Purpose
The purpose of this study was to examine the relationship between manifestations of racism in medical school and subsequent changes in graduating medical students’ intentions to practice in underserved or minority communities, compared with their attitudes and intentions at matriculation.

Method
The authors used repeated-measures data from a longitudinal study of 3,756 students at 49 U.S. medical schools that were collected from 2010 to 2014. They conducted generalized linear mixed models to estimate whether manifestations of racism in school curricula/policies, school culture/climate, or student attitudes/behaviors predicted first- to fourth-year changes in students’ intentions to practice in underserved communities or primarily with minority populations. Analyses were stratified by students’ practice intentions (no/undecided/yes) at matriculation.

Results
Students’ more negative explicit racial attitudes were associated with decreased intention to practice with underserved or minority populations at graduation. Service learning experiences and a curriculum focused on improving minority health were associated with increased intention to practice in underserved communities. A curriculum focused on minority health/disparities, students’ perceived skill at developing relationships with minority patients, the proportion of minority students at the school, and the perception of a tense interracial environment were all associated with increased intention to care for minority patients.

Conclusions
This study provides evidence that racism manifested at multiple levels in medical schools was associated with graduating students’ decisions to provide care in high-need communities. Strategies to identify and eliminate structural racism and its manifestations in medical school are needed.
Fostering Student–Faculty Partnerships for Continuous Curricular Improvement in Undergraduate Medical Education
Authors: Scott Kirstin W. , Callahan Dana G. , Chen Jie Jane , Lynn Marissa H. , Cote David J. , Morenz Anna , Fisher Josephine , Antoine Varnel L. , Lemoine Elizabeth R. , Bakshi Shaunak K. , Stuart Jessie , Hundert Edward M. , Chang Bernard S. , Gooding Holly 
Published: March 2019

Problem
A number of medical schools have used curricular reform as an opportunity to formalize student involvement in medical education, but there are few published assessments of these programs. Formal evaluation of a program’s acceptability and use is essential for determining its potential for sustainability and generalizability.

Approach
Harvard Medical School’s Education Representatives (Ed Reps) program was created in 2015 to launch alongside a new curriculum. The program aimed to foster partnerships between faculty and students for continuous and real-time curricular improvement. Ed Reps, course directors, and core faculty met regularly to convey bidirectional feedback to optimize the learning environment in real time.

Outcomes
A survey to assess the program’s impact was sent to students and faculty. The majority of students (202/222; 91.0%) reported Ed Reps had a positive impact on the curriculum. Among faculty, 35/37 (94.6%) reported making changes to their courses as a result of Ed Reps feedback, and 34/37 (91.9%) agreed the program had a positive impact on the learning environment. Qualitative feedback from students and faculty demonstrated a change in school culture, reflecting the primary goals of partnership and continuous quality improvement (CQI).

Next Steps
This student–faculty partnership demonstrated high rates of awareness, use, and satisfaction among faculty and students, suggesting its potential for local sustainability and implementation at other schools seeking to formalize student engagement in CQI. Next steps include ensuring the feedback provided is representative of the student body and identifying new areas for student CQI input as the curriculum becomes more established.
Practicalities of Total Intravenous Anesthesia and Target-controlled Infusion in Children
Authors: Anderson Brian J. , Bagshaw Oliver 
Published: March 2019

Abstract
Propofol administered in conjunction with an opioid such as remifentanil is used to provide total intravenous anesthesia for children. Drugs can be given as infusion controlled manually by the physician or as automated target-controlled infusion that targets plasma or effect site. Smart pumps programmed with pharmacokinetic parameter estimates administer drugs to a preset plasma concentration. A linking rate constant parameter (keo) allows estimation of effect site concentration. There are two parameter sets, named after the first author describing them, that are commonly used in pediatric target-controlled infusion for propofol (Absalom and Kataria) and one for remifentanil (Minto). Propofol validation studies suggest that these parameter estimates are satisfactory for the majority of children. Recommended target concentrations for both propofol and remifentanil depend on the type of surgery, the degree of surgical stimulation, the use of local anesthetic blocks, and the ventilatory status of the patient. The use of processed electroencephalographic monitoring is helpful in pediatric total intravenous anesthesia and target-controlled infusion anesthesia, particularly in the presence of neuromuscular blockade.
Pathogenesis and treatment of autoimmune rheumatic diseases
Authors: Liu Eric , Perl Andras 
Published: March 2019

Purpose of review
Autoimmune diseases are of unknown origin, and they represent significant causes of morbidity and mortality. Here, we review new developments in the understanding of their pathogenesis that have led to development of well tolerated and effective treatments.

Recent findings
In addition to the long-recognized genetic impact of the HLA locus, interferon regulatory factors, PTPN22, STAT4, and NOX have been implicated in pathogenesis of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Smoking, ultraviolet light, diet, and microbiota exert strong environmental influence on development of RA and SLE. Metabolism has been recognized as a critical integrator of genetic and environmental factors, and it controls immune cell differentiation both under physiological and pathological conditions.

Summary
With the advent of high-throughput genetic, proteomic, and metabolomic technologies, the field of medicine has been shifting towards systems-based and personalized approaches to diagnose and treat common conditions, including rheumatic diseases. Regulatory checkpoints of metabolism and signal transduction, such as glucose utilization, mitochondrial electron transport, JAK, mTOR, and AMPK pathway activation, and production of pro-inflammatory cytokines IL-1, IL-6, and IL-17 have presented new targets for therapeutic intervention. This review amalgamates recent discoveries in genetics and metabolomics with immunological pathways of pathogenesis in rheumatic diseases.
Screen Media and Autism Spectrum Disorder: A Systematic Literature Review
Authors: Slobodin Ortal , Heffler Karen Frankel , Davidovitch Michael 
Published: March 2019

ABSTRACT:

Objective:
Previous studies suggest that psychiatric disorders are associated with problematic use of screen media. This article systematically reviews the literature on the associations between screen media and autism spectrum disorder (ASD). The review uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Method:
Electronic databases were searched from inception to April 2018, using the term “ASD/autism” along with one of the following terms: “screen time”/“media”/“computer”/“phone”/“television”/“video game.”

Results:
A total of 16 studies met the inclusion criteria. The studies support the view that children and adolescents with ASD are exposed to more screen time than their typically developing peers or other clinical groups and that the exposure starts at a younger age. The content and context of screen use (e.g., with parents vs alone) may affect the behaviors associated with media exposure. Correlates and long-term consequences of early screen exposure (before the age of 3 years) remain largely unexamined.

Conclusion:
The current review provides important information about how ASD is associated with screen use and exposure. Future longitudinal research should examine the impact of early screen exposure on child development while accounting for potential moderating environmental factors (e.g., socioeconomic status, parent-child relationship). This will help determine whether—and if so, how much—exposure is detrimental and allow appropriate recommendations and interventions related to screen time among children with ASD.
When Children Are Not Read to at Home: The Million Word Gap
Authors: Logan Jessica A. R. , Justice Laura M. , Yumuş Melike , Chaparro-Moreno Leydi Johana 
Published: March 2019

ABSTRACT:

Objective:
In the United States, there are numerous ongoing efforts to remedy the Word Gap: massive differences in heard
vocabulary for poor versus advantaged children during the first 5 years of life. One potentially important resource for vocabulary exposure is children's book reading sessions, which are more lexically diverse than standard caregiver-child conversations and have demonstrated significant correlational and causal influences on children's vocabulary development. Yet, nationally representative data suggest that around 25% of caregivers never read with their children.

Method:
This study uses data from 60 commonly read children's books to estimate the number of words that children are exposed to during book reading sessions. We estimated the total cumulative word exposure for children who are read to at varying frequencies corresponding to nationally representative benchmarks across the first 5 years of life.

Results:
Parents who read 1 picture book with their children every day provide their children with exposure to an estimated 78,000 words each a year. Cumulatively, over the 5 years before kindergarten entry, we estimate that children from literacy-rich homes hear a cumulative 1.4 million more words during storybook reading than children who are never read to.

Conclusion:
Home-based shared book reading represents an important resource for closing the Word Gap.
Promoting Earlier Access to Pediatric Behavioral Health Services with Colocated Care
Authors: Valleley Rachel J. , Leja Ashley , Clarke Brandy , Grennan Allison , Burt Jennifer , Menousek Kathryn , Chadwell Mindy , Sjuts Tara , Gathje Rebecca , Kupzyk Kevin , Hembree Kristen 
Published: March 2019

ABSTRACT:

Objective:
This study aimed to determine whether youth access behavioral health (BH) care earlier (i.e., when problems are less severe) when receiving services in colocated pediatric primary care clinics.

Methods:
Six primary care clinics in the Midwest with a colocated BH provider participated in this study. Data on number of sessions attended/not attended with the BH provider, BH symptom severity as measured by the Child Behavior Checklist, parent report of length of presenting problem, and improvement ratings were collected and compared for on-site referrals and off-site referrals. Descriptive, independent sample t tests and regression analyses compared those referred from on-site physicians versus off-site referral sources.

Results:
Results demonstrated that youth receiving BH services at their primary care physician's office accessed services when problems were less severe and had been impacting their functioning for a shorter duration.

Conclusion:
This study is among the first to explore whether youth receiving BH services in primary care are accessing those services earlier than those who are referred from outside sources, resulting in improved patient outcomes.
Internal Dose Assessment after 131I-Iodide Misadministration in a Patient With Incompletely Blocked Thyroid Uptake: Personalized Internal Dose Assessment by Estimating Individual-Specific Biokinetics
Authors: Kwon Tae-Eun , Park MinSeok , Kang Jin-Kyu , Cho Minsu , Jang Seongjae , Kim Kyeong Min , Ha Wi-Ho , Jin Young Woo 
Published: March 2019

Abstract
In July 2017, a medical accident occurred in South Korea, in which 131I-iodide solution was misadministered to the wrong patient. Although the International Commission on Radiological Protection provided internal dose coefficients for iodine for blocked thyroid, they were not reliable enough for determining the dose to the patient (whose thyroid uptake was incompletely blocked) due to a discrepancy in biokinetics. Therefore, a personalized dose assessment was performed to derive the individual-specific dose coefficients for the patient. Initially, the thyroid biokinetics of the patient were statistically clarified by fitting bioassay monitoring results and the corresponding predicted bioassay values, which were calculated repeatedly for varying iodine transfer rates in an iodine biokinetic model. After determining the transfer rate for the patient, the individual-specific dose coefficients were then calculated in accordance with latest recommendations of the International Commission on Radiological Protection. According to the individual-specific biokinetics, the 24 h thyroid uptake fraction of iodine was estimated as 0.52%. The thyroid absorbed dose of the patient was evaluated as 21.2 Gy, which differed greatly (by about 9 Gy) from the dose evaluated simply using the reference data for blocked thyroid uptake. The personalized dose assessment carried out for the patient not only reduced considerable uncertainties in the internal dose calculation, but also improved the reliability of the calculated internal dose by adopting the latest dosimetric data, including specific absorbed fraction values based on voxel phantoms. Through the dose assessment of the patient, the methodology of personalized dose assessment considering individual-specific biokinetics was developed.
An iPad-based Measure of Processing Speed in Older Adults Hospitalized for Heart Failure
Authors: Gorodeski Eiran Z. , Rosenfeldt Anson B. , Fang Karen , Kubu Cynthia , Rao Stephen M. , Jansen Elizabeth A. , Dey Tanujit , Alberts Jay L. 
Published: March 2019

Background
In older adults hospitalized with heart failure (HF), cognitive impairment is associated with increased hospital readmission and mortality risk. There is no consensus on an objective, scalable method of cognitive screening in this population.

Objective
The aim of this project was to determine the feasibility, test-retest reliability, and convergent validity of the Processing Speed Test (PST), a test of information processing, attention, and working memory administered on an iPad in older adults hospitalized with HF.

Methods
Patients hospitalized with HF (n = 30) and age-, sex-, and education-matched controls (n = 30) participated in the study. To determine test-retest reliability, the PST was administered on an iPad on 2 occasions, separated by 12 to 48 hours. The Symbol Digit Modalities Test was administered at the first testing time point to determine convergent validity.

Results
Test-retest reliability of the PST was 0.80 and 0.92 in individuals with HF and controls, respectively. Convergent validity was 0.72 and 0.90 for individuals with HF and controls, respectively. Time to complete the PST was similar for both individuals with HF and controls (<5 minutes).

Conclusion
The iPad-based deployment of the PST was a feasible, reliable, and valid cognitive screen for older adults hospitalized with HF. Using a tablet-based self-administered cognitive screen in older adults with HF provides a method of cognitive assessment that is amenable to widespread clinical utilization.