bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apheresis to Mitigate Atherosclerotic Vascular Disease
Authors: Sachais Bruce S , Shaz Beth H 
Published: April 2018

Abstract

BACKGROUND
Therapeutic apheresis is a term used to describe a group of treatments where blood components are separated in real time, and one component is removed, exchanged, and/or treated to remove pathogenic substances from the circulation. Plasma exchange, which removed all plasma components, and lipid apheresis which selectively removes lipoproteins from circulation, have both been used to treat atherosclerotic vascular diseases.

METHODS
To review the literature regarding the application of therapeutic apheresis for atherosclerotic vascular diseases.

RESULTS
Primarily lipid apheresis is used to treat atherosclerotic vascular diseases, particularly familial hypercholesterolemia, lipoprotein (a) hyperlipoproteinemia and peripheral vascular diseases. Lipid apheresis can be used as first line or second line treatment with a strong evidenced-based recommendation. Its use has decreased atherosclerotic events.

CONCLUSION
Lipid apheresis is an important therapy for the treatment of familial hypercholesterolemia, lipoprotein (a) hyperlipoproteinemia and peripheral vascular diseases. Lipid apheresis does more than remove low-density lipoproteins and other lipoproteins but also decreases inflammatory markers and improves blood flow.
RANGER-DTL 2.0: rigorous reconstruction of gene-family evolution by duplication, transfer and loss
Authors: Bansal Mukul S , Kellis Manolis , Kordi Misagh , Kundu Soumya 
Published: April 2018

Abstract

Summary
RANGER-DTL 2.0 is a software program for inferring gene family evolution using Duplication-Transfer-Loss reconciliation. This new software is highly scalable and easy to use, and offers many new features not currently available in any other reconciliation program. RANGER-DTL 2.0 has a particular focus on reconciliation accuracy and can account for many sources of reconciliation uncertainty including uncertain gene tree rooting, gene tree topological uncertainty, multiple optimal reconciliations and alternative event cost assignments. RANGER-DTL 2.0 is open-source and written in C++ and Python.

Availability and implementation
Pre-compiled executables, source code (open-source under GNU GPL) and a detailed manual are freely available from http://compbio.engr.uconn.edu/software/RANGER-DTL/.

Supplementary information
Supplementary data are available at Bioinformatics online.
Investigating Predictors of Cognitive Decline Using Machine Learning
Authors: Casanova Ramon , Saldana Santiago , Lutz Michael W , Plassman Brenda L , Kuchibhatla Maragatha , Hayden Kathleen M 
Published: April 2018

Abstract

Objectives
Genetic risks for cognitive decline are not modifiable; however their relative importance compared to modifiable factors is unclear. We used machine learning to evaluate modifiable and genetic risk factors for Alzheimer’s disease (AD), to predict cognitive decline.

Methods
Health and Retirement Study participants, aged 65–90 years, with DNA and &gt;2 cognitive evaluations, were included (n = 7,142). Predictors included age, body mass index, gender, education, APOE ε4, cardiovascular, hypertension, diabetes, stroke, neighborhood socioeconomic status (NSES), and AD risk genes. Latent class trajectory analyses of cognitive scores determined the form and number of classes. Random Forests (RF) classification investigated predictors of cognitive trajectories. Performance metrics (accuracy, sensitivity, and specificity) were reported.

Results
Three classes were identified. Discriminating highest from lowest classes produced the best RF performance: accuracy = 78% (1.0%), sensitivity = 75% (1.0%), and specificity = 81% (1.0%). Top ranked predictors were education, age, gender, stroke, NSES, and diabetes, APOE ε4 carrier status, and body mass index (BMI). When discriminating high from medium classes, top predictors were education, age, gender, stroke, diabetes, NSES, and BMI. When discriminating medium from the low classes, education, NSES, age, diabetes, and stroke were top predictors.

Discussion
The combination of latent trajectories and RF classification techniques suggested that nongenetic factors contribute more to cognitive decline than genetic factors. Education was the most relevant predictor for discrimination.
Coaching Teamwork in the Classroom Using an Innovative Team-Coaching Process
Authors: Petty Gayle M. , Lingham Tony 
Published: April 2018

Abstract
The importance of health professionals working in teams was first acknowledged by the Institute of Medicine more than 15 years ago. Since then, teaching students to function in teams continues to present challenges in nursing education. This article presents an innovative process, using faculty as coaches in the classroom, to enhance student learning through experiential teamwork.
Nontraditional Academic-Community Partnership: A Survey of Student Knowledge and Competencies
Authors: Sarsfield Eileen , Burkhard Agnes 
Published: April 2018

AbstractThis pilot study examined student perceptions of the acquisition of core knowledge and basic community/public health generalist competencies gained through an innovative, nontraditional clinical partnership with an organization serving a vulnerable population. The Centers for Disease Control and Prevention Workplace Health Model was the conceptual framework. A survey, based on theEssentials of Baccalaureate Nursing Education for Entry Level Community/Public Health Nursing Practice,was completed by 25 BSN nursing students. Students rated the experience as influential/extremely influential in the areas of human diversity, health promotion/risk reduction, and communication. Findings suggest that students can achieve community/public health competencies in nontraditional community settings.
Anxiety of Active and Passive Role Groups in Clinical Simulation: A Pilot Study
Authors: Smith Tedra S. , Hogewood Connie , Etheridge Sherita , Britt Sylvia , Vance David E. 
Published: April 2018

Abstract
Clinical simulation within nursing programs is a hallmark teaching strategy. With faculty challenged to design effective simulations for large groups of students, students are often divided into an active or passive role group. This study examined the anxiety levels experienced by students in the two roles. Results indicated that trait anxiety was similar in both groups before and after the simulation; however, there was a significant decrease in state anxiety ratings in the active role group following the simulation. The finding that students in the active role group experienced reduced state anxiety can theoretically facilitate learning.
Impact of Intravenous Acetaminophen on Perioperative Opioid Utilization and Outcomes in Open Colectomies
Authors: Wasserman Isaac , Poeran Jashvant , Zubizarreta Nicole , Babby Jason , Serban Stelian , Goldberg Andrew T. , Greenstein Alexander J. , Memtsoudis Stavros G. , Mazumdar Madhu , Leibowitz Andrew B. 
Published: April 2018

Abstract

Background
The value of intravenous acetaminophen in postoperative pain management remains debated. The authors tested the hypothesis that intravenous acetaminophen use, in isolation and in comparison to oral, would be associated with decreased opioid utilization (clinically significant reduction defined as 25%) and opioid-related adverse effects in open colectomy patients.

Methods
Using national claims data from open colectomy patients (Premier Healthcare Database, Premier Healthcare Solutions, Inc., USA; 2011 to 2016; n = 181,640; 602 hospitals), we separately categorized oral and intravenous acetaminophen use: 1 (1,000 mg) or more than 1 dose on the day of surgery, postoperative day 1, or later. Multilevel models measured associations between intravenous or oral acetaminophen and (1) opioid utilization and (2) opioid-related adverse effects. Percent change and multiplicity-adjusted 99.5% CI are reported.

Results
Overall, 25.1% of patients received intravenous acetaminophen, of whom 48.0% (n = 21,878) received 1 dose on the day of surgery. In adjusted analyses, particularly more than 1 dose of intravenous acetaminophen (versus nonuse) on postoperative day 1 was associated with a −12.4% (99.5% CI, −15.2 to −9.4%) change in opioid utilization. In comparison, a stronger reduction was seen in those receiving more than 1 oral acetaminophen dose: −22.6% (99.5% CI, −26.2 to −18.9%). Unadjusted group medians were 550 and 490 oral morphine equivalents, respectively. Intravenous versus oral differences were less pronounced among those receiving more than 1 acetaminophen dose on the day of surgery: −8.0% (99.5% CI, −11.0 to −4.9%) median 499 oral morphine equivalents versus −8.7% (99.5% CI, −14.4 to −2.7%) median 445 oral morphine equivalents, respectively; all statistically significant, but none clinically significant. Comparable outcome patterns existed for opioid-related adverse effects.

Conclusions
The demonstrated marginal effects do not support routine use of intravenous acetaminophen given alternative nonopioid analgesic options.
Role of Network Science in the Study of Anesthetic State Transitions
Authors: Lee UnCheol , Mashour George A. 
Published: April 2018

Abstract
The heterogeneity of molecular mechanisms, target neural circuits, and neurophysiologic effects of general anesthetics makes it difficult to develop a reliable and drug-invariant index of general anesthesia. No single brain region or mechanism has been identified as the neural correlate of consciousness, suggesting that consciousness might emerge through complex interactions of spatially and temporally distributed brain functions. The goal of this review article is to introduce the basic concepts of networks and explain why the application of network science to general anesthesia could be a pathway to discover a fundamental mechanism of anesthetic-induced unconsciousness. This article reviews data suggesting that reduced network efficiency, constrained network repertoires, and changes in cortical dynamics create inhospitable conditions for information processing and transfer, which lead to unconsciousness. This review proposes that network science is not just a useful tool but a necessary theoretical framework and method to uncover common principles of anesthetic-induced unconsciousness.
Management of Tibial Bow in Fibular Deficiency
Authors: Westberry David E. , Carpenter Ashley M. , Barrera John , Westberry Alison 
Published: April 2018

Background:
Deformity of the tibia, including shortening and angulation, may accompany severe forms of postaxial hypoplasia (fibular deficiency). The current literature reflects varying opinions on the appropriate management for tibial deformity in the setting of fibular deficiency.

Methods:
We performed a retrospective review to determine outcomes of tibial deformity correction in patients with a primary diagnosis of fibular deficiency. Clinical and radiographic outcomes of patients treated with foot ablation were reviewed to establish indications for tibial deformity correction, identify occurrence of additional surgical procedures related to limb alignment or deformity, and characterize difficulties with prosthetic wear potentially related to residual or recurrent tibial deformity.

Results:
From 1989 to 2016, 51 patients (57 extremities) with fibular deficiency were managed with a foot ablation procedure. Twenty-five (44%) had simultaneous correction of the tibial deformity. The initial tibial deformity measured 42.5 degrees, was corrected to 5.6 degrees intraoperatively, and measured 18.6 degrees at follow-up, suggesting recurrent deformity. In follow-up, approximately half of the patients complained of redness and one third complained of a continued prominence along the anterior tibia. Thirty-two extremities had an isolated foot ablation procedure without tibial osteotomy. Radiographic review demonstrated mild tibial bowing at the time of amputation with a mean angular deformity of 15.4 degrees and remained unchanged during the follow-up period (mean, 12.7 degrees). Similar to the osteotomy group, approximately half of the patients complained of redness and erythema over the anterior bow, with one fourth noting prominence, and only 2 reporting significant pain.

Conclusions:
Tibial osteotomies in patients with more significant degrees of angular deformity can be safely performed at the same setting as foot ablative procedures for fibular deficiency. Recurrent deformity with growth may occur. Patients and their caregivers should be aware that rebound deformity may occur, but typically can be managed with prosthetic adjustment and without significant disruption to the child’s daily activities.

Level of Evidence:
Level IV (case series).
The Effect of Booster Seat Use on Pediatric Injuries in Motor Vehicle Frontal Crashes
Authors: Caskey Sean , Hammond Joshua , Peck Jeffrey , Sardelli Matthew , Atkinson Theresa 
Published: April 2018

Background:
Motor vehicle crashes are a significant source of pediatric mortality and morbidity. Studies indicate that booster seats significantly improve seat belt fit for children who have not attained a height of 145 cm (4’ 9”). This study examined injuries occurring in booster age children up to age 12, as the majority of children do not attain 145 cm until this age. The purpose of the study was to identify differences in injuries due to the type of restraint used, with attention to musculoskeletal injuries.

Methods:
Vehicle and occupant data were obtained from a publically available statistical sample of tow-away crashes. Frontal crashes over an 8-year period were examined. A data set of cases was created involving children ages 5 to 12 years who were unrestrained, restrained using the vehicle’s lap and shoulder belt, and restrained using a booster seat with the vehicle’s lap and shoulder seat belt. Injury severity, frequency, and patterns of distribution were compared.

Results:
Unrestrained children experienced moderate to severe injuries 3.8 to 19 times more frequently than children using restraints. There were more injuries to the head and face in unrestrained versus restrained children, but the head and face was the most frequently injured region for all groups. There were no serious cervical spine injuries reported for any group. Lower extremity fractures were not observed in booster seat users but occurred at similar rates in both unrestrained and seat belt restrained children. These fractures occurred in older children who were involved in more severe crashes.

Conclusions:
Unrestrained children were more likely to experience moderate and severe injuries than restrained children. The data sample suggests that booster use may reduce the risk of extremity fracture, as there were no extremity fractures in children restrained with booster seats.

Clinical Relevance:
This work provides evidence for the efficacy of booster use for preventing orthopaedic injury in children. This evidence can be used to inform parents and establish recommendations for best practices in transporting children.
Prognostic Significance of Nodal Location and Ratio in Stage IIIC Endometrial Carcinoma Among a Multi-Institutional Academic Collaboration
Authors: Mayadev Jyoti , Elshaikh Mohamed A. , Christie Alana , Nagel Christa , Kennedy Vanessa , Khan Nadia , Lea Jayanthi , Ghanem Ahmad , Miller David , Xie Xian-Jin , Folkert Michael , Albuquerque Kevin 
Published: April 2018

Purpose/Objective(s):
Stage IIIC endometrial carcinoma (EC) represents pathologically heterogenous patients with single/multiple pelvic (stage IIIC1) or paraaortic (stage IIIC2) lymph nodes (LNs). There is an increasing trend to offer adjuvant chemotherapy (CT) +/− radiation (RT) uniformly to these patients, regardless of substage. We investigate the prognostic significance of positive LN (pLN) number, ratio (%pLN), location (IIC1 vs. IIC2), and adjuvant treatment on patterns of failure and survival in a large collaborative multi-institutional series.

Materials and Methods:
Clinical data for stage III EC patients such as patient characteristics, surgery/pathologic details, adjuvant therapies (including CT, RT, and chemotherapy and radiation), and outcomes (including pelvic control [PC], disease-free survival [DFS], distant DFS, and overall survival [OS]) were collected from 3 academic institutions. Log-rank analyses, Cox regression univariate and multivariate analyses were performed.

Results:
Of the 264 patients queried for stage III disease, 237 (73%) had pLN, and complete LN sampling for analysis. The mean number of pLN in the combined data were 3.9, with 26.1% of all LN sampled positive; 121 patients (51%) staged IIIC1, and 116 patients (49%) staged IIIC2. There was a significant difference in number of pLN (P=0.0006) and total LN sampled by institution (range, 13 to 35; P=0.0004), without a difference in %pLN (P=0.35). Ninety-seven of 220 (44.1%) have ≥20% pLN. While controlling for substage and institution, a decrease in DFS (hazard ratio [HR], 1.1; P=0.007), and OS (HR, 1.1; P=0.01) was observed with every increase of 10% in the pLN ratio. There was a significant difference in DFS (HR, 1.8; P=0.003), PC (HR, 1.9; P=0.004), and distant DFS (HR, 1.6; P=0.03), as well as a trend for decreased OS (HR, 1.6; P=0.08) for substage IIIC2 versus IIIC1 disease; 5 years DFS 40% versus 45%, OS 50% versus 57%. Patients received no adjuvant therapy (10%), CT alone (27%), RT alone (16%), or chemotherapy and radiation (47%). There was no significant difference in PC, DFS, or OS between the various treatment regimens. On univariate analysis, while pLN was significant, treatment type did not impact DFS or OS. On multivariate analysis for DFS, patient age, race, and IIIC1 versus IIIC2 substage retained significance (HR, 0.56; P=0.01).

Conclusions:
Stage III EC patients with substage IIIC2 disease have a significantly increased risk of local and distant disease recurrence and death from EC. A decrease in DFS and OS was observed with every increase of 10% in the pLN ratio. Stage IIIC2 patients represent a high-risk subpopulation for whom clinical trials, or targeted regimens should be explored to achieve improved oncologic outcomes.
Multi-modal 3D Simulation Makes the Impossible Possible
Authors: Ganske Ingrid M. , Schulz Noah , Livingston Katie , Goobie Susan , Meara John G. , Proctor Mark , Weinstock Peter 
Published: April 2018

Summary:
B.Y. was born full term after a large vertex encephalocele was diagnosed prenatally. The unique challenge to repairing B.Y.’s encephalocele was a microcephalic skull and large proportion of likely functional extracranial brain tissue, which would need to be preserved. At Boston Children’s Hospital, a simulation-based collaborative presurgical planning and rehearsal process, using both digital and 3D printed models, enabled successful technical completion and outcome of an otherwise inoperable case.
Social Support Moderates the Relationship Between Perceived Stress and Quality of Life in Patients With a Left Ventricular Assist Device
Authors: Abshire Martha , Russell Stuart D. , Davidson Patricia M. , Budhathoki Chakra , Han Hae-Ra , Grady Kathleen L. , Desai Shashank , Dennison Himmelfarb Cheryl 
Published: April 2018

Background:
Living with a left ventricular assist device has significant psychosocial sequelae that affect health-related quality of life (HRQOL).

Objective:
The purpose of this study was to (1) describe psychosocial indicators of stress including perceived stress, depression, fatigue, and coping; (2) examine relationships among stress indicators by level of perceived stress; (3) examine relationships among indicators of stress and clinical outcomes; and (4) test the moderation of social support on the relationship between stress and clinical outcomes.

Methods:
Participants were recruited from 2 outpatient clinics in a cross-sectional study design. Standardized measures were self-administered via survey. Descriptive statistics, correlation, and multiple linear regression analysis were conducted.

Results:
The sample (N = 62) was mostly male (78%), black (47%), and married (66%), with a mean age of 56.5 ± 13 years. The overall sample had a moderate stress profile: moderate perceived stress (mean, 11.7 ± 7), few depressive symptoms (mean, 3.2 ± 3.9), and moderate fatigue (mean, 14.3 ± 9.1). Increased perceived stress was associated with fatigue, depressive symptoms, and maladaptive coping (P < .001). Regression analysis demonstrated that perceived stress and fatigue were significant correlates of overall HRQOL (adj. R
2 = 0.41, P < .0001). Social support moderated the relationship between perceived stress and HRQOL, controlling for fatigue (R
2 = 0.49, P < .001).

Conclusions:
Individuals living with left ventricular assist device with high perceived stress have worse depressive symptoms, fatigue, and coping. The influence of high social support to improve the relationship between stress and HRQOL underscores the importance of a comprehensive plan to address psychosocial factors.
Physical Therapist Student, Nursing Student, and Community Partner Perspectives of Working Together in a Chicago Neighborhood After-School Program
Authors: Healey William E. , Cygan Heide R. , Reed Monique , Huber Gail 
Published: April 2018

Background and Purpose.
Racial disparities in health across Chicago have worsened, despite increased attention at federal and local levels. Approaches to addressing health inequity include community-based participatory research (CBPR) and interprofessional education (IPE) experiences. The purpose of this case report is to describe the results of a community-based educational experience in a neighborhood after-school program from the perspectives of health professions students and their community partners.

Case Description.
The Westside Health Authority (WHA), a community-based organization in the Austin neighborhood of Chicago, approached their CBPR partners at Northwestern University and Rush University and asked for assistance to change an after-school program. In response, university faculty designed an IPE experience, which included six physical therapists (PTs) and seven nursing students. In collaboration with WHA Youth Development Center (YDC) staff, PT and nursing students developed and implemented a 10-week physical activity (PA) and nutrition program titled “Kids in Motion (KIM)”. Physical therapy and nursing faculty members provided oversight of KIM.

Outcomes.
Fourteen African American youth (6–12 years old) participated in KIM, which consisted of a PA session led by PT students (on Mondays), a nutrition activity conducted by nursing students (on Thursdays), and an integration of learned activities by YDC staff on other weekdays. Quantitative and qualitative measures were used to assess KIM outcomes.

Discussion and Conclusion.
Focus group findings suggested that the community partners' expectations of the health promotion program for youth were successfully met. In addition, the PT and nursing students indicated increased confidence and preparedness in working with underserved communities to plan programs based on areas of need identified by community stakeholders. Community-based and interprofessional experiences should be considered as sustainable methods to meet both the programming needs identified by community partners and the educational needs of health professions students.