bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive Load and Situation Awareness for Soldiers: Effects of Message Presentation Rate and Sensory Modality
Authors: Hollands Justin G. , Spivak Tzvi , Kramkowski Eric W. 
Published: February 2019

Objective: We sought to determine the influence of message presentation rate (MPR) and sensory modality on soldier cognitive load. Background: Soldiers commonly communicate tactical information by radio. The Canadian Army is equipping soldiers with a battle management system (BMS), which also allows them to communicate by text. Method: We varied presentation modality (auditory vs. visual) and MPR (fast or slow) in an experiment involving a tactical scenario. Participants (soldiers) received messages and periodically provided situation reports to higher level command, and the scored reports were used to provide a measure of situation awareness (SA). The detection response task (DRT) and NASA-TLX were used to measure cognitive load. Results: The fast MPR reduced DRT accuracy and increased response times relative to slow MPR. The NASA-TLX results also showed higher subjective workload ratings for several subscales with fast MPR. Messages presented visually produced greater cognitive load, with slower DRT response times for the visual than the auditory condition. SA scores were higher with slower MPR and auditory presentation. There was no statistical interaction of presentation modality and rate for any measure. Conclusion: Fast MPR and visual presentation increased cognitive load and degraded SA. Application: These findings show that the DRT can be used to measure workload effectively in a tactical military context and that the method of information presentation affects how soldiers process information in a BMS.
Associations of Hormonal Biomarkers With Mental Health and Healthy Behaviors Among Mothers of Very-Low-Birthweight Infants
Authors: Cho June , Su Xiaogang , Holditch-Davis Diane 
Published: February 2019

Objectives: To examine the concurrent use of self-report questionnaires and hormonal biomarkers, specifically levels of testosterone and cortisol, along with demographic variables and corrected age (CA) in the assessment of mental health and healthy behaviors among mothers of very-low-birthweight (VLBW, BW < 1,500 g) infants at five time points over 2 years post birth. Method: Data on 40 mothers from a neonatal intensive care unit of a tertiary medical center in the southeast United States were collected from the medical record, standard questionnaires for the mother (depressive symptoms, perceived stress, anxiety, mental health status, parenting stress, and healthy lifestyle behaviors), and biochemical measurement of maternal testosterone and cortisol using enzyme immunoassay at birth, 40 weeks’ postmenstrual age, and 6, 12, and 24 months CA. Results: Maternal self-report of mental health improved from birth to 6 or 12 months then worsened at 24 months. Mixed linear models showed that mothers with higher testosterone levels had more depressive symptoms and smoked more, whereas mothers with higher cortisol levels had healthier behaviors and exercised more. Testosterone levels were negatively correlated with cortisol levels. Marital status, education, and health insurance were the most predictive demographic variables for the levels of hormonal biomarkers, mental health, and healthy behaviors. Conclusions: The use of self-report and biochemical measurement was effective in assessing maternal mental health and healthy behaviors over 2 years post birth, when mothers of VLBW infants tend to experience more mental health problems and parenting difficulties than mothers of normal-BW full-term infants.
Predictors of Theory of Mind performance in bilingual and monolingual children
Authors: Buac Milijana , Kaushanskaya Margarita 
Published: February 2019

Aims and objectives/purpose/research questions: The goal of the current study was to examine whether language and Executive Function (EF) skills predict Theory of Mind (ToM) performance in bilingual and monolingual children. Design/methodology/approach: Participants included 44 monolingual English-speaking children ( MAge = 7.03, SD = 1.23), 44 simultaneous English-Spanish bilingual children ( MAge = 7.36, SD = 1.18), and 27 English first language (L1) bilinguals (native English speakers learning Spanish through dual immersion programs; MAge = 7.58, SD = 1.24). In the second-order false belief task, children were asked to reason about one character’s thoughts about another character’s thoughts. Three components of EF were measured: inhibition (via a flanker task); updating of working memory (via a Corsi blocks task); and shifting (via a card sort task). The Clinical Evaluation of Language Fundamentals 4th Edition indexed omnibus English language skills. Data and analysis: Separate logistic regression models were constructed to analyze the predictors of ToM performance for each group controlling for age, socioeconomic status, and non-verbal IQ. Findings/conclusions: Language ability, but not EF skills, predicted ToM performance in simultaneous bilinguals. In contrast, EF skills but not language predicted ToM performance in monolinguals and in English L1 bilinguals. Originality: This is the first study to show that children with distinct language acquisition histories approach verbal ToM problems differently. Significance/implications: It appears that the linguistic demands of the ToM task take priority for children with lower levels of target-language ability, while the cognitive demands of the task take priority for children with higher levels of target-language ability.
Optimizing Surgical Skills in Cardiac Surgery Residents with Cardiac Transplant in the High-Fidelity Porcine Model
Authors: Spooner Aaron J. , Faulkner Christina M. , Novick Richard J. , Kent William D. T. 
Published: February 2019

Objectives Simulation is a pivotal tool within cardiac surgery to facilitate learner growth and skill acquisition. There are many methods of simulation and it is possible to develop and implement new curricula incorporating these modalities. The objective of this paper is to describe the feasibility of a high-fidelity cardiac transplant simulation curriculum for surgical residents. Methods Our simulation setting was the Animal Resource Center at the University of Calgary. It was set up with 4 separate operating rooms, 2 for donor heart retrievals and 2 for heart implantations. This was done to allow 2 learners to participate with each animal, replicating the true intraoperative environment. Our teaching sessions were facilitated by 2 surgeons experienced in cardiac transplantation. In addition, we had support staff including multiple perfusionists, nurses, and anesthesia technologists. Results The curriculum was evaluated from many perspectives in real time throughout the simulation as well as afterward in posttest qualitative interviews with all participants. The residents readily identified the acquisition of and increased proficiency in specifically targeted surgical skills. In addition, the residents were able to practice communication, collaboration, and management. Furthermore, the simulation session and our debriefings contributed significantly to fostering a team approach. Conclusions The pig is an excellent preclinical model for acquiring and developing the skills necessary for human cardiac transplantation. The residents partaking in the curriculum were satisfied with the learning they received and saw value in the swine transplant curriculum. The overall curriculum was cost-effective, due to the low overall operating costs associated with it.
Analysis of the Effect of Dopamine Transporter Scan on the Diagnosis and Management in a Tertiary Neurology Center
Authors: Bhattacharjee Shakya , Paramanandam Vijayashankar , Bhattacharya Atrayee 
Published: February 2019

Background and Purpose: The dopamine transporter scan or DaT scan is abnormal in presynaptic parkinsonism but normal in nondegenerative or postsynaptic parkinsonism. In this study, we tried to ascertain the impact of DaT scan on the diagnosis and clinical management and if the semiquantitative analysis of the DaT scans has any correlation with the clinical symptoms. Methods: The electronic and nonelectronic records of patients of Plymouth Hospital NHS Trust, United Kingdom, from 2011 to 2015 were studied to find the indication, outcome, and the impact of the scan on the management of patients. The DaT scan results were assessed visually and semiquantitatively by the Department of Nuclear Medicine. The available data were statistically analyzed with the help of Microsoft XL2010 and GraphPad software. Results: A total of 258 people had DaT scan. The scan results suggested an alternate diagnosis in 50.5% of clinically diagnosed patients with Parkinson disease. Similarly, DaT scan changed the diagnosis of 40% of patients with clinical diagnosis of vascular parkinsonism, 25% of clinically diagnosed drug-induced parkinsonism, and 54% of patients with possible Lewy body dementia. Visual assessment of the DaT scan revealed that more than 60% had grade 2 abnormalities. The distribution volume ratio, a semiquantitative tool for tracer uptake, was significantly less in the patients with akinetic-rigid subtype of Parkinson disease in comparison to a tremor predominant subtype. Conclusions: Dopamine transporter scan had a significant impact in diagnosis and management.
A Retrospective Analysis of Softball-Related Head and Facial Injuries Treated in United States Emergency Departments, 2013-2017
Authors: Strickland John S. , Crandall Marie , Bevill Grant R. 
Published: February 2019

Background: Softball is a popular sport played through both competitive and recreational leagues. While head and facial injuries are a known problem occurring from games, little is known about the frequency or mechanisms by which they occur. Purpose: To analyze head/face injury diagnoses and to identify the mechanisms associated with such injuries. Study Design: Descriptive epidemiological study. Methods: A public database was used to query data related to head/facial injuries sustained in softball. Data including age, sex, race/ethnicity, injury diagnosis, affected body parts, disposition, incident location, and narrative descriptions were collected and analyzed. Results: A total of 3324 head and face injuries were documented in the database over the time span of 2013 to 2017, resulting in a nationwide weighted estimate of 121,802 head/face injuries occurring annually. The mean age of the players was 21.5 ± 14.4 years; 72.1% of injured players were female, while 27.9% were male. The most common injury diagnoses were closed head injuries (22.0%), contusions (18.7%), concussions (17.7%), lacerations (17.1%), and fractures (15.1%). The overwhelming majority of injuries involved being struck by a ball (74.3%), followed by colliding with another player (8.3%), colliding with the ground or a fixed object (5.0%), or being struck by a bat (2.8%). For those injuries caused by a struck-by-ball incident, most occurred from defensive play (83.7% were fielders struck by a hit or thrown ball) as opposed to offensive play (12.3% were players hit by a pitch or runners struck by a ball). Although helmet usage was poorly tracked in the database, female players (1.3%) were significantly more likely to have been wearing a helmet at the time of injury than were male players (0.2%) ( P = .002). Conclusion: The present study demonstrates that a large number of head and face injuries occur annually within the United States as a result of softball play. A variety of injuries were observed, with the majority involving defensive players being struck by the ball, which highlights the need for more focus on player safety by stronger adherence to protective headgear usage and player health monitoring.
Progression of mycosis fungoides occurs through divergence of tumor immunophenotype by differential expression of HLA-DR
Authors: Murray Duncan , McMurray Jack Luke , Eldershaw Suzy , Pearce Hayden , Davies Nathaniel , Scarisbrick Julia J. , Moss Paul 
Published: February 2019

Abstract
Immunotherapy is a valuable treatment for many cancer patients, and there is considerable interest in understanding the mechanisms of immune evasion to guide appropriate management. Mycosis fungoides (MF) is a malignant disorder of skin-homing CD4+ T cells, and it exhibits a highly variable clinical course during which the tumor-specific immune response may be an important determinant. An unusual feature of MF is that tumor-infiltrating lymphocytes (TILs) must attempt to control a malignant cell from within their own lineage. We obtained skin biopsies and blood from 43 patients with CD4+ MF and undertook a detailed phenotypic and functional analysis of CD4+ and CD8+ T cells. Clonotypic TCRBV staining allowed delineation of malignant and reactive CD4+ subsets. CD4+ and CD8+ TILs displayed a comparable “exhausted” phenotype that was characterized by expression of PD-1 and TIGIT but retained cytotoxic activity and production of interferon-γ and interleukin-17 in early-stage disease. In contrast, tumor cells were much more heterogeneous and were divided into 3 discrete subsets based on differential expression of HLA-DR: “cold” (DR−), “exhausted” (DR+ PD-1+), and “evasive” (DR++ PD-L1+) phenotypes. Disease progression was associated with increasing divergence of the tumor phenotype away from that of TILs and reduced functional activity within TILs. These observations reveal that the phenotype and function of TIL populations are constrained at all stages of disease, whereas the tumor evolves discrete phenotypic profiles of escape during clinical progression. The findings should help to direct appropriate immunotherapeutic interventions for individual patients.
Metallurgy of Continuous Hot Dip Aluminizing
Authors: Richards R.W. , Clarke H. , Jones R.D. , Clements P.D. 
Published: February 2019

In spite of a strong commercial interest in hot dipped aluminised steel strip, research over the past 60 years has been somewhat piecemeal. A relatively smaller body of work exists on this material compared with the equivalent galvanised product but the lack of systematic study and development means that it is difficult to rationalise and appraise the existing literature. This review is intended to provide an overall view of the salient results of previous work, providing key entry points to available literature.IMR/269© 1994 The Institute of Materials and ASM International. At the time the work was carried out Dr Richards and Mr Clarke were in the Division of Materials and Minerals Engineering, School of Engineering, University of Wales, Cardiff, UK. Dr Jones is in the Faculty of Technology, North East Wales Institute, Wrexham, Clwyd, UK and Dr Clements is with British Steel pic, Llanwern Works, Newport, Gwent, UK.
Drug Calculation Errors in Anesthesiology Residents and Faculty: An Analysis of Contributing Factors
Authors: Black Shira , Lerman Jerrold , Banks Shawn E. , Noghrehkar Dena , Curia Luciana , Mai Christine L. , Schwengel Deborah , Nelson Corey K. , Foster James M. T. , Breneman Stephen , Arheart Kris L. 
Published: February 2019

BACKGROUND:
Limited data exist regarding computational drug error rates in anesthesia residents and faculty. We investigated the frequency and magnitude of computational errors in a sample of anesthesia residents and faculty.

METHODS:
With institutional review board approval from 7 academic institutions in the United States, a 15-question computational test was distributed during rounds. Error rates and the magnitude of the errors were analyzed according to resident versus faculty, years of practice (or residency training), duration of sleep, type of question, and institution.

RESULTS:
A total of 371 completed the test: 209 residents and 162 faculty. Both groups committed 2 errors (median value) per test, for a mean error rate of 17.0%. Twenty percent of residents and 25% of faculty scored 100% correct answers. The error rate for postgraduate year 2 residents was less than for postgraduate year 1 (P = .012). The error rate for faculty increased with years of experience, with a weak correlation (R = 0.22; P = .007). The error rates were independent of the number of hours of sleep. The error rate for percentage-type questions was greater than for rate, dose, and ratio questions (P = .001). The error rates varied with the number of operations needed to calculate the answer (P < .001). The frequency of large errors (100-fold greater or less than the correct answer) by residents was twice that of faculty. Error rates varied among institutions ranged from 12% to 22% (P = .021).

CONCLUSIONS:
Anesthesiology residents and faculty erred frequently on a computational test, with junior residents and faculty with more experience committing errors more frequently. Residents committed more serious errors twice as frequently as faculty.
A Multivariable Model Predictive of Unplanned Postoperative Intubation in Infant Surgical Patients
Authors: Eisler Lisa D. , Hua May , Li Guohua , Sun Lena S. , Kim Minjae 
Published: February 2019

BACKGROUND:
Unplanned postoperative intubation is an important quality indicator, and is associated with significantly increased mortality in children. Infant patients are more likely than older pediatric patients to experience unplanned postoperative intubation, yet the literature provides few characterizations of this outcome in our youngest patients. The objective of this study was to identify risk factors for unplanned postoperative intubation and to develop a scoring system to predict this complication in infants undergoing major surgical procedures.

METHODS:
In this retrospective cohort study, The National Surgical Quality Improvement Program-Pediatric database was surveyed for all infants who underwent noncardiac surgery between January 1, 2012 and December 31, 2015 (derivation cohort, n = 56,962) and between January 1 and December 31, 2016 (validation cohort, n = 20,559). Demographic and perioperative clinical characteristics were examined in association with our primary outcome of unplanned postoperative intubation within 30 days of surgery. Risk factors were analyzed in the derivation cohort (2012–2015 data) using multivariable logistic regression with stepwise selection. Parameters from the final model were used to create a scoring system for predicting unplanned postoperative intubation. Data from the validation cohort were utilized to assess the performance of the scoring system using the area under the receiver operating characteristic curve.

RESULTS:
In the derivation cohort, 2.2% of the infants experienced unplanned postoperative intubation within 30 days of surgery. Of the 14 risk factors identified in multivariable analysis, 10 (age, prematurity, American Society of Anesthesiologists physical status, inpatient status, operative time >120 minutes, cardiac disease, malignancy, hematologic disorder, oxygen supplementation, and nutritional support) were included in the final multivariable logistic regression model to create the risk score. The area under the receiver operating characteristic curve of the final model was 0.86 (95% CI, 0.85–0.87) for the derivation cohort and 0.83 (95% CI, 0.82–0.85) for the validation cohort.

CONCLUSIONS:
About 1 in 50 infants undergoing major surgical procedures experiences unplanned postoperative intubation. Our scoring system based on routinely collected perioperative assessment data can predict risk in infants with good accuracy. Further investigation should assess the clinical utility of the scoring system for risk stratification and improvement in perioperative care quality and patient outcomes.
A hundred years of rabies in Kenya and the strategy for eliminating dog-mediated rabies by 2030
Authors: Bitek Austine O , Osoro Eric , Munyua Peninah M , Nanyingi Mark , Muthiani Yvonne , Kiambi Stella , Muturi Mathew , Mwatondo Athman , Muriithi Rees , Cleaveland Sarah , Hampson Katie , Njenga M. Kariuki , Kitala PM , Thumbi SM 
Published: February 2019

Background: Rabies causes an estimated 59,000 human deaths annually. In Kenya, rabies was first reported in a dog in 1912, with the first human case reported in 1928. Here we examine retrospective rabies data in Kenya for the period 1912 – 2017 and describe the spatial and temporal patterns of rabies occurrence in the country. Additionally, we detail Kenya’s strategy for the elimination of dog-mediated human rabies by 2030. Methods: Data on submitted samples and confirmed cases in humans, domestic animals and wildlife were obtained from Kenya’s Directorate of Veterinary Services. These data were associated with the geographical regions where the samples originated, and temporal and spatial trends examined. Results: Between 1912 and the mid 1970’s, rabies spread across Kenya gradually, with fewer than 50 cases reported per year and less than half of the 47 counties affected. Following an outbreak in the mid 1970’s, rabies spread rapidly to more than 85% of counties, with a 4 fold increase in the percent positivity of samples submitted and number of confirmed rabies cases. Since 1958, 7,584 samples from domestic animals (93%), wildlife (5%), and humans (2%) were tested. Over two-thirds of all rabies cases came from six counties, all in close proximity to veterinary diagnostic laboratories, highlighting a limitation of passive surveillance. Conclusions: Compulsory annual dog vaccinations between 1950’s and the early 1970’s slowed rabies spread. The rapid spread with peak rabies cases in the 1980’s coincided with implementation of structural adjustment programs privatizing the veterinary sector leading to breakdown of rabies control programs. To eliminate human deaths from rabies by 2030, Kenya is implementing a 15-year step-wise strategy based on three pillars: a) mass dog vaccination, b) provision of post-exposure prophylaxis and public awareness and c) improved surveillance for rabies in dogs and humans with prompt responses to rabies outbreaks.
Autism and social anxiety in children with sex chromosome trisomies: an observational study
Authors: Wilson Alexander C. , King Judith , Bishop Dorothy V.M. 
Published: February 2019

Background: Recent studies suggest that an extra sex chromosome increases the risk of both autism and social anxiety, but it unclear whether these risks are specific to particular karyotypes. Methods: We considered diagnostic data from an online psychiatric assessment (DAWBA – The Development and Well-Being Assessment) and questionnaire responses completed by parents of children with 47,XXX (N = 29), 47,XXY (N = 28) and 47,XYY (N = 32) karyotypes. Analysis focused mainly on 54 children who were diagnosed prenatally or on the basis of other medical concerns in childhood (Low Bias subgroup), to minimise ascertainment bias. Results: Children with symptoms of autism who fell short of meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria were coded as cases of Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS). The odds ratio of autism or PDDNOS in the Low Bias group was computed relative to gender-specific population norms. This gave log odds ratio (95% confidence interval) of 5.56 (4.25 - 6.88) for XXX girls; 4.00 (2.66 - 5.33) for XXY boys; and 4.60 (3.46 - 5.74) for XYY boys. Despite this elevated risk, most children had no autistic features. A diagnosis of DSM-IV Social Phobia was rare, though, in line with prediction, all three Low Bias cases with this diagnosis had 47,XXY karyotype. All three trisomy groups showed increased risk of milder symptoms of social anxiety. Conclusions: An increased risk of autism was found in girls with 47,XXX karyotype, as well as in boys with 47,XXY or 47,XYY. Symptoms of social anxiety were increased in all three karyotypes. There was wide variation in psychiatric status of children with the same karyotype, suggesting that an extra sex chromosome affects developmental stability in a non-specific way, with a diverse range of possible phenotypes.