bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Ordering Pattern of Laboratory Send-Out Tests Between Naturopathic Doctors and General Practitioners in a Pediatric Population
Authors: Liao Hsuan-Chieh , Baird Geoffrey , Dickerson Jane 
Published: September 2019

Abstract

Objectives
Naturopathy is defined as the practice of medicine for the treatment of human diseases with natural agents. It also emphasizes prevention and promotion of health through the self-healing process of the body. Even without any illness or symptoms, naturopathic doctors (NDs) often advocate for and use unique lab tests to make clinical judgments. Tests that are performed outside of the ordering institution, send-out tests, are at increased risk of ordering the wrong or unnecessary test and misinterpreting test results. Here we evaluate the laboratory send-out tests that were ordered by NDs and general practitioners (GPs) at a tertiary pediatric care center to identify opportunities for improved laboratory stewardship.

Methods
We performed a retrospective analysis from Seattle Children’s laboratory send-out tests, which were ordered between January 1, 2018, and December 31, 2018. We compared the tests ordered by NDs with general practitioners in our practice, by grouping the following provider specialties: adolescent medicine, family medicine, or pediatrics. All the requests were reviewed and categorized by test type: heavy metal, allergen, infectious disease, hormone and vitamin, hematology and immunology, toxicology, oncology, genetics, and others. Ordering frequency and abnormal rate from each category were analyzed. The abnormal rate was defined as percentage of abnormal results divided by total number of ordered tests.

Results
During the 12-month period, there were 20,312 send-out tests; 1,028 (5.1%) of them were ordered by 83 NDs for 329 patients, and 3,862 (19.0%) of them were ordered by 462 GPs for 2,139 patients. The most frequently ordered tests by NDs were heavy metal screens (506 tests, 49.2% of total), allergen panels (31.7%), and infectious disease tests (7.0%). The corresponding abnormal rates were 8.5%, 0.9%, and 8.3%, respectively, with an overall abnormal rate of 6.6%. For GPs, the most frequently ordered tests were hormone and vitamin analyses (1,346 tests, 34.9% of total), hematology and immunology tests (22.5%), and heavy metal screens (10.8%). The corresponding abnormal rates were 18.1%, 35.9%, and 18.8% and overall abnormal rate was 17.8%.

Conclusion
We observed different ordering patterns between GPs and NDs, with rates of abnormal findings significantly higher from the tests ordered by GPs. These data suggest some of the tests ordered by NDs have low positive predictive value or clinical significance and could be potentially mis- or overutilized. Understanding the patterns and the variety of testing from different providers can help target interventions to improve laboratory stewardship in this area.
Improving Adherence to the HIV Testing Algorithm With Resident Physician Intervention
Authors: Johnson Kimberly , Buchan Blake , Colon-Franco Jessica 
Published: September 2019

Abstract

Introduction
The CDC recommends the following algorithm for HIV testing: (1) a screening HIV-1/HIV-2 Ag/Ab immunoassay, (2) HIV-1/HIV-2 antibody differentiation immunoassay, and, if these results are discordant, (3) HIV-1 nucleic acid test (NAT). Final interpretation of this algorithm depends on its completion. To assess the adherence of this algorithm, a retrospective chart review was performed to reveal that 31% of discordant results were not followed up by NAT. A prospective interventional study was devised to improve adherence to the algorithm.

Methods
A retrospective chart review was performed on all HIV testing performed from January 2017 to June 2018. The patients with discordant results without NAT were identified. These results then prompted a prospective interventional study. Starting in November 2018, a daily automated report was created to identify patients with discordant results and no NAT ordered after 48 hours. This report prompted the client services department to either call the provider if they were an outside client and tell them to contact the pathology resident, or call the resident directly if the provider was an internal client. The resident then provided guidance to order NAT. The total number of patients with discordant results with the intervention was monitored for adherence to the algorithm indicated by clinicians ordering the NAT. Preliminary data from November 2018 to March 2019 were analyzed and compared to the original data.

Results
The retrospective data revealed a total of 71 patients with discordant results and 22 (31%) did not have NAT testing. The preliminary prospective data revealed a total of 27 patients with discordant results and 3 (11%) did not have NAT testing. These data were found to be statistically significant with P = .04 with a chi-square test.

Conclusion
Resident physician intervention has significantly improved the adherence to the HIV testing algorithm based on preliminary data.
Opsoclonus Myoclonus Ataxia Syndrome With Anti–Glutamic Acid Decarboxylase Antibody Positive: Response to Plasma Exchange
Authors: Taherian Mehran , Aghighi Maryam , Petras Melissa 
Published: September 2019

Abstract

Objectives
Opsoclonus myoclonus syndrome (OMS) is a very rare neurological disorder of probably autoimmune origin. Glutamic acid decarboxylase antibody (GAD-Ab) is one of many antibodies that have been associated with OMS. Common treatments include intravenous immunoglobulin (IVIG) and corticosteroids. To our knowledge, this is the fourth case of GAD-Ab-positive OMS reported and the first one responsive to plasma exchange (PLEX).

Clinical Presentation
The patient is a 77-year-old male who presented with new-onset tremors and gait disorder. He had been diagnosed with OMS and positive GAD-Ab 2 years ago. At the time of diagnosis, his condition was not responsive to IVIG or corticosteroids and seemed to improve following PLEX. He made a near full recovery and was prescribed a low dose of mycophenolate. The patient reported worsening in tremor and gait over the last several days. This was the first time he had signs of clinical relapse since diagnosis. His labs were notable for hyponatremia, elevated glucose, and acute kidney injury. Brain CT showed intracranial atherosclerosis and age-indeterminate generalized cortical atrophy, perhaps due to chronic microangiopathic white matter changes. GAD-Abs assessed on this admission were zero (normal is less than 5), whereas they were 143 before treatment 2 years ago, although no GAD-Ab titer was measured after PLEX. The patient received five sessions of PLEX with overall improvement.

Conclusion
We reported a rare case of OMS with positive GAD-Ab who responded to PLEX. GAD-Ab may be a predictive marker of patient symptoms and is recommended to be measured in patients with OMS before and after treatment.
Distribution of Blood Types and ABO Gene Frequencies in Egypt
Authors: Abdelmonem Mohamed , Fyala Amira , Boraik Ayman , Shedid Mohamed , Mohamed Amira Husseiny , Abdel-Rhman Mohammad 
Published: September 2019

Abstract

ABO blood group was first discovered by Landsteiner in 1901. Currently, there are more than 30 blood group systems, but ABO system remains the most clinically important of all blood groups in transfusion practice. The ABO blood group system antibodies are naturally occurring without any exposure to RBCs through transfusion or pregnancy, unlike the other blood group systems.

Method
The study was performed on a total of 40,591 healthy blood donors in Egypt. ABO and Rh (D) groupings were performed on all donors’ samples. Data on the frequency of ABO and Rh(D) blood groups were reported in numbers and percentages.

Results
The study showed that type A is the most common blood group (35.12%) in Egypt followed by O at 31.94%, followed by B at 23.12%, while AB had the least prevalence at 9.74%; A > O > B > AB. Our study showed that 91.78% of the donor population were Rh positive and 8.22% were Rh negative. The frequencies of the IA, IB, and IO alleles were calculated using the Hardy-Weinberg law of equilibrium. The calculated gene frequencies are 0.2537 for IA (p), 0.1812 for IB (q), and 0.5651 for IO (r). In the Egyptian population, O (r) records the highest value, followed by B (q) and A (p); O > B > A. The homozygous types were as follows: OO, 31.94%; AA, 6.43%; and BB, 3.28%. The heterozygous types were AO, 28.67%; BO, 20.47%; and AB, 9.78%.

Conclusions
The study provides the first accurate ABO gene frequency data as well as information on the distribution of ABO blood group Rh groups of various alleles in the Egyptian population. This information is very helpful in the effective management of the blood bank inventory. It will help transfusion services planning for future health challenge and improve blood transfusion practice.
Agreement of Enzyme-Linked Immunosorbent Assay With Rapid Plasma Reagin and Treponema pallidum Hemagglutination Assay for Screening and Diagnosis of Syphilis at National Blood Bank Service in Addis Ababa, Ethiopia
Authors: Ibrahim Jemal , Afework Ejigayehu , Hussein Mintewab 
Published: September 2019

Abstract

Objectives
To determine the agreement of enzyme-linked immunosorbent assay (ELISA) with rapid plasma reagin (RPR) and Treponema pallidum hemagglutination assay (TPHA) at the National Blood Bank Service in Addis Ababa, Ethiopia.

Methods
The study was conducted from January to June 2016 on 190 syphilis ELISA positive and 190 negative samples stored at the National Blood Bank Service (NBBS) laboratory, Addis Ababa, Ethiopia, from July 2015 to December 2015. A systematic random sampling method was used to select samples. The data were analyzed by SPSS version 20 software. The overall percent agreement, kappa value, sensitivity, specificity, positive predictive value, and negative predictive value of the tests were calculated.

Results
From 190 positive sera, 151 (80%) were confirmed as positive by TPHA, and 39 (20%) were found false positive; 59 (31.1%) of them were positive and 131 (68.9%) were false positive by RPR. From 190 negative sera, all were negative by RPR and TPHA. The sensitivity, specificity, positive predictive value, and negative predictive value of TPHA were 99.9%, 85%, 79%, and 100%, respectively, while RPR was 62%, 99%, 100%, and 63%, respectively. Overall percent agreement of ELISA with TPHA was 90% and corresponding kappa value was 0.795, and ELISA with RPR was 66% with a kappa value of 0.375.

Conclusion
TPHA was very sensitive; there was substantial agreement with ELISA. Whereas RPR was highly specific and less sensitive, there was fair agreement with ELISA. TPHA can be used interchangeably with ELISA to screen blood in blood bank laboratories.
Economics, Race, and the Postwar US Novel: A Quantitative Literary History
Authors: Sinykin Daniel , So Richard Jean , Young Jessica 
Published: September 2019

AbstractHow has the language of economics, as codified by economics as a discipline, entered the US novel in the postwar period? Have economists influenced novelists at the level of language, and if so, how and how much? We begin with the belief, inferred from current scholarship on economics and culture, but never before empirically tested, that economic language became more prevalent around 1980, especially among white men—a belief that we strive to complicate and give nuance. Readers may detect an irony in the relationship between our method and case study. No academic discipline has valorized the use of quantification for social analysis more than economics. As a discipline, its language has become saturated with the language of modeling. Cultural and literary critics have long argued that economics has even harmed society by creating false accounts of how humans behave and think. Can we take their tools, however, and make them ours as a way to critique economics itself?
Quantifying hydrologic controls on local- and landscape-scale indicators of coastal wetland loss
Authors: Stagg Camille L , Osland Michael J , Moon Jena A , Hall Courtney T , Feher Laura C , Jones William R , Couvillion Brady R , Hartley Stephen B , Vervaeke William C 
Published: September 2019

AbstractBackground and AimsCoastal wetlands have evolved to withstand stressful abiotic conditions through the maintenance of hydrologic feedbacks between vegetation production and flooding. However, disruption of these feedbacks can lead to ecosystem collapse, or a regime shift from vegetated wetland to open water. To prevent the loss of critical coastal wetland habitat, we must improve understanding of the abiotic–biotic linkages among flooding and wetland stability. The aim of this research was to identify characteristic landscape patterns and thresholds of wetland degradation that can be used to identify areas of vulnerability, reduce flooding threats and improve habitat quality.MethodsWe measured local- and landscape-scale responses of coastal wetland vegetation to flooding stress in healthy and degrading coastal wetlands. We hypothesized that conversion of Spartina patens wetlands to open water could be defined by a distinct change in landscape configuration pattern, and that this change would occur at a discrete elevation threshold.Key ResultsDespite similarities in total land and water cover, we observed differences in the landscape configuration of vegetated and open water pixels in healthy and degrading wetlands. Healthy wetlands were more aggregated, and degrading wetlands were more fragmented. Generally, greater aggregation was associated with higher wetland elevation and better drainage, compared with fragmented wetlands, which had lower elevation and poor drainage. The relationship between vegetation cover and elevation was non-linear, and the conversion from vegetated wetland to open water occurred beyond an elevation threshold of hydrologic stress.ConclusionsThe elevation threshold defined a transition zone where healthy, aggregated, wetland converted to a degrading, fragmented, wetland beyond an elevation threshold of 0.09 m [1988 North American Vertical Datum (NAVD88)] [0.27 m mean sea level (MSL)], and complete conversion to open water occurred beyond 0.03 m NAVD88 (0.21 m MSL). This work illustrates that changes in landscape configuration can be used as an indicator of wetland loss. Furthermore, in conjunction with specific elevation thresholds, these data can inform restoration and conservation planning to maximize wetland stability in anticipation of flooding threats.
Neurobehavioral Outcomes in School-Aged Children with Primary Snoring
Authors: Hagström Kati , Saarenpää-Heikkilä Outi , Himanen Sari-Leena , Lampinlampi Anna-Maria , Rantanen Kati 
Published: September 2019

Abstract

Objective
We assess behavioral and attentional problems and neurocognitive functioning in school-aged children with primary snoring (PS).

Methods
Seventeen children with PS and 27 non-snoring peers aged 6–10 years took part in the study. All children underwent a polysomnography (PSG) at the Sleep Laboratory. Snoring was defined by parents and with PSG. Children with obstructive sleep apnea were excluded. The parents completed the Sleep Disturbance Scale for Children. Parents and teachers assessed behavioral and attentional problems with the Child Behavior Checklist and the Conners’ Rating Scale-Revised. Neuropsychological assessment included the Wechsler Intelligence Scale for Children and the Developmental Neuropsychological Assessment (NEPSY test).

Results
The PS group had significantly more parent-reported internalizing, total, and attentional problems than the control group. Teachers did not report behavioral problems in the PS group. The PS and control groups had equal IQ scores and similar core neurocognitive functions, except for one visuospatial subtest. The PS group had significantly more inspiratory flow limitation and increased diaphragmatic electromyography compared with the controls. Parents reported significantly more daytime sleepiness in the PS group. Daytime sleepiness and snoring time were consistently associated with more behavioral and attentional problems. Flow limitation and more oxygen saturation values under 90% were associated with attentional problems, higher oxygen desaturation index, and lower mean oxygen saturation percentage with reduced language functions.

Conclusions
Snoring with an increase in respiratory effort without apneas and hypopneas and parent-reported daytime sleepiness may be linked to daytime symptoms. School-aged children with PS are at risk for behavioral and attentional problems, but not cognitive impairments.
PPNID: a reference database and molecular identification pipeline for plant-parasitic nematodes
Authors: Qing Xue , Wang Meng , Karssen Gerrit , Bucki Patricia , Bert Wim , Braun-Miyara Sigal 
Published: September 2019

Abstract

Motivation
The phylum Nematoda comprises the most cosmopolitan and abundant metazoans on Earth and plant-parasitic nematodes represent one of the most significant nematode groups, causing severe losses in agriculture. Practically, the demands for accurate nematode identification are high for ecological, agricultural, taxonomic and phylogenetic researches. Despite their importance, the morphological diagnosis is often a difficult task due to phenotypic plasticity and the absence of clear diagnostic characters while molecular identification is very difficult due to the problematic database and complex genetic background.

Results
The present study attempts to make up for currently available databases by creating a manually-curated database including all up-to-date authentic barcoding sequences. To facilitate the laborious process associated with the interpretation and identification of a given query sequence, we developed an automatic software pipeline for rapid species identification. The incorporated alignment function facilitates the examination of mutation distribution and therefore also reveals nucleotide autapomorphies, which are important in species delimitation. The implementation of genetic distance, plot and maximum likelihood phylogeny analysis provides more powerful optimality criteria than similarity searching and facilitates species delimitation using evolutionary or phylogeny species concepts. The pipeline streamlines several functions to facilitate more precise data analyses, and the subsequent interpretation is easy and straightforward.

Availability and implementation
The pipeline was written in vb.net, developed on Microsoft Visual Studio 2017 and designed to work in any Windows environment. The PPNID is distributed under the GNU General Public License (GPL). The executable file along with tutorials is available at https://github.com/xueqing4083/PPNID.

Supplementary information
Supplementary data are available at Bioinformatics online.
Bugs: Rethinking the History of Computing
Authors: McKinney Cait , Mulvin Dylan 
Published: September 2019

Abstract
This paper argues that scholars of computing, networks, and infrastructures must reckon with the inseparability of “viral” discourses in the 1990s. This co-assembled history documents the reliance on viral analogies and explanations honed in the HIV/AIDS crisis and its massive loss of life, widespread institutional neglect, and comprehensive technological failures. As the 1990s marked a period of intense domestication of computing technologies in the global North, we document how public figures, computer experts, activists, academics, and artists used the intertwined discourses surrounding HIV and new computer technologies to explicate the risks of vulnerability in complex, networked systems. The efficacy of HIV as an analogy is visible in the circulation of viral concepts, fears surrounding interdependence, and emergent descriptions of precarity in the face of a widespread “infrastructure crisis.” Through an analysis of this decade, we show how HIV/AIDS discourses indelibly marked the domestication of computing, computer networks, and nested, digitized infrastructures.
Potentially inappropriate medications in older adults: a population-based cohort study
Authors: Roux Barbara , Sirois Caroline , Simard Marc , Gagnon Marie-Eve , Laroche Marie-Laure 
Published: September 2019

AbstractBackgroundNon-optimal medication use among older adults is a public health concern. A concrete picture of potentially inappropriate medication (PIM) use is imperative to ensure optimal medication use.ObjectiveTo assess the prevalence of PIMs in community-dwelling older adults and identify associated factors.MethodsA retrospective population-based cohort study was conducted using the Quebec Integrated Chronic Disease Surveillance System (QICDSS). The QICDSS includes data on drug claims for community-dwelling older adults with chronic diseases or at risk of developing chronic diseases aged ≥65 years who are insured by the public drug insurance plan. Individuals aged ≥66 years who were continuously insured with the public drug plan between 1 April 2014 and 31 March 2016 were included. PIMs were defined using the 2015 Beers criteria. We conducted multivariate robust Poisson regression analyses to explore factors associated with PIM use.ResultsA total of 1 105 295 individuals were included. Of these, 48.3% were prescribed at least one PIM. The most prevalent PIMs were benzodiazepines (25.7%), proton-pump inhibitors (21.3%), antipsychotics (5.6%), antidepressants (5.0%) and long-duration sulfonylureas (3.3%). Factors associated with PIM exposure included being a woman [rate ratio (RR): 1.20; 95% confidence interval (CI): 1.20–1.21], increased number of medications and having a high number of chronic diseases, especially mental disorders (RR: 1.50; 95% CI: 1.49–1.51).ConclusionAlmost one out of two community-dwelling older adults use a PIM. It is imperative to reduce the use of PIMs, by limiting their prescription and by promoting their deprescribing, which necessitates not only the active involvement of prescribers but also patients.
Influence of labeling on the glycan affinities and specificities of glycan-binding proteins. A case study involving a C-terminal fragment of human galectin-3
Authors: Kitova Elena N , Han Ling , Vinals Daniel F , Kitov Pavel I , Derda Ratmir , Klassen John S 
Published: September 2019

Abstract
Glycan interactions with glycan-binding proteins (GBPs) play essential roles in a wide variety of cellular processes. Currently, the glycan specificities of GBPs are most often inferred from binding data generated using glycan arrays, wherein the GBP is incubated with oligosaccharides immobilized on a glass surface. Detection of glycan–GBP binding is typically fluorescence-based, involving the labeling of the GBP with a fluorophore or with biotin, which binds to fluorophore-labeled streptavidin, or using a fluorophore-labeled antibody that recognizes the GBP. While it is known that covalent labeling of a GBP may influence its binding properties, these effects have not been well studied and are usually overlooked when analyzing glycan array data. In the present study, electrospray ionization mass spectrometry (ESI-MS) was used to quantitatively evaluate the impact of GBP labeling on oligosaccharide affinities and specificities. The influence of three common labeling approaches, biotinylation, labeling with a fluorescent dye and introducing an iodination reagent, on the affinities of a series of human milk and blood group oligosaccharides for a C-terminal fragment of human galectin-3 was evaluated. In all cases labeling resulted in a measurable decrease in oligosaccharide affinity, by as much as 90%, and the magnitude of the change was sensitive to the nature of the ligand. These findings demonstrate that GBP labeling may affect both the absolute and relative affinities and, thereby, obscure the true glycan binding properties. These results also serve to illustrate the utility of the direct ESI-MS assay for quantitatively evaluating the effects of protein labeling on ligand binding.