bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embodied Spatial Practices and the Power to Care
Authors: Paradis Elise , Liew Warren Mark , Leslie Myles 
Published: January 2019

Abstract
Drawing on an ethnographic study of teamwork in critical care units (CCUs), this chapter applies Henri Lefebvre’s ([1974] 1991) theoretical insights to an analysis of clinicians’ and patients’ embodied spatial practices. Lefebvre’s triadic framework of conceived, lived, and perceived spaces draws attention to the role of bodies in the production and negotiation of power relations among nurses, physicians, and patients within the CCU. Three ethnographic vignettes—“The Fight,” “The Parade,” and “The Plan”—explore how embodied spatial practices underlie the complexities of health care delivery, making visible the hidden narratives of conformity and resistance that characterize interprofessional care hierarchies. The social orderings of bodies in space are consequential: seeing them is the first step in redressing them.
Britain and Ireland, 100–700 CE
Authors: Petts David 
Published: January 2019

AbstractThis chapter reviews the evidence for the archaeology of early Christianity in Britain and Ireland. Here, the church had its origins in the areas that lay within the Roman Empire in the fourth century but rapidly expanded north and west in the early fifth century following the end of Roman rule. The evidence for church structures is limited and often ambiguous, with securely identifiable sites not appearing to any extent until the seventh century. There is a range of material culture that can be linked to the early church from the fourth to the seventh centuries; in particular, there are strong traditions of epigraphy and increasingly decorative stone carving from most areas. The conversion to Christianity also impacted burial rites, although the relationship between belief and mortuary traditions is not a simple one.
The impact of implementing a preprinted order form for inpatient management of otherwise healthy children admitted to a tertiary care centre with a diagnosis of bronchiolitis
Authors: Feder Joshua , Bijelic Vid , Barrowman Nick , McDonald Jaime , Murchison Barbara , Jetty Radha , Tjahjadi Anindita , Parker Kristy , Pothos Mary , Pound Catherine M 
Published: January 2019

Abstract

Objective
To examine the effect on length of stay (LOS) of a preprinted order (PPO) set for children admitted to hospital with a diagnosis of bronchiolitis, as well as on quality improvement measures, medical errors, and resource utilization.

Patients and methods
A retrospective chart review was performed of children admitted to the inpatient units at the Children’s Hospital of Eastern Ontario (CHEO) with a discharge diagnosis of bronchiolitis. Primary and secondary outcomes were compared between the pre-PPO (December 1, 2014 to June 30, 2015) and post-PPO (December 1, 2015 to June 30, 2016) periods. The primary outcome was LOS in days. Secondary outcomes included the proportion of quality improvement measures reached, the number of medical errors, and resource utilization.

Results
A total of 245 patients were included; 122 patients from the pre-PPO period (December 1, 2014 to June 30, 2015) and 123 patients from the post-PPO period (December 1, 2015 to June 30, 2016). Mean LOS was 3.1 days (2.7 to 3.5 days) and 2.8 days (2.4 to 3.2 days) in the pre- and post-PPO periods, respectively (multivariate analysis, P-value = 0.13). There were significant differences between the pre- and post-PPO periods in a number of quality improvement measures, although not in the number of medical errors. Significant reductions in oxygen, corticosteroid, antibiotic, and bronchodilator use were noted post-PPO implementation.

Conclusion
Although our bronchiolitis PPO did not significantly shorten LOS, it led to important improvements in quality improvement measures and in resource utilization efficiency.
Association Between Government Health Insurance Status and Physical Activity in American Youth
Authors: Fabricant Peter D. , McLaren Son H. , Suryavanshi Joash R. , Nwachukwu Benedict U. , Dodwell Emily R. 
Published: January 2019

Background:
Health insurance plans provide health programming access and affect physical activity levels in American youth, leading to health disparities in American children. The primary purpose of the current study was to investigate the relationship between health insurance status and physical activity level in American youth.

Methods:
A national, United States census weighted cross-sectional survey was performed analyzing 2002 noninstitutionalized children living in the United States between the ages of 10 to 18 years, equally split by age and sex, with state of residency and race/ethnicity proportional to the 2010 census distribution. Multiple linear regression was performed to investigate the relationship between insurance status and activity level (measured by HSS Pedi-FABS activity score) while controlling for relevant demographic and socioeconomic covariables.

Results:
HSS Pedi-FABS activity scores were normally distributed with a mean of 15.4±8.5 points (of 30 possible points). Patients with an insurance status of “government/Medicaid,” “other,” or “none” each demonstrated significantly lower physical activity scores (14.2±8.5 vs. 13.6±9.0 vs. 10.1±8.5) than children with private insurance (16.5±8.2) (one-way ANOVA with Dunnett-adjusted pairwise comparisons, P<0.001), which remained statistically significant while controlling for Area Deprivation Index, age, gender, race/ethnicity, and Body Mass Index (β=−1.8, P<0.001).

Conclusions:
Government/Medicaid health insurance status and lack of health care coverage are associated with low levels of physical activity in American children, even while controlling for socioeconomic confounders. Collaborative work between health care providers and community/ school-based programs may be a reasonable approach to expanding access to recreation, organized sports, and physical activity for publicly and uninsured children.

Level of Evidence:
Level II—Prognostic Study.
The Successful Mechanical Lipectomy Treatment of Cerebral Fat Embolism following Autologous Fat Injection
Authors: Zhou Kena , Cai Congbo 
Published: January 2019

Summary:
Autologous fat injection is becoming a more and more widely accepted procedure in plastic surgery nowadays. Concomitantly, there are many complications. The most serious one is arterial fat embolism, for which there is only poor prognosis and no effective treatment. Here, we report the first case of successful treatment of cerebral fat embolization with the help of mechanical lipectomy. Our patient was found unconscious with left-sided hemiparesis after a facial fat injection surgery 4 hours before. Cerebral artery computed tomography angiography indicated it was multiple fat embolism. Then Solitaire stent (4 × 20 mm) and Solumbra (continuously negative pressure attraction) were utilized for the mechanical extraction of fat emboli. The patient recovered from left-side hemiparesis to muscle strength of Medical Research Council scale grade 4, and National Institutes of Health Stroke Scale score was 0 after 3 months visit. In the cerebral infarction after fat transplantation, mechanical lipectomy can be a novel and significant treatment.
External Validation of ASPECT (Algorithm for Suspected Pulmonary Embolism Confirmation and Treatment)
Authors: Klil-Drori Adi J. , Prajapati Dwip , Liang Zhiying , Wang Meng , Toupin Dominique , Alothman Latifah , Lang Eddy , Suryanarayan Deepa , Tagalakis Vicky 
Published: January 2019

Background:
Administrative health care databases are increasingly being used to study pulmonary embolism (PE), but the validity of single PE codes is variable. Using data from Quebec, Canada, we developed ASPECT (Algorithm for Suspected Pulmonary Embolism Confirmation and Treatment), combining 3 components to ascertain confirmed PE: emergency department (ED) diagnoses, imaging codes, and dispensed prescriptions or hospital diagnoses. Herein, we used unrelated administrative health care databases to externally validate ASPECT.

Methods:
We used ED electronic health records (ED-EHRs) to identify all residents of Calgary (Alberta, Canada) with PE codes between January and June, 2016. We applied ASPECT by identifying imaging studies in the ED-EHR, admission diagnoses in linked discharge abstract database and filled prescriptions in linked pharmacy information. Confirmed PE in ASPECT was validated against chart review in the ED-EHR.

Results:
The cohort included 498 patients. Overall, 258 (51.9%) were managed as outpatients and 327 were adjudicated to have confirmed PE; the positive predictive value (PV) of single PE codes was 65.6%. With ASPECT the positive PV was 96.5% [95% confidence interval (CI), 94.4–98.5%] and positive likelihood ratio was 10.9 (95% CI, 6.8–15.1). The negative PV and negative likelihood ratio were 85.1% (95% CI, 80.0–90.2%) and 0.1 (95% CI, 0.0–0.1), respectively. Overall agreement of ASPECT with confirmed PE was 92.2%. Further, ASPECT was similarly robust in inpatients and outpatients and was more precise than any 2-component combination of ASPECT.

Conclusions:
Our findings reiterate the limitations of using single administrative codes for PE and suggest ASPECT as an acceptable tool to study PE.
Assessment of Exocrine Pancreatic Function During Endoscopy in Children
Authors: Horvath Karoly , Mehta Devendra I. , Hill Ivor D. 
Published: January 2019

ABSTRACTThis article will review briefly the physiology of pancreatic enzyme secretion and the role of stimulated endoscopic testing for assessing exocrine pancreatic function. Published studies in both the pediatric and adult literature are reviewed. The technique and utility of endoscopic pancreatic function testing as the method of choice in the differential diagnosis of pancreatic disorders in childhood is described. Finally, emerging, clinically useful markers that can be measured in the pancreatic fluid will be described.
International Medical Graduates and the Integrated Plastic Surgery Residency Match
Authors: Lujan-Hernandez Jorge , Ibrahim Mohamed M. , Taub Peter J. 
Published: January 2019

Abstract
Plastic surgery continues to be one of the most competitive programs into which medical students attempt to match. The reasons for this include the complexity and diversity of cases, the opportunity to interact with multiple specialties, patient and surgeon satisfaction, and the potential for higher compensation compared with other specialties. The disparity between the relatively small number of plastic surgery residency positions and the large number of highly competitive candidates has created challenges for both the applicant and the residency program director. This challenge is even greater for international medical graduates because of traditional preconceived notions about the quality of the applicants. The authors sought to determine existing beliefs about international medical graduates among plastic surgeons.
Classifying Preoperative Opioid Use for Surgical Care
Authors: Vu Joceline V. , Cron David C. , Lee Jay S. , Gunaseelan Vidhya , Lagisetty Pooja , Wixson Matthew , Englesbe Michael J. , Brummett Chad M. , Waljee Jennifer F. 
Published: January 2019

Objective:
We characterized patterns of preoperative opioid use in patients undergoing elective surgery to identify the relationship between preoperative use and subsequent opioid fill after surgery.

Background:
Preoperative opioid use is common, and varies by dose, recency, duration, and continuity of fills. To date, there is little evidence to guide postoperative prescribing need based on prior opioid use.

Methods:
We analyzed claims data from Clinformatics DataMart Database for patients aged 18 to 64 years undergoing major and minor surgery between 2008 and 2015. Preoperative use was defined as any opioid prescription filled in the year before surgery. We used cluster analysis to group patients by the dose, recency, duration, and continuity of use. Our primary outcome was second postoperative fill within 30 postoperative days. Our primary explanatory variable was opioid use group. We used logistic regression to examine likelihood of second fill by opioid use group.

Results:
Out of 267,252 patients, 102,748 (38%) filled an opioid prescription in the 12 months before surgery. Cluster analysis yielded 6 groups of preoperative opioid use, ranging from minimal (27.6%) to intermittent (7.7%) to chronic use (2.7%). Preoperative opioid use was the most influential predictor of second fill, with larger effect sizes than other factors even for patients with minimal or intermittent opioid use. Increasing preoperative use was associated with risk-adjusted likelihood of requiring a second opioid fill compared with naive patients [minimal use: odds ratio (OR) 1.49, 95% confidence interval (95% CI) 1.45–1.53; recent intermittent use: OR 6.51, 95% CI 6.16–6.88; high chronic use: OR 60.79, 95% CI 27.81–132.92, all P values <0.001).

Conclusion:
Preoperative opioid use is common among patients who undergo elective surgery. Although the majority of patients infrequently fill opioids before surgery, even minimal use increases the probability of needing additional postoperative prescriptions in the 30 days after surgery when compared with opioid-naive patients. Going forward, identifying preoperative opioid use can inform surgeon prescribing and care coordination for pain management after surgery.
The Adherence of Home Pelvic Floor Muscles Training Using a Mobile Device Application for Women With Urinary Incontinence: A Randomized Controlled Trial
Authors: Araujo Camila C. , Marques Andrea de A. , Juliato Cassia R.T. 
Published: January 2019

Objectives
The objective of this study was to evaluate the use of a mobile device application (app) for the treatment of urinary incontinence through adherence to home pelvic floor muscle training (PFMT) and its impact on urinary symptoms.

Methods
This prospective randomized study included women with stress urinary incontinence. They were randomized into 2 groups: the app group, which used an app developed using the same visual component of electromyography as a guide for PFMT and followed exercises shown on the screen, and the control group, which received written instructions with the same protocol as the app group but without the dynamic sequence of PFMT images. Exercises were done twice a day. Reevaluation was repeated at 1, 2, and 3 months after the initial evaluation. Changes in urinary and vaginal symptoms were evaluated using questionnaires, and the Oxford Modified Scale was determined through digital palpation.

Results
Twenty-one women were included in the study (app group, n = 12; control group, n = 09). Adherence (number of repetitions) was higher in the app group at 2 and 3 months after PFMT (P < 0.001), but adherence decrease, especially in the control group, at 1, 2, and 3 months. Vaginal symptoms (P < 0.001), quality of life (P = 0.003), urinary symptoms (P < 0.001), and stress urinary symptoms (P < 0.001) showed improvement comparing baseline and during treatment, but there was no difference between the app and control groups (P values, 0.887, 0.817, 0.573, and 0.825, respectively).

Conclusions
Using the app increased adherence to PFMT in women with urinary incontinence symptoms and improved subjective perception.
MeshMonk: Open-source large-scale intensive 3D phenotyping
Authors: White Julie D. , Ortega-Castrillón Alejandra , Matthews Harold , Zaidi Arslan A. , Ekrami Omid , Snyders Jonatan , Fan Yi , Penington Tony , Van Dongen Stefan , Shriver Mark D. , Claes Peter 
Published: January 2019

AbstractIn the post-genomics era, an emphasis has been placed on disentangling ‘genotype-phenotype’ connections so that the biological basis of complex phenotypes can be understood. However, our ability to efficiently and comprehensively characterize phenotypes lags behind our ability to characterize genomes. Here, we report a toolbox for fast and reproducible high-throughput dense phenotyping of 3D images. Given a target image, a rigid registration is first used to orient a template to the target surface, then the template is transformed further to fit the specific shape of the target using a non-rigid transformation model. As validation, we used N = 41 3D facial images registered with MeshMonk and manually landmarked at 19 locations. We demonstrate that the MeshMonk registration is accurate, with 0.62 mm as the average root mean squared error between the manual and automatic placements and no variation in landmark position or centroid size significantly attributable to landmarking method used. Though validated using 19 landmarks for comparison with traditional methods, MeshMonk allows for automatic dense phenotyping, thus facilitating more comprehensive investigations of 3D shape variation. This expansion opens up an exciting avenue of study in assessing genomic and phenomic data to better understand the genetic contributions to complex morphological traits.
Serodiagnostic potential of synthetic peptides derived from African swine fever virus putative protein pCP312R
Authors: Ochwo Sylvester , Atuhaire David Kalenzi , Afayoa Mathias , Kisseka Majid , Magambo Phillip Kimuda , Ndekezi Christian , Okuni Julius Boniface , Olaho-Mukani William , Ojok Lonzy 
Published: January 2019

AbstractAfrican swine fever (ASF) is a hemorrhagic disease of domestic swine, with often high mortality rates registered. To date there is still no vaccine produced against ASF, and disease management in countries including Uganda, where the disease is endemic is dependent on accurate and timely diagnosis programs and quarantine. This study aimed at contributing more knowledge towards ASF diagnosis by investigating the serodiagnostic potential of synthetic peptides of an ASF putative protein pCP312R. Antigenic regions of the pCP312R putative protein were identified using Kolaskar and Tongaonkar antigenicity prediction method and twelve (12) peptides were predicted, out of which four (4) peptides were selected and synthesised. An additional peptide derived from the carboxyl end of the ASFV p54 protein was also synthesised and used as a control. Polyclonal rabbit antibodies raised against each of the five peptides was used in immunohistochemistry, and each demonstrated ability to localize viral antigen in pig tissue albeit with slightly varying intensities, at a dilution of 1:200, with antibodies against peptides cpr1, cpr2, cpr3 and cpr4 all accurately staining infected macrophages. However all the peptides evaluated in this study performed moderately when used in indirect ELISA tests giving the following results; CP1; diagnostic sensitivity of 55% (95% CI, 0.3421-0.7418) and specificity of 96% (95% CI, 0.8046-0.9929), CP2; diagnostic sensitivity of 100% (95% CI, 0.8389-1) and specificity of 52% (95% CI, 0.335-0.6997), CP3; diagnostic sensitivity of 95% (95% CI, 76.39-99.11) and specificity of 88% (95% CI, 70.04-95.83), CP4; diagnostic sensitivity of 90% (95% CI: 0.699-0.9721) and specificity of 76% (95% CI: 0.5657-0.885) and p54; diagnostic sensitivity of 100% (95% CI, 0.8389-1) and specificity of 56% (95% CI, 0.3707-0.7333). This study presents the first time synthetic peptides have been successfully predicted, designed and evaluated for Serodiagnosis of African swine fever in domestic pigs. This study in addition showed that there is potential for use of polyclonal anti-peptide antibodies in the diagnosis of ASF using immunohistochemistry.
Gene Panel Sequencing in a Chinese High-risk Breast Cancer Cohort
Authors: Zhang Xianyu , Wang Xiaohong , Song Bingbing , Shao Kang , Li Guibo , Jian Wenjing , Lin Cong , Wang Min , Ye Xiaofei , Xie Jingjing , Xia Bingshu , Xu Shouping , Cao Boyang , Xiao Liyun , Zhang Zhao , Liu Meng , Fang Enhao , Jin Haoxuan , Wei Xiaofeng , Dean Michael , Wang Jian , Yang Huanming , Wang Xianming , Zhu Shida , Hou Yong , Pang Da 
Published: January 2019

AbstractCurrently, over 20 genes have been defined that can confer susceptibility for high-risk breast cancer. Although research has proved the utility of multiple-gene sequencing in the assessment of breast cancer risk, there is little data from China patients. Here, we use a multiple-gene sequencing panel to identify the variant spectrum in Chinese high-risk breast cancer subjects.A total of 829 Chinese high-risk breast cancer patients participated in the research. The coding regions of 115 hereditary cancer susceptibility genes were sequenced using a next generation sequencing platform. In total, 193 pathogenic variants were identified in 45 genes from 177 patients. The pathogenic variant carrier rate is 21.4%: with 10.5% patients carrying a BRCA1 or BRCA2 mutation only, 10.0% of patients carried non-BRCA gene mutations only, while 1.0% of patients carried both a BRCA1/2 and a non-BRCA gene mutation. Variants of uncertain significance (VUS) totaling 2632 were identified in 115 genes from 787 of 829 patients: 82.5% patients carried more than one VUS, and only 5.1% patients did not carry any VUS. Families carrying pathogenic variants were tracked and adenoma was founded in three of them. Our data provide a comprehensive analysis of potential susceptibility variations of high-risk for breast cancer in a Chinese population. This data will be useful for the comparison of the susceptibility variation spectrum between different populations and to discover potential pathogenic variants to improve the prevention and treatment of high-risk breast cancer.
Glycosylphosphatidylinositol Biosynthesis and Remodeling are Required for Neural Crest Cell, Cardiac and Neural Development
Authors: Lukacs Marshall , Roberts Tia , Chatuverdi Praneet , Stottmann Rolf W. 
Published: January 2019

AbstractThe glycosylphosphatidylinositol (GPI) anchor attaches nearly 150 proteins to the cell surface. Patients with pathogenic variants in GPI biosynthetic pathway genes display an array of phenotypes including seizures, developmental delay, dysmorphic facial features and cleft palate. There is virtually no mechanism to explain these phenotypes. we identified a novel mouse mutant (cleft lip/palate, edema and exencephaly; Clpex) with a hypomorphic mutation inPost-Glycophosphatidylinositol Attachment to Proteins-2 (Pgap2). Pgap2is one of the final proteins in the GPI biosynthesis pathway and is required for anchor maturation. We found theClpexmutation results in a global decrease in surface GPI expression. Surprisingly,Pgap2showed tissue specific expression with enrichment in the affected tissues of theClpexmutant. We found the phenotype inClpexmutants is due to apoptosis of neural crest cells (NCCs) and the cranial neuroepithelium, as is observed in the GPI anchoredFolate Receptor 1-/-mouse. We showed folinic acid supplementationin uterocan rescue the cleft lip phenotype inClpex. Finally, we generated a novel mouse model of NCC-specific total GPI deficiency in theWnt1-Crelineage. These mutants developed median cleft lip and palate demonstrating a cell autonomous role for GPI biosynthesis in NCC development.