bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clustering trees: a visualization for evaluating clusterings at multiple resolutions
Authors: Zappia Luke , Oshlack Alicia 
Published: July 2018

Abstract
Clustering techniques are widely used in the analysis of large datasets to group together samples with similar properties. For example, clustering is often used in the field of single-cell RNA-sequencing in order to identify different cell types present in a tissue sample. There are many algorithms for performing clustering, and the results can vary substantially. In particular, the number of groups present in a dataset is often unknown, and the number of clusters identified by an algorithm can change based on the parameters used. To explore and examine the impact of varying clustering resolution, we present clustering trees. This visualization shows the relationships between clusters at multiple resolutions, allowing researchers to see how samples move as the number of clusters increases. In addition, meta-information can be overlaid on the tree to inform the choice of resolution and guide in identification of clusters. We illustrate the features of clustering trees using a series of simulations as well as two real examples, the classical iris dataset and a complex single-cell RNA-sequencing dataset. Clustering trees can be produced using the clustree R package, available from CRAN and developed on GitHub.
The Perils and Promises of Disability Biography
Authors: Nielsen Kim E. 
Published: July 2018

Abstract
Biographical scholarship provides a means by which to understand the past. Disability biography writes disabled people into historical narratives and cultural discourses, acknowledging power, action, and consequence. Disability biography also analyzes the role of ableism in shaping relationships, systems of power, and societal ideals. When written with skilled storytelling, rigorous study, nuance, and insight, disability biography enriches analyses of people living in the past. Disability biography makes clear the multiple ways by which individuals and communities labor, make kinship, persevere, and both resist and create social change. When using a disability analysis, biographies of disabled people (particularly people famous for their disability, such as Franklin Delano Roosevelt and Helen Keller) reveal the relationality and historically embedded nature of disability. In an ableist world, such acts can be revolutionary.
Disability in Modern Chinese Cinema
Authors: Riep Steven L. 
Published: July 2018

Abstract
Depictions of disability in Chinese-language films from China and Taiwan, once a rarity, have become mainstream since the 1980s and have shifted from critiquing national policies, historical accounts, and collective experiences to highlighting disabled people as complex characters and advocating for greater support for them. These films reveal how disability has become a positive source of identity in its own right. Films from the late 1980s and early 1990s such as Tian Zhuangzhuang’s The Blue Kite use disability to offer critiques of official policies or alternative accounts of historical events. Zhou Sun’s Breaking the Silence and Xue Xiaolu’s Ocean Heaven, which focus on caregiving parents and their disabled children, reveal the need for private, extragovernmental networks of support as well as greater government support for those with disabilities and their families. Finally, films such as Zhang Yimou’s Happy Times feature characters with impairments living rich and rewarding lives, countering stereotypes about disability.
Central Nervous System Pain Pathways
Authors: Todd Andrew J. , Wang Fan 
Published: July 2018

Abstract
Nociceptive primary afferents detect stimuli that are normally perceived as painful, and these afferents form synapses in the dorsal horn of the spinal cord and the spinal trigeminal nucleus. Here they are involved in highly complex neuronal circuits involving projection neurons belonging to the anterolateral tract (ALT) and interneurons, which modulate the incoming sensory information. The ALT neurons convey somatosensory information to a variety of brain regions that are involved in the various aspects of the pain experience. A spinothalamic-cortical pathway provides input to several regions of the cerebral cortex, including the first and second somatosensory areas (S1, S2), the insula and the cingluate cortex. These regions are thought be responsible for the sensory-discriminative aspects of pain (S1), pain-related learning (S2), the autonomic and motivational responses (insula), and the negative affect (cingulate). Another ascending system, The spinoparabrachial-limbic pathway targets a variety of brain regions, including the amygdala, and is likely involved in the affective component of pain. A descending system that includes the limbic system, the periaqueductal gray matter of the midbrain, the locus coeruleus, and the rostral ventral medulla, can suppress pain, and this operates partly through the monoamine transmitters noradrenaline and serotonin which are released in the spinal and trigeminal dorsal horn.
Plays 1598–1603
Authors: Lowe Eleanor 
Published: July 2018

Abstract
The chapter begins by marking out the boundaries of ‘early Jonson’ with reference to theatre history and bibliography, before providing recorded responses to Jonson in the contemporary theatre. It identifies 1597 as a key year in his dramatic development, particularly pointing to the influence of George Chapman on Jonson’s playwriting and on popular London theatre more generally. The Case Is Altered, Jonson’s first extant performed play, is analysed in detail, with special attention paid to his presentation of households on the stage (the carefully delineated status of the steward, his lord, and other servants), and integral use of properties, costume and objects in stage business. The conclusion points to Jonson’s skill in crafting little worlds within the theatre, and in bringing London onto the stage.
Introduction to Ecclesiology
Authors: Avis Paul 
Published: July 2018

Abstract
The purpose of this introductory chapter is to provide the reader with an overview of the theological discipline of ecclesiology and a basic orientation to its questions and methods. Noting the boost that ecclesiology received from Karl Barth’s Church Dogmatics, Vatican II, and the Ecumenical Movement, the chapter proceeds to explain the etymology of ‘ecclesiology’ and then to define it as the discipline that is concerned with comparative, critical, and constructive reflection on the dominant paradigms of the identity of the church. It then mentions the primary sources of ecclesiology and charts its late arrival on the theological scene. It explores why ecclesiology is inherently problematic—because the church is a divine mystery. Recent developments within ecclesiology are introduced: missiological, ecumenical, feminist, practical, and ethnographical. Four questions to wrestle with are briefly discussed and the chapter ends by raising the possibility of ecclesiology as a vocation.
Liberation Ecclesiologies with Special Reference to Latin America
Authors: Maldonado Michelle Gonzales 
Published: July 2018

Abstract
This chapter starts by reflecting on the historic European and North American dominance of theology, including ecclesiology, and by noting that in recent decades minority voices from the global South have begun to make themselves heard, salient among them liberation theologians. Liberation theology, emanating from—but not confined to—Latin America, is introduced. It has developed a new theological method, with radical implications for ecclesiology. In liberation theology the principal subjects of the church are not the members of the ecclesiastical hierarchy, but the poor or otherwise marginalized, gathered in ‘base communities’ to read the Bible in the light of their experience of oppression. The gospel message is not primarily concerned with individual salvation but with social and economic justice and the sustaining of communities of mutual support. The targets of Liberation Theology also include colonialism, racism and ethnocentrism, gender discrimination, and oppression on grounds of sexual orientation.
Peer Mentoring as a Successful Retention Strategy for a Baccalaureate Nursing Program in a Historically Black College and University
Authors: Igbo Immaculata N. , Sule Ejim N. 
Published: July 2018

Abstract
A university-based, student-run nursing organization improved cultural awareness, academic environment, and performance for members of the organization. The International Student Nursing Organization sponsored cultural events and a peer mentoring program. Members who participated in the peer mentoring program were randomly matched as mentors (seniors) or mentees (juniors); mentors were awarded service hours. Statistical data was tracked over two semesters for the first cohort of students. Mentors had a higher aggregate score on their comprehensive exit and nursing licensure exams when compared to their graduating class as a whole. A collegial and learning environment was created that promoted students’ professional and leadership skills.
Failing to Fail in Undergraduate Nursing: Understanding the Phenomenon
Authors: Docherty Angie 
Published: July 2018

Abstract

AIM
The aim of the study was to explore and understand the phenomenon of “failing to fail.”

BACKGROUND
Phase 1 of a mixed-methods study suggested faculty in clinical settings instructed students that should not have passed preceding placements; students in didactic settings also passed exams that merited a fail. Phase 2 explored this phenomenon.

METHOD
A multisite qualitative case study targeted baccalaureate and community college faculty to support analysis using replication logic. Data collection was conducted via semistructured interview.

RESULTS
Eighteen demographically diverse cases were recruited (including age, experience, and full-/part-time status). Factors supporting failing to fail included being good enough, clinical/didactic dichotomy, team grading, and being the bad guy.

CONCLUSION
The consistency of enabling factors suggests a collective approach is required to address failing to fail, including pedagogical preparation and cross-school mechanisms for ensuring grading parity. Effort must address integrity and teaching excellence in all aspects of nursing education.
Budget Friendly Simulation for Clinical Nursing Education: Putting It All Together
Authors: Zamora Zelne , Shedd Joanna , Kittipha Panicha 
Published: July 2018

Abstract
Clinical simulation in nursing has become increasingly valuable in helping students learn tasks and assessments in a nonthreatening environment. Evaluating student assessments can promote collegiality among faculty. This article focuses on three tips for faculty used by one university to objectively capture a clinical snapshot in a cost-effective manner: 1) write one’s own scenarios, 2) create assessment forms using Word, and 3) employ bar scanning with quick response code readers.
Competencies, Milestones, and a Level of Supervision Scale for Entrustable Professional Activities for Scholarship
Authors: Mink Richard B. , Myers Angela L. , Turner David A. , Carraccio Carol L. 
Published: July 2018

Problem
Scholarship is an important element of both undergraduate and graduate medical education, and scholarly activity is required for all pediatric fellows. However, despite the creation of entrustable professional activities (EPAs) for scholarship, the specific progressive levels of performance and the appropriate level of supervision for a given performance level have not been defined. The authors developed competencies and milestones for the scholarship EPA to provide a framework for assessment across the continuum; a level of supervision scale was also developed.

Approach
The Vitae Researcher Development Framework served as a template to create the competencies and milestones for the scholarship EPA. Beginning in September 2015 and using a modified Delphi approach, three drafts were circulated to individuals with expertise in various types of scholarship until broad agreement was achieved. Then, in October 2016, the Steering Committee of the Subspecialty Pediatrics Investigator Network created a level of supervision scale, modeled after one it had previously developed.

Outcomes
Eight competencies were identified as important in making entrustment decisions related to scholarship. For each competency, five milestone levels that span the continuum from novice to expert were created. A supervision scale with five progressive levels of entrustment was also created.

Next Steps
Next steps include a study to obtain validity evidence for the supervision scale and determine the correlation between milestone and supervision levels. These competencies, milestones, and supervision levels can potentially serve as a road map for trainees and junior faculty and also play a role in the assessment of physician–scientists.
Massachusetts Child Psychiatry Access Program for Moms
Authors: Byatt Nancy , Straus John , Stopa Arielle , Biebel Kathleen , Mittal Leena , Moore Simas Tiffany A. 
Published: July 2018

OBJECTIVE:
To describe the utilization and quality assessment of a population-based program to help health care providers address mental health and substance use disorders among pregnant and postpartum women, the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms).

METHODS:
The Massachusetts Child Psychiatry Access Program for Moms builds health care providers' capacity to address perinatal mental health and substance use disorders through 1) trainings and toolkits, 2) telephonic access to perinatal psychiatric consultation, and 3) facilitating referral to community resources. Clinical encounter data were collected during telephone consultations. Focus groups were conducted with health care providers and staff from enrolled practices. In-depth interviews were conducted with patients served by the practices that participated in the focus groups. Transcribed interviews were analyzed by two researchers using an iterative, interpretive process with a grounded theory framework.

RESULTS:
In the first 3.5 years, MCPAP for Moms enrolled 145 obstetric practices, conducted 145 trainings for 1,174 health care providers, and served 3,699 women. Of telephone consultations provided, 42% were with obstetric care providers–midwives and 16% with psychiatrists. Health care providers perceived that MCPAP for Moms facilitates health care providers detecting and addressing depression and women disclosing symptoms, seeking help, and initiating treatment. Obstetric practices reported that they need additional support to more proactively address and further improve depression care.

CONCLUSION:
The high volume of encounters, sustained utilization over 3.5 years, and qualitative themes identified from health care providers and patients demonstrate that MCPAP for Moms is a feasible, acceptable, and sustainable approach to increasing access to evidence-based treatments for perinatal mental health and substance use disorders on a population-based level.
Cumulative Financial Burden of Readmissions for Biliary Pancreatitis in Pregnant Women
Authors: Juo Yen-Yi , Khrucharoen Usah , Sanaiha Yas , Seo Young-Ji , Dutson Erik , Benharash Peyman 
Published: July 2018

OBJECTIVE:
To evaluate the cumulative hospitalization cost differences between routine cholecystectomy and an observational approach during index hospitalization for pregnant patients.

METHODS:
A retrospective cohort study of 1,245 pregnant women with biliary pancreatitis across the United States between 2010 and 2014 was performed using the Nationwide Readmissions Database. Cumulative costs and complications were compared between patients with and without cholecystectomy during both initial and subsequent hospitalizations.

RESULTS:
Cholecystectomy was performed at index hospitalization in 374 patients (374/1,245 [30.0%]). Those who did not undergo index cholecystectomy experienced higher 30-day readmissions (33.7% vs 5.3%, P<.01), and 24.5% eventually underwent interval cholecystectomy. Incidence of bile duct injury was exceedingly low for cholecystectomies performed during either index or subsequent hospitalizations (4/548 [0.7%] vs 12/213 [1.5%], P<.01). No significant difference in risk of premature delivery and abortion was observed (13.3% vs 13.2%, P=.98). Most common diagnoses during readmission included cholelithiasis (44.9%), acute pancreatitis (29.9%), cholecystitis (19.9%), choledocholithiasis (12.8%), chronic pancreatitis (4.2%), cholangitis (1.7%), and pancreatic pseudocyst (1.1%). Patients who underwent cholecystectomy during the index hospitalization had the lowest average cumulative hospitalization episodes, followed by patients undergoing nonoperative management; patients undergoing interval cholecystectomy experienced the highest average hospitalization episodes (1.4 vs 1.7 vs 2.9 hospitalizations, P<.01 for both comparisons). Although initial hospitalization cost was higher for patients who underwent cholecystectomy during index admission, the cumulative hospitalization cost became lower when costs for subsequent readmissions were factored in.

CONCLUSION:
Early cholecystectomy should be considered in pregnant patients with biliary pancreatitis to reduce readmission costs, because there were no differences in postoperative outcomes.
Prophylactic Negative Pressure Wound Therapy and Wound Complication After Cesarean Delivery in Women With Class II or III Obesity
Authors: Wihbey Kristina A. , Joyce Ellen M. , Spalding Zachary T. , Jones Hayley J. , MacKenzie Todd A. , Evans Rebecca H. , Fung June L. , Goldman Marlene B. , Erekson Elisabeth 
Published: July 2018

OBJECTIVE:
To compare the occurrence of superficial surgical site infections in obese women using prophylactic negative pressure therapy with standard dressings after cesarean delivery.

Methods:
We conducted a randomized controlled, nonblinded, two-center study of prophylactic negative pressure therapy compared with standard surgical dressings placed at the time of primary closure at cesarean delivery in obese women with body mass indexes (BMI) of 35 or higher (ie, class II and III obesity). Our primary outcome was occurrence of a superficial surgical site infection. We assumed a superficial surgical site infection occurrence rate of 20% and intended to recruit 400 women. However, after low enrollment of 166 women over 24 months, an interim analysis for futility was conducted and the decision was made to halt the study.

RESULTS:
Women were recruited between January 5, 2015, and January 7, 2017, from two sites. The mean BMI on admission was 44.9 (±8) for the prophylactic negative wound therapy group and 43.4 (±7) for the standard dressing group. There were no differences in the occurrence of observed superficial surgical site infections between women using prophylactic negative pressure wound therapy (12/80 [15%]) compared with women who received the standard dressing (8/81 [10%], P=.35, relative risk 1.52, 95% CI 0.66–3.52). There were no differences in the occurrence of composite wound complications between women using prophylactic negative pressure wound therapy (25/80 [31%]) compared with women who received the standard dressing (24/81 [30%], P=.87).

CONCLUSION:
In this randomized controlled trial that did not achieve full anticipated enrollment, we did not observe a decrease in superficial surgical site infections after cesarean delivery in obese women with the use of prophylactic negative pressure wound therapy.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT02390401.
Influence of Body Mass Index on Fetal Fraction Increase With Gestation and Cell-Free DNA Test Failure
Authors: Rolnik Daniel L. , Yong Yuanqi , Lee Timothy J. , Tse Cheryl , McLennan Andrew C. , da Silva Costa Fabricio 
Published: July 2018

OBJECTIVE:
To assess the influence of body mass index (BMI) on fetal fraction increase with gestational age and on the rates of test failure.

METHODS:
We performed a cross-sectional study of consecutive singleton pregnancies in which cell-free DNA screening for fetal aneuploidies was performed from 10 weeks of gestation, between May 2013 and January 2018, at two fetal medicine clinics in Australia using one of two different platforms. Maternal characteristics, fetal fraction, and failure after a first attempt (“no-call”) and after resampling (“test failure”) were recorded. Body mass index was classified as normal (BMI less than 25.0), overweight (BMI 25.0–29.9), obesity class I (BMI 30.0–34.9), and obesity classes II and III (BMI 35.0 or greater). Fetal fraction and proportions of no-call results and test failure were compared between the groups.

RESULTS:
Of 14,223 singleton pregnancies included, 8,583 (60.3%) were screened with platform A and 5,640 (39.7%) with platform B. Median fetal fraction values were lower, and no-call and failure rates were higher in increased BMI groups across both platforms (P<.001 in both). When compared with women with normal BMIs, women with BMIs of 35 or greater had a significantly smaller increase in fetal fraction (0.1 vs 0.3 units/wk, P<.001, in both platforms). In this subgroup, when compared with women with normal BMIs, the odds ratios for a no-call result were 22.0 (95% CI 13.8–35.3, 16.6% vs 0.9%) and 8.0 (95% CI 4.1–15.6, 7.8% vs 1.0%) and for a failed test were 25.0 (95% CI 11.2–55.7, 6.4% vs 0.3%) and 5.8 (95% CI 2.0–17.3, 2.7% vs 0.5%) using platforms A and B, respectively.

CONCLUSION:
The increase in fetal fraction throughout gestation in women with BMIs of 35 or above is minimal. Postponing the test is unlikely to reduce test failure rates in this population.
Validation and Clinical Evaluation of a Method for Double-Blinded Blood Pressure Target Investigation in Intensive Care Medicine*
Authors: Grand Johannes , Meyer Anna Sina P. , Hassager Christian , Schmidt Henrik , Møller Jacob E. , Kjaergaard Jesper 
Published: July 2018

Objectives:
No double-blinded clinical trials have investigated optimal mean arterial pressure targets in the ICU. The aim of this study was to develop and validate a method for blinded investigation of mean arterial pressure targets in patients monitored with arterial catheter in the ICU.

Design:
Prospective observational study (substudy A) and prospective, randomized, controlled clinical study (substudy B).

Setting:
ICU, Department of Cardiology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.

Patients:
Adult patients resuscitated from out-of-hospital cardiac arrest.

Interventions:
Standard blood pressure measuring modules were offset to display 10% lower or higher blood pressure values. We then: 1) confirmed this modification in vivo by comparing offset to standard modules in 22 patients admitted to the ICU. Thereafter we 2) verified the method in two randomized, clinical trials, each including 50 out-of-hospital cardiac arrest patients, where the offset of the blood pressure module was blinded to the treating staff.

Measurements and Main Results:
Substudy A showed that the expected separation of blood pressure measurements was achieved with an excellent correlation of the offset and standard modules (R
2 = 0.997). Bland-Altman plots showed no bias of modified modules over a clinically relevant range of mean arterial pressure. The primary endpoint of the clinical trials was between-group difference of norepinephrine dose needed to achieve target mean arterial pressure. Trial 1 aimed at a 10% difference between groups in mean arterial pressure (targets: 65 and 72 mm Hg, respectively) and demonstrated a separation of 5 ± 1 mm Hg (p < 0.001). The difference in norepinephrine dose was not significantly different (0.03 ± 0.03 µg/kg/min; p = 0.42). Trial 2 aimed at a 20% difference between groups in mean arterial pressure (targets: 63 and 77 mm Hg, respectively). Separation was 12 ± 1 mm Hg (p < 0.01) in mean arterial pressure and 0.07 ± 0.03 µg/kg/min (p < 0.01) in norepinephrine dose.

Conclusions:
The present method is feasible and robust and provides a platform for double-blinded comparison of mean arterial pressure targets in critically ill patients.