bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are Female Applicants Rated Higher Than Males on the Multiple Mini-Interview? Findings From the University of Calgary
Authors: Ross Marshall , Walker Ian , Cooke Lara , Raman Maitreyi , Ravani Pietro , Coderre Sylvain , McLaughlin Kevin 
Published: November 2016

Purpose
The multiple mini-interview (MMI) improves reliability and validity of medical school interviews, and many schools have introduced this in an attempt to select individuals more skilled in communication, critical thinking, and ethical decision making. But every change in the admissions process may produce unintended consequences, such as changing intake demographics. In this article, two studies exploring gender differences in MMI ratings are reported.

Method
Cumulative meta-analysis was used to compare MMI ratings for female and male applicants to the University of Calgary Cumming School of Medicine between 2010 and 2014. Multiple linear regression was then performed to explore gender differences in MMI ratings after adjusting for other variables, followed by a sensitivity analysis of the impact of varying the weight given to MMI ratings on the odds of females being ranked in the top 150 applicants for 2014.

Results
Females were rated higher than male applicants (standardized mean difference 0.21, 95% CI [0.11, 0.30], P < .001). After adjusting for other explanatory variables, there was a positive association between female applicant and MMI rating (regression coefficient 0.23 [0.14, 0.33], P < .001). Increasing weight assigned to MMI ratings was associated with increased odds of females being ranked in the top 150 applicants.

Conclusions
In this single-center study, females were rated higher than males on the MMI, and the odds of a female applicant being offered a position increased as more weight was given to MMI ratings. Further studies are needed to confirm and explain gender differences in MMI ratings.
Building a Global, Online Community of Practice: The OPENPediatrics World Shared Practices Video Series
Authors: Wolbrink Traci A. , Kissoon Niranjan , Mirza Nabila , Burns Jeffrey P. 
Published: November 2016

Problem
Health care professionals are familiar with engaging in local communities of practice (CoPs) within their hospital, region, and/or country, but despite the availability of online technologies that facilitate online global collaboration, the health care sector has yet to fully embrace these tools.

Approach
In 2013, OPENPediatrics (an online social learning platform) launched the World Shared Practices video (WSP) series to engage and coalesce the global community of critical care clinicians. Each month, a 30- to 45-minute video featuring a pediatric critical care medicine expert, interspersed with questions for the audience, is released. Viewers contribute to the community discussion by leaving comments that display alongside the video. Clinicians are encouraged to asynchronously host an educational conference so they can watch the videos and participate in the discussion together.

Outcomes
From March 2013–November 2015, 28 WSPs were launched on a variety of topics. They were viewed over 18,414 times by 1,864 viewers in 132 countries and 760 hospitals; 1,155 comments were submitted. Attending physicians/consultants were the largest audience (36% [671/1,864]), and 37% (30/81) of responding viewers that commented in WSPs watched in small groups. The WSP series was reported to add value to respondents’ learning or teaching and to have had a positive impact on their knowledge or practice.

Next Steps
Future research will focus on further describing the context and structure of the CoP and on more deeply investigating its higher-level outcomes and impact. More work is needed to identify barriers and strategies that improve online community engagement.
NaoXinTong Enhances Atorvastatin-induced Plaque Stability While Ameliorating Atorvastatin-induced Hepatic Inflammation
Authors: Yang Xiaoxiao , Li Yan , Sun Lei , Liu Ying , Ma Chuanrui , Chen Yuanli , Tan Hao , Li Qi , Li Xiaoju , Wang Yong , Duan Yajun , Zhao Buchang , Han Jihong 
Published: November 2016

Abstract:Buchang NaoXinTong (NXT) is a Chinese medicine that has been used for many years for treatment of patients with coronary heart disease (CHD) in China. Statins substantially reduce hypercholesterolemia and CHD mortality and morbidity. However, there is still a lot of CHD patients who do not respond well to statin therapy. Herein, we report the effects of NXT on atorvastatin-inhibited atherosclerosis and atorvastatin-induced hepatic side effects. After 10 weeks of high-fat diet (HFD) feeding, apoE-deficient mice were randomly divided into 4 groups and received the following treatment for another 8 weeks: group 1, HFD; group 2, HFD containing NXT; group 3, HFD containing atorvastatin; and group 4, HFD containing both NXT and atorvastatin. After treatment, serum lipid profiles, atherosclerotic lesions, and hepatic lipid content and inflammation were determined. NXT moderately increased high-density lipoprotein cholesterol levels, although had little effect on atorvastatin-induced reduction of low-density lipoprotein cholesterol levels. Both NXT and atorvastatin reduceden facelesions and sinus lesions of aortic root. In addition, NXT enhanced atorvastatin-induced lesion plaque stability by increasing smooth muscle cell/collagen content and reducing macrophage accumulation and calcification in lesion areas. The co-treatment of NXT and atorvastatin further reduced hepatic triglyceride levels by downregulating acyl-CoA:diacylglycerol acyltransferase 1 while activating hormone-sensitive lipase, adipose triglyceride lipase, and comparative gene identification-58 expression. The AMPKα pathway was also further activated by the co-treatment. More importantly, the liver injuries caused by atorvastatin, such as hepatic inflammation and elevated serum aminotransferase activities, were substantially attenuated by NXT. Therefore, our study demonstrates that NXT enhances atorvastatin-induced plaque stability and ameliorates atorvastatin-induced hepatic side effects.
Validating the Quality of Life After Brain Injury Through Rasch Analysis
Authors: Chang Feng-Hang , Chen Chih-Yi , Liang Wen-Miin , Lin Mau-Roung 
Published: November 2016

Objective:
The Quality of Life after Brain Injury (QOLIBRI), a cross-cultural instrument, has been validated in several languages; however, traditional psychometric approaches have critical limitations. Therefore, we applied the Rasch model for validating the 37-item QOLIBRI scale among a Chinese population with traumatic brain injury.

Participants and Setting:
In total, 587 participants (mean age: 44.2 ± 15.4 years; women, 46.3%) were surveyed in neurosurgery departments at 6 hospitals in Taipei, Taiwan.

Main Outcome Measure:
The QOLIBRI.

Results:
Of the 6 subscales of the QOLIBRI, 4 (cognition, self, daily life and autonomy, and social relationships) were unidimensional, valid, and reliable, whereas the remaining 2 (emotions and physical problems) exhibited poor unidimensionality, item and person reliability, and person-item targeting. Five items (energy, concentrating, getting out and about, sex life, and achievements) showed considerable differential item functioning among age groups, disability levels, and time since traumatic brain injury.

Conclusion:
According to item response theory, we identified psychometric issues in the emotions and physical problems subscales of the QOLIBRI as well as several differential item functioning items. Future research is required to determine whether similar results are observed in other language versions of the QOLIBRI or in other countries.
Incidence and Associated Risk Factors of Traumatic Brain Injury in a Cohort of Homeless and Vulnerably Housed Adults in 3 Canadian Cities
Authors: Nikoo Mohammadali , Gadermann Anne , To Matthew J. , Krausz Michael , Hwang Stephen W. , Palepu Anita 
Published: November 2016

Objective:
To examine the factors associated with incident traumatic brain injury (TBI) among homeless and vulnerably housed persons over a 3-year follow-up period.

Setting and participants:
Data were obtained from the Health and Housing in Transition study, which tracked the health and housing status of 1190 homeless or vulnerably housed individuals in 3 Canadian cities for 3 years.

Design and Main Measures:
Main measure was self-reported incident TBI during the follow-up period. Factors associated with TBI were ascertained using mixed-effects logistic regression.

Results:
During first, second, and third years of follow-up, 187 (19.4%), 166 (17.1%), and 172 (17.9%) participants reported a minimum of 1 incident TBI, respectively. Among 825 participants with available data for all 3 years of follow-up, 307 (37.2%) reported at least 1 incident TBI during the 3-year follow-up period. Lifetime prevalence of TBI, endorsing a history of mental health diagnoses at baseline, problematic alcohol and drug use, younger age, poorer mental health, and residential instability were associated with increased risk of incident TBI during follow-up period.

Conclusion:
Mental health support and addressing residential instability and problematic substance use may reduce further risk of TBI and its associated poor health and social outcomes in this population.
The Minimal Clinically Important Difference for the Mayo-Portland Adaptability Inventory
Authors: Malec James F. , Kean Jacob , Monahan Patrick O. 
Published: November 2016

Objectives:
To determine the Minimal Clinically Important Difference (MCID) and Robust Clinically Important Difference (RCID) of the Mayo-Portland Adaptability Inventory–4 (MPAI-4) as measures of response to intervention.

Methods:
Retrospective analysis of existing data. Both distribution- and anchor-based methods were used to triangulate on the MCID and to identify a moderate, that is, more robust, level of change (RCID) for the MPAI-4. These were further evaluated with respect to clinical provider ratings.

Participants:
Data for individuals with acquired brain injury in rehabilitation programs throughout the United States in the OutcomeInfo Database (n = 3087) with 2 MPAI-4 ratings.

Main Measures:
MPAI-4, Supervision Rating Scale, Clinician Rating of Global Clinical Improvement.

Results:
Initial analyses suggested 5 T-score points (5T) as the MCID and 9T as the RCID. Eighty-one percent to 87% of clinical raters considered a 5T change and 99% considered a 9T change to indicate meaningful improvement.

Conclusions:
5T represents the MCID for the MPAI-4 and 9T, the RCID. Both values are notably less than the Reliable Change Index (RCI). While the RCI indicates change with a high level of statistical confidence, it may be insensitive to change that is considered meaningful by providers and participants as indicated by the MCID.
Factors Associated With Rehabilitation Outcomes After Traumatic Brain Injury: Comparing Functional Outcomes Between TBIMS Centers Using Hierarchical Linear Modeling
Authors: Dahdah Marie N. , Hofmann Melissa , Pretz Christopher , An Viktoriya , Barnes Sunni A. , Bennett Monica , Dreer Laura E. , Bergquist Thomas , Shafi Shahid 
Published: November 2016

Objective:
To examine differences in patient outcomes across Traumatic Brain Injury Model Systems (TBIMS) rehabilitation centers and factors that influence these differences using hierarchical linear modeling (HLM).

Setting:
Sixteen TBIMS centers.

Participants:
A total of 2056 individuals 16 years or older with moderate to severe traumatic brain injury (TBI) who received inpatient rehabilitation.

Design:
Multicenter observational cohort study using HLM to analyze prospectively collected data.

Main Outcome Measures:
Functional Independence Measure and Disability Rating Scale total scores at discharge and 1 year post-TBI.

Results:
Duration of posttraumatic amnesia (PTA) demonstrated a significant inverse relationship with functional outcomes. However, the magnitude of this relationship (change in functional status for each additional day in PTA) varied among centers. Functional status at discharge from rehabilitation and at 1 year post-TBI could be predicted using the slope and intercept of each TBIMS center for the duration of PTA, by comparing it against the average slope and intercept.

Conclusions:
HLM demonstrated center effect due to variability in the relationship between PTA and functional outcomes of patients. This variability is not accounted for in traditional linear regression modeling. Future studies examining variations in patient outcomes between centers should utilize HLM to measure the impact of additional factors that influence patient rehabilitation functional outcomes.
USE OF A CARBONIC ANHYDRASE INHIBITOR IN X-LINKED RETINOSCHISIS
Authors: Andreuzzi Paola , Fishman Gerald A. , Anderson Robert J. 
Published: November 2016

Purpose:
To evaluate changes in cystic-appearing macular lesions and visual acuity in patients with X-linked retinoschisis while being treated with a carbonic anhydrase inhibitor.

Methods:
A retrospective analysis of 68 eyes from 36 patients between the ages of 5 years and 61 years with X-linked retinoschisis were monitored while on a carbonic anhydrase inhibitor. Macular cystic-appearing lesions were monitored with optical coherence tomography. Snellen visual acuity measurements were converted to logarithm of the minimum angle of resolution equivalent Early Treatment Diabetic Retinopathy Study letters for analysis. Analyses for changes in both visual acuity and macular cysts included comparisons between treatment and pretreatment segments.

Results:
Forty-five eyes (66%) had a reduction of their cysts while on a carbonic anhydrase inhibitor. Twenty eyes (29%) showed no cystic change, whereas 3 eyes (4%) demonstrated worsening of their cysts with treatment when compared with pretreatment. There was a statistically significant improvement in logarithm of the minimum angle of resolution visual acuity while on treatment relative to pretreatment (P < 0.0001). The estimated average Early Treatment Diabetic Retinopathy Study equivalent improvement was 0.09 (slightly less than one line on the Early Treatment Diabetic Retinopathy Study chart) with a 95% confidence interval of 0.08 to 0.11.

Conclusion:
Considering the entire 36 patients in this cohort, while statistically significant, the average improvement in visual acuity was modest. Nonetheless, in individual patients, the improvement was more substantial. Improvement in the extent of cystic macular lesions was observed in a high percentage of cases.
CLINICAL PRESENTATION AND DISEASE COURSE OF USHER SYNDROME BECAUSE OF MUTATIONS IN MYO7A OR USH2A
Authors: Testa Francesco , Melillo Paolo , Bonnet Crystel , Marcelli Vincenzo , de Benedictis Antonella , Colucci Raffaella , Gallo Beatrice , Kurtenbach Anne , Rossi Settimio , Marciano Elio , Auricchio Alberto , Petit Christine , Zrenner Eberhart , Simonelli Francesca 
Published: November 2016

Purpose:
To evaluate differences in the visual phenotype and natural history of Usher syndrome caused by mutations in MYO7A or USH2A, the most commonly affected genes of Usher syndrome Type I (USH1) and Type II (USH2), respectively.

Methods:
Eighty-eight patients with a clinical diagnosis of USH1 (26 patients) or USH2 (62 patients) were retrospectively evaluated. Of these, 48 patients had 2 disease-causing mutations in MYO7A (10 USH1 patients), USH2A (33 USH2 patients), and other USH (5 patients) genes. Clinical investigation included best-corrected visual acuity, Goldmann visual field, fundus photography, electroretinography, and audiologic and vestibular assessments. Longitudinal analysis was performed over a median follow-up time of 3.5 years.

Results:
Patients carrying mutations in MYO7A had a younger age of onset of hearing and visual impairments than those carrying mutations in USH2A, leading to an earlier diagnosis of the disease in the former patients. Longitudinal analysis showed that visual acuity and visual field decreased more rapidly in subjects carrying MYO7A mutations than in those carrying USH2A mutations (mean annual exponential rates of decline of 3.92 vs. 3.44% and of 8.52 vs. 4.97%, respectively), and the former patients reached legal blindness on average 15 years earlier than the latter.

Conclusion:
The current study confirmed a more severe progression of the retinal disease in USH1 patients rather than in USH2 patients. Furthermore, most visual symptoms (i.e., night blindness, visual acuity worsening) occurred at an earlier age in USH1 patients carrying mutations in MYO7A.
F usarium solani SUBRETINAL ABSCESS IN A PATIENT WITH ACUTE MYELOID LEUKEMIA
Authors: Schlaen Ariel , Ingolotti Mariana , Lorenzon Pablo , Mancini Jorge , Couto Cristobal , Casanova Maria , Kusminsky Gustavo , Tisi Baña Matias , Pineda Gloria , Rima Alejandra , Saravia Mario 
Published: November 2016

Purpose:
To report on a case of Fusarium solani subretinal abscess in a patient with acute myeloid leukemia treated with an allogenic bone marrow transplant.

Methods:
A 47-year-old male with a history of acute myeloid leukemia with intermediate cytogenetic risk was admitted in our hospital. The disease relapsed after two cycles of chemotherapy. He was then treated with an allogenic bone marrow transplant, with busulfan, cyclophosphamide, and thymoglobulin. One week after the procedure, a sepsis of unknown origin in neutropenia occurred. Blood cultures and sputum were negative for bacteria and fungi. At the eighth week after the procedure, the patient had acute vision loss of the right eye. Funduscopy in the right eye revealed an inferior temporal yellowish white elevated lesion of approximately 10 disk areas and superficial perifoveal and perilesional hemorrhages.

Results:
Vitrectomy was performed and samples from the vitreous and the subretinal abscess material were sent for analysis. Vitreous and subretinal specimens grew colonies of a fungus morphologically consistent with F. solani.

Conclusion:

Fusarium solani should be included in the differential diagnosis of subretinal abscesses.
Pediatric Ventilator-Associated Infections: The Ventilator-Associated INfection Study
Authors: Willson Douglas F. , Hoot Michelle , Khemani Robinder , Carrol Christopher , Kirby Aileen , Schwarz Adam , Gedeit Rainer , Nett Sholeen T. , Erickson Simon , Flori Heidi , Hays Spencer , Hall Mark 
Published: November 2016

Objective:
Suspected ventilator-associated infection is the most common reason for antibiotics in the PICU. We sought to characterize the clinical variables associated with continuing antibiotics after initial evaluation for suspected ventilator-associated infection and to determine whether clinical variables or antibiotic treatment influenced outcomes.

Design:
Prospective, observational cohort study conducted in 47 PICUs in the United States, Canada, and Australia. Two hundred twenty-nine pediatric patients ventilated more than 48 hours undergoing respiratory secretion cultures were enrolled as “suspected ventilator-associated infection” in a prospective cohort study, those receiving antibiotics of less than or equal to 3 days were categorized as “evaluation only,” and greater than 3 days as “treated.” Demographics, diagnoses, comorbidities, culture results, and clinical data were compared between evaluation only and treated subjects and between subjects with positive versus negative cultures.

Setting:
PICUs in 47 hospitals in the United States, Canada, and Australia.

Subjects:
All patients undergoing respiratory secretion cultures during the 6 study periods.

Interventions:
None.

Measurements and Main Results:
Treated subjects differed from evaluation-only subjects only in frequency of positive cultures (79% vs 36%; p < 0.0001). Subjects with positive cultures were more likely to have chronic lung disease, tracheostomy, and shorter PICU stay, but there were no differences in ventilator days or mortality. Outcomes were similar in subjects with positive or negative cultures irrespective of antibiotic treatment. Immunocompromise and higher Pediatric Logistic Organ Dysfunction scores were the only variables associated with mortality in the overall population, but treated subjects with endotracheal tubes had significantly lower mortality.

Conclusions:
Positive respiratory cultures were the primary determinant of continued antibiotic treatment in children with suspected ventilator-associated infection. Positive cultures were not associated with worse outcomes irrespective of antibiotic treatment although the lower mortality in treated subjects with endotracheal tubes is notable. The necessity of continuing antibiotics for a positive respiratory culture in suspected ventilator-associated infection requires further study.
Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies
Authors: Kinuthia John , Richardson Barbra A. , Drake Alison L. , Matemo Daniel , Unger Jennifer A. , McClelland Raymond S. , John-Stewart Grace 
Published: November 2016

Background:
Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods.

Methods:
HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying.

Results:
Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4–12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex.

Conclusions:
High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.