bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral Nerve Blockade for Primary Total Knee Arthroplasty
Authors: McIsaac Daniel I. , McCartney Colin J. L. , Walraven Carl van 
Published: December 2016

Abstract

Background
Although peripheral nerve blocks decrease pain after total knee arthroplasty, the population-level impact of nerve blocks on arthroplasty resource utilization is unknown.

Methods
We conducted a population-based cohort study using linked administrative data from Ontario, Canada. We identified all adults having their first primary knee arthroplasty between 2002 and 2013. Using propensity scores to adjust for measureable confounders, we matched nerve block patients to a patient who did not receive a block. Within the matched cohort, we estimated the independent association of blocks with outcomes (length of hospital stay [primary]; and readmissions, emergency department visits, and falls [secondary]).

Results
One hundred seventy-eight thousand two hundred fourteen patients were identified; 61,588 (34.6%) had a block. The mean hospital stay was 4.6 days with a block compared to 4.8 without. After matching, there was a statistically significant decrease in the length of stay in the block group (relative risk, 0.98; 95% CI, 0.97 to 0.99; P < 0.001). Blocks were associated with a significant decrease in readmissions (relative risk, 0.87; 95% CI, 0.79 to 0.88; P < 0.001) but not emergency department visits (relative risk, 1.02; 95% CI, 0.98 to 1.05) or falls (relative risk, 1.37; 95% CI, 0.90 to 2.08). The association of blocks with length of stay after 2008 was inconsistent; overall, they were associated with longer stays; however, single-shot blocks were associated with shorter stays, while continuous techniques prolonged the length of stay.

Conclusions
Nerve blocks in total knee arthroplasty patients were associated with statistically significant reductions in length of stay and readmissions, but not emergency department visits or falls. The significance of these findings at the patient level and in contemporary practice requires further exploration in prospective randomized studies at low risk of indication bias.
Comparison of 3 Methods for Maintaining Inter-Fragmentary Compression After Fracture Reduction and Fixation
Authors: Au Brigham , Groundland John , Stoops T. Kyle , Santoni Brandon G. , Sagi H. Claude 
Published: December 2016

Objectives:
It is recommended that the intra-articular component of a supracondylar distal femoral fracture be stabilized by a lag screw to create interfragmental compression. Generally, it is thought that lag screw fixation should precede any positional screw or locking screw application. This study compared 3 methods of maintaining interfragmentary compression after fracture reduction with a reduction clamp.

Methods:
Intra-articular vertical split fractures were created in synthetic femora. A force transducer was interposed between the medial and lateral condyles and 20 lbs of compression was applied to the fracture with a reduction clamp. 3.5-mm cortical lag screws (group 1), 3.5-mm cortical position screws (group 2), and 5.4-mm distal locking screws through a distal femur locking plate (group 3) were placed across the fracture (n = 4/group). After screw placement, the clamp was removed and the amount of residual interfragmentary compression was recorded. After 2 minutes, a final steady-state force was measured and compared across groups.

Results:
Locking screws placed through the plate (group 3) maintained 27% of the initial force applied by the clamp (P = 0.043), whereas positional screws (group 2) maintained 90% of the initial force applied by the clamp (P = 0.431). The steady-state compression force measured with lag screws (group 1) increased by 240% (P = 0.030) relative to the initial clamp force. The steady-state force in the lag screw group was significantly greater than groups 1 and 2 (P = 0.012).

Conclusions:
When reducing intra-articular fractures and applying interfragmentary compression with reduction clamps, additional lag screws increase the amount of compression across the fracture interface. Compressing a fracture with reduction clamps and relying on locking screws to maintain the compression result in a loss of interfragmentary compression and should be avoided. This study lends biomechanical support that lag screws placed outside of the plate before locking screws for fracture fixation help maintain optimal interfragmentary compression.
Corneal Biomechanical Changes After Trabeculectomy and the Impact on Intraocular Pressure Measurement
Authors: Pillunat Karin R. , Spoerl Eberhard , Terai Naim , Pillunat Lutz E. 
Published: December 2016

Purpose:
To evaluate corneal biomechanical changes induced by trabeculectomy and their impact on intraocular pressure (IOP) measurements.

Materials and Methods:
In total, 35 eyes of 35 consecutive glaucoma patients undergoing first-time trabeculectomy with mitomycin C were enrolled in this prospective interventional case series. Goldmann applanation tonometry (GAT) IOP, central corneal thickness, axial length, and Ocular Response Analyzer measurements [Goldmann-correlated IOP (IOPg), corneal-compensated IOP (IOPcc), corneal hysteresis (CH), and corneal resistance factor (CRF)] were assessed before and 6 months after uncomplicated trabeculectomy. Linear mixed models were used to compare the parameters before and after surgery.

Results:
IOP, central corneal thickness, and axial length showed a strong correlation with CH and CRF preoperatively and postoperatively. After adjusting for these influencing factors, CH changed from 7.75±1.46 to 7.62±1.66 mm Hg (P=0.720) and CRF from 8.67±1.18 to 8.52±1.35 mm Hg (P=0.640) after trabeculectomy, but these changes were not statistically significant. IOP decreased statistically significantly with all IOP measurements (P=0.001). IOPcc was statistically significantly higher than GAT (4.82±5.24 mm Hg; P=0.001) and IOPg (2.92±1.74 mm Hg; P=0.001) preoperatively and postoperatively (GAT, 3.29±3.36 mm Hg; P=0.001; IOPg, 3.35±1.81 mm Hg; P=0.001). The difference between IOPcc and GAT (P=0.5) and IOPcc and IOPg (P=0.06) did not change significantly before or after trabeculectomy.

Conclusions:
Despite a marked IOP reduction and a possible weakening of the ocular walls after trabeculectomy, corneal structural tissue properties are not altered, and therefore, the accuracy of IOP measurements is not changed postoperatively. It seems likely, however, that Goldmann-correlated IOP measurements are underestimated in glaucoma patients before and after surgery.
Referral to Low Vision Services for Glaucoma Patients: Referral Patterns and Characteristics of Those Who Refer
Authors: Kaleem Mona A. , West Sheila K. , Im Lily T. , Swenor Bonnielin K. 
Published: December 2016

Purpose:
To identify characteristics of ophthalmologists and practices who refer glaucoma patients to low vision services (LVS).

Materials and Methods:
An online survey was distributed to members of the American Glaucoma Society. The survey queried demographics of responders and their clinical practices, criteria and barriers to referral to LVS. Survey responders were categorized as high referrers if they reported referring >5 patients to LVS and low referrers if they referred ≤5. χ2 and Fischer exact tests were used to compare characteristics between high and low referrers. Logistic regression analyses were used to calculate odds ratios and 95% confidence intervals and determine factors associated with referrer status.

Results:
High referrers to LVS tended to have >10 patients per month who had already seen a low vision provider (53% vs. 10%, P<0.001), reported following the American Academy of Ophthalmology’s Preferred Practice Pattern (PPP) recommendations for LVS referrals (38% vs. 18%, P=0.011), and expressed satisfaction with their current referral practices (86% vs. 70%, P=0.049). In the fully adjusted model those who followed PPP were 2.5 times more likely to report being a high referrer as compared with a low referrer (95% confidence interval, 1.1-5.3). However, only 22% of ophthalmologists reported following these guidelines in their practice. The number of years in practice, practice location or type, volume of patients seen each week, and distance to a low vision clinic were not associated with referral.

Conclusions:
Familiarity with PPP guidelines may positively influence LVS referral practices.
Perceptions of Teamwork in the Interprofessional Bedside Rounding Process
Authors: Beaird Genevieve , Dent John M. , Keim-Malpass Jessica , Muller Abigail Guo Jian , Nelson Nicole , Brashers Valentina 
Published: December 2016

Abstract:
Patient perceptions of teamwork have been a relatively undiscovered domain. Our study investigated the use of the Patients' Insights and Views of Teamwork (PIVOT) survey on an acute cardiology unit in an academic teaching hospital with patients receiving Rounding with Heart, an interprofessional bedside rounding initiative, and others receiving traditional rounding processes. Sixty-three subjects were surveyed during their hospital stay. We found a significant difference (p = .006) in PIVOT scores between those receiving interprofessional rounding and those not receiving this rounding structure. In an item-by-item analysis, four specific items were found to be significant which were supported by analysis of qualitative data. Observations of the structured interprofessional rounding process by our research team reveal themes that emerged from observations: (1) openness/inclusivity, (2) patient-centeredness, (3) attending role/shared leadership, (4) nonconfrontational learning, (5) efficacy, and (6) team at bedside. Our results indicate that patients may be able to recognize the teamwork in the structured bedside rounding process and that interfacing with the team may be an important component to patients. We conclude that patient perceptions of teamwork are a valuable informant to modeling collaborative practices, and there are key observable components to the structured rounding model that may foster collaboration among different disciplines.
Reducing Restraint With Clozapine in Involuntarily Admitted Patients With Schizophrenia
Authors: Ifteni Petru , Szalontay Andreea S. , Teodorescu Andreea 
Published: December 2016

Background:
In the entire world, restraint and seclusion are common interventions in psychiatric inpatient settings because of aggressive behavior.

Study Question:
Our objective was to test for the immediate antiaggressive property of clozapine compared with other antipsychotic treatments in an enriched cohort with high rates of restraint during early hospitalization.

Methods:
We present a retrospective chart review in all involuntary admissions with schizophrenia during 2011–2014 in Psychiatry and Neurology Hospital, Brasov, Romania. Timing and number of restraints in addition to clinical, demographic, and treatment characteristics were extracted. Based on our earlier observation of clinical efficacy of early, fast titration of clozapine, we tested the hypothesis that clozapine treatment was associated with reduced use of restraint and with longer restraint-free periods.

Results:
In 115 consecutive patients with schizophrenia (age = 39.7 ± 11.1 years; male = 59%) involuntarily admitted because of externalized (74.7%) or self-directed violence (25.2%), restraint was used in 89.6%; with a median duration of 3 hours until restraint past admission. Antipsychotics used immediately after hospitalization included haloperidol (70.4%), clozapine (11.3%), olanzapine (10.4%), and other second-generation antipsychotics (7.9%). Comparison of restraint characteristics favored immediate clozapine use with highly reduced rates of restraint (23% vs. 95.6%; P < 0.001) and significantly extended hours until restraint [(118, 24, 426 hours) vs. (3, 0.25, 48 hours); median; 25th, 75th percentile; P < 0.001] relative to the remaining cohort. These effects remained highly significant after controlling for potential moderators of restraint use in multivariate models.

Conclusions:
These retrospective data suggest an early antiaggressive effect of clozapine during the immediate use of clozapine in highly problematic patients.
Outcomes From Pediatric Gastroenterology Maintenance of Certification Using Web‐based Modules
Authors: Sheu Josephine , Chun Stanford , O'Day Emily , Cheung Sara , Cruz Rusvelda , Lightdale Jenifer R. , Fishman Douglas S. , Bousvaros Athos , Huang Jeannie S. 
Published: December 2016

ABSTRACTObjectives:Beginning in 2013, the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) sponsored and developed subspecialty field–specific quality improvement (QI) activities to provide Part 4 Maintenance of Certification (MOC) credit for ongoing certification of pediatric gastroenterologists by the American Board of Pediatrics. Each activity was a Web‐based module that measured clinical practice data repeatedly over at least 3 months as participants implemented rapid cycle change. Here, we examine existing variations in clinical practice among participating pediatric gastroenterologists and determine whether completion of Web‐based MOC activities improves patient care processes and outcomes.Methods:We performed a cross‐sectional and prospective analysis of physician and parent‐reported clinical practice data abstracted from Web‐based MOC modules on the topics of upper endoscopy, colonoscopy, and informed consent collected from pediatric gastroenterologists from North America from 2013 to 2016.Results:Among 134 participating pediatric gastroenterologists, 56% practitioners practiced at an academic institution and most (94%) were NASPGHAN members. Participating physicians reported data from 6300 procedures. At baseline, notable practice variation across measured activities was demonstrated. Much of the rapid cycle changes implemented by participants involved individual behaviors, rather than system/team‐based improvement activities. Participants demonstrated significant improvements on most targeted process and quality care outcomes.Conclusions:Pediatric gastroenterologists and parents reported baseline practice variation, and improvement in care processes and outcomes measured during NASPGHAN‐sponsored Web‐based MOC QI activities. Subspecialty‐oriented Web‐based MOC QI activities can reveal targets for reducing unwarranted variation in clinical pediatric practice, and can effectively improve care and patient outcomes.
Continuous Venovenous Hemofiltration in Children Less Than or Equal to 10 kg: A Single-Center Experience
Authors: Kaempfen Sirée , Dutta-Kukreja Pompa , Mok Quen 
Published: December 2016

Objectives:
The aim of this study was to review the data from patients with a body weight less than or equal to 10 kg who required continuous venovenous hemofiltration, to assess the feasibility and problems associated with continuous venovenous hemofiltration in this population and compare the results with the current literature.

Design:
Retrospective study design.

Setting:
PICU in a single tertiary pediatric referral center.

Patients:
Children less than or equal to 10 kg who received continuous venovenous hemofiltration between January 2008 and July 2014 were included in the study.

Interventions:
Clinical data from these children were analyzed, and the differences between survivors and nonsurvivors were evaluated and compared with results from current literature. In a subgroup analysis of children less than or equal to 5 kg compared with children between 5 and 10 kg, the survival rate, indications for continuous venovenous hemofiltration, and continuous venovenous hemofiltration characteristics were assessed.

Measurements and Main Results:
In total, 71 continuous renal replacement therapy episodes in 70 children were included in the study. Children in our cohort had a survival rate of 57.7% (41/71). Survivors had less frequent need for vasopressor support prior to continuous venovenous hemofiltration, lower oxygen requirement and percent fluid overload at continuous venovenous hemofiltration initiation. Survival rate was not significantly different in children less than or equal to 5 kg compared with 5–10 kg. However, in children less than or equal to 5 kg, metabolic manipulation was a significantly more frequent indication for continuous venovenous hemofiltration, heparin use was lower and maximal blood flow rate was higher.

Conclusions:
We have shown that continuous venovenous hemofiltration can be performed with good outcomes in children less than or equal to 10 kg using relatively high blood flow rates and with the current equipment available.
Chronic Stress and C-Reactive Protein in Mothers During the First Postpartum Year
Authors: Guardino Christine M. , Dunkel Schetter Christine , Hobel Calvin J. , Gaines Lanzi Robin , Schafer Peter , Thorp John M. , Shalowitz Madeleine U. 
Published: December 2016

ABSTRACT

Objective
Elevated levels of C-reactive protein (CRP) are associated with increased risk of cardiovascular and metabolic disease. The current study tested associations between psychosocial stress and CRP in a large sample of women during the first postpartum year.

Methods
We analyzed data collected by the five-site Community Child Health Network study, which studied a predominately poor population. Participants (n = 1206 women; 54% African American, 23% white, 23% Hispanic/Latina) were recruited shortly after the birth of a child. Multiple linear regression analyses tested associations of psychosocial stress in several life domains (financial, neighborhood, family, coparenting, partner relationship, discrimination, and interpersonal violence) with log-transformed CRP concentrations at 6-month and 1-year postpartum.

Results
Forty-eight percent of participants showed evidence of elevated CRP (≥3 mg/L) at 6-month postpartum, and 46% had elevated CRP at 12-month postpartum. Chronic financial stress at 1-month postpartum predicted higher levels of CRP at 6- (b = .15, SE = .05, p = .006) and 12-month postpartum (b = .15, SE = .06, p = .007) adjusting for race/ethnicity, income, education, parity, health behaviors, and chronic health conditions, though associations became nonsignificant when adjusted for body mass index.

Conclusions
In this low-income and ethnic/racially diverse sample of women, higher financial stress at 1-month postbirth predicted higher CRP. Study findings suggest that perceived financial stress stemming from socioeconomic disadvantage may be a particular deleterious form of stress affecting maternal biology during the year after the birth of a child.
Ancient individuals from the North American Northwest Coast reveal 10,000 years of regional genetic continuity
Authors: Lindo John , Achilli Alessandro , Perego Ugo , Archer David , Valdiosera Cristina , Petzelt Barbara , Mitchell Joycelynn , Worl Rosita , Dixon E. James , Fifield Terence E. , Rasmussen Morten , Willerslev Eske , Cybulski Jerome S. , Kemp Brian M. , DeGiorgio Michael , Malhi Ripan S. 
Published: December 2016

AbstractRecent genome-wide studies of both ancient and modern indigenous people of the Americas have shed light on the demographic processes involved during the first peopling. The Pacific northwest coast proves an intriguing focus for these studies due to its association with coastal migration models and genetic ancestral patterns that are difficult to reconcile with modern DNA alone. Here we report the genome-wide sequence of an ancient individual known as“ShukáKáa”(“Man Ahead of Us”) recovered from the On Your Knees Cave (OYKC) in southeastern Alaska (archaeological site 49-PET-408). The human remains date to approximately 10,300 cal years before present (BP). We also analyze low coverage genomes of three more recent individuals from the nearby coast of British Columbia dating from approximately 6075 to 1750 cal years BP. From the resulting time series of genetic data, we show that the Pacific Northwest Coast exhibits genetic continuity for at least the past 10,300 cal BP. We also infer that population structure existed in the late Pleistocene of North America withShukáKáaon a different ancestral line compared to other North American individuals (i.e., Anzick-1 and Kennewick Man) from the late Pleistocene or early Holocene. Despite regional shifts in mitochondrial DNA haplogroups we conclude from individuals sampled through time that people of the northern Northwest Coast belong to an early genetic lineage that may stem from a late Pleistocene coastal migration into the Americas.Significance StatementThe peopling of the Americas has been examined on the continental level with the aid of single-nucleotide polymorphism arrays, next generation sequencing, and advancements in ancient DNA, all of which have helped elucidate major population movements. Regional paleogenomic studies, however, have received less attention and may reveal a more nuanced demographic history. Here we present genomewide sequences of individuals from the northern Northwest Coast covering a time span of ~10,000 years and show that continental patterns of demography do not necessarily apply on the regional level. In comparison with existing paleogenomic data, we demonstrate that geographically linked population samples from the Northwest Coast exhibit an early ancestral lineage and find that population structure existed among Native North American groups as early as the late Pleistocene.
CrowdVariant: a crowdsourcing approach to classify copy number variants
Authors: Greenside Peyton , Zook Justin M. , Salit Marc , Poplin Ryan , Cule Madeleine , DePristo Mark 
Published: December 2016

AbstractCopy number variants (CNVs) are an important type of genetic variation and play a causal role in many diseases. However, they are also notoriously difficult to identify accurately from next-generation sequencing (NGS) data. For larger CNVs, genotyping arrays provide reasonable benchmark data, but NGS allows us to assay a far larger number of small (< 10kbp) CNVs that are poorly captured by array-based methods. The lack of high quality benchmark callsets of small-scale CNVs has limited our ability to assess and improve CNV calling algorithms for NGS data. To address this issue we developed a crowdsourcing framework, called CrowdVariant, that leverages Google’s high-throughput crowdsourcing platform to create a high confidence set of copy number variants for NA24385 (NIST HG002/RM 8391), an Ashkenazim reference sample developed in partnership with the Genome In A Bottle Consortium. In a pilot study we show that crowdsourced classifications, even from non-experts, can be used to accurately assign copy number status to putative CNV calls and thereby identify a high-quality subset of these calls. We then scale our framework genome-wide to identify 1,781 high confidence CNVs, which multiple lines of evidence suggest are a substantial improvement over existing CNV callsets, and are likely to prove useful in benchmarking and improving CNV calling algorithms. Our crowdsourcing methodology may be a useful guide for other genomics applications.
DiffTAD: Detecting Differential contact frequency in Topologically Associating Domains Hi-C experiments between conditions
Authors: Zaborowski Rafal , Wilczynski Bartek 
Published: December 2016

AbstractMotivationIn recent years, the interest in analyzing chromosome conformation by Hi-C and related techniques has grown. It has been shown that contact frequency matrices obtained by these methods correlate with other methods of measurement of activity such as transcriptomics and histone modification assays. This brings a question of testing for differential contact frequency between experiments to the field.ResultsIn this work, we provide a freely available software that implements two statistical methods for testing the significance of differential contact frequency in topological domains between two experiments. One method follows an empirical, permutation based approach to computing p-values, while the other is a parametric test based on the Poisson-Binomial distribution.AvailabilityThe software is freely available on the GNU General Public License athttps://bitbucket.org/rzaborowski/differential-analysisContact[r.zaborowski|bartek]@mimuw.edu.plSupplementary informationSupplementary data are available atBioinformaticsonline.