bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Quality Improvement to Increase Utilization of Enteral Therapy in Pediatric Crohn Disease
Authors: Shaikhkhalil Ala K. , Boyle Brendan , Smith Jennifer , Dotson Jennifer L. , Donegan Amy , Kim Sandra C. , Maltz Ross M. , Crandall Wallace 
Published: January 2018

ABSTRACTIntroduction:Exclusive enteral nutrition (EEN) for induction of remission in children with Crohn disease (CD) is recommended as first‐line therapy, but underutilized in the United States related to real and perceived barriers. We hypothesized that quality improvement (QI) methodology could increase use of EEN.Methods:We developed, implemented, and revised an algorithm and a set of tools to facilitate use of EEN. Through a series of Plan Do Study Act cycles, the approach was modified to overcome provider and patient/family barriers. The primary outcome, the percentage of newly diagnosed CD patients who receive EEN per month between July 2013 and October 2015, assessed using statistical process control. Secondary outcomes, including the short pediatric Crohn disease activity index (sPCDAI), body mass index (BMI) z score, erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), albumin, and hemoglobin were compared before and after EEN.Results:Among patients newly diagnosed with CD, 73 patients initiated EEN and were included (mean age 12.7 ± 2.9 years, 49% girls, 86% white). Rates of utilization of EEN increased significantly from a baseline of <5% to an average of approximately 50%. Of the 73 patients who started EEN, 37 (50%) completed a minimum of 8 weeks. Of those completing therapy, 25 (71%) achieved remission, with a significant reduction of sPCDAI (33.6 ± 14.4 to 10.7 ± 12.3, P < 0.0001)Conclusions:Use of QI methodology to systematically implement tools designed to improve utilization was effective in increasing the use of EEN. Among those completing therapy, EEN was effective in inducing remission.
Suicide Prevention
Authors: Davidson Judy E. , Zisook Sidney , Kirby Brittany , DeMichele Gianni , Norcross William 
Published: January 2018

OBJECTIVE
The aim of this study was to describe the pilot expansion of a proactive suicide risk–screening program, initially designed for physicians, to nurses.

BACKGROUND
The Healer Education, Assessment and Referral (HEAR) program detects at-risk physicians and facilitates referral to mental healthcare. Nothing similar has been available for at-risk nurses. Local nurse suicides served as the catalyst to extend the HEAR program to nurses.

METHODS
Education, outreach, and an encrypted, online, anonymous, proactive risk screening were conducted to identify and refer nurses with depression and suicide risk.

RESULTS
During the 1st 6 months of the program, 172 of 2475 (7%) nurses completed questionnaires; 74 (43%) were rated as high risk, and another 98 (55%) as moderate risk; 12 (7%) reported current active thoughts or actions of self-harm, and 19 (11%) reported previous suicide attempts. Forty-four (26%) received in-person or verbal counseling, and 17 accepted referral for continued treatment.

CONCLUSIONS
An encrypted, anonymous, proactive risk screening is effective at identifying nurses at risk and referring them to mental healthcare.
Exploring the Use of Educational Material About Shoulder Dysfunction
Authors: Burke Katherine , Ellrodt Amy Swartz , Levine Jason , Adams Taylor , Allis Rebecca , Macmurdie Ian , Paganoni Sabrina 
Published: January 2018

AbstractShoulder pain is a common secondary complication of amyotrophic lateral sclerosis (ALS) that can contribute to functional decline and decreased participation in daily activities. The purpose of this study was to assess the effectiveness of an educational brochure aimed at improving knowledge regarding shoulder pain and dysfunction in people with ALS. Participants completed a preintervention survey with questions regarding their knowledge of how ALS may affect their shoulders. After completing the presurvey, they were mailed a brochure that described shoulder health and range of motion and stretching exercises. Four weeks after receiving the brochure, participants were then asked to determine the effectiveness of the educational materials in terms of impact on shoulder-related knowledge and self-efficacy with regard to prevention of shoulder pain and dysfunction. More than 50% of participants reported pain, decreased range of motion, or weakness in at least one shoulder since being diagnosed with ALS. All participants were interested in receiving educational materials, and all agreed that the brochure was easy to interpret and understand, with most (87%) reporting that it was helpful. Educational brochures are one strategy to improve awareness about shoulder health and to educate patients with ALS about exercises that may help reduce shoulder pain and dysfunction.
Alcohol Use and HIV Disease Progression in an Antiretroviral Naive Cohort
Authors: Hahn Judith A. , Cheng Debbie M. , Emenyonu Nneka I. , Lloyd-Travaglini Christine , Fatch Robin , Shade Starley B. , Ngabirano Christine , Adong Julian , Bryant Kendall , Muyindike Winnie R. , Samet Jeffrey H. 
Published: January 2018

Background:
Alcohol use has been shown to accelerate disease progression in experimental studies of simian immunodeficiency virus in macaques, but the results in observational studies of HIV have been conflicting.

Methods:
We conducted a prospective cohort study of the impact of unhealthy alcohol use on CD4 cell count among HIV-infected persons in southwestern Uganda not yet eligible for antiretroviral treatment (ART). Unhealthy alcohol consumption was 3-month Alcohol Use Disorders Identification Test—Consumption positive (≥3 for women, ≥4 for men) and/or phosphatidylethanol (PEth—an alcohol biomarker) ≥50 ng/mL, modeled as a time-dependent variable in a linear mixed effects model of CD4 count.

Results:
At baseline, 43% of the 446 participants were drinking at unhealthy levels and the median CD4 cell count was 550 cells/mm3 (interquartile range 416–685). The estimated CD4 cell count decline per year was −14.5 cells/mm3 (95% confidence interval: −38.6 to 9.5) for unhealthy drinking vs. −24.0 cells/mm3 (95% confidence interval: −43.6 to −4.5) for refraining from unhealthy drinking, with no significant difference in decline by unhealthy alcohol use (P value 0.54), adjusting for age, sex, religion, time since HIV diagnosis, and HIV viral load. Additional analyses exploring alternative alcohol measures, participant subgroups, and time-dependent confounding yielded similar findings.

Conclusion:
Unhealthy alcohol use had no apparent impact on the short-term rate of CD4 count decline among HIV-infected ART naive individuals in Uganda, using biological markers to augment self-report and examining disease progression before ART initiation to avoid unmeasured confounding because of misclassification of ART adherence.
Factors Influencing Perception of Facial Attractiveness: Gender and Dental Education
Authors: Jung Ga-Hee , Jung Seunggon , Park Hong-Ju , Oh Hee-Kyun , Kook Min-Suk 
Published: January 2018

Purpose:
This study was conducted to investigate the gender- and dental education-specific differences in perception of facial attractiveness for varying ratio of lower face contour.

Methods:
Two hundred eleven students (110 male respondents and 110 female respondents; aged between 20–38 years old) were requested to rate facial figures with alterations to the bigonial width and the vertical length of the lower face. We produced a standard figure which is based on the “golden ratio” and 4 additional series of figures with either horizontal or vertical alterations to the contour of lower face. The preference for each figure was evaluated using a Visual Analog Scale. The Kruskal Wallis test was used for differences in the preferences for each figure and the Mann–Whitney U test was used to evaluate gender-specific differences and differences by dental education.

Results:
In general, the highest preference score was indicated for the standard figure, whereas facial figure with large bigonial width and chin length had the lowest score.
Male respondents showed significantly higher preference score for facial contour that had a 0.1 proportional increase in the facial height-bigonial width ratio over that of the standard figure.
For horizontal alterations to the facial profiles, there were no significant differences in the preferences by the level of dental education. For vertically altered images, the average Visual Analog Scale was significantly lower among the dentally-educated for facial image that had a proportional 0.22 and 0.42 increase in the ratio between the vertical length of the chin and the lip.

Conclusion:
Generally, the standard image based on the golden ratio was the most. Slender face was appealed more to males than to females, and facial image with an increased lower facial height were perceived to be much less attractive to the dentally-educated respondents, which suggests that the dental education might have some influence in sensitivity to vertical changes in lower face.
Wedge Osteotomy for Correction of Chin Asymmetry
Authors: Costa Pedro Jorge Cavalcante , de Gauw Johnny Holanda , Costa Filho José Zenou 
Published: January 2018

Abstract
Chin deviation is generally the visible reflex of a mandibular asymmetry. The difficulty in obtaining a symmetrical result exists, but it can be minimized with the appropriate surgical technique. This article reports the mentoplasty technique with wedge osteotomy performed in an individual with a right-sided chin deviation. Three osteotomies were performed vertically and equidistantly, forming a bone wedge on the contralateral side of the deviation. Horizontal repositioning associated with the rotation caused by the vertical impaction of the chin after bone wedge removal was effective in solving esthetic problems of facial asymmetry, meeting the patient's main complaint.
Mandibular Osteonecrosis Associated With Raloxifene
Authors: Pontes Hélder Antônio Rebelo , Souza Lucas Lacerda de , Uchôa Daniel Cavalléro Colares , Cerqueira João Mateus Mendes 
Published: January 2018

Abstract
Osteonecrosis is a disease with diverse pathophysiology, clinical presentation, and management. It may be associated with some medications used to treat systemic issues with bone metabolism. A few cases of jaw bone osteonecrosis have been associated with raloxifene. In this paper, the authors present a clinical report of a 64-year-old woman who presented with a necrosis foci in the right alveolar ridge of the mandible, associated with continued raloxifene use.
Peripheral Giant Cell Granuloma Associated With Dental Implants
Authors: Scarano Antonio , Lorusso Carmen , Mortellaro Carmen , Limongelli Luisa , Tempesta Angela , Favia Gianfranco 
Published: January 2018

Abstract:
Peripheral giant cell granuloma (PGCG) is a nonneoplastic lesion of the oral mucosa arising on the buccal or lingual attached gingiva or alveolar mucosa and the crest of the edentulous alveolar ridge and contains numerous giant cells. This case series describes 3 cases regarding the clinical and surgical management of PGCG associated with dental implants.

Materials and Methods:
This case series presents 3 patients, mean age 36 years, who showed a pedunculated painless lesion associated with dental implants that radiographically appeared as an osseous rarefaction corresponding the implants.

Discussion:
Histological examination provided the diagnosis of PGCG. The treatment approach consisted in a surgical complete resection of the lesion and implant removal. After 1-year-follow-up, all the investigated cases did not show signs of recurrence.

Conclusion:
A correct diagnosis and an appropriate surgical treatment of peri-implant giant cell granuloma are very important aspects for proper management of the lesion.
Meta-analysis of surgeon-performed central line placement: Real-time ultrasound versus landmark technique
Authors: Gurien Lori A. , Blakely Martin L. , Crandall Marie C. , Schlegel Cameron , Rettiganti Mallikarjuna R. , Saylors Marie E. , France Daniel J. , Anders Shilo , Thomas Sheila L. , Dassinger Melvin S. 
Published: January 2018

BACKGROUND
Major health care agencies recommend real-time ultrasound (RTUS) guidance during insertion of percutaneous central venous catheters (CVC) based on studies in which CVCs were placed by nonsurgeons. We conducted a meta-analysis to compare outcomes for surgeon-performed RTUS-guided CVC insertion versus traditional landmark technique.

METHODS
A systematic review of the literature was performed, identifying randomized controlled trials (RCT) and prospective “safety studies” of surgeon-performed CVC insertions comparing landmark to RTUS techniques. Searches were conducted in MEDLINE, Cochrane, and Web of Science, with additional relevant articles identified through examination of the bibliographies and citations of the included studies. Two independent reviewers selected relevant studies that matched inclusion criteria, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A meta-analysis was conducted using random effects models to compare success and complication rates.

RESULTS
Three RCTs were identified totaling 456 patients. The RTUS guidance was associated with better first attempt success (odds ratio [OR], 4.7; 95% confidence interval [CI], 1.5–14.7, p = 0.008) and overall success (OR 6.5, 95% CI: 2.7–15.7, p < 0.0001). However, there were no differences in overall complication (OR 1.9 (95% CI, 0.8–4.4, p = 0.14)) or arterial puncture (OR 2.0 (95% CI, 0.7–5.6, p = 0.18) rates between the two methods.

CONCLUSION
Despite many studies involving nonsurgeons, there are only three RCTs comparing RTUS versus landmark technique for surgeon-performed CVC placement. The RTUS guidance is associated with better success than landmark technique, but no difference in complication rates. No study evaluated how RTUS was implemented. Larger studies examining RTUS use during surgeon-performed CVC placements are needed.

LEVEL OF EVIDENCE
Systematic review and meta-analysis, level III.
PET and ictal SPECT can be helpful for localizing epileptic foci
Authors: von Oertzen Tim J. 
Published: January 2018

Purpose of review
Functional neuroimaging with PET and SPECT is a commonly used tool in presurgical evaluation. The following article reviews the literature of PET and SPECT in presurgical assessment of epilepsies published in the last year.

Recent findings
FDG-PET adds concomitant information in temporal and extratemporal lobe epilepsy in adults and children. The pattern of hypometabolism in FDG-PET is a good additional predictor or seizure outcome in TLE with mesial temporal sclerosis or negative MRI. There is growing evidence that diagnostic value of FDG-PET increases with postprocessing. Although several methods were applied in the reviewed literature, all of them seem to outperform the visual analysis. Imaging of the epileptic focus with ictal SPECT is depending on short injection latencies. It is particularly useful in patients with nonlesional MRI and mostly of extratemporal localization. Areas of hyperperfusion remote of SOZ are reflecting the epileptic network. Combining more concordant investigations including PET and SPECT in MRI-negative evaluation adds to better presurgical stratification and therefore, better postsurgical outcome. FET-PET shows increased uptake in status epilepticus.

Summary
PET and SPECT are important investigations to localize the epileptic focus in temporal lobe and nonlesional extratemporal epilepsies. Postprocessing for both modalities is important to increase diagnostic value.
Intravenous Valproic Acid Add-On Therapy in Acute Agitation Adolescents With Suspected Substance Abuse: A Report of Six Cases
Authors: Battaglia Claudia , Averna Roberto , Labonia Milena , Riccioni Assia , Vicari Stefano 
Published: January 2018

Abstract
The aim of this study was to test efficacy and safety of intravenous (IV) valproate for aggression in children and adolescents with mood or conduct disorder and concomitant substance abuse. Six patients received a 20 mg/kg dose of IV valproic acid as an add-on therapy to their standard therapy with second-generation antipsychotics and benzodiazepines. Agitation and general psychopathology were measured at baseline and after the first injection using the Modified Overt Aggression Scale, the Brief Psychiatric Rating Scale, and the Children’s Global Assessment Scale. The findings suggested that in emergency psychiatry clinical settings, IV valproate was effective in reducing agitation and aggressive behaviors with a good tolerability profile and better treatment compliance.
Mechanism of evolution by genetic assimilation
Authors: Nishikawa Ken , Kinjo Akira R. 
Published: January 2018

AbstractConrad H. Waddington discovered the phenomenon of genetic assimilation through a series of experiments on fruit flies. In those experiments, artificially exerted environmental stress induced plastic phe-notypic changes in the fruit flies, but after some generations the same phenotypic variant started to appear without the environmental stress. Both the initial state (where the phenotypic changes were environmentally induced and plastic) and the final state (where the phenotypic changes were genetically fixed and constitutive) are experimental facts. However, it remains unclear how the environmentally induced phenotypic change in the first generation becomes genetically fixed in the central process of genetic assimilation itself. We have argued that the key to understanding the mechanism of genetic assimilation lies in epigenetics, and proposed the “cooperative model” in which the evolutionary process depends on both genetic and epigenetic factors. Evolutionary simulations based on the cooperative model reproduced the process of genetic assimilation. Detailed analysis of the trajectories has revealed genetic assimilation is a process in which epigenetically induced phe-notypic changes are incrementally and statistically replaced with multiple minor genetic mutations through natural selection. In this scenario, epigenetic and genetic changes may be considered as mutually independent but equivalent in terms of their effects on phenotypic changes. This finding rejects the common (and confused) hypothesis that epigenetically induced phe-notypic changes depend on genetic mutations. Furthermore, we argue that transgenerational epigenetic inheritance is not required for evolution by genetic assimilation.
Is the blunderbuss a misleading visual metaphor for stasis and punctuated evolution?
Authors: Waller John T. 
Published: January 2018

AbstractI discuss the usefulness of the so-called “blunderbuss pattern” of phenotypic evolution as a visual metaphor for stasis and punctuated evolution that was originally put forward in Uyeda et al. (2011) in their highly influential paper “The million-year wait for macroevolutionary bursts”. I argue the blunderbuss pattern is not surprising, and in some cases it is misleading. I review several publications that cite Uyeda et al. (2011) that seem to be confused about the meaning of the pattern and what it implies. I do not critique the original analysis within Uyeda et al (2011), but show the blunderbuss pattern itself would be produced even when assuming a Brownian motion (completely gradual) model of phenotypic divergence. Finally, I discuss how the interesting results of the paper have been overlooked in favor of the surprisingly powerful, but also misleading visual metaphor of the blunderbuss.
An Automated Workflow for Segmenting Single Adult Cardiac Cells from Large-Volume Serial Block-Face Scanning Electron Microscopy Data
Authors: Hussain Akter , Ghosh Shouryadipta , Kalkhoran Siavash Beikoghli , Hausenloy Derek J. , Hanssen Eric , Rajagopal Vijay 
Published: January 2018

ABSTRACTThis paper presents a new algorithm to automatically segment the myofibrils, mitochondria and nuclei within single adult cardiac cells that are part of a large serial-block-face scanning electron microscopy (SBF-SEM) dataset. The algorithm only requires a set of manually drawn contours that roughly demarcate the cell boundary at routine slice intervals (every 50th, for example). The algorithm correctly classified pixels within the single cell with 97% accuracy when compared to manual segmentations. One entire cell and the partial volumes of two cells were segmented. Analysis of segmentations within these cells showed that myofibrils and mitochondria occupied 47.5% and 51.6% on average respectively, while the nuclei occupy 0.7% of the cell for which the entire volume was captured in the SBF-SEM dataset. Mitochondria clustering increased at the periphery of the nucleus region and branching points of the cardiac cell. The segmentations also showed high area fraction of mitochondria (up to 70% of the 2D image slice) in the sub-sarcolemmal region, whilst it was closer to 50% in the intermyofibrillar space. We finally demonstrate that our segmentations can be turned into 3D finite element meshes for cardiac cell computational physiology studies. We offer our large dataset and MATLAB implementation of the algorithm for research use atwww.github.com/CellSMB/sbfsem-cardiac-cell-segmenter/. We anticipate that this timely tool will be of use to cardiac computational and experimental physiologists alike who study cardiac ultrastructure and its role in heart function.
Machine Learning Approach to Predicting Stem-Cell Donor Availabilitys
Authors: Sivasankaran Adarsh , Williams Eric , Albrecht Mark , Switzer Galen E. , Cherkassky Vladimir , Maiers Martin 
Published: January 2018

0. AbstractThe success of Unrelated Donor stem-cell transplants depends not only on finding genetically matched donors but also on donor availability. On average 50% of potential donors in the NMDP database are unavailable for a variety of reasons, after initially matching a patient, with significant variations in availability among subgroups (e.g., by race or age). Several studies have established univariate donor characteristics associated with availability. Individual consideration of each applicable characteristic is laborious. Extrapolating group averages to individual donor level tends to be highly inaccurate. In the current environment with enhanced donor data collection, we can make better estimates of individual donor availability. In this study, we propose a Machine Learning based approach to predict availability of every registered donor, to be used during donor selection and reduce the time taken to complete a transplant.