bluuebunny/crossref_metadata_2025_split huggingface dataset:
Verification of organ doses calculated by a dose monitoring software tool based on Monte Carlo Simulation in thoracic CT protocols
Authors: Guberina Nika , Suntharalingam Saravanabavaan , Naßenstein Kai , Forsting Michael , Theysohn Jens , Wetter Axel , Ringelstein Adrian 
Published: June 2017

Background The importance of monitoring of the radiation dose received by the human body during computed tomography (CT) examinations is not negligible. Several dose-monitoring software tools emerged in order to monitor and control dose distribution during CT examinations. Some software tools incorporate Monte Carlo Simulation (MCS) and allow calculation of effective dose and organ dose apart from standard dose descriptors. Purpose To verify the results of a dose-monitoring software tool based on MCS in assessment of effective and organ doses in thoracic CT protocols. Material and Methods Phantom measurements were performed with thermoluminescent dosimeters (TLD LiF:Mg,Ti) using two different thoracic CT protocols of the clinical routine: (I) standard CT thorax (CTT); and (II) CTT with high-pitch mode, P = 3.2. Radiation doses estimated with MCS and measured with TLDs were compared. Results Inter-modality comparison showed an excellent correlation between MCS-simulated and TLD-measured doses ((I) after localizer correction r = 0.81; (II) r = 0.87). The following effective and organ doses were determined: (I) (a) effective dose = MCS 1.2 mSv, TLD 1.3 mSv; (b) thyroid gland = MCS 2.8 mGy, TLD 2.5 mGy; (c) thymus = MCS 3.1 mGy, TLD 2.5 mGy; (d) bone marrow = MCS 0.8 mGy, TLD 0.9 mGy; (e) breast = MCS 2.5 mGy, TLD 2.2 mGy; (f) lung = MCS 2.8 mGy, TLD 2.7 mGy; (II) (a) effective dose = MCS 0.6 mSv, TLD 0.7 mSv; (b) thyroid gland = MCS 1.4 mGy, TLD 1.8 mGy; (c) thymus = MCS 1.4 mGy, TLD 1.8 mGy; (d) bone marrow = MCS 0.4 mGy, TLD 0.5 mGy; (e) breast = MCS 1.1 mGy, TLD 1.1 mGy; (f) lung = MCS 1.2 mGy, TLD 1.3 mGy. Conclusion Overall, in thoracic CT protocols, organ doses simulated by the dose-monitoring software tool were coherent to those measured by TLDs. Despite some challenges, the dose-monitoring software was capable of an accurate dose calculation.
Comparison of Concussion Rates Between NCAA Division I and Division III Men’s and Women’s Ice Hockey Players
Authors: Rosene John M. , Raksnis Bryan , Silva Brie , Woefel Tyler , Visich Paul S. , Dompier Thomas P. , Kerr Zachary Y. 
Published: June 2017

Background: Examinations related to divisional differences in the incidence of sports-related concussions (SRC) in collegiate ice hockey are limited. Purpose: To compare the epidemiologic patterns of concussion in National Collegiate Athletic Association (NCAA) ice hockey by sex and division. Study Design: Descriptive epidemiology study. Methods: A convenience sample of men’s and women’s ice hockey teams in Divisions I and III provided SRC data via the NCAA Injury Surveillance Program during the 2009-2010 to 2014-2015 academic years. Concussion counts, rates, and distributions were examined by factors including injury activity and position. Injury rate ratios (IRRs) and injury proportion ratios (IPRs) with 95% confidence intervals (CIs) were used to compare concussion rates and distributions, respectively. Results: Overall, 415 concussions were reported for men’s and women’s ice hockey combined. The highest concussion rate was found in Division I men (0.83 per 1000 athlete-exposures [AEs]), followed by Division III women (0.78/1000 AEs), Division I women (0.65/1000 AEs), and Division III men (0.64/1000 AEs). However, the only significant IRR was that the concussion rate was higher in Division I men than Division III men (IRR = 1.29; 95% CI, 1.02-1.65). The proportion of concussions from checking was higher in men than women (28.5% vs 9.4%; IPR = 3.02; 95% CI, 1.63-5.59); however, this proportion was higher in Division I women than Division III women (18.4% vs 1.8%; IPR = 10.47; 95% CI, 1.37-79.75). The proportion of concussions sustained by goalkeepers was higher in women than men (14.2% vs 2.9%; IPR = 4.86; 95% CI, 2.19-10.77), with findings consistent within each division. Conclusion: Concussion rates did not vary by sex but differed by division among men. Checking-related concussions were less common in women than men overall but more common in Division I women than Division III women. Findings highlight the need to better understand the reasons underlying divisional differences within men’s and women’s ice hockey and the need to develop concussion prevention strategies specific to each athlete population.
Discontinuation of Vasopressin Before Norepinephrine in the Recovery Phase of Septic Shock
Authors: Hammond Drayton A. , McCain Kelsey , Painter Jacob T. , Clem Oktawia A. , Cullen Julia , Brotherton Amy L. , Chopra Divyan , Meena Nikhil 
Published: June 2017

Background: Guidance for the discontinuation of vasopressors in the recovery phase of septic shock is limited. Norepinephrine is more easily titrated; however, septic shock is a vasopressin deficient state, which exogenous vasopressin endeavors to resolve. Discontinuation of vasopressin before norepinephrine may result in clinically significant hypotension. Methods: This retrospective, cohort study compared discontinuation of norepinephrine and vasopressin in medically, critically ill patients in the recovery phase of septic shock from May 2014 to June 2016. Difference in clinically significant hypotension after norepinephrine or vasopressin discontinuation was evaluated with χ2 test. Linear regression was performed, examining the effect of agent discontinuation on clinically significant hypotension. Baseline variables were examined for a bivariate relationship with clinically significant hypotension; those with P < .2 were included in the model. Results: Vasopressin was discontinued first or last in 62 and 92 patients, respectively. Sequential Organ Failure Assessment scores at 72 hours (7.9 vs 7.6, P = .679) were similar. In unadjusted analysis, when vasopressin was discontinued first, more clinically significant hypotension developed (10.9% vs 67.8%, P < .001). There was no difference in intensive care unit (174 vs 216 hours, P = .178) or hospital duration (470 vs 473 hours, P = .977). In adjusted analyses, discontinuing vasopressin first was associated with increased clinically significant hypotension (odds ratio [OR]: 13.837, 95% confidence interval [CI]: 3.403-56.250, P < .001) but not in-hospital (OR: 0.659, 95% CI: 0.204-2.137, P = .488) or 28-day mortality (OR: 0.215, 95% CI: 0.037-1.246, P = .086). Conclusion: Adult patients receiving norepinephrine and vasopressin in the resolving phase of septic shock may be less likely to develop clinically significant hypotension if vasopressin is the final vasopressor discontinued.
Compliance With WHO/UNICEF BFHI Standards in Croatia After Implementation of the BFHI
Authors: Zakarija-Grković Irena , Boban Marija , Janković Sunčana , Ćuže Anamarija , Burmaz Tea 
Published: June 2017

Background: The primary goal of the Baby-Friendly Hospital Initiative (BFHI) is to create conditions in maternity facilities that enable women to initiate and sustain the practice of breastfeeding exclusively. Research aim: This study aimed to determine hospital practices and breastfeeding rates before and after BFHI implementation and assess compliance with UNICEF/World Health Organization (WHO) standards for seven of the BFHI’s Ten Steps to Successful Breastfeeding ( Ten Steps). Methods: Mothers of healthy, term infants ( N = 1,115) were recruited from the postnatal ward of the University Hospital of Split, Croatia, between February 2008 and July 2011 and followed for 12 months in a repeated-measures, prospective, longitudinal, three-group, nonequivalent, cohort study. Breastfeeding rates, hospital practices—including seven of the Ten Steps—and maternal sociodemographic data were collected. Results: Parts of all seven Ten Steps that were assessed improved significantly post-BFHI. Step 3 (“antenatal education”) showed the least improvement, whereas Step 7 (“rooming-in”; 2.6% pre-BFHI vs. 98.5% post-BFHI) and Step 9 (“no pacifiers/teats”; 21.8% pre-BFHI vs. 99.4% post-BFHI) showed the greatest improvement. Six months after Baby-Friendly designation, only Steps 7 and 9 were in full compliance with UNICEF/WHO standards. In-hospital, exclusive-breastfeeding rates rose markedly ( p < .001), but no change occurred in breastfeeding rates at 3, 6, or 12 months. Conclusion: Full implementation of the BFHI was associated with significant improvement in hospital practices and in-hospital, exclusive-breastfeeding rates, but it did not affect breastfeeding rates postdischarge, emphasizing the vital role of community support. Baby-Friendly Hospital Initiative standards declined rapidly post-hospital designation, indicating the need for regular monitoring and reassessment as well as ongoing, effective training for hospital staff.
Breastfeeding After Early Repair of Cleft Lip in Newborns With Cleft Lip or Cleft Lip and Palate in a Baby-Friendly Designated Hospital
Authors: Burianova Iva , Kulihova Katarina , Vitkova Veronika , Janota Jan 
Published: June 2017

Background: Goals of treatment of orofacial cleft are to improve feeding, speech, hearing, and facial appearance. Early surgery brings faster healing, better cosmetic effect, and fewer complications. Breastfeeding rates after early surgery are unknown. Early repair of the cleft lip may influence breastfeeding rates. Research aim: The aim of this study was to evaluate breastfeeding after early repair of the cleft lip in a Baby-Friendly designated hospital. The rate of breastfeeding in newborns with cleft lip was compared to cleft lip and palate. Methods: This was a retrospective cohort study. The study group included infants with cleft lip and cleft lip and palate operated on in the first 2 weeks of life. Newborns and their mothers were supported by a team promoting breastfeeding. Results: One hundred four infants (70 boys and 34 girls) were included. Isolated cleft lip was present in 56 (53.8%) infants, and cleft lip and palate in 48 (46.2%). Forty-four (78.6%) of the infants with a cleft lip were breastfed, 3 (5.4%) received human milk via bottle or syringe, and 9 (16.0%) were formula fed. Three (6.2%) of the infants with a cleft lip and palate were breastfed, 31 (64.6%) received human milk via bottle or Haberman feeder, and 14 (29.2%) were formula fed. Conclusion: The rate of breastfeeding in patients following early surgery of the cleft lip was high and comparable to the general population. The rate of breastfeeding in babies with cleft lip and palate after early repair of the cleft lip remained low.
Using a Music Video Parody to Promote Breastfeeding and Increase Comfort Levels Among Young Adults
Authors: Austen Erin L. , Beadle Julie , Lukeman Sionnach , Lukeman Ellen , Aquino Nicola 
Published: June 2017

Background: North Americans are not meeting the World Health Organization’s breastfeeding recommendations. Young adults understand that breastfeeding is healthy but are uncomfortable seeing breastfeeding. Research aim: The aim of the current project was to determine if a music video parody promoting breastfeeding is perceived by young adults to be an effective means of promotion and if exposure to such a video could increase comfort levels. Methods: Young adults rated how comfortable they felt looking at breastfeeding and bottle-feeding images (pretest). Two months later, a subset of participants watched the music video parody “Breastfeeding My Baby.” In Phase 1, participants completed the picture-rating task again (posttest) after a 2-month delay, plus a survey to assess memory and perception of the video. In Phase 2, participants were reminded of the video before completing the comfort ratings, and in the final phase, posttest measures were administered only 1 week after exposure to the video. Results: Across all phases, the video was perceived to be effective and was memorable. Breastfeeding comfort ratings were comparable at pretest across participant groups; comfort ratings improved at posttest for participants who saw the video but only if they were reminded of seeing it before providing their ratings. At shorter intervals between seeing the video and completing the posttests, comfort ratings for breastfeeding images increased for all participants, highlighting the general importance of exposure to breastfeeding. Conclusion: Young adults are receptive to using a music video parody to promote breastfeeding, which can help to increase comfort levels with breastfeeding.
The Role of Social-Cognitive and Emotional Factors on Exclusive Breastfeeding Duration
Authors: Shepherd Lee , Walbey Cherokee , Lovell Brian 
Published: June 2017

Background: Previous research has suggested that exclusive breastfeeding is likely to be predicted by social-cognitive variables and fear. However, there is little research assessing the role of regret and self-conscious emotions (e.g., pride and guilt) in promoting exclusive breastfeeding. Research aim: The primary aim of this research was to determine whether social-cognitive variables, fear, regret, and self-conscious emotions predict exclusive breastfeeding duration. The secondary aim of this research was to assess whether these factors predict infant-feeding choice (i.e., exclusively breastfed, combination fed, or generally formula fed). Methods: In this nonexperimental one-group self-report survey, 375 mothers rated social-cognitive variables toward breastfeeding (attitude, subjective norm, perceived control, and self-efficacy), their fear toward inadequate nutrition from breastfeeding and breastfeeding damaging their physical appearance, and the extent to which mothers may feel pride toward breastfeeding and negative self-conscious emotions (guilt and shame) and regret for not breastfeeding their infant. Results: Exclusive breastfeeding duration was positively predicted by self-efficacy, pride, and regret but negatively predicted by the fear toward inadequate nutrition. We also found that in contrast with exclusive breastfeeding, generally formula feeding an infant was associated with lower self-efficacy, pride, and regret but higher subjective norm and fear toward inadequate nutrition through breastfeeding. Conclusion: The authors argue that it is important to consider the role of self-conscious emotions and regret on exclusive breastfeeding.
Large Compressive Pseudomeningocele Causing Early Major Neurologic Deficit After Spinal Surgery
Authors: Raudenbush Brandon L. , Molinari Andrew , Molinari Robert W. 
Published: June 2017

Study Design: Retrospective review. Objectives: Large compressive pseudomeningocele causing a major neurologic deficit is a very rare complication that is not well described in the existing literature. Methods: Institutional review board consent was obtained to study 2552 consecutive extradural spinal surgical cases performed by a single senior spinal surgeon during a 10-year period. The surgeon’s database for the decade was retrospectively reviewed and 3 cases involving postoperative major neurologic deficits caused by large compressive pseudomeningocele were identified. Results: The incidence of postoperative compressive pseudomeningocele causing major neurologic deficit was 0.12% (3/2552) per decade of spinal surgery with approximately 1.3% of cases incurring incidental durotomy. Average age of the patients was 57 years (range 45-78). One patient had posterior cervical spine surgery, and 2 patients had posterior lumbar surgery. All 3 patients had intraoperative incidental durotomy repaired during their index procedure. Large compressive pseudomeningocele causing major neurologic deficit occurred in the early 2-week postoperative period in all patients and was clearly identified on postoperative magnetic resonance imaging. All 3 patients were treated with emergent decompression and repair of the dural defect. All patients recovered neurologic function after revision surgery. Conclusions: Incidental durotomy and repair causing a large compressive pseudomeningocele after spine surgery is a rare and potentially devastating event. Early postoperative magnetic resonance imaging assists in the diagnosis. Emergent decompression combined with revision dural repair surgery may result in improved outcomes. Surgeons should be cognizant of this rare cause of early postoperative major neurologic deficit in patients who had previous dural repair.
Project RED Impacts Patient Experience
Authors: Cancino Ramon S , Manasseh Chris , Kwong Lana , Mitchell Suzanne E , Martin Jessica , Jack Brian W 
Published: June 2017

Background: Hospitalized patients are frequently unprepared to care for themselves after discharge often leading to unplanned hospital readmission. One strategy to reduce readmission rates is improving the quality of patient education and preparation before hospital discharge. The ReEngineered Discharge (RED) is a standardized hospital-based program designed to provide patients and caregivers the information they need to continue care at home. Objectives: We sought to study the impact of the RED intervention on posthospitalization adult patient experience scores in an urban academic safety-net hospital. Methods: We conducted a descriptive study of a pilot program that compared posthospitalization survey responses to the Press Ganey survey item “Instructions were given about how to care for yourself at home.” We compared the survey results for 3 groups of adult patients: those receiving the RED program, those receiving a standard discharge on the same hospital unit, and those receiving a standard discharge on other hospital units. Results: A greater percentage of adult patients who received the RED discharge program rated the quality of their discharge as “very good” as compared to those receiving a standard discharge on the same hospital unit and those receiving a standard discharge on other hospital units (61%, 35%, and 41%, respectively, P = .0001). Conclusion: Delivery of a standardized hospital discharge program resulted in a larger proportion of top-box “very good” responses on a Press Ganey posthospitalization survey. Future research should examine whether hospital-based transition programs can sustain improvement in patient experience measures and whether these improvements can be observed in other patient populations.
An improved Plasmodium cynomolgi genome assembly reveals an unexpected methyltransferase gene expansion
Authors: Pasini Erica M , Böhme Ulrike , Rutledge Gavin G. , Voorberg-Van der Wel Annemarie , Sanders Mandy , Berriman Matt , Kocken Clemens HM , Otto Thomas D. 
Published: June 2017

Background: Plasmodium cynomolgi, a non-human primate malaria parasite species, has been an important model parasite since its discovery in 1907. Similarities in the biology of P. cynomolgi to the closely related, but less tractable, human malaria parasite P. vivax make it the model parasite of choice for liver biology and vaccine studies pertinent to P. vivax malaria. Molecular and genome-scale studies of P. cynomolgi have relied on the current reference genome sequence, which remains highly fragmented with 1,649 unassigned scaffolds and little representation of the subtelomeres. Methods: Using long-read sequence data (Pacific Biosciences SMRT technology), we assembled and annotated a new reference genome sequence, PcyM, sourced from an Indian rhesus monkey. We compare the newly assembled genome sequence with those of several other Plasmodium species, including a re-annotated P. coatneyi assembly. Results: The new PcyM genome assembly is of significantly higher quality than the existing reference, comprising only 56 pieces, no gaps and an improved average gene length. Detailed manual curation has ensured a comprehensive annotation of the genome with 6,632 genes, nearly 1,000 more than previously attributed to P. cynomolgi. The new assembly also has an improved representation of the subtelomeric regions, which account for nearly 40% of the sequence. Within the subtelomeres, we identified more than 1300 Plasmodium interspersed repeat (pir) genes, as well as a striking expansion of 36 methyltransferase pseudogenes that originated from a single copy on chromosome 9. Conclusions: The manually curated PcyM reference genome sequence is an important new resource for the malaria research community. The high quality and contiguity of the data have enabled the discovery of a novel expansion of methyltransferase in the subtelomeres, and illustrates the new comparative genomics capabilities that are being unlocked by complete reference genomes.
Incidence of acetabular dysplasia in breech infants following initially normal ultrasound: The effect of variable diagnostic criteria
Authors: Brusalis C. M. , Price C. T. , Sankar W. N. 
Published: June 2017

Purpose This study aimed to determine the incidence of acetabular dysplasia at six months of age in patients with breech presentation and previously normal hip ultrasounds, reporting primary radiographic measurements to allow for comparison with other patient cohorts. Methods A retrospective analysis of breech infants with initially normal clinical examinations and hip ultrasounds was performed to determine the rate of subsequent acetabular dysplasia and to characterise the distribution of acetabular index (AI). At approximately six months of age, AI was measured bilaterally on anteroposterior (AP) pelvic radiographs and reported using descriptive statistics. Results A total of 94 hips in 47 breech infants were eligible for analysis. All infants demonstrated normal ultrasound findings at a mean age of 6.9 ± 1.7 weeks and returned for follow-up at a mean age of 6.4 ± 0.5 months. On AP pelvic radiographs, mean right hip AI was 25.0°, with an interquartile range (IQR) (25th -75th percentile) of 23° to 27° and mean left hip AI was 25.5°, with an IQR of 22° to 28°. If one applies a single commonly used threshold value for defining dysplasia (AI ≥ 30°), 10/94 hips (10.6%) meet diagnostic criteria. Alternatively, strict adherence to previously established normative AI values stratified by gender and laterality results in 4/94 hips (4.3%) qualifying as significantly dysplastic. Conclusions The proportion of breech infants who, despite normal initial ultrasound findings, were diagnosed with dysplasia at six months supports observation of breech-born patients beyond six weeks. Reliance on different threshold values for diagnosing acetabular dysplasia can lead to discrepancies in incidence rates.