bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of health information exchange on recognition of medication discrepancies is interrupted when data charges are introduced: results of a cluster-randomized controlled trial
Authors: Boockvar Kenneth S , Ho William , Pruskowski Jennifer , DiPalo Katherine E , Wong Jane J , Patel Jessica , Nebeker Jonathan R , Kaushal Rainu , Hung William 
Published: April 2017

Abstract

Objectives
To determine the effect of health information exchange (HIE) on medication prescribing for hospital inpatients in a cluster-randomized controlled trial, and to examine the prescribing effect of availability of information from a large pharmacy insurance plan in a natural experiment.

Methods
Patients admitted to an urban hospital received structured medication reconciliation by an intervention pharmacist with (intervention) or without (control) access to a regional HIE. The HIE contained prescribing information from the largest hospitals and pharmacy insurance plan in the region for the first 10 months of the study, but only from the hospitals for the last 21 months, when data charges were imposed by the insurance plan. The primary endpoint was discrepancies between preadmission and inpatient medication regimens, and secondary endpoints included adverse drug events (ADEs) and proportions of rectified discrepancies.

Results
Overall, 186 and 195 patients were assigned to intervention and control, respectively. Patients were 60 years old on average and took a mean of 7 medications before admission. There was no difference between intervention and control in number of risk-weighted discrepancies (6.4 vs 5.8, P = .452), discrepancy-associated ADEs (0.102 vs 0.092 per admission, P = .964), or rectification of discrepancies (0.026 vs 0.036 per opportunity, P = .539). However, patients who received medication reconciliation with pharmacy insurance data available had more risk-weighted medication discrepancies identified than those who received usual care (8.0 vs 5.9, P = .038).

Discussion and Conclusion
HIE may improve outcomes of medication reconciliation. Charging for access to medication information interrupts this effect. Efforts are needed to understand and increase prescribers’ rectification of medication discrepancies.
Differentiating Nonoccupational Postexposure Prophylaxis Seroconverters and Non-Seroconverters in a Community-Based Clinic in Los Angeles, California
Authors: Beymer Matthew R. , Weiss Robert E. , Bolan Robert K. , Kofron Ryan M. , Flynn Risa P. , Pieribone David L. , Kulkarni Sonali P. , Landovitz Raphael J. 
Published: April 2017

AbstractBackgroundNonoccupational postexposure prophylaxis (nPEP) is a 28-day regimen of antiretroviral medications taken within 72 hours of human immunodeficiency virus (HIV) exposure to prevent HIV acquisition. Although nPEP has been recommended since 1998, few studies have analyzed the characteristics that distinguish nPEP failures (seroconverters) and successes (non-seroconverters).MethodsThis retrospective study analyzed all nPEP courses prompted by sexual exposure that were prescribed at the Los Angeles LGBT Center between March 2010 and July 2014. Fisher exact tests and logistic regressions were used to determine characteristics that distinguished nPEP seroconverters from non-seroconverters.ResultsOf the nPEP courses administered, 1744 had a follow-up visit for HIV testing within 24 weeks of exposure and 17 individuals seroconverted. Seven reported a known re-exposure, 8 self-reported only condom-protected sex subsequent to the initial exposure, and 2 reported abstinence since the exposure. In multivariable analyses, seroconverters were more likely than non-seroconverters to report methamphetamine use, incomplete medication adherence, and nPEP initiation later in the 72-hour window.ConclusionsNonoccupational postexposure prophylaxis is an important emergency tool for HIV prevention. Our findings corroborate that timing of the initial nPEP dose is an important predictor of seroconversion. Although the current study did not offer the initial nPEP dose at the beginning of the visit, use of this fast-track dosing schedule will ensure that the first dose is taken as early as possible postexposure and may lower the likelihood for seroconversion. Furthermore, we recommend systematic screening for substance use because these individuals may be well suited for pre-exposure prophylaxis given their sustained risk.
Efficacy of Endoscopic Fluorescein Video Angiography in Aneurysm Surgery—Novel and Innovative Assessment of Vascular Blood Flow in the Dead Angles of the Microscope
Authors: Hashimoto Koji , Kinouchi Hiroyuki , Yoshioka Hideyuki , Kanemaru Kazuya , Ogiwara Masakazu , Yagi Takashi , Wakai Takuma , Fukumoto Yuichiro 
Published: April 2017

Abstract

BACKGROUND: In aneurysm surgery, assessment of the blood flow around the aneurysm is crucial. Recently, intraoperative fluorescence video angiography has been widely adopted for this purpose. However, the observation field of this procedure is limited to the microscopic view, and it is difficult to visualize blood flow obscured by the skull base anatomy, parent arteries, and aneurysm.

OBJECTIVE: To demonstrate the efficacy of a new small-caliber endoscopic fluorescence video angiography system employing sodium fluorescein in aneurysm surgery for the first time.

METHODS: Eighteen patients with 18 cerebral aneurysms were enrolled in this study. Both microscopic fluorescence angiography and endoscopic fluorescein video angiography were performed before and after clip placement.

RESULTS: Endoscopic fluorescein video angiography provided bright fluorescence imaging even with a 2.7-mm-diameter endoscope and clearly revealed blood flow within the vessels in the dead angle areas of the microscope in all 18 aneurysms. Consequently, it revealed information about aneurysmal occlusion and perforator patency in 15 aneurysms (83.3%) that was not obtainable with microscopic fluorescence video angiography. Furthermore, only endoscopic video angiography detected the incomplete clipping in 2 aneurysms and the occlusion of the perforating branches in 3 aneurysms, which led to the reapplication of clips in 2 aneurysms.

CONCLUSION: The innovative endoscopic fluorescein video angiography system we developed features a small-caliber endoscope and bright fluorescence images. Because it reveals blood flow in the dead angle areas of the microscope, this novel system could contribute to the safety and long-term effectiveness of aneurysm surgery even in a narrow operative field.
Long-Standing Scalp Retraction Technique Using an External Fixator for Sunken Skin Flap Syndrome
Authors: Kim Min Su , Park Ik Seong 
Published: April 2017

Abstract

BACKGROUND AND IMPORTANCE
The authors report a novel external scalp retraction technique for sunken skin flap syndrome (SSFS).

CLINICAL PRESENTATION
A 48-year-old male patient suffered neurological deterioration due to SSFS after decompressive craniectomy. Cranioplasty is the gold standard for therapeutic management of SSFS, but could not be performed due to intracranial wound infection. The patient underwent external fixation of a metal plate as a frame for the skull and the scalp was pulled outward to the frame by skin suture. The patient returned to daily activities at home for 3 months with this scalp traction frame, which was needed for infection control.

CONCLUSION
External scalp traction is useful for the temporary relief of pressure caused by SSFS.
A Side Door to Meckel's Cave: Anatomic Feasibility Study for the Lateral Transorbital Approach
Authors: Priddy Blake Harrison , Nunes Cristian Ferrareze , Beer-Furlan Andre , Carrau Ricardo , Dallan Iacopo , Prevedello Daniel Monte-Serrat 
Published: April 2017

Abstract

BACKGROUND: In the last decade, endoscopic skull base surgery has significantly developed and generated a plethora of techniques and approaches for access to the cranial ventral floor. However, the exploration for the least-aggressive, maximally efficient approach continues.

OBJECTIVE: To describe in detail an anatomical study, along with the technical nuances of a novel endoscopic approach to Meckel's Cave (MC) using a lateral transorbital (LTO) route.

METHODS: Eighteen orbits of injected cadaveric specimens were operated on, using an endoscopic LTO approach to MC, middle cranial fossa, and paramedian skull base preserving the orbital rim. Surgical navigation and an after-the-fact infratemporal craniectomy were utilized to identify the limits of the approach.

RESULTS: Following a transorbital approach opening a trapezoid window at the superolateral aspect (average 166.7 mm2), a middle fossa “peeling” and full visualization of MC was accomplished with no difficulties in all specimens. The entire approach was performed extradurally without the need to expose the temporal lobe.

CONCLUSION: In a cadaveric model, the endoscopic LTO approach affords a direct route to access MC. Its main advantage is that it is minimally disruptive in nature, less brain retraction is required, and it reaches the middle fossa in an anterolateral perspective. It also requires no manipulation of the temporalis muscle, limited cosmetic incision, and rapid recovery. It seems a viable alternative to traditional approaches for lesions lateral to the cranial nerves at the cavernous sinus and MC, that is, schwannomas. Clinical utilization of this approach will challenge its efficacy and identify limitations.
An in Vitro Biomechanical Model of Differing Pedicle Screw Configurations for Long Construct Segmental Thoracic Fixation
Authors: Tuchman Alexander , Turner Alexander W L , Metzger Melodie F , Acosta Frank L 
Published: April 2017

Abstract

BACKGROUND
The optimum pattern of pedicle screw (PS) fixation during long-segment thoracic fixation has not been determined.

OBJECTIVE
To evaluate rod stress and construct stability with minimal, alternating, skipped, and bilateral PS constructs in the iatrogenically destabilized thoracic spine.

METHODS
Eight cadaveric thoracic specimens (T3-T12) were initially tested intact to ±5 Nm using a custom 6 degree-of-freedom spine testing apparatus in flexion-extension (FE), lateral bending (LB), and axial rotation. Specimens were instrumented with T4-T10 bilateral PS, with Ponte osteotomies to introduce instability. Rods were bent to fit the PS and then spines were tested with the minimal, alternating, skipped, and bilateral fixation patterns. Range of motion (ROM) was calculated from T4-T10 and segmentally. In addition, strain gauges fixed to the spinal rods measured rod stress under FE and LB. Results were compared using ANOVA and post hoc Holm Sidak tests.

RESULTS
All fixation patterns provided significant reductions in ROM with respect to the intact spine. In all motion planes, minimal provided the least amount of rigidity, while bilateral provide the greatest; however, no statistically significant differences were detected in FE. In LB and axial rotation, skipped, alternating, and bilateral were all significantly more rigid than minimal (P < .01). Rod strains were greatest under LB and correlated with overall construct ROM, where bilateral had significantly lower strain than the other patterns (P < .05).

CONCLUSION
All constructs effectively decreased thoracic ROM. There was significant improvement in stabilization and decreased rod stress when more fixation points beyond the minimal construct were included.
Microsurgical Endoscope-Assisted Gravity-Aided Transfalcine Approach for Contralateral Metastatic Deep Medial Cortical Tumors
Authors: Barkhoudarian Garni , Farahmand Daniel , Louis Robert G , Oksuz Erol , Sale Danjuma , Villanueva Pablo , Kelly Daniel F 
Published: April 2017

Abstract

BACKGROUND
Traditional approaches to deep medial cortical tumors utilize transcortical or ipislateral interhemispheric approaches, which can result in cortical damage or retraction injury. To reduce these risks, the microscopic transfalcine approach has been previously described.

OBJECTIVE
To describe this approach performed with endoscopic assistance for metastatic tumor resection, demonstrating appropriate and safe tumor resection without injury to the contralateral hemisphere.

METHODS
Eleven consecutive patients harboring medial, deep metastatic tumors are reported. Tumor resection was performed with endoscopic assistance with 2 surgeons. Clinical outcomes are recorded.

RESULTS
All 11 patients underwent safe tumor resection. Gross total resection was achieved in 73% of patients. The application of the angled endoscope allowed for further tumor resection in 91% of patients. There were no complications in these patients. The contralateral brain did not demonstrate clinical or radiographic injury as well.

CONCLUSION
This series suggests that the endoscopic transfalcine approach in the lateral position can be a safe and effective approach for resecting medial interhemispheric metastatic tumors. It allows excellent tumor visualization, eliminates the need for brain retraction, minimizes parenchymal transgression, and improves surgical ergonomics. A familiarity of endoscopy and neuroanesthesia support is helpful when utilizing this approach.
Use of Risk Model for Assessment of Residents’ Perception of Complexity of Surgical Steps: Example of Modular Component Steps of Lumbar Spinal Fusion Surgery
Authors: Raskin Jeffrey S , Liu Jesse J , Holste Katherine , Brown Sarah , Hardaway Fran , Pang Priscilla , Raslan Ahmed M 
Published: April 2017

Abstract

BACKGROUND
Quality improvement projects increasingly emphasize standardization of surgical work flow to optimize operative room efficiency. Removing special cause variability resulting from nonsurgical waste is an obvious target; however, resident surgical education must be maintained, even in the setting of process improvement.

OBJECTIVE
To describe the impact of resident-identified “risky” or “uncomfortable” procedural steps on operative time during transforaminal lumbar interbody fusion (TLIF).

METHODS
TLIF procedure steps were defined. An 8 2-part questions survey regarding comfort level and perceived risk assessment at each step was developed and completed by junior (17) and senior residents (10), and by faculty (6) from orthopedic, and neurological surgery. A risk matrix was constructed defining 2 zones: a “danger zone”; responses were high risk (3-5) and low comfort (1-3), and a “safe zone”; responses were low risk (1-2) and high comfort (4-5). One-tailed Chi-square with Yates correction was performed.

RESULTS
Risk matrix analysis showed a statistical difference among “danger zone” respondents between junior resident and faculty groups for exposure, pedicle screw placement, neural decompression, interbody placement, posterolateral fusion, and hemostasis. A radar graph identifies percent of respondents who fall within the “danger zone”.

CONCLUSION
Resident perception of surgical complexity can be evaluated for procedural steps using a risk matrix survey. For TLIF, residents may assign more risk and may be less comfortable performing steps in a training-level-dependent manner. Identification of particular high-risk or uncomfortable steps should prompt strict faculty oversight to improve patient safety, monitor resident education, and reduce operative time.
The Feeding Network of Aplysia
Authors: Cropper Elizabeth C. , Jing Jian , Weiss Klaudiusz R. 
Published: April 2017

Abstract
This review focuses on the neural control of feeding in Aplysia. Its purpose is to highlight distinctive features of the behavior and to describe their neural basis. In a number of molluscs, food is grasped by a radula that protracts, retracts, and hyperretracts. In Aplysia, however, hyperretraction can require afferent activation. Phase-dependent regulation of sensorimotor transmission occurs in this context. Aplysia also open and close the radula, generating egestive as well as ingestive responses. Thus, the feeding network multitasks. It has a modular organization, and behaviors are constructed by combinations of behavior-specific and behavior-independent neurons. When feeding is initially triggered in Aplysia, responses are poorly defined. Motor activity is not properly configured unless responses are repeatedly induced and modulatory neurotransmitters are released from inputs to the central patter generator (CPG). Persistent effects of modulation have interesting consequences for task switching.
Parental Love
Authors: Richards Norvin 
Published: April 2017

Abstract
This chapter begins from the intuition that love comes in different forms, and that the forms differ in the objects to which they are suited. It applies those thoughts to parental love. It identifies a sense in which it would be better if a parent’s love had certain qualities. It identifies some of those qualities and explains what it is about parenthood that makes them auspicious in a parent’s love. It draws contrasts between love of the kind that is suited to parenthood in this way and love of the kind that is suited to friendship and to relationships of other kinds.
Eucharist
Authors: McPartlan Paul 
Published: April 2017

Abstract
After noting convergences regarding the Eucharist between the teaching of the Second Vatican Council and the views of the 1963 Faith and Order conference, this chapter surveys a wide range of bilateral and multilateral ecumenical agreed statements on the Eucharist achieved in recent decades. It finds broad progress in them regarding three specific aspects of the Eucharist, namely, the links between the Eucharist and the Church, the Eucharist and the Holy Spirit, and the Eucharist and the future (or eschatology), respectively. It identifies outstanding issues, especially regarding the Eucharist as sacrament and sacrifice, and suggests how the progress provides a new context for tackling those issues. The relationship between baptismal and eucharistic ecclesiologies is then considered, and also ways in which the Eucharist has been recognized in ecumenical dialogue as influencing the structure of the Church. Attention is finally given to ecological implications of the Eucharist.
Job-Finding among the Poor
Authors: Smith Sandra Susan 
Published: April 2017

Abstract
This article examines whether social ties play a significant role in job seeking by poor people. A number of studies provide evidence that in relative and absolute terms, the poor rely heavily on social networks for job-finding. Without networks, poor job seekers are significantly less likely to find work. After considering what kinds of ties help the poor get ahead, this article discusses the role of weak ties as a source of job information and influence. It then explores the link between employment outcomes and network structure and composition as well as how people make leveraging ties, and how might this process of tie formation inform our understanding of network inequality. It also asks why leveraging ties are effective and concludes with an assessment of conditions that facilitate social capital activation.
Education
Authors: Hannum Emily , Xie Yu 
Published: April 2017

Abstract
This article explores the correlation between poverty and education. Poverty has been a core concept of interest in research on educational inequality. However, the conceptualization of poverty in empirical educational research does not always, or even usually, conform to definitions and measures that are prevalent in the poverty literature. To further complicate matters, the educational literature subscribes to no uniform set of alternative conceptualizations. This article begins with a discussion of three important functions of education in almost every modern society: imparting knowledge, socializing children, and transmitting family advantage or disadvantage. It then considers the impact of poverty on education at the national level and how education is affected by community and neighborhood poverty as well as household poverty. It concludes with an assessment of the impact of education on poverty.
Social Policy, Transfers, Programs, and Assistance
Authors: Lein Laura , Danziger Sandra K. , Shaefer H. Luke , Tillotson Amanda 
Published: April 2017

Abstract
This article examines poverty policies and programs in four areas: cash transfer programs, public provision of childcare, publically provided medical care, and public/social housing. Public provision for families in poverty includes programs that provide childcare, income supports, medical assistance, public housing, and employment assistance to family units. There are also policies that operate at a more general level to provide workforce and economic development and child welfare and early childhood education and support. Across nations, these policies vary along a number of dimensions. This article first considers each of the four poverty programs in detail before discussing the ramifications of differing national approaches to poverty in the context of the turn toward neoliberalism and the worldwide recession that began in 2007.
Why and When Do Peasants Rebel?
Authors: Trejo Guillermo 
Published: April 2017

Abstract
This article explores the origins and consequences of direct political action as a means for the rural poor to overcome economic destitution. Three forms of rural collective action are discussed: peaceful protest, armed rebellion, and civil war. The article first reviews classic statements and recent findings in the literature on peasant collective action before considering why poor peasants rebel. Drawing on recent studies of peasant protest, armed insurgency, and civil war, it then outlines four lessons that help us rethink dynamics of poor people’s movements. It also assesses the long-term economic and political consequences of peasant collective action and whether violent or nonviolent forms of rural mobilization have an impact on land redistribution and democratization. Finally, it describes conditions under which the poor try to overcome their destitution through direct political action.
Unions and Poverty
Authors: Rosenfeld Jake , Laird Jennifer 
Published: April 2017

Abstract
This article examines the ways that labor unions seek to curtail poverty by systematizing the available evidence both by geography and according to whether the research focuses on indirect or direct linkages between organized labor and poverty. Lobbying the government to maintain funding for an antipoverty program such as food stamps represents an indirect effect of unions on poverty. Fighting to expand health insurance coverage for the elderly and raising the minimum wage are other indirect pathways that unions have undertaken on behalf of the poor. This article first considers the influences of unions on poverty in the United States, advanced industrialized democracies, and developing countries before discussing the specific mechanisms that link unionization rates with levels of economic disadvantage.
Housing Programs
Authors: Kemp Peter A. 
Published: April 2017

Abstract
This article examines the nature and role of housing programs for low-income households in the rich democracies. It first describes the characteristics of housing and why these can be problematic for people living in poverty before discussing the social construction of “the housing question.” It then explores private and public responses to these problematic aspects of housing. Private “solutions” include poor dwelling conditions, undermaintenance, overcrowding, high rent-to-income ratios, and homelessness. Public “solutions” include public health regulations, minimum building standards, rent controls, public housing, housing vouchers, and tax expenditures. The article shows that some public solutions have been regarded as the causes of other “poverty problems”—including high levels of joblessness and ethnic segregation—that have in turn been the subject of policy responses. Finally, it analyzes housing affordability as well as the impact of housing allowances and mortgage subsidies in relation to poverty.